Prevalence of Dental Fluorosis Among Primary School Children in Rural Areas of Chidambaram Taluk, Cuddalore District, Tamil Nadu, India

Background:

Fluorosis is one of the common but major emerging areas of research in the tropics. It is considered endemic in 17 states of India. However, the Cuddalore district of Tamil Nadu is categorised as a fluorosis non-endemic area. But clinical cases of dental fluorosis were reported in the field practice area of Department of Community Medicine, Rajah Muthiah Medical College, Annamalai University, Chidambaram. Since dental fluorosis has been described as a biomarker of exposure to fluoride, we assessed the prevalence and severity of dental fluorosis among primary school children in the service area.

Materials and Methods:

Children studying in six primary schools of six villages in the field practice area of Rural Health Centre of Faculty of Medicine, Annamalai University, Chidambaram, were surveyed. Every child was clinically examined at the school by calibrated examiners with Dean''s fluorosis index recommended by WHO (1997). Chi-square test, Chi-square trend test and Spearman''s rank correlation coefficient test were used for statistical analysis.

Results:

Five hundred and twenty-five 5- to 12-year-old school children (255 boys and 270 girls) were surveyed. The overall dental fluorosis prevalence was found to be 31.4% in our study sample. Dental fluorosis increased with age P < 0.001, whereas gender difference was not statistically significant. Aesthetically objectionable dental fluorosis was found in 2.1% of the sample. Villages Senjicherry, Keezhaperambai and Kanagarapattu revealed a community fluorosis index (CFI) score of 0.43, 0.54 and 0.54 with 5.6%, 4.8% and 1.4% of objectionable dental fluorosis, respectively. Correlation between water fluoride content and CFI values in four villages was noted to be positively significant.

Conclusion:

Three out of six villages studied were in ‘borderline’ public health significance (CFI score 0.4-0.6). A well-designed epidemiological investigation can be undertaken to evaluate the risk factors associated with the condition in the study region.     

Study on Entomological Surveillance and its Significance during a Dengue Outbreak in the District of Tirunelveli in Tamil Nadu,India

ObjectivesTo study the significance of entomological surveillance, the house index (HI), container index (CI), and Breteau index (BI) were determined to estimate the degree of a major dengue outbreak in Tirunelveli, Tamil Nadu, India (Latitude: 8°42′N; Longitude: 77°42′E) in May 2012.MethodsThe HI, CI, and BI were determined in a primary health center (PHC) in the village of Maruthamputhur (Pappakudi taluk, Tirunelveli) by carrying out an antilarval (AL) work that involved door-to-door search for immature stages of Aedes spp. mosquitoes by trained field workers and volunteers. The work of field workers was evaluated by a junior and senior entomologist the following day.ResultsBefore the AL work, the reported numbers of fever cases from Week 1 to 5 in Maruthamputhur were 211, 394, 244, 222, and 144 with two deaths. By contrast, after the AL work, these numbers were considerably reduced and there was no fever-related death (the HI was reduced from 48.2% to 1.6%, the CI from 28.6% to 0.4%, and the BI from 48.2 to 1.6).ConclusionBecause no specific medicine and vaccines are available to treat dengue fever and dengue hemorrhagic fever, entomological surveillance and its significance can be used to halt the outbreak of dengue as shown in this study.     

2010年济宁市任城区预防接种门诊现状调查

[目的]了解济宁市任城区预防接种门诊运行情况,探讨更好的运转模式,提高免疫规划工作质量。[方法]2010年12月,对济宁市任城区全部9处预防接种门诊进行调查,并随机抽查1~2岁儿童196名调查疫苗接种率。[结果]济宁市任城区的9处预防接种门诊,均达到省级示范化接种门诊标准,实行按日接种制度。调查乡镇级免疫接种人员66人,均持证上岗。调查儿童196人,"五苗"全程接种率为94.39%,卡介苗、乙型肝炎疫苗、麻疹疫苗及时接种率分别为100.00%、97.96%、92.86%。调查儿童家长90人,60.00%的认为有必要建立临时接种点。[结论]济宁市任城区预防接种门诊运行良好。     

