ABSTRACT
Background: Neonatal mortality rate (NMR) is one of the major contributors to infant mortality rate. The neonatal mortality depends on many factors birth weight, gestational age, post-natal care; it also depends on maternal social and environmental conditions which contribute to the social determinants of maternal health. This study was taken up to identify maternal social determinants contributing to outcome among outborn neonates in order to reduce neonatal deaths. The present was conducted to assess the outcome among the outborn neonates and assess the maternal social determinants of health affecting the outcome.Methods: A cross sectional study conducted in sick newborn care units (SNCU), Hassan Institute of Medical Sciences, Hassan among all out born neonates. After taking prior written consent, all mothers/bystanders of outborn neonates were interviewed using predesigned, pretested semi-structured proforma. Social factors, environmental conditions and antenatal care affecting the maternal health were collected. Neonatal outcome data was collected from SNCU register. The mothers/bystanders of outborn neonates not willing to give consent and re-admitted neonates were excluded from the study. Data analysis was done using SPSS V20.0.Results: Of 353 outborn neonates admitted, 16.1% was mortality rate. Number of antenatal care visits, consumption of iron tablets, gestational age, high risk mother, staff attending delivery, birth weight, referral time (at p≤0.5) and distance from hospital, passive smoking exposure, maternal services utilization (at p-value <0.1) were significantly associated with poor outcome among outborn neonates.Conclusions: There is need for establishment of SNCUs at sub-divisional levels.
ABSTRACT
Background: Animal bites cause a big burden in terms of morbidity and mortality throughout the world. These bites could be caused by rabid animals causing rabies. Annually about 59,000 persons die of rabies, of which 20,000 is from India alone. Rabies though 100% fatal is preventable with post-exposure prophylaxis which includes wound wash, anti-rabies vaccination (ARV) and rabies immunoglobulin. The objectives of the present study was to describe the demographic profile of animal bite cases and to assess the management practices of animal bite cases reporting to dedicated anti-rabies clinic (ARC) of a tertiary care hospital, Hassan, Karnataka.Methods: A cross-sectional study was conducted from the inception of anti-rabies clinic (12th October 2017) to August 2018 among animal bite cases reported to ARC. They were interviewed by using a semi-structured, pre-designed and pre-tested proforma. Data regarding socio-demographic profile were collected from the animal bite victims. All the animal bite cases were managed as per WHO guidelines.Results: The total number of animal bite victims reported to ARC during the study period was 3500. Majority of the bite victims belonged to adult population (20-60 years). Majority were males (66.2%). 77% belonged to the rural population. Dogs (97.1%) were the most common biting animal. 79% of the bites were provoked. Turmeric powder was the most commonly used irritant. Most bites belonged to Category III (84%). Category I, II, III bites were managed appropriately according to WHO guidelines.Conclusions: Knowing the burden, socio-demographic characteristics and the management of animal bite victims in the dedicated ARC of HIMS has helped the programme officer in implementing the National Rabies Control Programme in Hassan district.