Intestinal parasitism in Magama Gumau rural village and Jos township in north central Nigeria

OBJECTIVE: To determine the prevalence of intestinal parasitosis in one rural village and one urban centre in North Central Nigeria. METHODS: A total of 111 single stool specimens from all the volunteered rural dwellers and 93 specimens from randomly selected urban dwellers were examined using Formol-ether and modified Ziehl-Neelsen techniques; during the months of June and July 2005. A questionnaire was completed for each subject and the nutritional status of the adults was assessed using the anthropometric measurements (weight and height for age and Biomass index). RESULTS: The results suggest very high prevalence rates of intestinal parasitosis of 72.1% and 69.9% for the rural and urban populations respectively. All the age groups were infected. The males in the rural area had a prevalence of 69.2% as against 74.6% in females (P>0.05); while in the urban area, the males were more significantly infected (77.4%) compared with the females with 66.1% (P< 0.05). Those with normal BMI (18.5-24.9 kg/m2) had the highest prevalence of 79.3% and 72.4% for the rural and urban populations respectively. The prevalence of the parasites in the rural and urban populations respectively were: Entamoeba coli (16.2% and 9.7%); E. histolytica (18.9% and 18.3%); E. hartmani (1.8% ad 0.0%); Endolimax nana (16.2% and 18.3%); Iodamoeba butschlii (0.0% and 1.1%); Giardia lamblia (7.2% and 4.3%); Schistosoma mansoni (9.9% and 0.0%); Strongyloides stercoralis (0.9% and 0.0%); Hookworm (4.5% and 5.4%); Ascaris lumbricoides (1.8% and 0.0%); Enterobius vermicularis (0.0% and 1.1%); Cryptosporidium parvum (29.7% and 19.4%); and Enterocytozoon bieneusi/Encephalitozoon intestinalis (39.6% and 47.3%). Polyparasitism was recorded in 48.6% of the rural subjects and 36.6% of the urban subjects. CONCLUSION: The study has shown a very high prevalence of intestinal parasitosis in both the rural and urban populations and that C. parvum and E. bieneusi/E. intestinalis are harboured by apparently healthy individuals.     

Community based trials and informed consent in rural north India

Disease control has increasingly shifted towards large scale, disease specific, public health interventions. The emerging problems of HIV, hepatitis, malaria, typhoid, tuberculosis, childhood pneumonia, and meningitis have made community based trials of interventions a cost effective long term investment for the health of a population. The authors conducted this study to explore the complexities involved in obtaining informed consent to participation in rural north India, and how people there make decisions related to participation in clinical research.     

Cost of ambulatory care of diabetes mellitus: a study from north India

Background: Diabetes mellitus is a chronic and potentially disabling disease that represents an important public health and clinical concern because of the economic burden it imposes on the person, family, and society. Despite this, data regarding cost of care of diabetes mellitus from developing countries are scarce. This study aimed to assess the cost of care of Indian patients with diabetes mellitus. Methods: Cost of illness in 50 outpatients with diabetes mellitus (diagnosed according to WHO criteria, Expert Committee, 1997) was assessed over a six month period using a specially designed questionnaire, together with structured assessments of disability. Results: Total annual cost of care was 14 508 rupees (263.78 euros). The largest proportion of the total cost was made up of direct costs (68%), followed by indirect costs (28.76%) and provider''s costs (2.8%). Drug costs were high. Total treatment cost was significantly higher in those who were more educated, those who visited the hospital more often, and those receiving a greater number of drugs. Conclusion: From this study it can be concluded that diabetes mellitus is an expensive illness to treat even in developing countries. The main brunt of financial burden is borne by the family. Any efforts at cost reduction should, therefore, have the family as its focus, and relieving the family of this financial burden needs to be prioritised.     

Evaluation of nomophobia among medical students using smartphone in north India

BackgroundSmartphone's popularity has risen to such an extent in recent years that it is unimaginable for the people to stay away from it for a minute. The excessive usage has given rise to a condition termed as nomophobia or a feeling of discomfort or anxiety experienced whenever unable to use the smartphone. The aim of this study was to evaluate nomophobia among medical students who are using smartphones.MethodsA cross-sectional study was conducted among the undergraduate medical students. A 20-item nomophobia questionnaire was used to assess the prevalence of nomophobia among the students, and also the purpose and in which context smartphone was used was also asked. Data collected were coded and entered into a Microsoft Excel spreadsheet. It was analysed using the Statistical Package for the Social Sciences, version 16, software (SPSS Inc., Chicago, IL, USA). A chi-square test was used to test the association, and p < 0.05 was considered significant.ResultsThe mean age of the 451 students was 20.7 ± 1.72 years, and the majority were females. Mild nomophobia was seen in 15.5% of the students; 67.2% were having moderate nomophobia, while 17.3% were suffering from severe nomophobia. The overall highest mean score was for ‘not able to communicate’ dimension of nomophobia and lowest for ‘giving up convenience.’ConclusionNomophobia is an emerging behavioural problem which needs attention. It is of serious concern that all medical students were suffering from nomophobia, with varying grade of severity. Increasing awareness regarding the harmful effects of smartphone addiction is needed.     

