Browsing by Author "Gopalakrishnan, P"

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    Prevalence of dental fluorosis and associated risk factors in Alappuzha district, Kerala
    (The National Medical Journal of India, 1999) Gopalakrishnan, P; Vasan, RS; Sarma, PS; Ravindran Nair, KS; Thankappan, KR
    BACKGROUND:Fluorosis is considered endemic in 15 states of India. Dental fluorosis is the most convenient biomarker of exposure to fluoride. In Kerala, although the condition is reported to be endemic in the districts of Alappuzha and Palakkad, there are no systematic epidemiological studies evaluating dental fluorosis. We studied the prevalence of dental fluorosis among school children in Ambalappuzha taluk, Alappuzha district, Kerala and evaluated the contribution of potential risk factors. METHODS: We conducted a community-based, cross-sectional survey of 1142 school children (630 girls, 512 boys) in the age group of 10-17 years, using a multistage random cluster sampling technique. A pre-tested structured questionnaire was used to assess exposure to various sources of fluoride. A dental specialist examined all the children to determine the presence or absence of dental fluorosis and graded the degree of dental fluorosis using Dean's Index. The water fluoride content in the study area was obtained from the district water authority department. Bivariate associations were examined using the Chi-square and Chi-square trend tests, while multiple logistic regression was used to evaluate the association of select risk factors with the presence or absence of dental fluorosis. RESULTS: The overall prevalence of dental fluorosis in our study sample was 35.6% and the community fluorosis index was 0.69. The prevalence of dental fluorosis was higher in the urban compared to the rural areas (55.3% v. 16.8%; p < 0.001), and in girls compared to boys (39.2% v. 31.3%; p < 0.01). The prevalence of dental fluorosis was higher among children who consumed pipe water as compared to children who consumed well water (44.8% v. 12.7%; p < 0.001). We noted a step-wise increase in the prevalence of dental fluorosis with a corresponding increase in water fluoride content in different panchayats (p = 0.024). The principal factor associated with the presence of dental fluorosis was a high fluoride content of drinking water (OR 1.85, 95% Cl: 1.17-2.92). We did not observe any significant association between dental fluorosis and the intake of brick-tea, consumption of fish or the use of toothpaste. CONCLUSION: Dental fluorosis is a public health problem in the Ambalappuzha taluk. Active steps must be taken to partially defluoridate the water before distribution to reduce the morbidity associated with dental fluorosis in this area. Similar surveys are required in other parts of India to identify areas with high water fluoride content and determine the extent and manner in which defluoridation can be carried out.
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    Tobacco Use in Kerala: Findings from three recent studies
    (National Medical Journal of India, 2005) Pradeepkumar, AS; Sailesh Mohan; Gopalakrishnan, P; Sarma, PS; Thankappan, KR; Nichter, M
    BACKGROUND:We reviewed the literature on tobacco use in Kerala and present data from three recently conducted unpublished studies. METHODS:Three cross-sectional studies were conducted; a community-based study of 1,298 individuals aged 15 years and above (mean age 37.4 years, men 630), a school-based study of 1,323 boys (mean age 14.7 years), and a college-based study of 1,254 male students (mean age 18.2 years). Information on tobacco use and sociodemographic variables was collected using pre-tested, structured interview schedules and questionnaires.RESULTS: In the community study, 72% of men and 6% of women had ever used tobacco. Compared to men with > 12 years of schooling, those with < 5 years of schooling were 7 times more likely to smoke (OR 7, CI 3.2-15.6). The age at initiation of smoking was 19 years among those < 25 years of age compared to 25.5 years among ever smokers > 44 years. In the school study, the age at initiation among boys aged < or = 1 3 years was 10.7 years compared with 13.2 years among > or = 16-year-old boys. Boys whose fathers and friends used tobacco were 2 times and 2.9 times more likely to use tobacco (OR 2.0, CI 1.3-3.1 and OR 2.9, CI 1.6-5.1), respectively, compared with their counterparts. In the college study, 29% of the commerce students used tobacco compared with 5.3% of polytechnic students (p < 0.001).CONCLUSION:Survey data suggest that the age at initiation of tobacco use appears to be falling. A series of cross-sectional studies with larger sample sizes of the youth is required to confirm this impression. Tobacco use habits of fathers and peers are significant influences on youth smoking. There is a need to focus on particular types of colleges as these appear to have high-risk tobacco use environments.
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    Tobacco use in Kerala: Findings from three recent studies
    (NATIONAL MEDICAL JOURNAL OF INDIA, 2005)
    Background. We reviewed the literature on tobacco use in Kerala and present data from three recently conducted unpublished studies.Methods. Three cross-sectional studies were conducted; a community-based study of 1298 individuals aged 15 years and above (mean age 37.4 years, men 630), a school-based study of 132 3 boys (mean age 14.7 years), and a college-based study of 1254 male students (mean age 18.2 years). Information on tobacco use and sociodemographic variables was collected using pre-tested, structured interview schedules and questionnaires.Results. In the community study, 72% of men and 6% of women had ever used tobacco. Compared to men with > 12 years of schooling, those with <5 years of schooling were 7 times more likely to smoke (OR 7, Cl 3.2-15.6). The age at initiation of smoking was 19 years among those <25 years of age compared to 25.5 years among ever smokers >44 years. In the school study, the age at initiation among boys aged: 13 years was 10.7 years compared with 13.2 years among 2:16-year-old boys. Boys whose fathers and friends used tobacco were 2 times and 2.9 times more likely to use tobacco (OR 2.0, Cl 1.3-3.1 and OR 2.9, Cl 1.6-5.1), respectively, compared with their counterparts. In the college study, 29% of the commerce students used tobacco compared with 5.3% of polytechnic students (p<0.001).Conclusion. Survey data suggest that the age at initiation of tobacco use appears to be failing. A series of cross-sectional studies with larger sample sizes of the youth is required to confirm this impression. Tobacco use habits of fathers and peers are significant influences on youth smoking. There is a need to focus on particular types of colleges as these appear to have high-risk tobacco use environments.