Relationship between body mass index and percentage of body fat, estimated by bio-electrical impedance among adult females in a rural community of North India: A cross-sectional study

Introduction:

Body adiposity measured by percentage of body fat (BF%) is found to be better predictor of cardiovascular morbidity and mortality than body mass index (BMI). Limited information exists showing relationship between BMI and BF% in North Indian population.

Objectives:

To study the relationship between BMI and BF% among North Indian adult females across various age strata and level of BMI.

Materials and Methods:

This was a cross-sectional study conducted at Ballabgarh Health and Demographic Surveillance Site (HDSS) among randomly selected females. BMI using standard techniques and BF% using bioelectrical impedance analysis was estimated. Linear regression was performed using general linear model with BF% as dependent variable and BMI as main independent variable.

Results:

Mean (±2 SD) age of participants was 41.3 ± 15.7 years. Mean BMI (±SD) was 23.3 (±4.6) kg/m², whereas mean fat mass (±2 SD) and BF% (±95% CI) was 19.2 (±7.9) kg and 33.6 (±6.9) %. BMI and BF% were highly correlated among obese (r = 0.77), whereas least correlated (r = 0.32) in underweight females. Across age strata, correlation between BMI and BF% was maximum in 18–35 years age group (r = 0.95), whereas least in females ≥56 years (r = 0.67). Age and BMI together predicted 73% of variability in BF% in hierarchical linear regression model.

Conclusions:

In this population, we have found strong correlation between BMI and BF% particularly at higher level of BMI and in younger females. There is need to conduct more robust prospective longitudinal studies to assess BF%, which is a better predictor of cardiovascular morbidity and mortality.

Prevalence and determinants of anxiety disorders among adolescents in a rural community from northern India

INTRODUCTION

There is scarce data available on community based prevalence of Anxiety Disorders (ADs) amongst adolescents in north Indian settings.

OBJECTIVE

To determine the prevalence of anxiety disorders, and associated factors amongst adolescents in a rural community of Ballabgarh block, district Faridabad, Haryana.

METHODS

Participants (10-19 years) were enrolled through simple random sequence from a sampling frame of adolescents residing in 28 villages of Ballabgarh block using household survey technique. They were screened using Screen for Childhood Anxiety Related Emotional Disorders (SCARED) tool and then subjected to confirmatory diagnosis using Mini-International Neuropsychiatric Interview for Children/Adolescent (MINI KID). All adolescents with ADs were assessed for co-psychiatric morbidities using MINI-KID and functional impairment using Children Global Assessment Scale (CGAS). Prevalence and 95% Confidence intervals are reported. Additionally, socio-demographic factors were elicited using a semi-structured interview schedule and associations were determined using multivariable logistic regression analysis.

RESULTS

A total of 678 adolescents participated in this study with mean age (SD) as 14.2 (2.5) years. The age adjusted prevalence of anxiety disorders was found to be 16.6% (95% CI: 16.0-17.2). The most prevalent anxiety disorder among participants was social anxiety disorders followed by specific phobias. Female sex and low socio-economic status were associated with anxiety disorders. Two third of adolescents with ADs had no functional impairment and almost one third were found to have one or more co-existing psychiatric co-morbidity.

CONCLUSION

We found a high prevalence of ADs in rural north Indian community settings warranting adequate health system response at primary care level.

Anxiety Disorders among Adolescents in a Rural Area of Northern India using Screen for Child Anxiety-Related Emotional Disorders Tool: A Community-based Study

Background

Anxiety disorders are the most frequent mental disorders encountered in childhood and adolescent years. The number of epidemiological studies done in this area within India is limited.

Objectives

We determined the prevalence of anxiety disorders among adolescents in a rural community of Ballabgarh block, district Faridabad, Haryana. Secondarily, we also assessed sociodemographic and other factors associated with anxiety disorders among adolescents.

