A Study of Morbidity Pattern in Street Sweepers: A Cross-sectional Study

Background:

Street sweepers play an important role in maintaining the health and hygiene within the cities. This job exposes the street sweepers to a variety of risk factors such as dust, toxins and diesel exhaust pollution, which make them vulnerable to develop certain occupational diseases. Therefore, it was thought necessary to study the morbidity profile in this occupational group.

Objectives:

To study the prevalence of morbidities among street sweepers and comparison group.

Study Design:

A cross-sectional study with a comparison group.

Study Setting:

Nagpur Municipal Corporation, Nagpur.

Subjects:

The study included two groups: (1) A study group comprising 273 street sweepers. (2) A comparison group comprising 142 class IV workers working in the office buildings of Nagpur Municipal Corporation, Nagpur.

Materials and Methods:

A pretested proforma was used to record the necessary information such as clinical history, sociodemographic factors, findings of clinical examination and investigations performed.

Results and Conclusions:

The important morbidities detected among street sweepers were the following: anemia (20.5%), hypertension (9.5%), upper respiratory tract infections (URTI) (7.3%) and chronic bronchitis (5.9%). In the comparison group, important morbidities detected were the following: anemia (20.4%), hypertension (11.3%), hyperacidity (9.9%), URTI (7.0%) and refractive error (7.0%). Chronic bronchitis was detected in two subjects (1.4%) of the comparison group. The prevalence of chronic bronchitis was significantly high among street sweepers than that of subjects of the comparison group. Therefore, it is recommended that further studies with a larger sample size be undertaken to identify the factors responsible for higher prevalence of chronic bronchitis among the street sweepers.     

Epidemiology of Accidents in Tile Factories of Mangalore City in Karnataka

Background:

Occupational accidents are a major point of concern in industries. The academic community should take the first step to address the long-neglected concerns of occupational safety.

Objective:

To assess the prevalence and pattern of occupational accidents.

Materials and Methods:

A record-based, cross-sectional study was done in three tile factories of Mangalore city, in Karnataka. A total of 416 workers were analyzed for the year 2004, and data regarding age, sex, job duration, type and nature of injury, body parts involved, and time of injury were collected in a prestructured proforma.

Statistical Analysis:

Proportions, Chi-square test, Univariate and Multivariate analysis.

Results:

The overall prevalence rate of accidents was found to be 18.5%. It was found that almost around 86% of the accidents had affected the limbs (upper limb 24.7%, lower limb 61%), around half (52%) of the injuries were contributed by superficial injuries, 40% of accidents were due to stepping/striking against objects and while handling. Hand tools and machinery in motion contributed to around 20% of the accidents. Accidents were more common among the younger age group and less-experienced workers. Multiple logistic regression analyses revealed that the age group of 30-39 years had an independent significant association with accidents (OR = 0.21, P = 0.04).

Conclusion:

Accidents in tile industries are an important occupational health problem in this area of the country. There is a need for proper safety training of the workers.     

A Study of Visual and Musculoskeletal Health Disorders among Computer Professionals in NCR Delhi

Objective:

To study the prevalence of health disorders among computer professionals and its association with working environment conditions.

Study design:

Cross sectional.

Materials and Methods:

A sample size of 200 computer professionals, from Delhi and NCR which included software developers, call centre workers, and data entry workers.

Result:

The prevalence of visual problems in the study group was 76% (152/200), and musculoskeletal problems were reported by 76.5% (153/200). It was found that there was a gradual increase in visual complaints as the number of hours spent for working on computers daily increased and the same relation was found to be true for musculoskeletal problems as well. Visual problems were less in persons using antiglare screen, and those with adequate lighting in the room. Musculoskeletal problems were found to be significantly lesser among those using cushioned chairs and soft keypad.

Conclusion:

A significant proportion of the computer professionals were found to be having health problems and this denotes that the occupational health of the people working in the computer field needs to be emphasized as a field of concern in occupational health.     

A Study of Dysmenorrhea During Menstruation in Adolescent Girls

Research question:

What is the prevalence of dysmenorrhea severity and its associated symptoms among adolescent girls?

Objectives:

(1) To study the prevalence of dysmenorrhea in high school adolescent girls of Gwalior. (2) To study the evidence of severity of the problem with associated symptoms and general health status.

