An epidemiological study on quality of life among rural elderly population of nothern India.

Background: Population ageing is a recognized international reality, both in developed and developing countries. The number of elderly in the developing world is increasing due to demographic transition, whereas their condition is deteriorating as a result of fast eroding traditional family system coupled with rapid modernization and urbanization. Current statistics for the elderly gives a prelude to a new set of medical, social and economic problems that could arise if a timely initiative in this direction is not taken. Aims & Objective: To determine the pattern of physical morbidity in rural elderly population and to study health related quality of life and utilization of health services among them. Material and Methods: A community based cross-sectional design was adopted for studying the health problems of elderly and their health related quality of life, using WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire. Simple random sampling technique was used for sample collection. A total of 660 individual ≥ 60 years of age were taken up for the study purpose. Results: An overwhelming majority (68.2%) of elderly enjoyed a good quality of life, while those having a fair/poor quality of life were ≤ 15%. Quality of life was better in males in physical, psychological, social and environmental domains. It was more in subjects who had graduated and currently married, belonged to non-scheduled cast and living in extended families (p<0.001). Majority of the subjects were anaemic (64.5%), suffering from dental problems (62.2%) and joint pains (51.4%). Maximum numbers of subjects (92.7%) were utilizing non-government health care facility due to long distance from their houses (33.3%). Conclusion: There is a need to highlight the medical and psychosocial problems that are being faced by the elderly people in India and strategies for bringing about an improvement in their quality of life.

Iodine Deficiency Disorder in Children Aged 6-12 Years of Ambala, Haryana.

We conducted this study to assess the prevalence of goitre among 2700 children (6-12 yr) of district Ambala in Haryana. Children were examined as per standards laid by National iodine deficiency disorder control programme (NIDDCP). Multi stage cluster sampling method was used. Urine and salt samples were also studied for iodine concentration. The overall prevalence of goitre in the studied subjects was 12.6%. The median urinary iodine excretion in the study sample was more than 100μg/L Iodine content was found to be adequate in 88% of salt samples. We conclude that there was a high prevalence of goitre in young children despite iodine repletion. This calls for identification of factors to strengthen NIDDCP and the need to emphasize use of iodized salt in Haryana.

Women and AIDS Awareness and Attitudes in a peri-urban setting in Punjab.

Women account for 39.3% of HIV/AIDS infection in India. There are many biological and socio-cultural factors which make her highly vulnerable to HIV infection. Knowledge regarding HIV/AIDS can help her in protecting herself from the disease. This study was conducted to the level of awareness of young females with respect to knowledge of the HIV/AIDS, its modes of transmission, methods to prevent it, availability of testing and treatment and attitudes in relation to HIV/AIDS. A cross sectional study was done in a peri-urban setting in Patiala, Punjab among 1044 females in the age group 15-24 yrs using a self designed semistructured questionnaire. 93.9%had heard about AIDS. Television was the most common source of information (79.7%). Knowledge about the different modes of transmission was high (68-78%), but knowledge about preventive methods especially condom use was low (34-54%). Increase in educational status was seen to significantly increase the knowledge of the modes of transmission and preventive methods (p<.001). Knowledge of symptoms of HIV was low. (2-15%). Only 28.5% knew about the availability of HIV testing facility. 33.8% knew about treatment available for HIV. The study subjects were having favorable attitude towards people living with HIV/AIDS. There is a need to focus the education programs and the mass media towards preventive methods rather than just the knowledge of the modes of transmission. Greater emphasis needs to be placed on making people aware about the existence of HIV testing facility and availability of treatment.

Awareness of hypertension among a north Indian population.

Developing countries are going through a demographic transition. Non-communicable diseases like hypertension are emerging in epidemic proportions. Education and awareness among people is the key to reduce the burden of the disease. To see the levels of awareness and characteristic of aware and unaware hypertensives, 7630 employees in Shimla town were screened for hypertension. Hypertension was detected in 2535 cases of which 559 (22.05%) were aware. The aware hypertensives were predominantly symptomatic and had higher age and blood pressure than the unaware hypertensives. The aware hypertensives were predominantly overweight. This low level of awareness highlights the need for a comprehensive hypertension education programme to be taken up at the national level.