High prevalence of bacteriuria in pregnancy and its screening methods in north India

The study aims at finding out the prevalence of bacteruria in pregnancy in an urban setting and ascertaining methods to screen them in primary care clinics. A total of 1 61 pregnant ladies visiting a primary care clinic were screened for bacteriuria based on the symptomatology. Urine culture was done to know the prevalence of bacteriuria. Sensitivities and specificities were calculated for each symptom and risk assessment. A score card was developed based on combination of positive risk assessment and constellation of symptoms. Prevalence of symptomatic and asymptomatic bacteriuria was found to be 19.87% and 4.34% respectively. Prevalence of bacteriuria was significantly high among those who had intercourse more frequently and those with less water intake. Those with a score of more than or equal to 4, as per score card were 60% more likely to suffer from bacteriuria. When combined with microscopic examination for leucocytes on positively screened, the positive predictive value was found to be 89%. It is concluded that prevalence of symptomatic bacteriuria is common among pregnant women. Syndromic management of cases on the basis of score card is helpful in resource constraint areas. This may be combined with microscopic examination of urine to entail rational use of antibiotics.     

农村高血压用药依从性及其影响因素的研究

目的：分析农村高血压用药现状及依从性的影响因素。方法：2001年5月对河北省某农村208名确诊的高血压患者进行用药情况及其相关因素的问卷调查和血压测量，用多元Logistic回归进行用药依从性影响因素的分析。结果：高血压患者用药依从率为36．1％，影响其用药依从性的因素有高血压病程的长短，患者对高血压知识了解的多少（P＜0．05）。结论：对患者进行健康教育，提高其高血压知识水平，则可提高用药依从性。     

Upper aero-digestive tract cancer--descriptive analysis of eight years study in north east India

Medical reports of eight years study of upper aero-digestive tract cancer were retrospectively evaluated. The patients were classified according to their age, sex, primary tumour localisation and tumoural stage. There were 53.06% males and 46.94% females, with male to female ratio of 1.13:1. The peak incidence for all primary tumour localisations were observed in the sixth decade of life. Most common primary tumour localisation site was in the oesophagus (30.41%) followed by oropharyngeal cancer (25.91%) and laryngopharyngeal cancer (19.21%). Of all the patients, only 13.79% cases presented at the early stage of the disease and the rest 86.21% presented in the late stage of the disease. The proportion of patients presenting with metastatic nodes was 85.31%.     

Indoor air pollution in a Kenyan village

In April 1986, a study was carried out within rural households in Maragua area, Muranga District, Republic of Kenya, to assess the degree of indoor air pollution and to find its relationship, if any, to acute respiratory infections (ARI) among children aged below 5 years within the study. This study was carried out within an ongoing aetiological and epidemiological community study on ARI as a collaborative effort between the Department of Paediatrics, University of Nairobi; the Department of Chemistry, Kenyatta University; the Department of Environmental Sciences, Agricultural University, Wagenigen, The Netherlands; the World Health Organization; and the Ministry of Health, Republic of Kenya. Repeated 24 hour measurements of respirable suspended particles (RSP) and nitrogen dioxide (NO2), were carried out in 36 randomly selected houses where most of the cooking was done on open fires using firewood and crop residues as fuel. Data on house characteristics and activity in the study were gathered by questionnaire. The mean of 24 hour average RSP concentration (1400mg/m3), average during the 7 hours of daily burning (3000-4000mg/m3), and evening peak levels (up to 3600mg/m3) indicate that deleterious health effects due to exposure to excessive levels of toxic pollutants in smoke from biomass combustion are likely to occur especially among pre-school children and women. Concentrations of selected polycyclic hydrocarbons in the particulate material were found to be high. It was not possible to demonstrate a relationship between the indoor air pollution and episodes of ARI partly because of small sample size and also the more or less homogeneous nature of pollution among all the households.     

江苏省吴县农村医疗服务门诊利用调查

本文调查了吴县农村医疗服务门诊利用情况,发现吴县农村医疗服务门诊利用率高于全国水平(17.33％);合作医疗组的门诊利用(19.40％)优于自费医疗组(15.81％);其门诊医疗服务主要由村、乡两级承担(2/3),女性在更年期就诊率高于男性,这与女性更年期生理特征有关。