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Bhitora RD, Gosalia VV, Solanki HM. Sociodemographic Factors and Antenatal Service Utilization among Severe Acute Malnutrition Children under 2 Years of Age, Western India (Rajkot, Gujarat) - A Hospital-based Case-Control Study. Indian J Community Med 2025; 50:246-250. [PMID: 40124815 PMCID: PMC11927835 DOI: 10.4103/ijcm.ijcm_147_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/09/2024] [Indexed: 03/25/2025] Open
Abstract
Severe Acute Malnutrition (SAM) is multifactorial including poor maternal health, sociodemographic factors, and poor quality of diet of both the mother and child. Present study was carried out to determine sociodemographic factors and antenatal service utilization for SAM occurrence. This hospital-based case-control study was carried out from April 2021 to April 2022. Cases (77) and controls (77) were matched for age and sex with 1:1 ratio. Cases were selected from Nutritional Rehabilitation Centre and controls from an immunization clinic using WHO's Multicentric Growth Reference Study Criteria 2006. Mothers of study participants were interviewed by using semistructured questionnaires. The weight and height of study participants were measured. The odds of children having SAM increased significantly with illiterate parents, working mothers, and labor work of fathers. The absence of toilet facility at home and poor hygienic practices of mothers were significant risk factors. Mother's <4 antenatal visits, home deliveries, and participants with low birth weight were associated with SAM. Logistic regression stated laborer fathers, poor hand washing practices of mothers, absence of toilet facility at home, and low birth weight of study participants were found independent determinants for SAM. Risk factors identified in the present study are modifiable and can be addressed through health system interventions.
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Affiliation(s)
- Rujal D. Bhitora
- Community Medicine Department, P D U Government Medical College, Rajkot, Gujarat, India
| | - Vibha V. Gosalia
- Community Medicine Department, P D U Government Medical College, Rajkot, Gujarat, India
| | - Harsha M. Solanki
- Community Medicine Department, P D U Government Medical College, Rajkot, Gujarat, India
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Mishra M, Rao YK, Shrivastav D, Tripathi P, Singh DD. Indian perspective on childhood malnutrition: Prevalence, pathophysiology, risk factors, and prevention. World J Clin Pediatr 2024; 13:91971. [PMID: 39654663 PMCID: PMC11572616 DOI: 10.5409/wjcp.v13.i4.91971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 08/04/2024] [Accepted: 10/08/2024] [Indexed: 10/30/2024] Open
Abstract
BACKGROUND Childhood malnutrition contributes over half of the childhood mortality around the world, predominantly in South-Asian and sub-Saharan countries. AIM To summarize the childhood malnutrition epidemiology along with the comorbid factors associated with it and its management within the community. METHODS The data collection process involved conducting a comprehensive search using specific keywords such as child nutrition disorders and India with Boolean operators. The search was conducted in the Scopus and PubMed electronic databases. RESULTS Inadequate energy consumption initiates pathological alterations in the form of growth retardation, fat, visceral, and muscle loss, a reduction in basal metabolic rate, and a significant reduction in total energy expenditure. It has become evident that malnutrition shows an increased prevalence and incidence rate, despite available guidelines for the management of malnutrition. CONCLUSION Malnutrition can be a major player in the establishment of severe infections that result in significant post discharge mortalities in children. Future trials are required to fill the prime gaps in knowledge regarding the identification of other contributory factors in the pathogenesis of malnutrition and post-discharge infection. New biomarkers for early detection of malnutrition should be the priority of the scientific community for the early management of malnutrition.