Prevalence of NIDDM in the general population (> 40 years) in Shimla.

A random survey for determining the prevalence of NIDDM was conducted in the population aged 40 years and above of Shimla town. 1195 subjects were screened for estimation of NIDDM prevalence from seven randomly selected wards. The prevalence of NIDDM in age group 40 years and above was 4.86% (5.17% in males and 4.38% in females). NIDDM was found to be positively associated with increasing age, BMI, WHR, family history of diabetes and negatively with physical activity. Stress should be on early detection of diabetes to reduce the heavy burden of morbidity and mortality caused by diabetes.

Immunization coverage among urban and rural children in the Shimla hills.

A cross sectional study was carried out to assess immunisation coverage among 257 urban and 339 rural children aged 13-36 months who were vaccinated at pulse polio booths in Shimla hills. 84.37% urban children and 57.59% rural children were fully vaccinated. BCG scar was negative in a large number of children, especially from rural areas. Increasing maternal education was associated with complete immunisation. OPV I-III dropouts were 3% among urban children and 15% among rural. The corresponding dropout rates for DPT I-III were 1% and 8% respectively. The immunisation coverage in this region was higher than others. Sustained efforts are required to achieve full immunisation coverage and eradicate polio and measles.

Age during breast feeding and timely suckling.

A cross sectional study of 398 mothers and infants was conducted to assess the age at first breast feeding, and its determinants, in Shimla. We found that the timely first suckling rate was 0.10 in urban group and 0.11 in rural group. The median age at initiation of breast feeding was five hours among urban cases and four hours among rural cases. Most of the infants were breast fed by the age of 24 hours which is a positive sign and is higher than previous studies. Absence of definite trend vs mother's education may be due to other factors. A community-based educational programme to promote early breast feeding is required, along with training on lactation management counselling for health workers. This will help in achieving healthy child development through prevention of childhood malnutrition.

An epidemiological study of obesity in Shimla Town.

A cross sectional study of 888 randomly selected subjects in Shimla town was done to determine prevalence of obesity, its relation to age and physical activity. The prevalence of obesity was 21.5% using cut off levels of BMI 25. The prevalence of obesity rose significantly with age. Obesity was less in those having moderate physical activity as compared to those with low and high activity. Primary prevention is required to tackle this disease risk factor through health education focussing on promotion of moderate regular physical activity.

Congenital heart disease among school children in Shimla hills.

A stratified random sample of 15,080 school going children out of 40,950 children in the age group of 5 to 16 years were screened for the prevalence of congenital heart disease and rheumatic fever/rheumatic heart disease. Thirty children were found to be suffering from definite congenital heart disease giving a prevalence of 2.25 per thousand. Atrial septal defect was the commonest lesion (38.2%) with a prevalence of 0.87 per thousand followed by ventricular septal defect (32.2%) with a prevalence of 0.73 per thousand. The prevalence of congenital heart disease was found to be significantly more in female (3.3 per thousand) than in male children (1.4 per thousand) (p < 0.05). Three (8.8%) cases had a family history of congenital heart disease. Rheumatic fever/rheumatic heart disease was found to have a significant prevalence among cases with congenital heart disease (8.8%) as compared to children without congenital heart disease (0.3%) (p < 0.001). The findings suggest the need for screening of family members of those suffering from congenital heart disease and that special attention be paid to the occurrence of rheumatic fever/rheumatic heart disease in cases of congenital heart disease.

Problems and prospects of a traditional source of potable water in hilly terrains.

During epidemic investigation, water sources were tested for quality for drinking purpose. Out of 30 khatris tested, water of 86.7% khatris was fit for human consumption and fecal coliform was not found in any of them. Modification of these khatris was stressed by respondents.