Opinion: Childhood Obesity - One Of The Major Public Health Challenges Of The 21st CenturyThe Childhood obesity increases the risk of non-communicable diseases like diabetes, hypertension and coronary artery disease at an younger age

New Delhi: Globally, the prevalence of child obesity has reached epidemic levels alarmingly both in developed as well as in developing countries.But India has a double nutritional burden of undernutrition and obesity. As per the World Health Organization report, it has been estimated that over 41 million children under five years of age are overweight and almost half of these children live in Asia. UNICEF reports that the number of children aged 5-19 years who are overweight has nearly doubled over the past 15 years.

India has 14.4 million children with obesity and is the home to the 2nd highest number of obese children in the world after China. It is obvious that India is battling a full-blown crisis of obesity which is only anticipated to worsen in the years to come. The fundamental reason for this problem is the energy imbalance between the amount of calories consumed and the calories spent. Today, even amongst children, there is a global shift in the dietary pattern towards increasing intake of energy dense foods that are rich in fat and sugar and low in vitamins, minerals and other useful micronutrients. In addition there is also a trend towards decreased level of physical activity due to increasing sedentary nature of recreation, changing modes of transportation using vehicles and rapid urbanization.

The problem of overweight and obesity in children is likely to continue into adulthood. Infants with excessive weight gain have more adipose cells laid down in their body (hyperplastic obesity) than normal infants. It is a well-established fact that most adipose cells are formed early in life. This leads to hyperplastic obesity in adults which is difficult to treat. The Childhood obesity increases the risk of non-communicable diseases like diabetes, hypertension and coronary artery disease at an younger age. In addition childhood obesity affects the child’s social and emotional well-being and self esteem. Depression and social withdrawal is more often seen in the children.

ASSESSMENT OF CHILDHOOD OBESITY

Although obesity can be made out at the first sight, a precise assessment has to be made with measurements and use of reference standards and charts:

Body weight
Body Mass Index(BMI): Weight (Kg) / Height2 (m)

Broca index:
Height (cm) -100

For example if a person’s height is 160 cm his ideal weight is 160 -100= 60 Kg

Skin fold thickness: A large proportion of body fat is located under the skin and is most accessible for measurement. The Harpenden skin calipers are used to measure body fat at the mid triceps level. The main drawback of skin fold thickness measurement has poor reproducibility.

Waist circumference: This is measured at the midpoint between the lower costal margin and the iliac crest, It is an indicator of intra abdominal fat mass which indicates an increased risk for metabolic syndrome.

Waist-hip ratio: An increased ratio again indicates increased abdominal fat accumulation.

Waist circumference can be used as a measure of central obesity which is a risk factor for type 2 diabetes and coronary artery disease.

Other methods: Estimation of body fat.It can be defined as an excess of body fat of over 25% for males and 30% for females. The technique is relatively complex and hence, cannot be used for routine clinical or epidemiological purposes.

DEFINITION OF CHILDHOOD OBESITY

The Centre for Disease Control and Prevention (CDC) has defined childhood obesity in terms of body mass index (BMI). The World Health Organization (WHO) 2006 growth charts and BMI have been introduced subsequently.

Overweight is defined as BMI ≥ 85th percentile and obesity as BMI ≥ 95th percentile in the chart.

THE MAGNITUDE OF CHILDHOOD OBESITY

The past four decades have seen almost a 10 fold increase in the number of children and adolescents with obesity, and this in turn could lead to a decline in life expectancy in the future. As per the UNICEF data, the global prevalence of childhood obesity has increased from 4.2% in the 1990s to 6.7% in 2010 and is further anticipated to raise to 9.1% by 2020.

Similarly in the adolescent age group of 12-19 years obesity prevalence has increased from 5 to 18.1%.

In India the key studies are from the National Family Health Surveys (NFHS) and National Nutrition Monitoring Bureau (NNMB) surveys. It was found that the prevalence of childhood and adolescent obesity was higher in the North when compared to South India. The overall prevalence of childhood obesity in 2010 was estimated to be 19.3% of and this has significantly increased.