Study design:

An explorative survey technique with a correlational approach.

Setting and Participants:

Nine hundred and seventy adolescent girls of age 15 to 20 years, studying in the higher secondary schools (Pre-University Colleges) of Gwalior.

Statistical analysis:

Percentages, Chi-square test, and Test-Retest Method.

Results:

The prevalence of dysmenorrhea in adolescent girls was found to be 79.67%. Most of them, 37.96%, suffered regularly from dysmenorrhea severity. The three most common symptoms present on both days, that is, day before and first day of menstruation were lethargy and tiredness (first), depression (second) and inability to concentrate in work (third), whereas the ranking of these symptoms on the day after the stoppage of menstruation showed depression as the first common symptoms. Negative correlation had found between dysmenorrhea and the General Health Status as measured by the Body surface area.     

Work-related Musculoskeletal Disorder: An Occupational Disorder of the Goldsmiths in India

Background:

Gold ornament making industries are one of the widespread small-scale industries of India. These industries belong to the unorganized sector of the state. A large number of goldsmiths are working there for prolonged period in cross leg posture at semi-confined workstation.

Objectives:

The aim of this study is to identify Occupational Disorder of the Goldsmiths in India.

Materials and Methods:

In the spresent study, 120 male goldsmiths were randomly selected from the Davangere district of Karnataka. A detailed questionnaire study on discomfort feeling was done by the modified Nordic questionnaire, which considering the information about work nature, job stress and discomfort feeling. The existing workstations were assessed by the measurement of work areas. Analysis of body posture by rapid upper limb assessment was done to evaluate the work stress during their job.

Results:

From the analysis, it was revealed that MSDs were the major problem of the goldsmiths. The activities of the goldsmiths were also highly repetitive. Moreover, the questionnaire study revealed that most of the workers were affected by occupational disorder like pain at neck (80%), shoulder (20%), wrist (45%), and low back (75%) and also eye problem like irritation (30%) and burning sensation (70%). They also perform their job in hazardous postures. It was recorded that the workstations were poorly illuminated (19 Lux) in respect to precision work. Accidents like cut and burn occurred frequently due to the unsafe condition of the workstation.

Conclusions:

From the observation and analysis of the result it was concluded that health of the goldsmiths were highly affected improper body posture and workload. Twisting, bending, and over-reaching are the resultant of poorly designed workstation. These actions force them into a non-neutral position that increases the overall discomfort and pain at the lower back, neck, and shoulders. Moreover, lack of proper illumination at work site also exerts an additional adverse effect on the health of the goldsmiths.     

Unmet Family Planning Need: Differences and Levels of Agreement Between Husband-Wife, Haryana, India

Research question:

Is there agreement between husbands and wives regarding unmet need of family planning?

Hypothesis:

The unmet need of family planning is perceived more by women then their husbands.

Objective:

1) To ascertain the unmet needs of family planning for husbands and wives. 2) To ascertain the level of agreement between husbands and wives regarding unmet needs of family planning.

Design:

A cross-sectional survey

Setting:

Dayalpur village in Intensive field practice area of Comprehensive Rural Health Services project (CRHSP), Ballabgarh, Haryana.

Study Period:

July 2003- June 2005.

Participants

included 200 married couples selected by simple random sampling.

Statistical Analysis:

Level of agreement between husbands and wives was analyzed using Kappa statistics.

Results:

Unmet need for family planning was 11% (22 out of 200) for husbands and 17.5% (35 out of 200) for wives. The difference was seen both in unmet need for spacing (M-3.5% vs. F-6%) as well as limiting family size (M-7.5% vs. F-11.5%). Overall, 93.5% concordance was observed amongst husbands and wives. In all the cases where disagreement was seen (6.5%), wives reported having unmet need for contraception whereas their husbands perceived none. The unadjusted Kappa statistic was 0.73 and prevalence adjusted Kappa was 0.88.

Conclusion:

Unmet need for family planning was significantly higher for wives compared to husbands. Despite high degrees of agreement amongst the couples, the nature of disconcordance reinforces the need for policy makers to take into account the perspective of men.     