Materials and Methods

This community-based cross-sectional study was conducted among 729 adolescents (10-19 years). Screen for Child Anxiety-Related Emotional Disorders tool was used for assessing prevalence and type of anxiety disorders. Sociodemographic and personal factors were included in the logistic regression multivariable model to establish associations. Adjusted odds ratios (AOR) along with 95% confidence intervals (CI) are computed.

Results

The prevalence of anxiety disorders among adolescents was (22.7%; 95% CI: 19.7-26.0). Girls (27.6%) had higher prevalence than boys (18.3%) (P < 0.01). Social anxiety disorder (14.3%; 95% CI: 11.7-16.9) was the most common form of anxiety disorder. Female sex (AOR 1.8; 95% CI 1.2-2.6; P < 0.01), lower-middle socioeconomic status (AOR 1.96; 95% CI 1.2-3.1; P < 0.01), and presence of stressful event within the past 1-year (AOR 2.48; 95% CI: 1.12-5.06; P = 0.01) were found to be associated with the presence of anxiety disorders.

Conclusions

Anxiety disorders are common among adolescents in rural settings of India. Tackling them will require appropriate health systems response. Adequate interventions should be incorporated at primary care level to address the mental health concerns of adolescents.

Cause of death during 2009-2012, using a probabilistic model (InterVA-4): an experience from Ballabgarh Health and Demographic Surveillance System in India

Objectives

The present study aimed to estimate the age and cause-specific mortality in Ballabgarh Health and Demographic Surveillance System (HDSS) site for the years 2009 to 2012, using a probabilistic model (InterVA-4).

Methods

All Deaths in Ballabgarh HDSS from January 1, 2009, to December 31, 2012, were included in the study. InterVA-4 model (version 4.02) was used for assigning cause of death (COD). Data from the verbal autopsy (VA) tool were extracted and processed with the InterVA-4 model. Cause-specific mortality rate (CSMR) per 1,000 person-years was calculated.

Results

A total of 2,459 deaths occurred in the HDSS during the year 2009 to 2012. Among them, 2,174 (88.4%) valid VA interviews were conducted. Crude death rate ranged from 7.1 (2009) to 6.4 (2012) per 1,000 population. The CSMR per 1,000 person-years over the years (2009–2012) for non-communicable diseases, communicable diseases, trauma, neoplasm, and maternal and neonatal diseases were 1.78, 1.68, 0.68, 0.49, and 0.48, respectively. The most common causes of death among children, adults, and the elderly were infectious diseases, trauma, and non-communicable diseases, respectively.

Conclusions

Overall, non-communicable diseases constituted the largest proportion of mortality, whereas trauma was the most common COD among adults at Ballabgarh HDSS. Policy-makers ought to focus on prevention of premature CODs, especially prevention of infectious diseases in children, and intentional self-harm and road traffic accidents in the adult population.

The Ballabgarh Health and Demographic Surveillance System (CRHSP-AIIMS)

The Ballabgarh Health and Demographic Surveillance System (HDSS), also known as the Comprehensive Rural Health Services Project (CRHSP) Ballabgarh, is located in north India and was established in 1961 to develop a model for rural health-care practice in India. In addition to demographic surveillance and community-based research, CRHSP Ballabgarh provides preventive, health-promotion, and curative services to its surrounding population. The population served by CRHSP Ballabgarh in 2011 was about 90,000. The system collects data for the entire population through fortnightly visits by health workers (HWs). The system's data base is updated once every month and further updated with missing data and special morbidity surveillance data during the annual census. Since 1961, CRHSP Ballabgarh has collected demographic data, reproductive data, and health data about mothers and their children. More recently, the project began collecting data on diseases such as tuberculosis, and because of changes in life style it recently began collecting data about non-communicable diseases (NCD) and risk factors for NCDs. Nonetheless, an adverse sex ratio, with more boys than girls, and a stagnant neonatal mortality rate, remain major challenges in the population served by CRHSP Ballabgarh. The project shares data with different agencies for health-management purposes, which can be made available to bona fide researchers on receipt of a proposal (enquiries should be directed to: crhsp.ballabgarh@gmail.com); collaboration requests are welcome.