FACTORS INFLUENCING CHILDHOOD OBESITY

The etiology of childhood obesity is multifactorial.

Genetic factors:

Obesity amongst parents influences obesity in children. Twin studies have shown a close correlation between weight of identical twins even when they are brought up in different environments. There is a genetic predisposition to obesity. The following genes have been studied namely the fat mass and obesity-associated (FTO) gene, leptin gene and its receptor, tumor necrosis factor alpha (TNF-α), the melanocortin 4 receptor gene (MC4R), Ectoenzyme nucleotide pyrophosphatase phosphodiesterase 1 (ENPP1) genes.

The roles of these genes are complex and interdependent, being linked to different cornerstones in obesity development, such as appetite behavior, control of food intake and energy balance, insulin signaling, lipid and glucose metabolism, metabolic disorders, adipocyte differentiation, and so on.

There is a compelling evidence to show that regular physical activity is protective against obesity. Television viewing amongst children and adolescents has increased dramatically over the recent years. Every extra hour of television viewing increase the prevalence of obesity by 2%. In addition children watching television also consume advertised goods that includes sweetened cereals, beverages and salty snacks leading to obesity.

Eating habits:

Dietary factors have been studied extensively and has been proved to contribute to childhood obesity. The factors that have examined are fast food consumption, sugary beverages, snack foods and portion sizes.

Fast food consumption:

Increased fast food consumption in the recent years has been linked to increased prevalence of obesity. Children from families where both parents are working are given fast foods more often as they find most convenient.

Sugary beverages:

Sugary drinks is an another factor that has been associated with obesity. Sugary drinks not only includes soda, but also juices and other sweetened beverages. Sugary drinks are less filling and hence consumed in larger amounts which results in higher calorie intake.

Snack foods:

Snack foods are another factor which contributes to childhood obesity. Snack foods include chips, baked foods and candies.

Infant feeding:

The inappropriate use of bottles for feeding infants and early introduction of solid foods before 4 months of age increase the risk of childhood obesity .

Environmental factors:

Children should be given opportunities to walk or take their bike to school.Children living in unsafe areas who do not have access to safe walking paths have fewer opportunities to be physically active contributing to obesity.

Social cultural factors:

In many societies including ours, food has been used as a reward, as a way to control others, as part of socialization. This practice increases the risk of developing obesity amongst children.

Family factors:

Family factors play an important role in the cause of obesity.The food that is available in the household, the food preferences of the family members can influence the food that the child consumes. Studies have shown children with an overweight mother and living in a single parent household have increased risk of becoming obese. In addition family habits, whether the family members are sedentary or physically active can influence the child’s level of activity.

Psychological factors:

Depression may be the cause of obesity and it could also be the consequence of obesity.Adolescents having depression are more likely to overeat or make poor food choices, tend to avoid exercising, and become more sedentary, all of which contribute to obesity.

Ethnicity:

Certain ethnic groups are susceptible to the development of obesity and this becomes apparent when they become exposed to a more affluent lifestyle.

Drugs:

Long term use of certain drugs like corticosteroids can promote excessive weight gain.

PROBLEMS OF CHILDHOOD OBESITY

The health-related problems associated with obesity in children include physical, psychological and social.

Psychological and social issues: Children who are obese tend to have lower self-esteem. They are depressed and withdrawn. This in turn, reflects in poor academic performance and socialization.

Physical problems: The physical problems of childhood obesity are many. Obese children are at increased risk of developing cardiovascular disease, hypertension and dyslipidemia. There is also an increase the risk of developing type 2 diabetes. Respiratory conditions like Asthma tends to be exacerbated with increasing obesity. Extreme obesity can cause obstructive sleep apnoea. Increase weight on musculoskeletal system can lead to joint pains. Obesity may also result in fatty degeneration of the liver.

