Profile of Patients Attending an Animal Bite Management Clinic in Rural Pondicherry, India.

Aims: In India, annual incidence of animal bite is estimated as 1.7 per 100 population and that of human rabies as 1.7 per 1,00,000 population. Since rabies is universally fatal it requires prevention through timely management by wound care, Anti-Rabies Vaccine (ARV) and rabies immunoglobulin. Study Design: Retrospective record review. Place and Duration of Study: Animal Bite Management (ABM) clinic of a Primary Health Centre in rural Pondicherry, south India, between January and December, 2011. Methodology: This study is a secondary analysis of data collected at an Animal Bite Management (ABM) clinic in a primary health centre in rural Pondicherry. The study population was mainly rural and agrarian. All victims of animal bite, who sought treatment from the ABM clinic between January and December, 2011 were included. Wound washing and administration of ARV through intramuscular route was provided for all victims. Data on factors like age, gender, place of residence, biting animal was collected. Means and proportions were calculated. Chi square test for categorical and t-test for continuous variables were applied. Results: A total of 767 victims sought treatment from ABM clinic. The mean age was 29 years (1 to 84 years). Mean distance of travel to ABM clinic was 2.1 km. About a third of all cases occurred during summer (March to May). Majority of victims were bitten by dog (85%) followed by cat (9%) and monkey (6%). Only 61.7%, 32.2%, 0.8% and 0% turned up for day 3, day 7, day 14 and day 28 doses of ARV schedule. Of those who came, only 70% came on due day. There was no statistically significant difference in treatment seeking based on gender and distance from ABM clinic. Conclusion: The high dropout rate for Day 3 and subsequent doses of the ARV and the delayed administration of Day 3 and Day 7 are worrying facts because only a full and timely ARV course will provide complete protection against rabies. Aims: In India, annual incidence of animal bite is estimated as 1.7 per 100 population and that of human rabies as 1.7 per 1,00,000 population. Since rabies is universally fatal it requires prevention through timely management by wound care, Anti-Rabies Vaccine (ARV) and rabies immunoglobulin. Study Design: Retrospective record review. Place and Duration of Study: Animal Bite Management (ABM) clinic of a Primary Health Centre in rural Pondicherry, south India, between January and December, 2011. Methodology: This study is a secondary analysis of data collected at an Animal Bite Management (ABM) clinic in a primary health centre in rural Pondicherry. The study population was mainly rural and agrarian. All victims of animal bite, who sought treatment from the ABM clinic between January and December, 2011 were included. Wound washing and administration of ARV through intramuscular route was provided for all victims. Data on factors like age, gender, place of residence, biting animal was collected. Means and proportions were calculated. Chi square test for categorical and t-test for continuous variables were applied. Results: A total of 767 victims sought treatment from ABM clinic. The mean age was 29 years (1 to 84 years). Mean distance of travel to ABM clinic was 2.1 km. About a third of all cases occurred during summer (March to May). Majority of victims were bitten by dog (85%) followed by cat (9%) and monkey (6%). Only 61.7%, 32.2%, 0.8% and 0% turned up for day 3, day 7, day 14 and day 28 doses of ARV schedule. Of those who came, only 70% came on due day. There was no statistically significant difference in treatment seeking based on gender and distance from ABM clinic. Conclusion: The high dropout rate for Day 3 and subsequent doses of the ARV and the delayed administration of Day 3 and Day 7 are worrying facts because only a full and timely ARV course will provide complete protection against rabies.

Causes of death in rural adult population of North India (2002-2007), using verbal autopsy tool.

Background: With the on-going epidemiological transition, information on the pattern of mortality is important for health planning. Verbal autopsy (VA) is an established tool to ascertain the cause of death in areas where routine registration systems are incomplete or inaccurate. We estimated cause-specific mortality rates in rural adult population of 28 villages of Ballabgarh in North India using VA. Materials and Methods: During 2002-2007, trained multi-purpose health workers conducted 2294 VA interviews and underlying cause of death was coded by physicians. Proportional mortality (%) was calculated by dividing the number of deaths attributed to a specific cause by the total number of deaths for which a VA was carried out. Findings: 61% of deaths occurred among males and 59% occurred among those aged ≥60 years. The leading causes of death were diseases of the respiratory system (18.7%) and the circulatory system (18.1%). Infectious causes and injuries and other external causes, each accounted for around 15% of total deaths followed by neoplasms (6.8%) and diseases of the digestive system (4%). Among those 45 years of age, more than half of deaths were attributed to non-communicable diseases (NCDs) alone. Accidents and injuries were responsible for one-fourth of deaths in 15-30 years age group. Conclusion: NCDs and injuries are emerging as major causes of death in this region thereby posing newer challenges to public health system.

Prevalence of knee osteoarthritis amongst perimenopausal women in urban resettlement colony in South Delhi.

A community-based cross-sectional study was carried out in an urban resettlement colony in South Delhi to study the prevalence of knee osteoarthritis in women aged ≥40 years and treatment seeking behavior of women suffering from osteoarthritis. Osteoarthritis was diagnosed by using clinical criteria given by American College of Rheumatology for diagnosis of Idiopathic Osteoarthritis of knee joints. A total 260 women were interviewed out of which 123 (47.3%) women were found to be suffering from knee osteoarthritis. Prevalence of osteoarthritis found to be increased with age. Less than half of those with osteoarthritis underwent treatment. With this high prevalence of osteoarthritis, there is need to spread awareness about the disease, its prevention, and rehabilitation in the community

A review of tracking progress towards elimination of Iodine deficiency disorders in Tamil Nadu, India.

Background : Iodine deficiency disorders (IDD) are significant health problem in India. But there is dearth of regional/state level information for the same. Objective: This study was designed to study the current status of IDD in Tamil Nadu. Materials and Methods: A cross-sectional community-based survey was conducted in the state of Tamil Nadu. The study population was children in the age group of 6-12 years and the probability proportional to size 30 cluster methodology was used for sample selection. The parameters studied were prevalence of goiter, urinary iodine excretion, and iodine content in salt at the household level. Results: A total of 1230 children aged between 6 and 12 years were studied. The total goiter rate was 13.5% (95% CI: 11.1-14.9). The median urinary iodine excretion was found to be 89.5 μg/L (range, 10.2-378 μg/L). The 56% of the urinary iodine excretion values were <100 μg/L. The proportion of households consuming adequately iodized salt (iodine content ≥ 15 parts per million) was 18.2% (95% CI: 16.1-20.5). Conclusion: The total goiter rate of 13.5% and median urinary iodine excretion of 89.5 μg/L is indicative of iodine deficiency in Tamil Nadu.