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July-September 2008 Volume 52 | Issue 3
Page Nos. 115-172
Online since Wednesday, September 29, 2010
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EDITORIAL |
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Injury: The most underappreciated and unattended pandemic |
p. 115 |
Sanjay Chaturvedi PMID:19189831 |
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ORIGINAL ARTICLES |
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Prevalence of risk factors for non-communicable disease in a rural area of Faridabad district of Haryana |
p. 117 |
A Krishnan, B Shah, Vivek Lal, DK Shukla, Eldho Paul, SK Kapoor PMID:19189832Background and Objectives: To estimate the prevalence and levels of common risk factors for noncommunicable disease in a rural population of Haryana. Methods: The study involved a survey of 1359 male and 1469 female respondents, aged 15-64 years. Multistage sampling was used for recruitment (PHCs/ sub-centres/ villages). All households in the selected villages were covered, with one male and one female interviewed in alternate household. WHO STEP- wise tool was used as the study instrument which included behavioural risk factor questionnaire and physical measurements of height, weight, waist circumference and blood pressure. The age adjusting was done using rural Faridabad data from Census 2001. Results: The age adjusted prevalence of daily smoked tobacco was 41% for men and 13% for women. Daily smokeless tobacco use was 7.1% and 1.2% for men and women respectively. The prevalence of current alcohol consumption was 24.6% among men and none of the women reported consuming alcohol. The mean number of servings of fruits and vegetables per day was 3.7 for men and 2.7 for women. The percentage of people undertaking at least 150 minutes of physical activity in a week was 77.8% for men and 54.5% for women. Among men 9.0 % had BMI > 25.0 compared to 15.2% among women. The prevalence of measured hypertension, i.e. >140 SBP and/or >90 DBP or on antihypertensive drugs was 10.7% among men and 7.9% among women. Conclusion: The study showed a high burden of tobacco use and alcohol use among men, inactivity and overweight among women and low fruit and vegetable consumption among both sexes in rural areas. |
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Epidemiology of disability in a rural community of Karnataka |
p. 125 |
KS Ganesh, A Das, JS Shashi PMID:19189833Objectives: To determine the prevalence and pattern of disability in all age groups in a rural community of Karnataka. Methods: A community-based cross-sectional study was conducted during January-December 2004 among 1000 study subjects of all age groups selected randomly from four villages under rural field practice area of a teaching institution. Subjects were interviewed and examined using a predesigned schedule. Percentage prevalence, chi square test and multiple logistic regression analysis were used for statistical analysis. Results: The prevalence of disability was found to be 6.3%. Both physical and mental disabilities are of great concrn in this area. 80% of the disabled had multiple disabilities. Knowledge and occupation plays a major role as determinants of disability. Chronic medical conditions are also more common among disabled. |
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Elimination of iodine deficiency disorders - Current status in Purba Medinipur district of West Bengal, India |
p. 130 |
AB Biswas, I Chakraborty, DK Das, A Chakraborty, D Ray, K Mitra PMID:19189834Background and Objectives: Towards sustainable elimination of iodine deficiency disorders (IDD), the existing programme needs to be monitored through recommended methods and indicators. Thus, we conducted the study to assess the current status of IDD in Purba Medinipur district, West Bengal. Methods: It was a community based cross-sectional study; undertaken from October 2006 - April 2007. 2400 school children, aged 8-10 years were selected by '30 cluster' sampling technique. Indicators recommended by the WHO/UNICEF/ICCIDD were used. Subjects were clinically examined by standard palpation technique for goitre, urinary iodine excretion
was estimated by wet digestion method and salt samples were tested by spot iodine testing kit. Results: The total goitre rate (TGR) was 19.7% (95% Cl = 18.1 - 21.3 %) with grade I and grade II (visible goitre) being 16.7% and 3% respectively. Goitre prevalence did not differ by age but significant difference was observed in respect of sex. Median urinary iodine excretion level was 11.5 mcg/dL and none had value less than 5 mcg/dL. Only 50.4% of the salt samples tested were adequately iodised (? 15 ppm). Conclusion: The district is in a phase of transition from iodine deficiency to iodine sufficiency as evident from the high goitre prevalence (19.7%) and median urinary iodine excretion (11.5mcg/dL) within optimum limit. But, salt iodisation level far below the recommended goal highlights the need for intensified efforts towards successful transition. |
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SPECIAL ARTICLE |
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Integrated diseases surveillance project (IDSP) through a consultant's lens |
p. 136 |
K Suresh PMID:19189835India has long experienced one of the highest burdens of infectious diseases in the world, fueled by factors including a large population, high poverty levels, poor sanitation, and problems with access to health care and preventive services. It has traditionally been difficult to monitor disease burden and trends in India, even more difficult to detect, diagnose, and control outbreaks until they had become quite large.