2004年淄博市周村区口腔诊疗机构消毒状况调查

[目的]了解淄博市周村区口腔诊疗机构的消毒水平。[方法]2004年11月按《医院消毒卫生标准》和《消毒技术规范》对淄博市周村区口腔诊疗机构进行抽样检测和评价。[结果]区级以上口腔诊疗机构样品总合格率为96.00%,乡镇口腔诊疗机构样品总合格率为83.33%,厂矿口腔诊疗机构样品总合格率为84.00%,个体口腔诊疗机构样品总合格率为73.33%。使用中消毒液的总合格率为84.62%,印模的总合格率为88.00%,紫外线消毒灯的总合格率为84.85%。28处口腔诊疗机构的紫外线消毒灯、高压灭菌器、戊二醛等基本消毒设施的配备率达不到100%。各采样项目的合格率虽然均在80.00%以上,但还达不到高标准的消毒灭菌要求,还存在医源性传播的隐患。[结论]消毒质量以区级以上医院为主有一定保证;但以个体口腔诊疗机构为主在消毒工作中还存在较多问题,需要进一步加强和提高。     

Prevalence of posttraumatic stress disorder in a coastal fishing village in Tamil Nadu, India, after the December 2004 tsunami

Two months after the December 2004 tsunami in Tamil Nadu, India, we surveyed adults aged 18 years or older in a severely affected coastal village using structured interviews and the Harvard Trauma Questionnaire. The prevalence of posttraumatic stress disorder was 12.7% (95% confidence interval [CI]=9.4%, 17.1%), and odds of posttraumatic stress disorder were higher among individuals with no household incomes, women, and those injured during the tsunami. In addition to promoting feelings of safety, interventions aimed toward populations affected by the December 2004 tsunami need to focus on income-generating activities. Also, there is a need to target initiatives toward women and those individuals injured during the tsunami, given that these groups are more likely to experience posttraumatic stress disorder.     

上海市青浦某村社区居民糖尿病患病率调查

[目的]了解青浦区某村35～74岁常住居民糖尿病患病率及其影响发病因素。[方法]按分层随机抽样原则,抽取青浦区某镇一个行政村1000名35～74岁本地常住居民进行横断面调查,采用口服75g葡萄糖耐量实验（OGTT）进行筛查。[结果]糖尿病、糖耐量受损、空腹血糖受损和糖调节受损的标化患病率分别为7．17％、1．14％、10．6％、11．8％。女性患病率高于男性（11．3％,6．7％,P〈0．05）。随着年龄的增加,糖尿病的患病率增加。年龄大、女性、肥胖、高血压、高脂血症、有糖尿病家族史是糖尿病患病的危险因素。[结论]青浦区该村糖尿病患病率明显高于1997年全国流行病学调查的患病率水平,且随着地区的城市化和人口老龄化进程加快,糖尿病患病率将升高。     

Prevalence of Chikungunya in Urban Field Practice Area of a Private Medical College, Chennai

Background:

The outbreak of Chikungunya in India started during December 2005 with more than 11,00,000 cases. Many cases with symptoms suggestive of Chikungunya reported to our urban health-training centre. Hence this study was done to estimate the prevalence of Chikungunya, to study the common treatment-seeking behavior, control measures and the sequalae of Chikungunya by follow-up.

Materials and Methods:

This cross-sectional study was done in Anagaputhur an urban field practice area of our college. The study was done on a sample selected by systematic random sampling. Any person with fever and joint pain, with an onset from 1 August 2006 to 31 August 2006, were enrolled as cases. The cases were followed up after three months.

Results:

Chikungunya prevalence in the community was 22.3%; 52% of them were females and 56% of cases were in the 15-44 years age group. Median duration of acute phase was three days. Ninety-one percent of them had multiple joints’ involvement. Seventy-eight percent sought treatment from the private sector. Sixty-seven percent reported artificial collections of water around their household and 44% complained of mosquito problems during the day. Eighty-eight percent used mosquito repellents for personal protection. On follow-up 95% of them had residual joint pain, 43% had residual joint swelling and 11% had disabilities with median duration of 30 days.

Conclusions:

Prevalence of Chikungunya was 22.3%, predominantly affecting the age group of 15-44 years and females. The private sector was commonly sought for treatment. Entomological survey indicated Aedes breeding. Eleven percent had disabilities due to the sequelae.     

