ABSTRACT
Objectives To determine the economic burden of thalassemia on parents of thalassemic children
Study design, settings and duration: Descriptive nonprobability, purposive sampling done in PHRC Research Centres of Multan, Lahore, Islamabad, Karachi, Peshawar and Quetta from July 2013 to June 2014
Patients and Methods: After taking informed written consent, parents/guardians of thalassemia major children were interviewed. All information was recorded on the pre-tested questionnaire. Data was entered and analyzed using SPSS version 11
Results: A total of 600 guardians/ parents of the thalassemic children were included in the study. There were 57% boys and 43% girls with a mean age of 9.40 +/- 5.66 years. Among them, 47.8% were from rural and 52.2 % from urban areas. Almost 71% children were transfusion dependent. The family history of cousin/interfamilial marriage was present in 78.2% while parental consanguinity was present in 72.8%. Only 1.7% parents got premarital screening for thalassemia. In private sector 56.8% had to pay nothing while others had to pay from Rs. 500 to Rs. 2000 per visit. Expenditure per month in private thalassemia centres showed that 57% had to bear no cost at all, 12.2% had to spend up to Rs. 1000, while 24.8% Rs. 1001 to 5000 and 6% had to pay more than Rs. 5000. In the government sector cost per visit in 35.5% was up to Rs. 500 while others had to pay between Rs. 501 to more than Rs. 2000. Monthly cost at government sector almost doubled. Total expenditure [private and government sector] per month was Rs. 9626 for each patient
Conclusion: Total cost [both direct and indirect] for the management of thalassemia was quite high and this cost puts significant economic burden on the affected thalassemic families. This disease puts social, financial and psychological impacts on suffering families, so prevention-based strategies like premarital screening, prenatal diagnosis and genetic counseling should be adopted in Pakistan. A national screening project for thalassemia is the need of the day
ABSTRACT
To determine the existing knowledge, attitude and behavior about reproductive and sexual health in adolescents of Karachi and seek their opinion about reproductive health education. Study type, settings and duration: A cross sectional study was conducted on adolescents [17-19 years] of both gender studying in colleges of Karachi during 2010. Subjects and Methods: Using stratified sampling procedure, a cross sectional study was carried out. After informed consent and ensuring confidentiality an anonymous quantitative questionnaire was completed to ascertain the knowledge of adolescents on reproductive health. A total of 912 adolescents [470 males and 442 females] of 12 public and private sector colleges of Karachi participated in the study. Acquaintance to reproductive health was present in 75% males and 71% females and most participants confirmed discussing reproductive health issues with friends. About 81% males and 91% females affirmed for a need for enhanced reproductive health education and awareness while over 50% of the respondents were of the opinion that the right age for reproductive health education was 16 to 18 years. Confining sexual activity to one partner and avoiding exposure to blood and needles for the prevention of AIDS was known to 38% males and 44% females but the prevention of sexually transmitted infections using condoms, was known to only 1/3 rd of the respondents. Although 70% of the respondents of both genders knew that pregnancy can be avoided but only 20% knew about contraceptives. Most adolescents' knew about the reproductive cycle but were not well aware of how to avoid exposures to sexually transmitted infections and pregnancies. Policy message: Reproductive health education is insufficient in adolescents should be gender specific and socio culturally sensitive