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Affiliation(s)
- Malvika Mishra
- Department of Pediatrics, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur 208002, Uttar Pradesh, India
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur 303002, Rajasthan, India
| | - Yashwant Kumar Rao
- Department of Pediatrics, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur 208002, Uttar Pradesh, India
| | - Dharmsheel Shrivastav
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur 303002, Rajasthan, India
- Department of Biotechnology and Microbiology, Noida International University, Greater Noida 201003, India
| | - Prashant Tripathi
- Department of Biochemistry, Government Medical College, Jalaun, Orai 285001, Uttar Pradesh, India
| | - Desh Deepak Singh
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur 303002, Rajasthan, India
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Olarte-Bernal M, Guevara-Santamaría FR, Jacome-Suarez JC, Palacios-Ariza MA, Medina-Parra J, Merchán-Chaverra RA, Cuellar-Fernandez YM. Description of the etiological factors behind acute moderate and severe malnutrition in children under 5 years hospitalized at two high-complexity referral centers: Case series. Nutr Clin Pract 2024; 39:1509-1516. [PMID: 39257059 DOI: 10.1002/ncp.11206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/16/2024] [Accepted: 08/08/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Acute malnutrition in children <5 years of age has a direct relationship with medical complications and mortality. We aimed to describe the etiologic factors in children with moderate and severe non-illness-related acute malnutrition who required hospitalization for treatment of malnutrition in two high-complexity hospital centers in Bogotá, Colombia. METHODS This is a multicenter case series (December 2016 to December 2020) including patients aged 1-59 months with a weight/height indicator less than -2 SD. Electronic health records were reviewed, and demographic (sex, age, city of origin, and socioeconomic status) and clinical data (gestational age at birth, edema, and nutrition status) were collected. Descriptive analysis of information was performed. An exploratory bivariate analysis by diagnostic categories of moderate and severe acute malnutrition vs days of hospitalization was also performed. RESULTS Forty-five patients were included, 62.2% of whom were male, with a median age of 14 months (Q1-Q3: 7-24). The main etiologic factors of malnutrition were related to problems with total food intake (33.3%), transition in consistency of feeding (31.1%), and breastfeeding technique (22.2%). Only 13.3% had problems related to food insecurity. There were no statistically significant differences between moderate (median: 7 days; Q1-Q3: 5-12) and severe (median: 8 days; Q1-Q3: 5-16) acute malnutrition when compared by days of hospitalization. CONCLUSIONS The main etiologic factors of malnutrition in our study population were related to problems in the amount of food provided and transition in consistency of complementary feeding.
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Affiliation(s)
- Mónica Olarte-Bernal
- Departamento de Nutrición y Terapia, Clínica Infantil Santa María del Lago, Clínica Colsanitas SA, Grupo Keralty, Bogotá, DC, Colombia
| | | | - Jennyfer Carolina Jacome-Suarez
- Departamento de Nutrición y Terapia, Clínica Infantil Santa María del Lago, Clínica Colsanitas SA, Grupo Keralty, Bogotá, DC, Colombia
| | - María Alejandra Palacios-Ariza
- Grupo de investigación en Salud de la infancia, Fundación Universitaria Sanitas, Clínica Colsanitas, Grupo Keralty, Bogotá, DC, Colombia
- Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, DC, Colombia
| | - Jorge Medina-Parra
- Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, DC, Colombia
| | - Ricardo Alfonso Merchán-Chaverra
- Departamento de Nutrición y Terapia, Clínica Infantil Santa María del Lago, Clínica Colsanitas SA, Grupo Keralty, Bogotá, DC, Colombia
- Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, DC, Colombia
- Grupo de investigación en Nutrición Clínica, Fundación Universitaria Sanitas, Clínica Colsanitas, Grupo Keralty, Bogotá, DC, Colombia
- Centro Latinoamericano de Nutrición (CELAN), Chía (Cundinamarca), Colombia, Colombia
| | - Yeny Marjorie Cuellar-Fernandez
- Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, DC, Colombia
- Grupo de investigación en Nutrición Clínica, Fundación Universitaria Sanitas, Clínica Colsanitas, Grupo Keralty, Bogotá, DC, Colombia
- Centro Latinoamericano de Nutrición (CELAN), Chía (Cundinamarca), Colombia, Colombia
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Begna G, Bikila H, Biru B, Diriba D, Tolera C, Dessalegn R, Tafesse T, Amenu D. Determinants of severe acute malnutrition among children less than five years visiting health centers in Leqa Dulacha District, East Wallaga Zone, Oromia Region, Ethiopia: A case control study. Health Sci Rep 2024; 7:e1939. [PMID: 38706803 PMCID: PMC11066183 DOI: 10.1002/hsr2.1939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/09/2024] [Accepted: 02/17/2024] [Indexed: 05/07/2024] Open
Abstract