Family Based Interventions

Suggestions for promotion of good nutrition For infants and young children

  • promotion of exclusive breastfeeding for the first six months of life
  • continuation of breastfeeding until two years and beyond
  • introduction of complementary feeds which are adequate, safe and nutritious from six months of age

For children and adolescents

  • Provision of healthy breakfast every day before school
  • Provision of healthy school snacks containing grains, nuts, green vegetables and fruits
  • Restriction of packaged snacks
  • Restriction of sugar sweetened soft drinks

Suggestions for promotion of physical activities

  • reduction of non-active time example television viewing and computer at home
  • encouraging walking or bicycling to school
  • playing active games as part of daily routine at least 30 minutes a day for children

School Based Interventions

Children spend a large portion of the time in schools.

  • schools can encourage children to make healthy food choices
  • schools can involve children in physical activities like lengthening the time for physical activity
  • children should be encouraged in various physical activities like dances, games and sports

Community Based Interventions

The term community includes the environment in which the child lives. Communities can organize

  • social events like healthy food festivals
  • conduct education programmes on healthy eating
  • encourage people to adopt healthy lifestyles
  • provide a safe neighbourhood for children to play like having safe playgrounds and bike paths

NATIONAL HEALTH PROGRAMS

India has launched numerous campaigns in the recent months to address this crisis. The Eat Right India movement promotes the value of health and emphasis the importance of a balanced, adequate and nutritious diet . The Food Safety and Standards Authority of India (FSSAI) is moving towards eliminating trans fats from the country’s food supply by the year 2022. Our Prime Minister has launched a Fit India movement to encourage Indians to participate in more exercise

Childhood obesity is a major public health problem not only in India, but all over the world. Childhood obesity crisis can be addressed by educating children and their parents about healthy nutrition and encouraging them to stay physically active. The rising trend of childhood obesity is worrying. Inventions need to be done at the family, community, national and international level to address this pandemic. Sustainability of these interventions is vital. This will lead to a nationwide healthy future for our children and the generations to come.

 

About The Author: Prof Dr. R. Somasekar, MD, DCH, FIAP; Prof of Paediatrics, Sree Balaji Medical College & Hospital; Dean (Retd) Kanyakumari Govt Medical College & Hospital; Former Prof of Paediatrics, Madras Medical College; Past President IAP- Chennai City Branch

 

 

 

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

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World

4,29,71,161Cases
1,28,60,263Active
2,89,57,428Recovered
11,53,470Deaths
Coronavirus has spread to 189 countries. The total confirmed cases worldwide are 4,29,71,161 and 11,53,470 have died; 1,28,60,263 are active cases and 2,89,57,428 have recovered as on October 26, 2020 at 3:48 am.

India

79,09,959 45148Cases
6,53,717 -14437Active
71,37,228 59105Recovered
1,19,014 480Deaths
In India, there are 79,09,959 confirmed cases including 1,19,014 deaths. The number of active cases is 6,53,717 and 71,37,228 have recovered as on October 26, 2020 at 2:30 am.

State & District Details

State Cases Active Recovered Deaths
DistrictCases
Mumbai45,478
Thane13,660
Pune9,920
Mumbai Suburban5,363
Aurangabad1,974
Nashik1,575
Raigad1,462
Palghar1,421
Solapur1,291
Jalgaon1,039
Akola757
Nagpur692
Kolhapur646
Satara629
Ratnagiri350
Amravati291
Dhule228
Hingoli208
Jalna201
Ahmednagar190
Nanded176
Yavatmal150
Sangli145
Latur139
Osmanabad125
Sindhudurg114
Buldhana88
Parbhani78
gondia69
Beed54
Nandurbar42
Gadchiroli42
Bhandara41
Chandrapur32
Washim13
Wardha11

16,45,020 6,059

1,41,001 299

14,60,755 5,648

43,264 112

DistrictCases
Kurnool795
Krishna557
Guntur511
Anantapur428
East Godavari356
Chittoor319
Sri Potti Sriramulu Nell*296
Y.S.R.205
West Godavari199
Srikakulam183
Prakasam104
Visakhapatnam103
Vizianagaram23

