ABSTRACT
Background: The prevalence of diabetes mellitus has increased in lower income countries. Poorly managed diabetes leads to serious complications. Diabetic foot ulcer (DFU) is most common complication. Diabetes and its complications cause significant economic loss to patients and their families, health systems, and even national economies. Objectives: The objective of the study is (i) to assess the economic burden for the management of DFU among patients attending tertiary care hospital, in central Karnataka and (ii) to study the association of health expenditure with sociodemographic factors. Materials and Methods: This facility-based cross-sectional study was carried out among 100 patients with diabetic foot attending tertiary care hospital in central Karnataka. Results: 31% of participants reported in the age group of 61–70 years, 84% were males, 68% were from rural areas, 45% were illiterate, and 37% were currently not working. 55% of participants were belonging lower socioeconomic status. The major part of the health expenditure was the indirect expenditure. The mean direct expenditure was 431.40 INR and mean indirect expenditure was 611.98 INR. In direct health expenditure, major cost was for medication (mean 1165.8 INR) followed by investigation (mean 113.16 INR). In indirect health expenditure, major cost was loss of wages of patient and caregiver. No sociodemographic factors except age were associated with economic burden. Conclusions: The major part of the economic burden was the indirect expenditure. No sociodemographic factors except age were significantly associated with health-care expenditure for DFU.
ABSTRACT
Background: HIV continues to be a major public health problem. Single daily oral dose in formulation containing tenofovir and emtricitabine is approved for HIV-negative people who are at high risk of acquiring HIV. Since pre-exposure prophylaxis (PrEP) does not prevent other sexually transmitted infections and is not a contraceptive, it should not replace with other well-established HIV prevention interventions. Objective: The objective of this study was as follows: (i) Awareness toward HIV PrEP among private practitioners and (ii) willingness to recommend HIV PrEP to the people at risk of HIV. Materials and Methods: It is a cross-sectional study. This study was conducted among 100 private practitioners of Davangere city. Results: In the present study, 63% of private practitioners were correctly knowing the drugs used in HIV PrEP. About 3% and 13% of practitioners knew the contraindications and side effects of HIV PrEP, respectively. About 17% of practitioners correctly knew efficacy of HIV PrEP. About 83% of practitioners opine PrEP would not have impact on ART drug resistance. All study participants felt that HIV PrEP should be made available to target group at risk of HIV. The knowledge score was poor among 27% of private practitioners. Knowledge score was good among 23% of practitioners. The attitude score was poor among 13% of practitioners and it was good among 64% of practitioners. All the study participants were willing to recommend PrEP to at least one of the at-risk populations. Private practitioners were most willing to recommend PrEP to men who have sex with men (76%) and serodiscordant couples (60%). Conclusions: In the present study, although over two-third of health-care providers scored average to good in knowledge related to HIV PrEP, they were less aware of eligibility criteria, contraindications, side effects, and efficacy of PrEP. Most of the respondents had favorable attitude about HIV PrEP. Almost all participants were willing to prescribe PrEP to at least one of the risk populations and were more willing prescribe to serodiscordant couples and men who have sex men.