美沙酮门诊治疗人员617例感染HIV和HCV分析

目的了解荆州市美沙酮门诊吸毒人员HIV、HCV的感染状况及其影响因素。方法对吸毒人员吸毒行为、肝功能有无异常、营养情况、并发症等进行问卷调查,并采血样检测HIV抗体、HCV抗体。结果 617名吸毒者中,HIV、HCV感染率分别为2.1%和70.5%。HCV感染与吸毒年限有关。男女吸毒人员吸毒行为比较:初吸毒年龄和吸毒年限差异有统计学意义(均P<0.01和P<0.05),但平均吸毒频次、平均吸毒量差异无统计学意义(均P>0.05)。女性吸毒人员中有并发症的比例(21.43%)高于男性吸毒人员中有并发症的比例(12.83%),差异有统计学意义(P<0.01)。营养状况不同吸毒人员的HCV感染无统计学差异(P>0.05),但营养状况不同吸毒人员肝功能和并发症的发生率差异有统计学意义(P<0.01)。用多因素logistic分析吸毒人员感染HCV的主要影响因素,其顺序为初吸年龄、吸毒量、肝功能、并发症、年龄。其中初吸年龄与HCV感染呈负相关。结论对吸毒人群中的高危行为应采取干预措施并在该人群中开展艾滋病知识的宣传教育工作。     

Study on the Correlation of Premises Condition Index and the Presence of Larvae of Aedes Species Mosquitoes in Human Dwellings of the Cuddalore District of Tamil Nadu,India

ObjectivesTo predict dwellings for the presence of Aedes larvae rapidly based on Premises Condition Index (PCI) factors, we studied the possible presence of Aedes species mosquitoes larvae among houses in the Chidambaram urban of Cuddalore District in Tamil Nadu, India based on the scores of variables in PCI, namely House, Yard and degree of shadow. Data of these variables were collected in September and October 2006 from 1813 houses in the Chidambaram urban area during the intensive vector control activities employed for the prevention and control of Chikungunya.MethodsThe association between presence of larvae and the variables of PCI was tested by Chi-square and Correlation. The predictability of the presence of Aedes larvae based on PCI factors was computed by logistic regression.ResultsThe study shows 301 containers in 132 houses were found positive with Aedes species out of 1813 houses surveyed. It was further observed that the probability of presence of positive premises was four times higher in the premises with 75% shadow compared with premises with a 25% shadow. These findings showed a significant association (p < 0.001) with positive premises.ConclusionsIt is concluded that this study helps in conducting rapid survey to identify the presence of Aedes larvae with a minimum number of staff for both inspection and treatment of Aedes larvae during the epidemic situation.     

Coping with the Asian tsunami: perspectives from Tamil Nadu, India on the determinants of resilience in the face of adversity

The Asian tsunami of December 26, 2004 wreaked havoc along the southeastern coast of India and resulted in devastating losses. The high rates of long-term mental health consequences in adult survivors predicted immediately after the disaster have not been borne out by recent surveys. This qualitative study explored the psychological impact of the tsunami on survivors with a view to gaining insights into the ethno-cultural coping mechanisms of affected communities and evaluating resilience in the face of incomprehensible adversity. We conducted focus group discussions 9 months after the tsunami with two groups of fishermen, two groups of housewives, a group of village leaders and a group of young men in four affected villages of Nagapattinam district in Tamil Nadu, India. In spite of incomplete reconstruction of their lives, participants reconstructed meaning for the causes and the aftermath of the disaster in their cultural idiom. Qualitative changes in their social structure, processes and attitudes towards different aspects of life were revealed. Survivors valued their unique individual, social and spiritual coping strategies more than formal mental health services. Their stories confirm the assertion that the collective response to massive trauma need not necessarily result in social collapse but also includes positive effects. The results of this study suggest that interventions after disaster should be grounded in ethno-cultural beliefs and practices and should be aimed at strengthening prevailing community coping strategies.     

新型农村合作医疗制度对宁夏回族自治区和山东省村卫生室影响的研究

目的分析新型农村合作医疗(简称新农合)制度的开展对村卫生室产生的影响,为新农合和村卫生室更好地协调发展提供建议。方法采取定性调查结合现有政策文件,描述随着新农合的开展,新农合定点和非定点村卫生室在业务量及服务质量等方面的变化情况,分析可能原因。结果随着新农合的开展,没有足够的公共卫生经费会影响开展公共卫生工作的积极性;新农合在某种程度上提升了村卫生室的医疗服务质量。结论宁夏回族自治区应该加大村卫生室能力建设,尽快把村卫生室纳入新农合定点单位,山东省应设法进一步降低村卫生室药品价格,同时给予村卫生室一定的公共卫生服务补助。     

