ABSTRACT
Introduction: Challenges faced by the primary caregivers during the COVID‑19 pandemic help to identify their needs and health seeking behavior during pandemic. Objectives: (1) To describe the factors associated with periodic follow‑up at the hospital which posed as difficulties to their primary caregivers during the COVID‑19 pandemic. (2) To identify the measures adopted by these primary caregivers to overcome those difficulties. MaterialsandMethods: This hospital‑based cross‑sectional observational study was conducted from May to August 2021 among 57 primary caregivers of children with chronic diseases registered before March 1, 2020, who were under periodic follow‑up in our pediatrics department. Data were collected by direct or telephonic interview using a predesigned semi‑structured questionnaire and analyzed using descriptive and inferential statistics like mean, standard deviation, proportions and paired “t”‑test using Epi info and IBM SPSS trial version 28.0. Results: Frequency of hospital visits of 14 (24.6%) subjects were reduced during the COVID pandemic compared to the prepandemic period. During the COVID pandemic, 42 (73.7%) subjects had faced transportation difficulties, 23 (40.3%) had faced financial difficulties, 22 (38.6%) had skipped their scheduled follow‑up visits and around 31.6% of them have feared of contracting COVID. None had availed telemedicine consultation for their children either before or during the pandemic. Conclusions: Difficulties faced in transportation, fear of contracting COVID, financial difficulties, and lack of awareness of teleconsultation services were identified as their major obstacles.
ABSTRACT
Background: Scrub typhus is one among the re-emerging infectious diseases throughout the world. Various studies conducted across India reveals that its public health importance is increasing. This study was conducted 1) To describe the socio-demographic and epidemiological profile of patients admitted with scrub typhus. 2) To assess the health care seeking behaviour of these patients. 3) To estimate the cost factors incurred in the current episode of illness. Methods: This prospective study was conducted from January to December 2013 among all lab confirmed cases of scrub typhus admitted to department of medicine and pediatrics of JSS Hospital, Mysore. The study subjects were interviewed with a pre-tested and structured questionnaire. Data regarding socio-demographic profile, epidemiological profile, disease outcome, health care seeking behaviour and cost factors incurred with current episode of illness were collected. Data entry and analysis were done with SPSS.v.22.0 using descriptive statistics like mean, standard deviations and inferential statistics like chi-square test. Results: Among 192 patients tested positive by Weil-Felix test and/or Immuno-Chromatographic Test (ICT) for scrub typhus majority 105 (54.7%) were males and were predominantly 135 (70.3 %) from rural areas. Mostly 172(89.6%) were unaware of any mite bite in the past. Majority 167 (87.0%) of them had visited atleast three Health Care Facilities (HCF) for treatment. The mean ± SD total duration of illness was 15.6 ± 4.1 days. Most 104 (54.2 %) of them had suffered from illness for 11-15 days. Majority 175 (91.1%) of them had recovered while 3 (1.6%) of them had succumbed to the condition. The median Total direct cost, total indirect cost and overall total cost were Rs. 7500 (7000-9500), Rs. 3000 (2500-3500) and Rs. 10500 (10000-13000) respectively. Most 104 (54.2%) of them spent from money borrowed from others, followed by 78 (40.6%) spent Out Of Pocket (OOP). Conclusion: People from rural areas, unskilled workers and children were affected predominantly. With timely diagnosis and appropriate treatment, significant morbidity and mortality could be prevented. Promotion of various public and private health insurance schemes among public would minimise the OOP expenditure and prevents debts.
ABSTRACT
Background: Lack of proper communication skills among budding doctors is considered to be a major gap existing between teaching and practice of public health in various parts of India. Therefore a competency based teaching curriculum is needed to sharpen these skills necessary for bridging this gap and achieving a successful community based medical education. Methods: This cross-sectional study was conducted among a group of 28 students from a batch of 133 students in their fourth semester of second year undergraduate medical education, who attended their posting in the department of community medicine at JSS medical college (JSS University) in Mysore, for a period of one month during May 2014. A new educational intervention namely student‟s short seminar was included in addition to their routine community medicine teaching curriculum. At the end of the postings a feedback regarding the intervention was collected from the students using a pretested structured questionnaire. Results: Questions related to the intervention were rated by the students in a six point Likert scale. The median total score was 15.0 (12-17). Among 28 students majority 16 (57.1%) of them had graded it as good while 11 (39.3%) had graded it as fair and 1 (3.6%) of them had graded it as poor based on the median total score. Conclusion: Community based medical education can fulfil its purpose when it can advocate not only the cognitive domain (Knowledge) but also the affective domain (Attitudes) and psychomotor domain (Skills) of the learning process. Hence it is the foremost duty of the faculties in the department of community medicine in medical colleges to inculcate interest towards public health by introducing innovative and interactive teaching and learning interventions.