pure – india overview dubai – jan 2006. pure-india: investigators and sites bangalore mario vaz...

PURE – IndiaOverview

Dubai – Jan 2006

PURE-India: Investigators and sites

BangaloreMario VazAnura V Kurpad

Jaipur: Prof. Rajeev Gupta

ChennaiProf V Mohan

Trivandrum Prof. Soman

ChandigarhProf. Rajesh Kumar

TIME LINE OF PURE-India

July 2000Conceptualisation

Jan 2001Data starts-B’lore

Dec 2001~ 2500 subjects

PURE-India MtgIdentification ofOther centres (3)

Dec 2002~5000Other centres start data

ChandigarhAs 5th centre

Dec2005~ 22,000

ALL

CENTRESChandigarh

Jaipur Bangalore

Chennai Trivandrum

Households surveyed

25421 1583 4988 11668 3113 4069

Eligible households

20530 1431 4462 7972 2715 3950

Eligible individuals 40589 2829 9247 16205 5098 7210

Participants 21934 2110 3801 9465 3096 3462

Response Rate (%) 54 74.6 41.1 58.4 60.7 48

Recruitment Status – PURE India Centers

Urban Rural

Response rate (%) 52 56

Participants 9665 12269

Completed measurements (%)

93 91

Provided blood sample (%)

90 83

PURE – INDIA Recruitment Status

The PURE-India Study is carried out in states with very diverse characteristics

CENTRE States Birth Rate /1000

Infant Mortality Rate / 1000

Life expectancy at birth

Literacy rate (%)

Population density / sq. km

Bangalore Karnataka 22.2 58 63.3 61.1 275

Andhra Pradesh

20.8 66 62.4 67.0 275

Chennai Tamil Nadu 17.8 49 64.1 68.6 478

Trivandrum Kerala 17.2 11 73.3 90.9 819

Jaipur Rajasthan 31.0 79 60 61.0 165

Chandigarh Chandigarh 16.1 24 - 81.2 7903

Haryana 26.7 65 64.1 73.5 477

s

N

Present analysis: numbers

Total Urban Rural

Bangalore 9290 3323 5967

Chennai 2877 1773 1104

Trivandrum 3048 1369 1679

Jaipur 2689 1749 940

Chandigarh 587 264 223

All centres 18491 8478 9913

The PURE-India Study is carried out in states with very diverse characteristics

CENTRE States Relative Human Development Rank

Bangalore Karnataka 3

Andhra Pradesh 4

Chennai Tamil Nadu 2

Trivandrum Kerala 1

Jaipur Rajasthan 5

Chandigarh Chandigarh -

Haryana -

Household income (Rs/month) by location

0

2000

4000

6000

8000

10000

12000

All centres TRIV CHEN BANG JAIP CHAND

urban

rural

~ $ 235

~ $ 45

All centres TRIV CHEN BANG JAIP CHANDurban 9378 6841 7797 9914 11732 10989rural 2360 3074 2156 1852 4068 3491

Education level below high school (%): Urban-Rural - males

0

10

20

30

40

50

60

70

80

90

100

ALL TRIV CHEN BANG JAIP CHAND

Male-urban

Male-rural

ALL TRIV CHEN BANG JAIP CHANDMale-urban 25.6 26.1 32.5 20.2 30.5 30.5Male-rural 78.9 44.4 65.5 86.2 90.2 70.5

Education level below high school (%): Urban-Rural - females

0

10

20

30

40

50

60

70

80

90

100

ALL Triv CHEN BANG JAIP CHAND

Female-urban

Female-rural

ALL Triv CHEN BANG JAIP CHANDFemale-urban 54.6 42.3 59 51.4 66.4 48.8Female-rural 85.9 48.8 92.6 96.1 99 91.7

TV ownership (%) by location

0

10

20

30

40

50

60

70

80

90

100


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 92.6 88.5 90.2 94.1 94.2 95.9rural 40.2 69 67.9 24.4 26.2 90.2

2-wheeler ownership (%) by location

0

10

20

30

40

50

60

70


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 53.5 43.2 34.8 60.9 66.5 66.5rural 10.8 15.1 17.5 7.7 10.3 15.3

Kitchen mixer ownership (%) by location

0

10

20

30

40

50

60

70

80

90


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 75.6 77 70.4 83.2 62.1 75.1rural 16.2 52 22.7 4.5 4.1 11.3

Current tobacco use (%): Urban-Rural - males

0

10

20

30

40

50

60

70


Male-urban

Male-rural

All centres TRIV CHEN BANG JAIP CHANDMale-urban 27.4 38.6 27.3 22.9 30.5 25.2Male-rural 50.2 44.1 49.3 49.5 64.7 46.2

Current tobacco use (%): Urban-Rural - females

0

10

20

30

40

50

60

70


Female-urban

Female-rural

All centres TRIV CHEN BANG JAIP CHANDFemale-urban 3.3 0 4.2 1 8.5 5.6Female-rural 13.4 0.1 16.9 15.5 28.1 9.7

Current alcohol use (%): Urban-Rural - males

0

10

20

30

40

50

60

70

80

90

100


Male-urban

Male-rural

All centres TRIV CHEN BANG JAIP CHANDMale-urban 32.5 56 39 33.6 9.7 88.5Male-rural 30 40.7 49.4 26 20.2 90.9

% of males who are sedentary by location

0

10

20

30

40

50

60

70

80

90


urban

rural


% of females who are sedentary by location

0

10

20

30

40

50

60

70

80

90


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 55.7 22.2 62.8 64.3 55.6 80.4rural 32.1 46 38.3 20.6 47.1 65