8,07,023 2,997

30,860 609

7,69,576 3,585

6,587 21

DistrictCases
Udupi1,176
Kalaburagi669
Yadgir538
Bengaluru Urban529
Raichur369
Mandya346
Belagavi337
Bidar219
Hassan205
Davangere204
Vijayapura201
Dakshina Kannada179
Chikkaballapura149
Mysuru107
Bagalkote103
Uttara Kannada95
Shivamogga67
Dharwad61
Ballari60
Gadag45
Bengaluru Rural40
Tumakuru36
Kolar29
Haveri24
Chikkamagaluru19
Chitradurga14
Koppal5
Kodagu4
Ramanagara3
Chamarajanagara0

8,02,817 4,439

81,069 5,699

7,10,843 10,106

10,905 32

DistrictCases
Chennai23,324
Chengalpattu1,314
Thiruvallur774
Villupuram509
Kanchipuram503
Tiruvannamalai496
Cuddalore477
Ariyalur444
Tirunelveli433
Tuticorin333
Kallakurichi324
Madurai322
Salem258
Coimbatore188
Virudhunagar185
Dindigul175
Perambalur133
Ranipet133
Thanjavur130
Theni129
Tiruchirappalli119
Ramanathapuram119
Tiruppur116
Kanniyakumari110
Tenkasi103
Nagapattinam99
Karur88
Namakkal83
Erode75
Vellore71
Thiruvarur67
Pudukkottai53
Sivaganga46
Tirupathur45
Krishnagiri43
The Nilgiris17
Dharmapuri15

7,09,005 2,869

30,606 1,181

6,67,475 4,019

10,924 31

DistrictCases
Gautam Buddha Nagar1,119
Agra933
Ghaziabad794
Meerut504
Lucknow386
Saharanpur298
Kanpur Nagar286
Moradabad252
Varanasi243
Hapur225
Aligarh215
Basti214
Amethi206
Rampur203
Jaunpur194
Firozabad190
Barabanki168
Gorakhpur166
Bulandshahr166
Siddharth Nagar159
Ghazipur159
Bijnor157
Deoria143
Azamgarh138
Sant Kabeer Nagar132
Mathura129
Ayodhya120
Muzaffarnagar117
Sambhal116
Sultanpur97
Ambedkar Nagar92
Maharajganj85
Amroha80
Rae Bareli78
Bahraich73
Kheri72
Kannauj69
Baghpat68
Kushi Nagar67
Bhadohi60
Ballia60
Gonda59
Etah52
Hardoi49
Balrampur49
Mau48
Mainpuri46
Etawah46
Hathras43
Unnao42
Jalaun41
Jhansi41
Shamli40
Chandauli38
Auraiya37
Farrukhabad36
Sitapur32
Prayagraj30
Banda27
Shahjahanpur25
Shravasti23
Budaun23
Mirzapur22
Bareilly17
Kasganj16
Pratapgarh15
Pilibhit15
Sonbhadra10
Kaushambi6
Kanpur Dehat4
Chitrakoot4
Lalitpur3
Hamirpur3
Mahoba3
Fatehpur3

4,70,270 2,032

27,317 364

4,36,071 2,368

6,882 28

DistrictCases
Kannur357
Kasaragod333
Palakkad224
Malappuram119
Kollam118
Thrissur106
Thiruvananthapuram104
Pathanamthitta98
Kozhikode90
Alappuzha76
Kottayam73
Ernakulam60
Idukki40
Wayanad36

3,92,930 6,843

96,688 832

2,94,910 7,649

1,332 26

DistrictCases
North West5,463
Central4,817
West4,768
New Delhi3,405
North3,059
East2,472
South East2,446
South West2,391
South2,329
North East1,914
Shahdara1,580