Routine Immunization - Do People Know About It? A Study Among Caretakers of Children Attending Pulse Polio Immunization in East Delhi

Research question:

Do caretakers of children under five years have sufficient knowledge regarding routine immunization (RI)?

Objective:

To assess the knowledge about RI among caretakers of young children.

Settings:

Pulse polio immunization centres in East Delhi.

Study design:

Cross-sectional study.

Participants:

Six hundred and eighty-two caretakers accompanying children under 5 years to pulse polio booths in November 2006.

Study tool:

Pre-tested semi-open-ended questionnaire.

Statistical analysis:

Proportions, Chi-square test.

Results:

The proportions of respondents who had awareness about different aspects of RI, such as weekday of RI (37.0%), age group for RI (49.1%), number of visits required in the first year of life (27.0%), were all low. When asked to name the four diseases covered under the RI program in Delhi, only 268 (39.3%) could name at least three. The education level of respondents was strongly associated with their knowledge about RI.

Conclusion:

The need of the hour is to make RI a ‘felt need’ of the community. Making caretakers more aware about RI is a vital step in achieving this goal.     

Tracking Progress Toward Elimination of Iodine Deficiency Disorders in Jharkhand, India

Research question:

What is the current status of Iodine Deficiency Disorders (IDD) in the state of Jharkhand?

Objectives:

(1) To determine the status of iodine deficiency in the state. (2) To determine the availability and cost of adequately iodized salt at the retail shops. (3) To study the perceptions of the community regarding iodine deficiency, salt and iodized salt.

Design:

A cross-sectional community-based survey.

Study setting:

Thirty clusters selected through the probability proportion to size (PPS) sampling in the state of Jharkhand.

Study participants:

Children aged 6-12 years, households, retail shopkeepers and opinion leaders.

Study tool:

Quantitative and qualitative methodology using a pretested questionnaire and focus group discussion used to carry out the community-based survey.

Results:

Total goiter rate (TGR) was 0.9%. Median urinary iodine level was 173.2 µg/L. The proportion of individuals with urinary iodine levels less than 100 and 50 µg/L were 26.4% and 10%, respectively. Slightly less than two-thirds (64.2%) of the households were found to be consuming adequately iodized salt as measured by titration (greater than 15 ppm). Iodized salt was available across the state and the cost varied between Re. 1 and Rs. 8 per kilogram. A common belief among the community was that iodized salt is equivalent to refined packet salt that is further equivalent to expensive salt.

Conclusion:

The results of the present survey show that the iodine nutrition in the state of Jharkhand is optimal. Considering that the consumption of adequately iodized salt should increase from 64.2% to the goal of more than 90%, sustained efforts are required in this place to consolidate the current coverage of adequately iodized salt and increase it to greater than 90%.     

A Study on the Role of Mobile Phone Communication in Tuberculosis DOTS Treatment

Background:

Every year, a lot of Tuberculosis (TB) patients undergo Directly Observed Treatment Short-course (DOTS) in Salem city, one of the high TB districts in South India. Mobile phone usage among these patients and health workers is common. Mobile phone communication has a great potential in TB treatment.

Objectives:

To analyze the mobile phone usage and its effectiveness in TB DOTS treatment.

Materials and Methods:

A cross-sectional survey with 150 TB patients was followed by a focus group discussion with treatment supervisors, DOTS providers, and health workers.

Results:

Majority of patients use mobile phones to make calls to health workers to clarify their doubts on side effects, food, and symptoms of the disease. TB treatment supervisors effectively use mobile phones to counsel patients to adhere to the treatment regimen. Patients see mobile phones as a useful communication tool in TB treatment though they prefer direct interpersonal communication with health workers. Though the mobile ownership is 68% among the TB patients, many of them are not able to send text messages or read messages in English.

Conclusion:

Mobile phone possession and usage is high among the patients. Patients need to be trained to use mobile phone features such as alarm, voice mail, and interactive voice response. Incentives like free talk time and short message service (SMS) will encourage patients to communicate frequently with health workers, thereby, increasing the chances of better adherence to DOTS. SMS could be made available in the regional languages.     

Protecting Health from Climate Change: Preparedness of Medical Interns

Context:

Climate change is a significant and emerging threat to public health and to meet the challenge, health systems require qualified staff.

