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.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.
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India
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 | 35,19,208 60,212 | 5,94,585 28,307 | 28,66,097 31,624 | 58,526 281 |
DistrictCases Kannur357 Kasaragod333 Palakkad224 Malappuram119 Kollam118 Thrissur106 Thiruvananthapuram104 Pathanamthitta98 Kozhikode90 Alappuzha76 Kottayam73 Ernakulam60 Idukki40 Wayanad36 | 11,80,397 7,515 | 52,450 4,536 | 11,23,133 2,959 | 4,814 20 |
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 | 10,83,647 8,778 | 78,636 2,632 | 9,92,003 6,079 | 13,008 67 |
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 | 9,47,129 6,984 | 49,985 3,677 | 8,84,199 3,289 | 12,945 18 |
DistrictCases Kurnool795 Krishna557 Guntur511 Anantapur428 East Godavari356 Chittoor319 Sri Potti Sriramulu Nell*296 Y.S.R.205 West Godavari199 Srikakulam183 Prakasam104 Visakhapatnam103 Vizianagaram23 | 9,32,892 4,228 | 25,850 2,735 | 8,99,721 1,483 | 7,321 10 |
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 | 7,50,156 13,468 | 43,510 5,415 | 6,95,210 7,972 | 11,436 81 |
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 | 7,23,582 17,963 | 95,980 14,404 | 6,18,293 3,474 | 9,309 85 |
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 | 6,24,224 4,817 | 29,050 2,519 | 5,84,740 2,278 | 10,434 20 |
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 | 4,71,994 15,121 | 1,09,139 10,283 | 3,57,668 4,682 | 5,187 156 |
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 | 3,75,092 5,528 | 40,690 4,249 | 3,31,423 1,251 | 2,979 28 |
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 | 3,60,206 6,690 | 34,555 3,875 | 3,20,729 2,748 | 4,922 67 |
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 | 3,53,632 8,998 | 43,539 4,888 | 3,05,832 4,070 | 4,261 40 |
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 | 3,53,086 1,784 | 10,033 1,259 | 3,41,123 523 | 1,930 2 |
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 | 3,34,738 2,157 | 25,459 1,328 | 3,07,499 821 | 1,780 8 |
DistrictCases Gurugram2,950 Faridabad867 Sonipat404 Rohtak145 Palwal120 Jhajjar114 Karnal104 Hisar98 Ambala93 Panipat78 Nuh68 Bhiwani60 Rewari56 Kurukshetra55 Sirsa50 Kaithal48 Mahendragarh47 CharkiDadri43 Panchkula39 Fatehabad38 Jind38 Yamunanagar19 | 3,24,544 3,845 | 24,207 1,720 | 2,97,039 2,109 | 3,298 16 |
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 | 2,90,385 4,157 | 20,149 3,096 | 2,68,606 1,047 | 1,630 14 |
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 | 2,79,203 2,980 | 28,184 318 | 2,43,410 2,612 | 7,609 50 |
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 | 2,21,483 590 | 4,271 537 | 2,16,093 52 | 1,119 1 |
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 | 1,44,594 2,844 | 17,155 1,812 | 1,26,178 1,003 | 1,261 29 |
DistrictCases Anantnag395 Srinagar300 Kulgam295 Baramulla271 Shopian255 Kupwara231 Bandipora175 Udhampur155 Ramban151 Jammu138 Budgam110 Pulwama108 Kathua53 Rajouri39 Ganderbal37 Poonch35 Doda27 Reasi26 Samba25 Kishtwar10 Mirpur0 Muzaffarabad0 | 1,40,650 1,269 | 8,681 773 | 1,29,932 493 | 2,037 3 |
DistrictCases Dehradun370 Nainital323 Tehri Garhwal110 Haridwar94 Udam Singh Nagar83 Almora71 Champawat45 Pithoragarh43 Chamoli36 PauriGarhwal36 Bageshwar31 Rudraprayag30 Uttar Kashi24 | 1,12,071 1,925 | 9,353 1,507 | 1,00,938 405 | 1,780 13 |
DistrictCases Hamirpur117 Kangra105 Una41 Solan32 Chamba29 Bilaspur21 Mandi21 Sirmaur11 Shimla10 Kullu4 Kinnaur2 Lahaul And Spiti0 | 71,394 619 | 6,269 200 | 63,990 408 | 1,135 11 |
DistrictCases South Goa69 North Goa57 | 63,342 562 | 4,888 323 | 57,601 236 | 853 3 |
DistrictCases Pondicherry111 Mahe4 Karaikal2 Yanam0 | 44,973 418 | 2,800 206 | 41,477 209 | 696 3 |
DistrictCases Dhalai196 Sepahijala174 Gomati74 South Tripura53 Unakoti49 West Tripura45 Khowai24 North Tripura14 | 33,844 39 | 312 14 | 33,138 25 | 394 |
DistrictCases Chandigarh313 | 31,564 397 | 3,370 15 | 27,793 381 | 401 1 |
DistrictCases Churachandpur32 Kangpokpi26 Imphal West21 Thoubal18 Imphal East10 Tengnoupal9 Bishnupur7 Senapati6 Chandel5 Kamjong5 Ukhrul4 Jiribam3 Pherzawl3 Kakching2 Tamenglong2 Noney1 | 29,540 26 | 118 15 | 29,046 11 | 376 |
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 | 16,902 14 | 55 14 | 16,791 | 56 |
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 | 14,387 87 | 270 77 | 13,966 10 | 151 |
DistrictCases Dimapur20 Mon8 Kohima7 Kiphire3 Tuensang3 Peren2 Phek1 Longleng0 Mokokchung0 Wokha0 Zunheboto0 | 12,427 11 | 174 7 | 12,160 4 | 93 |
DistrictCases Kargil77 LehLadakh43 | 11,070 165 | 851 130 | 10,088 35 | 131 |
DistrictCases East District3 South District3 North District0 West District0 | 6,435 25 | 175 14 | 6,124 11 | 136 |
DistrictCases South Andamans33 Nicobars1 North And Middle Andaman1 | 5,209 8 | 93 4 | 5,054 4 | 62 |
DistrictCases Kolasib11 Aizawl10 Mamit8 Lawngtlai2 Lunglei2 Saitual1 Champhai0 Hnahthial0 Khawzawl0 Saiha0 Serchhip0 | 4,685 30 | 204 29 | 4,469 1 | 12 |
DistrictCases Dadra And Nagar Haveli20 | 4,307 98 | 578 77 | 3,727 21 | 2 |
DistrictCases Lakshadweep District0 | 833 20 | 86 11 | 746 9 | 1 |