Daily dietary intakes in urban and rural populations: Bangalore centre

Rural Urban

Energy (kcal) 1843 2278

Carbohydrate intake (g)

362.4 350.5

Fat intake (g) 23.2 66

Sugar (g) 5.2 28.5

Salt (g) 2.4 8.1

Total vegetables (g) 50 158

Total fruits (g) 49 166

% of males who are overweight/obese (BMI ≥ 25)by location

0

10

20

30

40

50

60

70


urban

rural


% females who are overweight/obese (BMI ≥ 25)by location

0

10

20

30

40

50

60

70


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 53.9 49.2 56.2 56.1 49 69.9rural 17.5 39.7 27.1 6.6 7.8 33.1

Mean Waist-hip ratio: Males by location

0.7

0.75

0.8

0.85

0.9

0.95


urban

rural


Mean Waist-hip ratio: Females by location

0.70

0.75

0.80

0.85

0.90

0.95


Female-urban

Female-rural

All centres TRIV CHEN BANG JAIP CHANDFemale-urban 0.84 0.84 0.84 0.8 0.88 0.86Female-rural 0.79 0.83 0.85 0.74 0.83 0.85

Serum total cholesterol (mg/dl): Males - by location

50

70

90

110

130

150

170

190

210

230


urban

rural


Serum total cholesterol (mg/dl): Females - by location

50.00

100.00

150.00

200.00

250.00


Female-urban

Female-rural


Prevalence of hypertension (%): Males - by location

0

10

20

30

40

50

60


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 37.2 36.2 36.9 31.7 47.2 54.3rural 18 45.5 24.1 12.7 13.5 15.4

Prevalence of hypertension (%): Females - by location

0

10

20

30

40

50

60


urban

rural


Hypertension: known, treated and controlled(%): - by location

0

10

20

30

40

50

60

KNOWN CONTROLLED KNOWN ANDTREATED

TREATED ANDCONTROLLED

urban

rural


Prevalence of diabetes (%):Males - by location

0

5

10

15

20

25

30

35


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 22.7 27.4 30.9 17.9 23 -rural 7.6 28.1 10.9 3.7 5.7 -

Prevalence of diabetes (%):Females - by location

0

5

10

15

20

25


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 17.4 19.9 20.3 13.8 17.6 -rural 6.5 16.9 10.7 1.7 7.2 -

Prevalence of CHD (%):Males - by location

0

1

2

3

4

5

6

7

8

9

10


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 7 6.6 5.6 9 3.8 -rural 5.7 8.5 5.8 5.9 2 -

Prevalence of CHD (%):Females - by location

0

1

2

3

4

5

6

7

8

9

10


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 4.5 3.7 3.9 6.2 2.7 -rural 3 3.2 1.6 3.8 0.4 -

Daily dietary intakes in urban slums relative to other urban and rural populations

Rural Slums Urban

Energy (kcal) 1843 1971 2278

Carbohydrate intake (g)

362.4 301.1 350.5

Fat intake (g) 23.2 55.4 66

Sugar (g) 5.2 23.6 28.5

Salt (g) 2.4 9.5 8.1

Vegetable intake (g) 50 99 158

a Age and gender adjusted means,

Anthropometric profiles in urban and rural populations

Rural Slum Urban

Weight (kg) a 49 54.7 65.4

BMI (kg/m2) a 19.2 23 25.2

% overweight (BMI ≥ 25<30 kg/m2)

Men 4.9 12.4 39.3

Women 5.9 24.3 41.1

% obese

Men 0.6 2.3 5

Women 0.7 8.7 21.8a Age and gender adjusted

Prevalence: diabetes and hypertension in urban slums relative to other urban and rural

areas

Rural Slum Urban

Diabetes (Hx + FBS ≥ 126 mg/dl)

Men 4.2 8.2 20.5

Women 2 11.0 15.4

Hypertension (Hx + BP ≥ 140/90 mmHg)

Men 14.9 34.5 33.3

Women 12.0 37.0 29.7

Summary

• There is considerable heterogeneity in the variables that we have studied and in disease outcomes, across locations (urban-rural-urban slum), gender and region (centre)

• Urban-rural risk transitions generally follow patterns of development. In Kerala, there is evidence of a reversal of the transition with the rural population.

• Dietary data needs to analysed in most centres – this when available will help us understand some of the changes that we have observed across centres and locations

• Non responder data and issues of response bias are being analysed

CHALLENGES / ISSUES OF THE STUDY• Subjects in rural areas / slums unwilling to participate due to loss of daily wages

• Responder burden due to the length of questionnaires

• Working men unavailable during the day / particular seasons.

• No perceived benefits in some groups slums / urban areas.

• Takes 45 mins to enter one subjects data in the data entry system.

% use of wood as cooking fuel by location

0

10

20

30

40

50

60

70

80

90

100

All centres Bangalore Chennai Jaipur Trivandrum Chandigarh

urban

rural

% use of LPG (gas) as cooking fuel

by location

0

10

20

30

40

50

60

70

80

90

100


urban

rural

All centres TRIV CHEN BANG JAIP CHANDurban 77.1 57.5 73 75.6 95.5 98rural 13.1 21.2 37.4 4.7 10 29

Mean Waist circ (cm) : Males by location

50

55

60

65

70

75

80

85

90


urban

rural


Mean Waist circ (cm) : Females by location

50

55

60

65

70

75

80

85

90


Female-urban

Female-rural


pure – india overview dubai – jan 2006. pure-india: investigators and sites bangalore mario vaz...

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