Aims:

To study the preparedness of medical interns to meet the challenge of protecting health from climate change.

Settings and Design:

Medical colleges in a coastal town. Cross-sectional study.

Materials and Methods:

A proportionate number of medical interns from five medical colleges were included in the study. Level of awareness was used as a criterion to judge the preparedness. A self-administered, pretested, open-ended questionnaire was used. Responses were evaluated and graded.

Statistical Analysis Used:

Proportions, percentage, Chi-test.

Results:

About 90% of the medical interns were aware of the climate change and human activities that were playing a major role. Ninety-four percent were aware of the direct health impacts due to higher temperature and depletion in ozone concentration, and about 78% of the respondents were aware about the change in frequency / distribution of vector-borne diseases, water borne / related diseases, malnutrition, and health impact of population displacement. Knowledge regarding health protection was limited to mitigation of climate change and training / education. Options like adaptation, establishing / strengthening climate and disease surveillance systems, and health action in emergency were known to only nine (7%), eight (6%), and 17 (13%), respectively. Collegewise difference was statistically insignificant. Extra / co-curricular activities were the major source of knowledge.

Conclusions:

Majority of medical interns were aware of the causes and health impacts of climate change, but their knowledge regarding health protection measures was limited.     

Metabolic Syndrome: An Occupational Perspective

Objective:

To study the prevalence of Metabolic Syndrome (MS) in an Indian industrial setup and to study disparity in occurrence of MS in a working population based on occupational status.

Materials and Methods:

Cross-sectional study of 651 employees who underwent periodic medical examination. The International Diabetes Federation (IDF) definition of MS and International Standard Classification of Occupations (ISCO)-88 classification of occupations were used.

Results:

The overall crude prevalence of MS was found to be 18.5%. Nineteen percent of the non-manual workers and 18.3% of the manual workers suffered from MS. The single largest occupational category with MS was ISCO-88 group 1, which included the managers and senior officials. However, no difference was found among the manual and non-manual workers in prevalence of MS.     

Period Prevalence and Sociodemographic Factors of Hypertension in Rural Maharashtra: A Cross-Sectional Study

Background:

Hypertension is most common cardiovascular disease and it account for large proportion of all cardiovascular deaths and disability worldwide.

Research Questions:

What is the level of prevalence of hypertension in rural area? What are the soociodemographic factors associated with hypertension?

Objectives:

To find out prevalence of hypertension in rural area.

Study Design:

A community-based cross-sectional study setting: Rural Health Training Centre Paithan, field practice area of govt. medical college Aurangabad, Maharashtra.

Participants:

1297 persons aged 19 years and above.

Study Period:

June 2005 to December 2006.

Materials and Methods:

A house-to-house survey was conducted by the author himself, interviewed the participants by systematic random sampling method, using pretested structured standard questionnaire. Two independent blood pressure (BP) readings were taken in sitting position by visiting each participant at their home. Hypertension was defined as systolic BP more than or equal to 140 mm of Hg or diastolic BP more than or equal to 90 mm of Hg or those individuals currently taking antihypertensive treatment.

Statistical Tests:

Percentiles, Chi Square test, Chi-Square for linear trend, multiple logistic regression analysis on SPSS software Version 10.

Results:

Overall prevalence of hypertension in the study subjects was 7.24%. Multiple logistic regression analysis identified various factors significantly associated with hypertension were age, sex, BMI, additional salt intake, smoking, DM, alcohol consumption, and higher socioeconomic status.

Conclusions:

The overall prevalence of hypertension in study subjects was 7.24%.     

Dysmenorrhoea in Different Settings: Are the Rural and Urban Adolescent Girls Perceiving and Managing the Dysmenorrhoea Problem Differently?

Context:

It is well-known that every health problem, not only presents itself with different epidemiological profiles in different population settings, but is also perceived and managed differently. Having knowledge of these variations in its presentations and perceptions in different population settings, for example, in urban and rural settings, will be useful for its successful management.

Aim:

To study differences in epidemiological profiles, perceptions, socio economic losses, and quality-of-life losses and management of dysmenorrhoea in different settings for effective management.

Design and Setting:

A comparative cross-sectional study among adolescent school girls (101 girls in urban areas and 79 girls in rural areas) in the district of Karimnagar.