3,56,656 4,136

26,744 277

3,23,654 3,826

6,258 33

DistrictCases
Kolkata2,777
Howrah1,435
24 Paraganas North1,031
Hooghly604
24 Paraganas South281
Maldah235
Dinajpur Uttar216
Coochbehar210
Birbhum206
Medinipur West159
Medinipur East153
Nadia139
Purba Bardhaman130
Murshidabad125
Bankura116
Darjeeling97
Jalpaiguri88
Paschim Bardhaman70
Purulia66
Dinajpur Dakshin50
Alipurduar39
Kalimpong18
Jhargram9

3,49,701 4,127

37,017 210

3,06,197 3,857

6,487 60

DistrictCases
Ganjam581
Jajapur322
Khordha238
Baleshwar190
Kendrapara164
Cuttack155
Bhadrak137
Balangir129
Puri103
Sundargarh102
Jagatsinghapur91
Nayagarh86
Mayurbhanj73
Nuapada69
Gajapati61
Dhenkanal36
Boudh34
Kendujhar34
Deogarh33
Kalahandi33
Sonepur29
Kandhamal28
Anugul26
Malkangiri20
Bargarh16
Koraput16
Sambalpur16
Jharsuguda8
Nabarangpur2
Rayagada2

2,81,215 1,633

15,868 454

2,64,102 2,071

1,245 16

DistrictCases
Hyderabad2,475
Ranga Reddy183
Suryapet87
Jagitial77
Nizamabad76
MedchalMalkajgiri75
Mancherial43
YadadriBhuvanagiri40
Jogulamba Gadwal40
Vikarabad40
Nalgonda33
Warangal Urban32
Mahabubnagar30
Sangareddy26
Khammam26
Adilabad22
Nirmal21
Karimnagar17
RajannaSircilla16
Medak11
Kamareddy11
Mahabubabad10
Jayashankar Bhupalapally9
Nagarkurnool8
Kumuram Bheem Asifabad8
Jangoan8
Siddipet7
Peddapalli5
Bhadradri Kothagudem5
Warangal Rural4
Mulugu3
Narayanpet3
Wanaparthy1

2,31,834 582

18,611 854

2,11,912 1,432

1,311 4

DistrictCases
Patna279
Bhagalpur266
Rohtas256
Khagaria253
Begusarai243
Madhubani199
Munger188
Jehanabad178
Katihar175
Darbhanga143
Samastipur139
Siwan139
PurbiChamparan138
Purnia135
Banka134
Buxar134
Nalanda123
Gopalganj123
Nawada122
Sheikhpura118
Gaya115
Kaimur (bhabua)105
Bhojpur103
Saran101
Muzaffarpur96
Saharsa88
Supaul87
Vaishali87
Madhepura82
Kishanganj75
Aurangabad75
Sitamarhi73
Lakhisarai72
Araria68
Pashchim Champaran57
Arwal52
Jamui47
Sheohar20

2,11,689 431

9,722 737

2,00,918 1,161

1,049 7

DistrictCases
Kamrup Metro276
Golaghat203
Nagaon143
Hojai89
Dima Hasao86
Karimganj85
Tinsukia84
Cachar80
Dibrugarh61
Hailakandi57
Lakhimpur57
Marigaon50
Dhemaji47
Kamrup42
Kokrajhar37
Dhubri30
Charaideo29
Barpeta28
Udalguri28
Sonitpur27
Jorhat24
Nalbari23
Darrang20
Sivasagar20
Goalpara19
Biswanath16
Baksa14
KarbiAnglong13
Bongaigaon12
Chirang6
West KarbiAnglong5
South SalmaraMancachar4
Majuli2

2,04,171 204

17,510 2,761

1,85,755 2,961

906 4

DistrictCases
Jaipur2,177
Jodhpur1,748
Udaipur724
Bharatpur563
Kota503
Nagaur500
Ajmer379
Dungarpur374
Pali352
Jhalawar329
Bhilwara250
Sikar231
Chittorgarh188
Tonk171
Jalore164
Rajsamand140
Sirohi130
Bikaner112
Banswara91
Alwar90
Churu81
Jhunjhunu64
Dausa61
Dholpur60
Baran59
Jaisalmer53
Barmer34
Hanumangarh31
SawaiMadhopur26
Karauli17
Pratapgarh14
Ganganagar8
Bundi5