In an effort to improve the surveillance and response infrastructure in the country, in November 2004 the Integrated Disease Surveillance Project (IDSP) was initiated with funding from the World Bank. Given the surveillance challenges in India, the project seeks to accomplish its goals through, having a small list of priority conditions, many of which are syndrome-based at community and sub center level and easily recognizable at the out patients and inpatients care of facilities at lowest levels of the health care system, a simplified battery of laboratory tests and rapid test kits, and reporting of largely aggregate data rather than individual case reporting. The project also includes activities that are relatively high technology, such as computerization, electronic data transmission, and video conferencing links for communication and training.
The project is planned to be implemented all over the country in a phased manner with a stress on 14 focus states for intensive follow-up to demonstrate successful implementation of IDSP. The National Institute of Communicable Diseases chosen to provide national leadership may have to immediately address five issues. First, promote surveillance through major hospitals (both in public and private sector) and active surveillance through health system staff and community, second, build capacity for data collation, analysis, interpretation to recognize warning signal of outbreak, and institute public health action, third, develop a system which allows availability of quality test kits at district and state laboratories and /or culture facilities at identified laboratories and a national training program to build capacities for performing testing and obtaining high quality results, fourth, there must be a process established by which an appropriate quality assurance program can be implemented and fifth, encourage use of IT infrastructure for data transmission, analysis, routine communication (E-mail etc) and videoconferencing for troubleshooting, consultations and epidemiological investigations. These five activities must be addressed at the national level and cannot be left up to individual states/districts. |
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SHORT COMMUNICATIONS |
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Hypertension and epidemiological factors among tribal labour population in Gujarat |
p. 144 |
Rajnarayan R Tiwari PMID:19189836A cross sectional study was carried out in 2005 to find out the magnitude of hypertension among 154 tribal labourers of Gujarat belonging to Naika, Rathwa and Damor tribes. WHO classification of hypertension was taken as operational criteria and data was collected in pre-designed, pretested schedule. Blood pressure measurement was done twice on each subject using mercury sphygmomanometer. Overall magnitude of hypertension was found to be 16.9%, and only smoking was found to have significantly associated with it. |
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Respiratory morbidity among street sweepers working at Hanumannagar Zone of Nagpur municipal corporation, Maharashtra |
p. 147 |
Yogesh D Sabde, Sanjay P Zodpey PMID:19189837Due to the occupational exposure street sweepers are very much vulnerable to develop the chronic diseases of respiratory system. Therefore this study was undertaken to find out the proportion of chronic respiratory morbidity among the street sweepers and the role of various associated risk factors. The study included two groups: study group i.e. street sweepers and comparison group (Class IV workers working in the office buildings). Various risk factors studied were age, sex, socioeconomic status, length of service, smoking habit, type of house, area of residence, cooking fuel and pets. Proportion of chronic respiratory morbidity (chronic bronchitis, asthma and bronchiectasis) was higher (8.1%) among street sweepers compared to comparison group (2.1%), the difference being statistically significant. Unconditional multivariate logistic regression revealed that risk of having chronic respiratory morbidity among street sweepers was 4.24 (95 % CI of OR = 1.24 to 14.50) times higher than that in the comparison group and the risk increased significantly with increasing length of service (OR = 1.75, 95 % CI = 1.09 to 2.81). |
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Needle sticks injury among nurses involved in patient care: A study in two medical college hospitals of West Bengal |
p. 150 |
GK Joardar, C Chatterjee, SK Sadhukhan, M Chakraborty, P Dass, A mandal PMID:19189838A hospital-based retrospective study on a sample of 228 nurses involved in patient care, in two medical college hospitals of West Bengal, showed that 61.4% of them sustained at least one Needle Stick Injury (NSI) in last 12 months. The risk of such injuries per 1000 nurses per year was found to be 3,280. Out of the most recent injuries among 140 nurses, 92.9% remained unreported to appropriate authorities; in 52.9% events hand gloves were worn by the nurses; only 5% of those nurses received hepatitis B vaccine, 2.1% hepatitis B immunoglobulin and none of them received post exposure prophylaxis for HIV. |
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Dietary profile of sportswomen participating in team games at state/national level |
p. 153 |