Background In underdeveloped nations like Ethiopia, severe acute malnutrition (SAM) is one of the most pressing public health issues. Despite efforts to pinpoint the causes of SAM, the impact of parents' drug usage on their children's nutritional status remains unclear and unresolved. Objective The purpose of this research was to determine the risk factors for SAM in children under five who were attending medical facilities in the Leqa Dulacha district. Materials and Methods A health facility-based case-control study was carried out from March 1 to July 30, 2022, with 256 children under the age of five. Random sampling was used to identify study participants in a methodical manner. Mothers and other child caretakers were interviewed using a structured questionnaire and anthropometric measurements were performed using standardized, calibrated equipment. Epi-data version 3.1 was used to code and enter the data, and it was then exported to IBM SPSS for analysis. An analysis of multivariable binary logistic regression was conducted, and the measure of association employed was the adjusted odds ratio (AOR), with a 95% confidence interval (CI). Results A total of 96.5% of respondents responded. SAM in children was significantly correlated with the following factors: parent alcohol consumption [AOR = 3.142; 95% CI = (1.104, 8.945)]; child illness in the previous 15 days [AOR = 4.122; 95% CI = (1.686, 10.07)]; poor dietary diversity [AOR = 3.044; 95% CI = (1.189, 7.788)]; household food insecurity [AOR = 4.024; 95% CI = (1.544, 10.490)]; and parent chewing chat [AOR = 3.484; 95% CI = (1.329, 9.134)]. Conclusions A number of factors have been linked to SAM in children, including the use of health services, the child's illness within the previous 15 days, food security, child feeding practices, and parent substance use. Therefore, it is important to emphasize the value of health education programs on child feeding habits, particularly the significance of dietary diversity, and to work together to modify the way that parents raise their children.
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Affiliation(s)
- Garoma Begna
- Department of Public Health Emergency ManagementLeqa Dulacha District Health Office, East Wallaga ZoneNekemteEthiopia
| | - Haile Bikila
- Department of Public Health, Institutes of Health SciencesWallaga UniversityNekemteEthiopia
| | - Bayise Biru
- Department of Public Health, Institutes of Health SciencesWallaga UniversityNekemteEthiopia
| | - Debelo Diriba
- Department of Health and NutritionFood for Hungry Ethiopia, East Wallaga ZoneNekemteEthiopia
| | - Chimdesa Tolera
- Department of Public Health ManagementLeqa Dulacha District Health Office, East Wallaga ZoneNekemteEthiopia
| | - Ra'el Dessalegn
- Department of Health ScienceSibu Sire District, Sibu Sire Health Center, East Wollega Zone HealthNekemteEthiopia
| | | | - Dessalegn Amenu
- Department of Biology, College of Natural and Computational ScienceWollega UniversityNakemteEthiopia
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Chopra H, Paul B, Virk A, Pandey G, Lahariya C. Triple Burden of Malnutrition among Children in India: Current Scenario and the Way Forward. Indian J Pediatr 2023; 90:95-103. [PMID: 37505406 DOI: 10.1007/s12098-023-04739-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023]
Abstract
The triple burden of malnutrition (undernutrition, overnutrition and micronutrient deficiency) or TBM among under-five (U5) children is an increasingly recognised public health challenge. A literature search was conducted to identify studies published from 1976 to 2022, which had focused on information regarding different factors of child malnutrition. The findings were analysed and contextualised from policy and programmatic perspective. There is a high burden of various forms of malnutrition in India. Insufficient dietary intake and illnesses are immediate and most common causes of triple burden of malnutrition (TBM): (undernutrition, overnutrition and micronutrient deficiency). The other key factors associated with the TBM are lifestyle, nutritional practices, unsafe water, food insecurity, lack of sanitation & basic hygiene, unhealthy feeding & caring practices, inadequate health infrastructure, and suboptimal implementation of government nutrition schemes etc. There is scientific evidence that TBM has long term consequences on physical and mental development of children and has high cost to any society. The situation of TBM persists inspite of multiple ongoing government programs to tackle these challenges. The health service provision needs to move from the first 1,000 d to the first 3,000 d as well as focus on the interventions aimed at early childhood development. Multi-sectoral interventions through Anganwadi centres and schools (through education department) need to be conducted. The public health programs and primary healthcare services need to be realigned and health interventions should be implemented along with tackling social determinants of health and sustained community engagement and participation. Tackling TBM should be made a political priority. The life cycle approach for healthier children and society needs to be fully implemented.