Materials and Methods:

A cross-sectional survey using a pretested questionnaire was conducted among 180 adolescent girls in urban and rural settings.

Statistical Analyses Used:

Proportions and X² test.

Results:

The prevalence of dysmenorrhoea is 54% (53% in girls in urban areas and 56% in girls in rural areas) (X² _df = 0.1, P = 0.05). Sickness absenteeism (28–48%), socio economic losses, and perceived quality of life losses are more prevalent among girls in urban areas than in girls in rural areas. Girls in rural areas resort to physical labor and other natural methods to obtain relief while the girls in urban areas are mainly depending on medications.

Conclusions:

Dysmenorrhoea can also be managed effectively by natural methods without resorting to medicines, provided one is psychologically prepared to face it without anxiety.     

Prevalence of HIV/AIDS and Prediction of Future Trends in North-west Region of India: A six-year ICTC-based Study

Background:

The study was conducted to analyze previous six-year prevalence data of HIV infection in the Northwest region of India and predict future trends for a couple of years.

Objectives:

The study was conducted to aid SACS and NACO to plan and arrange resources for the future scenario.

Materials and Methods:

All the attendees of ICTC, Jaipur, from January 2002 to December 2007 were included and variables like age, sex, marital status, occupation, place of residence, pattern of risk behavior and HIV serostatus were studied. As per the strategy and policy prescribed by NACO, tests (E/R/S) were performed on the serum samples. Data was collected; compiled and analyzed using standard statistical methods. Future trends of HIV-prevalence in north-west India were anticipated.

Results:

The overall positivity rates among attendees of ICTC, were found to be 12.2% (386/3161), 11.8% (519/4381), 11.1% (649/5867), 13% (908/6983), 14% (1385/9911) and 17.34% (1756/10133) in the years 2002, 2003, 2004, 2005, 2006 and 2007 respectively. Future trends for the next couple of years depict further increase in prevalence without any plateau.

Conclusion:

Epidemiological studies should be carried out in various settings to understand the role and complex relations of innumerable behavioral, social and demographic factors, which will help, interrupt and control the transmission of HIV/ AIDS.     

Breast Feeding Practices and Newborn Care in Rural Areas: A Descriptive Cross-Sectional Study

Context:

Breastfeeding practices play an important role in reducing child mortality and morbidity. This study was aimed to describe the breastfeeding practices prevalent in rural areas.

Objectives:

The primary objective of this study was to describe the breastfeeding and newborn care practices in rural areas and the secondary objective was to describe the factors affecting the initiation and duration of breastfeeding.

Settings and Design:

The study was conducted in primary health care center (PHC) that is attached to a medical college in Kengeri, rural Bangalore, Karnataka.

Materials and Methods:

Mothers with children who were 9 months old who came to the PHC for measles vaccination were included in the study and data was collected using the pre-tested questionnaire on breastfeeding and newborn practices.

Results:

Our study shows 97% of the mothers initiated breastfeeding, 19% used pre lacteal feeds, 90% had hospital deliveries and 10% had home deliveries, and 50% used a house knife to cut the umbilical cord among home deliveries.

Conclusions:

This study emphasizes the need for breastfeeding intervention programs especially for the mother during antenatal and postnatal check-ups and practices like discarding the colostrum and early/late weaning are still widely prevalent and need to be addressed.     

Prevalence, Awareness, Treatment, and Control of Hypertension in Rural Areas of Davanagere

Objective:

To study the prevalence, awareness, treatment, and control of hypertension in the rural areas of Davanagere.

Type of Study:

Cross-sectional community-based study.

Setting:

Villages belonging to six sectors of the Davanagere Taluk.

Materials and Methods:

General population above 18 years.

Methodology:

A community-based sample was chosen by a multistage sampling technique. Subjects were screened for hypertension by a house-to-house survey. Subjects with systolic blood pressure more than 140 and diastolic blood pressure more than 90 mm of Hg, on hypertensive treatment, and history of hypertension were classified as hypertensives. The data thus obtained was compiled and analyzed.