Ritu Jain, S Puri, N Saini PMID:19189839A cross sectional study was conducted to assess dietary profile of 100 Delhi based national / state level sportswomen, aged 18 - 25 years, participating in team games - volleyball, hockey, football and kabaddi. Mean energy intake was found to be 1471 + 479 Kcal. Only 24 percent of the sports women met the recommendations of 60 - 65 energy percent from carbohydrates and 87 percent were consuming more than 25 energy percent from fat. The mean macronutrients and micronutrient intakes of all the subjects were much lower than the recommendations. Improper food choices were also observed in majority. It becomes necessary to generate awareness among sports personnel regarding proper nutrition practices. |
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Perception regarding quality of services in urban ICDS blocks in Delhi |
p. 156 |
A Davey, S Davey, U Datta PMID:19189840The good quality of the services is an important determinant for acceptance of a programme in a community. It not only enhances the credibility of a worker at the ground level but also generate the demand for the services. In this paper perception for the quality of the services was assessed through the exit interview of the beneficiaries at the Anganwadi centres (AWCs). 200 beneficiaries were included from 20 AWCs in a period of one and half month. 52.5% respondents were dissatisfied for the services provided from the AWC for one or more reason. The most common reason mentioned was the not easy accessibility of the AWC and less space available at the AWC (68.6%), followed by the poor quality of the food distributed (66.7%) and irregular pre school education (57.1%) from AWCs. |
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A study on delivery and newborn care practices in a rural block of West Bengal |
p. 159 |
P Das, S Ghosh, M Ghosh, A Mandal PMID:19189841A cross-sectional study was conducted in a rural block of the State of West Bengal to generate area specific data on the proportion of home deliveries and certain newborn care practices prevalent in that area. The study was done through house-to-house survey among 165 mothers who delivered in last six months. 83.6% deliveries were conducted at home and untrained persons attended 36.3% deliveries. Bath within 24 hours of delivery was given to 17.58% newborns. Birthweight was not recorded in 38.18%. High proportion of newborns, 78.5%, was given prelacteal feeding. The health system should urgently address the deficiencies in the delivery and newborn care practices in the study area. |
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Hospitalisation due to infectious and parasitic diseases in district civil hospital, Belgaum, Karnataka |
p. 161 |
AC Naik, S Bhat, SD Kholkute PMID:19189842To assess the burden of infectious and parasitic diseases on hospital services at District Civil Hospital (DCH) Belgaum, a retrospective study was carried out using discharge records concerning 8506 inpatients due to infectious and parasitic diseases among 95655 patients admitted for all causes during the reference period 2000-2003. Out of the 21 causes of infectious and parasitic diseases, only 5 contributed maximally towards hospital admission. The most frequent cause was intestinal infections (44.0%) followed by tuberculosis (35.4%). 57.5% of these admissions were from the productive age group of 20-54 years. Tuberculosis is the most important disease in terms of hospital bed days (59.7%). Tuberculosis and intestinal infectious diseases represent more than three-fourth of the overall burden in terms of hospital bed days. |
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REVIEW ARTICLE |
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Homelessness: A hidden public health problem |
p. 164 |
S Patra, K Anand PMID:19189843Homelessness is a problem, which affects not only the people who are homeless but the whole society. This problem is not well recognized among the public health professionals. This paper attempts to discuss the issues in the context of homelessness starting from the definition used to methodology of estimation of their numbers as well as their health problems and health care needs. There is lack of data on the health problems of homelessness from India. There is no special health or social programmes or services for this subsection of the society. The existing number of shelters is inadequate and as there are multiple barriers, which prevent them to have proper access to the existing health care system. With the changing social and economic scenario, homelessness is likely to increase. We need to recognize homelessness as a public health problem and attempt to target this group for special care in order to promote equity in health system. |
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LETTERS TO THE EDITOR |
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HIV/ AIDS awareness through mass media - the measurement of efforts made in an urban area of India |
p. 171 |
Hem Chandra, K Jamaluddin, L Masih, K Faiyaz, N Agarwal, D Kumar PMID:19189844 |
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Undernutrition in 5-10 year olds: Experiences from a PHC in Pondicherry |
p. 172 |
S Sarkar, S Ananthakrishnan PMID:19189845 |
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