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Affiliation(s)
- Harivansh Chopra
- Indian Association of Preventive & Social Medicine, National Body, India
- Department of Community Medicine, LLRM Medical College, Meerut, UP, India
| | - Bobby Paul
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, India
| | - Amrit Virk
- Department of Community Medicine, Dr. B R Ambedkar State Institute Medical Sciences (AIMS), Mohali, Punjab, India
| | - Gargi Pandey
- Department of Community Medicine, LLRM Medical College, Meerut, UP, India.
| | - Chandrakant Lahariya
- Integrated Department of Health Policy, Epidemiology, Preventive Medicine and Pediatrics, Foundation for People-centric Health Systems, New Delhi, India
- SD Gupta School of Public Health, The IIHMR University, Jaipur, India
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Al-Mushiki GM, Al-Samhari GA, Alahsab AA, Al-Shaebi F, Tao L, Zhong Q. Understanding risk factors for severe acute malnutrition among children during war conflict in yemen. Indian J Public Health 2023; 67:463-467. [PMID: 37929392 DOI: 10.4103/ijph.ijph_1220_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Severe acute malnutrition (SAM) is a major public health concern in Yemen, particularly in areas affected by ongoing conflict war. SAM is defined as a very low weight for height, by visible severe wasting, or by the presence of nutritional edema. The prevalence of SAM in Yemen has increased dramatically since the onset of the conflict. Prior studies have focused on evaluating prevalence, but this novel study aimed to assess the risk factors associated with SAM prevalence. Five thousand two hundred and seventeen patients of SAM admitted at 12 sentinel hospitals were enrolled, and data were collected and analyzed. Marasmus was the most common form. Numerous risk factors contribute to the high prevalence of SAM in Yemen, including food insecurity. The current conflict has hampered food production, distribution, and access. Awareness of risk factors can prevent SAM in the general population.
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Affiliation(s)
- Gaber M Al-Mushiki
- Post Graduate, Epidemiology and Biostatic Health, School of Public Health, Guangxi Medical University, Nanning; Department of Community Medicine, Faculty of Medicine and Health Sciences, Thamar University, Dhamar, Yemen
| | - Galal A Al-Samhari
- Post Graduate, Epidemiology and Biostatic Health, School of Public Health, Guangxi Medical University, Nanning; Department of Community Medicine, Faculty of Medicine and Health Sciences, Thamar University, Dhamar, Yemen
| | - Ameen A Alahsab
- Head of Children Nutrition Program, Office of Public Health and Population, Dhamar, Yemen
| | - Fadhl Al-Shaebi
- Department of Community Medicine, Faculty of Medicine and Health Sciences, Thamar University; Assistant Professor, Department of Immunology & Key Laboratory of Immune Mechanism and Intervention on Serious Disease in Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Lijun Tao
- Post Graduate, Epidemiology and Biostatic Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Qiuan Zhong
- Post Graduate, Epidemiology and Biostatic Health, School of Public Health, Guangxi Medical University, Nanning, China
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Tripoli FM, Accomando S, La Placa S, Pietravalle A, Putoto G, Corsello G, Giuffrè M. Analysis of risk and prognostic factors in a population of pediatric patients hospitalized for acute malnutrition at the Chiulo hospital, Angola. Ital J Pediatr 2021; 47:184. [PMID: 34507598 PMCID: PMC8434719 DOI: 10.1186/s13052-021-01140-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Malnutrition is a multifactorial pathology in which genetic, epigenetic, cultural, environmental, socio-economic factors interact with each other. The impact that this disease has on the health of children worldwide is dramatic. Severe acute malnutrition in particular is a disease affecting nearly 20 million preschool children worldwide, most of them in Africa and South East Asia. Objectives This work aims to investigate potential prognostic factors in the clinical evolution of acute malnutrition and potential risk factors for the development of the disease. Methods Our study was carried out at the “Hospital da Missão Catolica do Chiulo”, in Angola, where the NGO Doctors with Africa CUAMM has been operating since 2000. In the first part of the study we analyzed the characteristics and clinical evolution of 163 patients hospitalized for acute malnutrition at the UEN (Unidade Especial de Nutrição) of the Chiulo Hospital over a period of 6 months, in order to identify potential