1,86,243 1,821

16,668 432

1,67,736 2,240

1,839 13

DistrictCases
Bilaspur100
Korba100
Mungeli87
Baloda Bazar85
Jashpur77
Janjgir-Champa56
Mahasamund54
Rajnandgaon52
Kabirdham52
Raigarh47
Raipur46
Balod41
Korea39
Durg31
Bemetara21
Kanker19
Balrampur17
Surguja14
Gariyaband10
Surajpur9
Dhamtari6
Bijapur2
Bastar2
Dantewada0
Kondagaon0
Narayanpur0
Sukma0

1,75,959 1,368

23,743 156

1,50,398 1,499

1,818 25

DistrictCases
Indore3,839
Bhopal1,880
Ujjain799
Burhanpur351
Neemuch319
Jabalpur276
East Nimar266
Sagar228
Gwalior211
Khargone196
Dewas140
Dhar132
Mandsaur112
Morena109
Bhind87
Raisen71
Barwani60
Ratlam51
Rewa39
Shajapur39
Hoshangabad37
Vidisha37
Chhatarpur35
Betul35
Rajgarh31
Dindori29
Sheopur26
Damoh26
Satna24
Anuppur22
Panna20
Tikamgarh18
Sidhi17
Narsinghpur17
Chhindwara16
Agar Malwa15
Mandla15
Shivpuri15
Jhabua14
Shandol14
Singrauli13
Ashoknagar13
Datia12
Sehore12
Umaria10
Balaghat9
Guna8
Harda4
Alirajpur3
Katni3
Seoni2
Niwari0

1,67,249 951

11,237 240

1,53,127 1,181

2,885 10

DistrictCases
Ahmadabad17,125
Surat2,311
Vadodara1,555
Gandhinagar410
Mahesana159
Banas Kantha147
Bhavnagar146
Rajkot135
Arvalli134
Mahisagar125
Anand107
PanchMahals107
Patan105
SabarKantha101
Kachchh99
Kheda98
Jamnagar63
Bharuch56
Botad55
Surendranagar55
Valsad47
GirSomnath45
Dohad43
Chhotaudepur37
Naysari35
Junagadh31
Narmada25
DevbhumiDwarka22
Amreli16
Porbandar11
Tapi6
Dang5
Morbi4

1,67,011 919

13,914 51

1,49,411 963

3,686 7

DistrictCases
Gurugram2,950
Faridabad867
Sonipat404
Rohtak145
Palwal120
Jhajjar114
Karnal104
Hisar98
Ambala93
Panipat78
Nuh68
Bhiwani60
Rewari56
Kurukshetra55
Sirsa50
Kaithal48
Mahendragarh47
CharkiDadri43
Panchkula39
Fatehabad38
Jind38
Yamunanagar19

1,58,304 1,240

10,295 147

1,46,282 1,086

1,727 7

DistrictCases
Amritsar485
Jalandhar297
Ludhiana293
Tarn Taran163
Gurdaspur154
Hoshiarpur140
S.A.S Nagar137
Patiala132
Sangrur107
Shahid Bhagat Singh Nagar (Nawanshahr)99
Pathankot86
Rupnagar (Ropar)74
Faridkot74
Sri Muktsar Sahib71
Moga65
Bathinda60
Fatehgarh Sahib57
Fazilka53
Firozepur50
Kapurthala44
Mansa31
Barnala25

1,31,055 415

4,217 60

1,22,721 465

4,117 10

DistrictCases
East Singhbum170
Ranchi148
Hazaribagh110
Garhwa80
Ramgarh75
Koderma58
Simdega48
Dhanbad32
Gumla28
Palamu27
West Singhbhum21
SaraikelaKharsawan20
Giridih19
Bokaro16
Latehar14
Khunti10
Lohardaga8
Deoghar5
Dumka5
Pakur4
Jamtara2
Godda2
Chatra1
Sahebganj0

