Public Health

  • Relationship between Patients Perception of Recovery, Distance to Health Facility and Tuberculosis Treatment Default in Ebonyi State, Nigeria

    With the current launch of End TB Strategy by World Health Organization, this is a global call to reduce Tuberculosis death by 95percent and tuberculosis incidence by 90 percent by the year 2035. It becomes imperative to investigate some factors that may hinder the achievement of this goal and find solution to these limiting factors. The aim of this study was to determine the influence of distance to Direct Observation Treatment (DOT) centre on one hand and patients’ perception of improved prognostic outcome on tuberculosis treatment default. A random sample of 150 tuberculosis patients on treatment between May – August 2016 attending different health centers in Ebonyi State, Nigeria were interviewed. Data were collected using self-administered questionnaires from consenting TB patients. Chi-square statistical technique at 5 percent level of significance was used to test the null hypothesis of no relationship. Results indicated that 83 of the 150 TB patients defaulted in their treatment regimen, giving a default rate of 55.3 percent. Residential distance to health /DOT center was statistically associated with Tuberculosis (TB) treatment default, default increased with travel distance between patients’ residence and treatment center (X2 = 16.7003; df = 2; p < 0.001). Also, patients’ experience of disappearance of signs and symptoms as evidence of improved prognosis (perception of recovery) of TB illness was statistically associated with TB treatment default (X2 = 12.5468, df = 4, P = 0.014 ). This study emphasized the need for suitable specific measures for reducing treatment non-compliance as well as proper and repeated motivation of patients during treatment e.g. referring patients to nearby DOT centers, improving contact and default tracing, DOTS expansion and consolidation etc.

  • Semblances of “aangdan (organ donation)” with “kanyadan (gift of a maiden)”under hindu marriage

    This article seeks to draw parallels between various rituals and practices of the Indian wedding and the concept of organ donation and transplantation. The purpose of this article is to make it easier for the layman to relate to the concept of organ donation and transplantation. The article attempts to liken “Kanyadan” (giving away of a daughter in marriage) and “Aangdan” (organ donation); makes comparisons between the two using parameters of legal age, importance of love, search for a suitable match, appointment of middle men, financial investments and legal penalties etc. The article equates traditional match making on the basis of religion with the blood group matching in organ donation and transplantation. It further links the guna milap (Matching of fate lines) of the prospective bride and groom with that of Human Leukocyte Antigen (HLA) matching in organ donation and transplantation. It also highlights the significance of ensuring compatibility with internal environment irrespective of best selected matches in both the cases. The engagement ceremony to grant social approval to a marriage is equated with socio-legal approvals by “Authorization Committees” for organ donation and transplantation. Geography or spatial proximity also plays a crucial role in facilitating a marriage as well as organ transplant. The article also concludes that a combination of sadness and jubilation is common in both these events. The post-event management in both the cases is a roller coaster ride – full of apprehensions and anxieties – and needs more investments in terms of money, emotions and care. The two however differ on the infrastructure issue; while it’s easy to perform “Kanyadan” at any place by priests or pundits, availability of infrastructure and manpower is restricted in case of “Aangdan”. The author also draws parallel between some unusual marriages and unusual organ donation and transplantations and warns people against…

  • Considering Urban Aboriginal and Torres Strait Islander Conceptions of Health

    Drawing on the salutogenic, or ‘origins of health’ framework, this article explores the health and well-being conceptions of urban Aboriginal and Torres Strait Islander people and identifies individual and community health-enabling strategies employed to support their health and well-being. This qualitative study included 12 focus groups with 83 predominantly Indigenous Australian participants of Work It Out, a chronic disease self-management and rehabilitation program in South East Queensland. The focus groups explored meanings of health and well-being as well as strategies used to keep healthy and well. The findings indicate that urban Indigenous Australians participants view health as a balance between physical, psychological, socio-emotional and environmental factors and are active engagers in health enhancing behavior. This study provides new insights into the health and well-being conceptions of urban Indigenous Australians at risk of suffering from a chronic disease and reveals a unique view of health and well-being. Understanding how urban Indigenous Australians conceptualize health and well-being will contribute to the evidence base to inform culturally responsive public health programs and policy.

  • Community Based Management of Malaria: exploring the capacity/performance of Community Based Agents and their motivation

    Background: The use of antimalarial drugs and the prevention of man and vector contact remain the major control and prevention strategy of malaria until the availability of effective and safe vaccine. In Africa, one of the major strategies to malaria control and prevention is the home based malaria strategy through which trained community drug distributors identify and provide antimalarial drugs to children under five years with fever. This research aims at exploring the capacity, performance, and motivation of CBAs in Tamale Metropolis, Northern region, Ghana Methodology: A Survey, in-depth interviews and short ethnographic techniques were conducted among 104 CBAs who were trained and given logistical support to assess and treat children less than five years with malaria presumptively at home. Participants were selected randomly and represented urban, peri-urban and rural settings. Results: 96.2% of respondents identified malaria by presence of fever while 92.3% used fever as a cardinal sign. More than 82% of participants provided early treatment in all the three location. 64.4% of participants administered the correct number of days while 32.7% administered daily doses correctly, only 24% of CBAs knew that the Antimalarial medications they use have some side effects. 77.9% knew when to repeat drug dose when child vomit or when parent forget to give the dose. Most of the participant had registers and were reporting monthly, however, only 26.2% are somewhat motivated by some of the existing of the motivational packages. Conclusion: The overall performance and skills demonstrated by the CBAs are encouraging in all the three settings but documentation and reporting remains a challenge. Community based initiatives should be strengthened and promoted to provide homemade solutions in saving lives especially in resources limited settings. If community interventions such as community drug distribution of antimalarial drugs are needed to improving access to malaria prevention, much attention…

  • Study of Knowledge about Hypertension in Young Adult Population of Age Group 20 to 40 Years in an Urban Slum of Mumbai

    Context: Hypertension is a growing health problem throughout the World. There is paucity of data on awareness about hypertension, its causes and related complications in general population. Awareness about hypertension in younger population can prevent its development in later age. Thus to prevent & control the problem of hypertension there is a need for increasing knowledge and awareness about hypertension in younger population. Aim of this study is to assess knowledge about hypertension in younger population using a knowledge questionnaire. Methods: A cross-sectional community based study amongst 450 participants in the age group of 20 to 40 years using systematic sampling technique with a random start. Data was collected using a questionnaire form that was devised relevant to the study. Conclusion: Among 450 participants, 264 i.e. 58.7% participants had poor knowledge about hypertension (score < 7) and 186 i.e 41.3% good knowledge about hypertension (score > 7).