上海市杨浦区1956-2008年尘肺发病情况分析

[目的]分析上海市杨浦区1956～2008年尘肺发病情况,为制定尘肺的防治对策提供依据。[方法]对全区1956-2008年诊断的所有尘肺病例的发病情况进行调查,并进行统计分析。[结果]1956-2008年全区尘肺累积病例496例。其中,男性479例,占96.57%;女性17例,占3.43%。尘肺Ⅰ期病人298例、Ⅱ期151例、Ⅲ期47例,分别占60.08%、30.44%和9.48%。累积死亡病例294例,病死率达59.27%。尘肺累积病例分类排序前5位者依次为铸工尘肺、矽肺、电焊工尘肺、石棉肺和炭黑尘肺。铸工尘肺和矽肺病例共计421例,占全部尘肺病例的84.88%。发病行业集中在钢铁铸造、建筑材料开采和加工、耐火材料制品业和玻璃制造等行业。尘肺的平均发病年龄为（51.97±9.26）岁、平均接尘工龄为（21.75±9.97）年。尘肺病例结核合并率为9.27%,其病死率高达93.48%。在尘肺病例的死因构成中,死于尘肺者居首位,占25.85%,其次为心脑血管疾病和肺癌,分别占20.41%和16.67%。[结论]上海市杨浦区尘肺病控制已取得显著成效,应加强对尘肺并发症,特别是肺部疾病的预防和医疗诊治,以提高尘肺病人的生存质量。     

浙江省城市居民2周患病率的影响因素研究

目的使用不同方法分析浙江省城市居民2周患病率的影响因素。方法分别使用单水平Logistic回归和两水平Logistic回归,对浙江省第四次卫生服务调查的资料进行分析。结果由单水平Logistic回归得出的差异有统计学意义的一些影响因素在两水平Logistic回归模型中变得不明显。2种方法均得出的影响2周患病率的因素(P<0.05)有:户主受教育程度、个人受教育程度、就业状况、是否患有慢性病。结论卫生服务调查数据存在结构层次,两水平模型考虑了数据的层次结构,得出的影响因素比传统回归模型更可靠,因此认为使用两水平Logistic回归分析更为恰当。     

广州市白云区新生儿出生体重及影响因素调查

目的了解广州市白云区新生儿出生体重情况,找出新生儿出生体重影响因素。方法采用整群随机抽样的方法,抽取广州市白云区郊区共1006名婴儿及其母亲作为调查对象,逐一进行面对面问卷调查。调查内容包括:新生儿父母亲的社会人口学特征、母亲接受孕期保健情况、母亲孕前与临分娩前体重指数(BMI)及新生儿出生体重等。结果调查新生儿的平均出生体重均在正常范围内,且与母亲孕前BMI及胎龄密切相关。结论要加强健康教育,提供营养指导,做好孕期保健工作,保证孕母的健康,尽量降低早产儿的发生率。     

宁夏地区村卫生室服务能力现况研究

目的通过调查宁夏地区村卫生室的现状,分析其提供服务情况,发现目前存在的问题并提出合理的解决方案。方法研究时段为2009年度,采用文献研究法、定性调查和定量调查相结合的方式对服务能力进行研究。结果研究结果分为三部分,分别是宁夏地区村卫生室基本情况、资金来源及使用情况和服务能力情况。其中,服务能力包括村卫生室的人力资源情况、设备情况、药品情况和提供的服务情况等。通过以上研究,对结果进行讨论分析,为后面的建议提供理论依据。结论宁夏地区村卫生室基础建设及设备存在不足、缺少合格的乡村医生,村卫生室提供的药品数量、种类不全等,制约着其服务能力的提高。同时,宁夏地区农村卫生事业发展存在不均衡的现象。     

Impact of education campaign on community-based vector control in hastening the process of elimination of lymphatic filariasis in Tamil Nadu, South India

Globally mosquito-borne lymphatic filariasis (LF) is targeted for elimination by 2020. Towards this goal, the scope of community-based vector control as a supplementary strategy to mass drug administration (MDA) was assessed through an intensive education campaign and evaluated using pre- and post-educational surveys in an intervention and comparison village in Tamil Nadu, South India. Environmental and entomological indicators for breeding sites and mosquito density were examined before and after the intervention. Significant (P < 0.05) increase in knowledge was observed in intervention area with regard to transmission and control of LF. Relative change between intervention and comparison villages before and after intervention was also significant (z = >1.96). Multiple mosquito control and personal protection methods were in use during the post-intervention assessment and was evident from the significantly (P < 0.05) higher average score. Breeding sources declined significantly (P < 0.05) in the intervention village with a significant relative change (z = 4.32). Significant reduction in per man-hour indoor resting density of mosquitoes was observed in the intervention area compared to baseline. The per capita cost for reducing 87% of the mosquito density was $ 0.32 indicating the effectiveness of community-based approach. The usefulness of this strategy in the elimination of LF is discussed.