Results:

The prevalence rate of hypertension in the study population was 18.3% (95% CI, 16.7-19.9%). Prevalence of hypertension was more in males 19.1% (95% CI, 16.7-21.5%) than in females 17.5% (95% CI, 14.9-20.1%); 11.6%, 5.6%, and 1.2% of the total subjects had Grade I, Grade II, and Grade III, respectively. Only 33.8% of them were aware of their hypertensive status. Hypertensives of 32.1% were on treatment, and 12.5% adequately controlled their BP. About 6.9% of the total hypertensives had severe hypertension.

Statistical Analysis:

Proportions, One way Analysis of Variance, Chi-square test.     

Hand Hygiene Compliance in the Intensive Care Units of a Tertiary Care Hospital

Context:

Hand hygiene (HH) is the most important measure to prevent hospital-acquired infections but the compliance is still low.

Aims:

To assess the compliance, identify factors influencing compliance and to study the knowledge, attitude and perceptions associated with HH among health care workers (HCW).

Settings and Design:

Cross-sectional study conducted in 42 bedded Medical (Pulmonary, Medicine and Stroke) intensive care units (ICU) of a tertiary care hospital.

Materials and Methods:

HCWs (doctors and nurses) were observed during routine patient care by observers posted in each ICU and their HH compliance was noted. Thereafter, questionnaire regarding knowledge, perception and attitudes toward HH was filled by each HCW.

Statistical Analysis:

Percentages and χ² test.

Results:

The overall compliance was 43.2% (394/911 opportunities). It was 68.9% (31/45) in the intensivists, 56.3% (18/32) in attending physicians, 40.0% (28/70) in the postgraduate residents and 41.3% (301/728) in the nurses. Compliance was inversely related to activity index. Compliance for high, medium and low risk of cross-transmission was 38.8% (67/170), 43.8% (175/401) and 44.7% (152/340), respectively.

Conclusions:

Compliance of the study group is affected by the activity index (number of opportunities they come across per hour) and professional status. The HCWs listed less knowledge, lack of motivation, increased workload as some of the factors influencing HH.     

Knowledge, Attitude, and Practice of Dyeing and Printing Workers

Background:

Millions of workers are occupationally exposed to dyes in the world, but little is known about their knowledge and attitudes toward the effects of dye on their health..

Objectives:

The aim of this study was to assess the fabric dyers′ and fabric printers′ knowledge, attitude, and practice toward the health hazard of dyes.

Materials and Methods:

The present study was taken up in the Madurai district which is situated in the Southern Tamil Nadu, India. One hundred and forty-two workers employed in small-scale dyeing and printing units participated in a face-to-face confidential interview.

Results:

The mean age of fabric dyers and fabric printers was 42 years (±10.7). When enquired about whether dyes affect body organ(s), all the workers agreed that dye(s) will affect skin, but they were not aware that dyes could affect other parts of the body. All the workers believed that safe methods of handling of dyes and disposal of contaminated packaging used for dyes need to be considered. It was found that 34% of the workers were using personal protective equipment (PPE) such as rubber hand gloves during work.

Conclusion:

The workers had knowledge regarding the occupational hazards, and their attitudinal approach toward the betterment of the work environment is positive.     

Tobacco Use Among Adolescent Students and the Influence of Role Models

Background:

Seventy per cent of premature deaths among adults are due to behavioral patterns that emerge in adolescence, including smoking.

Objective:

The objective was to study the prevalence of tobacco use among adolescent students in South Delhi and its epidemiological correlates.

Materials and Methods:

This was a cross-sectional study.

Setting:

Three schools and two colleges of South Delhi were chosen. There were 550 adolescent students aged 14-19.

Statistical Analysis:

Statistical analysis was done using proportions, the chi-square test, and multivariate logistic regression.

Results:

A total of 88 (16.0%) students reported having ever tried cigarette or bidi smoking. The prevalence of current smoking was 7.1%. Exactly 10% (55) of the students reported having ever used smokeless forms of tobacco. The prevalence of tobacco use overall was found to be 20.9%, and was significantly higher (P=0.016) among the males than the females. Tobacco use was found to be significantly associated with having seen a brother/sister smoke (OR 5.15), best friend smoke (OR 2.92), and belonging to a nuclear family (OR 1.96).

Conclusions:

Tobacco use is still an important risk behavior among adolescent students. This study found a strong association of tobacco use by the adolescents with their having seen various role models ever smoking.