prognostic factors of the disease. The second part of our study was carried out by administering a questionnaire to a group of caregivers of malnourished children and to a group of caregivers of non-malnourished children admitted to Pediatrics for other causes, with the aim of identifying potential risk factors for the development of malnutrition. Results and conclusions The analysis of prognostic factors revealed that the most relevant are the WHZ (weight for height z-score) at the time of admission, the presence of Stunting and the presence of other pathologies or clinical conditions associated with severe acute malnutrition. The analysis of risk factors has shown that not only food shortages, but also errors in the timing of the suspension of breastfeeding and the timing of the introduction of complementary foods play an important role. Equally important were some family risk factors, including the size of the family unit and the presence of deceased children. It also emerged that the lack of knowledge of what a child needs to grow up healthy often affects the development of malnutrition. It follows that a useful and low-cost tool for preventing child malnutrition would be large-scale nutrition education campaigns.
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Affiliation(s)
- Federica Maria Tripoli
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.,Doctors with Africa, CUAMM, Chiulo, Ombadja, Angola
| | - Salvatore Accomando
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Simona La Placa
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | | | | | - Giovanni Corsello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Mario Giuffrè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
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Chawla S, Gupta V, Singh A, Grover K, Panika RK, Kaushal P, Kumar A. Undernutrition and associated factors among children 1-5 years of age in rural area of Haryana, India: A community based cross-sectional study. J Family Med Prim Care 2020; 9:4240-4246. [PMID: 33110839 PMCID: PMC7586623 DOI: 10.4103/jfmpc.jfmpc_766_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/08/2020] [Accepted: 06/19/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Children under five years of age are most vulnerable to the vicious cycles of malnutrition, disease/infection and resultant disability all of which influence the present condition of a child at the microlevel and the future human resource development of the nation at the macrolevel. Aim: The present study was conducted to estimate the prevalence of undernutrition among under-five children; and to determine the associated factors. Methods: All 112 Anganwadi Centres in block Lakhan Majra were enlisted and 30 Anganwadi Centres were selected by adopting systematic random sampling. From each selected Anganwadi Centre, 20 children of 15 years of age group were selected by simple random sampling, thus, a sample of 600 children was included in the study. Results: Overall prevalence of undernutrition in our study was found as follows: wasted 18.4%; underweight 38.3%; stunted 41.3%. Mothers who had four or more ANC visits and IFA intake for 100 or more days had lower prevalence of wasting, stunting, and underweight than the mothers with three or less ANC visits and inadequate IFA intake. Children with a history of pre-lacteal feeding had higher prevalence of stunting, underweight, and wasting than the children with no history of pre-lacteal feeding. Conclusion: Every endeavor should be made to combat the outcomes of undernutrition through multipronged approach such as growth monitoring, nutritional supplementation, etc., Also, present study findings reinforce the importance of proper infant and child feeding practices and appropriate maternal care in prevention of childhood undernutrition.
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Affiliation(s)
- Suraj Chawla
- Department of Community Medicine, SHKM Government Medical College, Nalhar, Haryana, India
| | - Vikas Gupta
- Department of Community Medicine, Government Medical College, Shahdol, Madhya Pradesh, India
| | - Abhishek Singh
- Department of Community Medicine, SHKM Government Medical College, Nalhar, Haryana, India
| | - Kashish Grover
- Department of Community Medicine, MMIMSR, Mullana, Haryana, India
| | - Ram Kumar Panika
- Department of Community Medicine, Government Medical College, Shahdol, Madhya Pradesh, India
| | - Pankaj Kaushal
- Department of Community Medicine, PGIMS, Rohtak, Haryana, India
| | - Anil Kumar
- Department of Community Medicine, PGIMS, Rohtak, Haryana, India
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