Suma Nair

Acceptability and effectiveness of a breast health awareness programme for rural women in India.

BACKGROUND Breast cancer being one of the leading cancers among women in developing countries, prevention or identification of the disease at an early stage is of paramount importance in saving as well as improving the quality of life. Breast health awareness appears to be a pragmatic method for this. OBJECTIVE To determine the acceptability and effectiveness of an educational intervention programme on breast health awareness for rural women by trained female health workers. SETTINGS AND DESIGN Community based non-randomised educational intervention study carried out over a period of 1 year. Three hundred and sixty rural women in the age group 30--59 years were randomly selected (and age-wise stratified), from a coastal village in Southern India. METHODS Women were educated on breast health and breast self-examination by specifically trained health workers and their awareness and proficiency levels were evaluated at the end of 1 and 3 months post-intervention. STATISTICAL ANALYSIS This was done using the Statistical Package for Social Sciences Version 10. RESULTS Following the educational intervention, a significant increase in overall awareness regarding breast cancer (z=-15.807; P< 0.001) as well as in the performance of self-examination of the breast 321/342 (93%) was observed. Forgetfulness or being too busy appeared to be the two most frequently perceived barriers. CONCLUSION This study clearly shows that a community oriented educational intervention programme emphasizing on proper technique can bring about the desirable behavioural change among women.

Risk factors for under-nutrition among children aged one to five years in Udupi taluk of Karnataka, India: A case control study

BACKGROUND Despite her apparent economic success, India is plagued by a high burden of under-nutrition among children under five. This study was aimed at understanding some of the risk factors for under-nutrition in a region with favourable maternal and child health indicators. METHOD A case control study was carried out among children aged one to five years attending the paediatric outpatient department in six rural health care centres in Udupi taluk of Karnataka in Southern India. A total of 162 children were included in the study, of which 56 were cases. A semi-structured questionnaire was used to interview the caregivers of the children and the nutritional status was graded according to the Indian Academy of Paediatrics (IAP) grading of protein-energy malnutrition. RESULTS Under-nutrition was associated with illness in the last one month [OR- 4.78 (CI: 1.83 -12.45)], feeding diluted milk [OR-14.26 (CI: 4.65 - 43.68)] and having more than two children with a birth interval ≤2 years [OR- 4.93 (CI: 1.78 - 13.61)]. Lack of exclusive breast feeding, level of education of the caregiver and environmental factors like source of water did not have an association. CONCLUSION Childhood illness, short birth interval and consumption of diluted milk were some of the significant contributory factors noted among this population. Information, Education, Communication (IEC) campaigns alleviating food fads and promoting birth spacing is needed.

Awareness of chronic disease related health benefits of physical activity among residents of a rural South Indian region: a cross-sectional study.

BackgroundPhysical activity trends for a lower-middle income country like India suggest a gradual decline in work related physical activity and no concomitant increase in leisure time physical activity. Perceived health benefits of physical activity and intention to increase physical activity have been established as independent correlates of physical activity status. In India, not much is known about peoples’ perceptions of health benefits of physical activity and their intention to increase physical activity levels. This study was performed to understand peoples’ perceptions and awareness about health benefits of physical activity in a rural South Indian region.MethodsThis cross-sectional study was conducted using a multistage cluster sampling design. A content validated, field tested questionnaire was administered in person by a trained interviewer in the participants’ native language. The questionnaire assessed the participants’ perceptions about their lifestyle (active or sedentary), health benefits of physical activity and need for increasing their physical activity. In addition, the participant’s physical activity was assessed using version 2 of global physical activity questionnaire. Frequencies and percentages were used to summarise perceived health benefits of physical activity and other categorical variables. Age and body mass index were summarised using mean ± SD, whereas physical activity (MET.min.wk −1) was summarised using median and interquartile range.ResultsFour hundred fifty members from 125 randomly selected households were included in the study, of which 409 members participated. 89% (364) of participants felt they lead an active lifestyle and 83.1% (340) of participants did not feel a need to increase their physical activity level. 86.1%, (352) of the participants were physically active. Though 92.4% (378) of participants felt there were health benefits of physical activity, majority of them (75.1%) did not report any benefit related to chronic diseases. None mentioned health benefits related to heart disease or stroke.ConclusionThere is low awareness of chronic disease related benefits of physical activity and participants do not see a need to increase their physical activity level. Public health awareness programs on importance and health benefits of physical activity would be useful to counter the anticipated decline in physical activity.

Health Care Workers and Standard Precautions: Perceptions and Determinants of Compliance in the Emergency and Trauma Triage of a Tertiary Care Hospital in South India

Background. Careful adherence to standard precautions can protect both health care workers (HCWs) and patients from infections. The present study identified the perceptions and compliance with the use of standard precautions and assessed the determinants of noncompliance among the HCWs in an emergency and trauma triage centre. Methods. A cross-sectional study using a semistructured questionnaire was carried out to collect the relevant information from the study participants. Results. A total of 162 HCWs were recruited into the study, who reported varying degrees of compliance with standard precautions. While most of them declared the use of hand rub (95%) and gloves (77%), reported use of protective eye gear and outer protective clothing was very low (22 and 28%, resp.). Despite a perceived risk of exposure to blood-borne infections, 8% of the HCWs had not completed the hepatitis B vaccination schedule. About 17% reported at least one needle stick injury in the past year but only 5.6% received medical attention. Conclusion. Inadequate adherence to standard precautions among health care providers warrants new training and monitoring strategies. Establishment of an effective occupational health cell incorporating these elements including periodic surveillance could be the way forward.