99,686 258

5,844 122

92,976 378

866 2

DistrictCases
Anantnag395
Srinagar300
Kulgam295
Baramulla271
Shopian255
Kupwara231
Bandipora175
Udhampur155
Ramban151
Jammu138
Budgam110
Pulwama108
Kathua53
Rajouri39
Ganderbal37
Poonch35
Doda27
Reasi26
Samba25
Kishtwar10
Mirpur0
Muzaffarabad0

91,861 532

7,565 115

82,858 639

1,438 8

DistrictCases
Dehradun370
Nainital323
Tehri Garhwal110
Haridwar94
Udam Singh Nagar83
Almora71
Champawat45
Pithoragarh43
Chamoli36
PauriGarhwal36
Bageshwar31
Rudraprayag30
Uttar Kashi24

60,376 221

4,425 117

54,958 329

993 9

DistrictCases
South Goa69
North Goa57

42,242 211

2,576 116

39,090 321

576 6

DistrictCases
Pondicherry111
Mahe4
Karaikal2
Yanam0

34,193 81

3,804 108

29,801 187

588 2

DistrictCases
Dhalai196
Sepahijala174
Gomati74
South Tripura53
Unakoti49
West Tripura45
Khowai24
North Tripura14

30,257 36

1,845 147

28,069 183

343

DistrictCases
Hamirpur117
Kangra105
Una41
Solan32
Chamba29
Bilaspur21
Mandi21
Sirmaur11
Shimla10
Kullu4
Kinnaur2
Lahaul And Spiti0

20,370 157

2,489 116

17,590 272

291 1

DistrictCases
Churachandpur32
Kangpokpi26
Imphal West21
Thoubal18
Imphal East10
Tengnoupal9
Bishnupur7
Senapati6
Chandel5
Kamjong5
Ukhrul4
Jiribam3
Pherzawl3
Kakching2
Tamenglong2
Noney1

17,162 140

4,166 1

12,857 138

139 1

DistrictCases
Changlang31
Papum Pare8
Lohit3
Namsai2
West Siang1
East Siang1
Upper Siang1
Tawang1
PakkeKessang1
West Kameng0
Upper Subansiri0
Tirap0
Siang0
Shi Yomi0
Anjaw0
Lower Subansiri0
Lower Dibang Valley0
Longding0
Leparada0
KurungKumey0
KraDaadi0
Kamle0
East Kameng0
Dibang Valley0
Lower Siang0

14,244 33

2,260 137

11,951 170

33

DistrictCases
Chandigarh313

14,038 61

653 21

13,167 80

218 2

DistrictCases
East Khasi Hills22
West Garo Hills5
South West Garo Hills4
North Garo Hills1
West Jaintia Hills1
West Khasi Hills1
East Garo Hills0
East Jaintia Hills0
Ribhoi0
South Garo Hills0
South West Khasi Hills0

9,018 136

1,605 31

7,332 104

81 1

DistrictCases
Dimapur20
Mon8
Kohima7
Kiphire3
Tuensang3
Peren2
Phek1
Longleng0
Mokokchung0
Wokha0
Zunheboto0

8,626 111

1,871 54

6,724 56

31 1

DistrictCases
Kargil77
LehLadakh43

5,933 20

736 54

5,126 74

71

DistrictCases
South Andamans33
Nicobars1
North And Middle Andaman1

4,245 20

204 5

3,983 15

58

DistrictCases
East District3
South District3
North District0
West District0

3,835 16

246 20

3,525 35

64 1

DistrictCases
Dadra And Nagar Haveli20

3,228 3

51 1

3,175 2

2

DistrictCases
Kolasib11
Aizawl10
Mamit8
Lawngtlai2
Lunglei2
Saitual1
Champhai0
Hnahthial0
Khawzawl0
Saiha0
Serchhip0

2,493 46

290 41

2,203 5

0

DistrictCases
Lakshadweep District0

0

0 0

0

0

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