Prevalence of oral premalignant lesions and its risk factors among the adult population in Udupi taluk of Coastal Karnataka, India

Objective: Globally oral cancer is one of the ten most common cancers with prevalence being high in Central and South East Asian countries. This survey was conducted to estimate the prevalence of oral pre-malignant lesions (OPML) and to identify their risk factors. Methods: A community based cross-sectional study was carried out among 2033 individuals aged ≥18 years. A questionnaire was administered to collect socio-demographic characteristics, various risk factors for oral cancer and presence of its symptoms. Oral cavity of all the participants was examined in detail by the study investigator as per WHO guidelines for the early diagnosis of oral neoplasia. Result: The prevalence of OPML was found to be 3.73%. Among those with OPML, all were ever tobacco consumers and had poor oral hygiene. A significant association was observed between OPML and younger age group (OR=2.56, 95% CI 1.08-6.02), males (OR=26.76, 95% CI 8.40-85.19) and low socio-economic status (OR = 1.91, 95% CI 1.20-3.02). Tobacco (p<0.001), alcohol (OR= 7.92, 95% CI 4.77-13.14) and areca nut consumption (OR = 5.48, 95% CI 3.42-8.77) were strongly associated with OPML. On multivariate analysis among ever tobacco users, OPML was associated with younger individuals, males and those using smokeless forms of tobacco (p <0.05). The study showed that the participants with OPML were more likely to be never married (OR=1.6, 95% CI 0.92-2.96), to be unskilled workers (OR= 1.45, 95% CI 0.61-3.43), to have suffered from oral trauma (OR =1.30, 95% CI 0.75-2.26), to have consumed hot and spicy food frequently (OR=1.53, 95% CI 0.96-2.24), to have consumed fruits infrequently (OR=1.53, 95% CI 0.90-2.59) and to report family history of any cancer (OR = 1.29, 95% CI 0.58-2.87). However, these associations were statistically insignificant. Conclusion: The study reinforces that use of substances such as tobacco, alcohol and areca nut are the modifiable risk factors for OPML.

Road safety and the community: an awareness survey among the coastal population of Karnataka

Background: Road traffic accidents (RTAs) pose a significant burden on the health care system in India with high out of pocket medical expenditure. Awareness about this public health problem is necessary to combat it and this study was carried out to assess knowledge and practice towards road safety among the adult population in the coastal region of Udupi taluk in Karnataka. Methods: A cross-sectional survey was carried out among 381 adults aged 18 years and above residing in the region for more than one year. A semi-structured questionnaire was used to assess their knowledge and practice towards road safety measures. Results: Most of the participants were in the age bracket of 18-44 years (61.4%), were females (65.1 %) and had up to 10 years of schooling. Overall knowledge was found to be low with only 30% reporting good knowledge. As regards practice, drivers fared better with a good majority (87%) reporting desirable practice. Younger age (OR=0.57, 95% CI, 0.36-0.92), male gender (OR=0.14, 95% CI, 0.08-0.23), higher level of schooling (OR=0.32, 95% CI, 0.20 -0.50) and knowing to drive (OR=0.04, 95% CI, 0.02-0.07) were found to be significantly associated with a greater level of knowledge regarding road safety measures. Conclusions: The study showed inadequate knowledge and poor road safety practices among good number of participants. This emphasises the need for a customized community based awareness campaign on road safety measures coupled with stringent legislation measures to bring about the desired change.

Knowledge, Attitude and Practice towards Medical Research among Students of a Medical College in Southern India

Background: Health research is a low priority area in the developing world, mostly due to inadequate research budgets, increased competition for research funding and financially better rewarding clinical careers. Medical students therefore have a narrow definition of research and what it entails. Although medical graduates worldwide consider academia and research as unattractive career options, evidence suggests that exposure to research activities during medical school leads to interest in the area and greater scientific output. Objectives: The objectives of this study were to assess the knowledge regarding medical research among the undergraduate medical students and to analyse their attitudes and practices towards research. Methodology: A questionnaire-based cross-sectional study was carried out among the undergraduate medical students of a medical school in southern India. Students present at the time of questionnaire administration during the lecture were recruited to the study. Results: Of the 585 respondents, 87% students felt that research was necessary in medical field and 25% of them expressed familiarity with various study designs. Majority of the students felt that research and clinical practice were related entities and nearly 44% had a positive attitude towards a career in research. While lack of financial returns and/or professional status were identified as the reasons for not pursuing research as a career option, holistic education and updated information were considered as chief motivating factors to undertake research. Internet was counted to be the major source of information regarding medical research. Only 25% of the study population had an exposure to research during their medical course and 9% attempted to publish their research work. One-third of the students were of the opinion that research should be a mandatory component of the medical curriculum; however, only 26% felt they had enough time for the same during the medical course. Conclusion::The study reports a wide gap between knowledge and practices towards research among the medical students. Negative attitude, lack of awareness and indifference to research as a career option are potential roadblocks. Promotion of research culture and research-based learning in the medical curriculum are necessary to address the pressing need for physician-scientists.

Pyronaridine for treating uncomplicated malaria

This is the protocol for a review and there is no abstract. The objectives are as follows:To compare pyronaridine (alone or in combination) with other antimalarial drugs for treating people with uncomplicated P. falciparum malaria.