Knowledge and attitude towards Tuberculosis amongsandstone quarry workers in desert parts of Rajasthan.

Aim: The present study was conducted to test the knowledge and attitude of sand-stone quarry workers of Jodhpur on tuberculosis. Material and Methods: Nineteen sand-stone quarry sites were selected randomly in Jodhpur district from which 376 quarry workers were interviewed who consented to participate in the study. Results: Their literacy rate was 28.5%. More than half (50.5%) had heard about tuberculosis from neighbours followed by friends (42.6%) and family members (37.2%). Only 1.6% knew that tuberculosis was caused by germs and 45.2% respondents had misconception that TB was a hereditary disease. Literates were more aware than illiterates about symptoms of tuberculosis. Only 6.9% knew about the need of treatment for 6-8 months and 0.8% knew about the use of BCG vaccine for prevention of tuberculosis. Tendency to discriminate TB patients was evident as 72.6% respondents opined to isolate TB patients from the family and 80.6% opined to avoid sharing food with these patients. Conclusion: Extensive health education directed towards bringing a change in attitude among sandstone quarry workers is needed to create awareness and remove myths about tuberculosis in such groups of people in the community.

A study of an epidemic of acute respiratory disease in Jaipur town.

AIM: To detect an association between the sudden epidemic with respiratory symptoms, and fogging with dichlorovos in Jaipur town and to find out probable mechanism of causation of the epidemic. SUBJECTS AND METHODS: In this community based study of the epidemic, house to house survey of households selected using systematic random sampling was carried out. The incidence in the exposed and unexposed population, the relative risk and attributable risk were calculated. RESULTS: The incidence of cases was high (58.9%) in subjects present on roads at the time of fogging as compared to in those who were inside rooms of the houses (5.4%) and in those who were not in the locality at that time (1.8%) [Relative Risk (RR)=32.7 and Attributable Risk (AR)=96.9%]. CONCLUSION: High RR and AR in the present epidemic indicate strong association between fogging and occurrence of symptoms. In absence of signs and symptoms of organophosphorus poisoning it suggests that this could have been due to an inappropriate solvent or defective functioning of fog generator, leading to generation of an unusual dark fog, that might have irritated eyes and respiratory tract of exposed residents.

Drug resistance in tuberculosis patients in Jodhpur district.

Drug resistant tuberculosis is a serious problem in control of tuberculosis. To assess this problem in Jodhpur district, Sputum samples of symptomatic quarry workers and cases of pulmonary tuberculosis attending District Tuberculosis Clinic (DTC) Jodhpur were tested for culture of Mycobacterium tuberculosis complex (MTB) and their sensitivity to antituberculous drugs, using proportion method. Primary drug resistance to isoniazid was observed in 16.67%, to streptomycin in 16.67%, to ethambutol in 6.67% and to rifampicin in 6.67%. Acquired resistance to isoniazid was 61.76%, to streptomycin was 51.52%, to rifampicin was also 70.59%, and to ethambutol was 39.39%. Proportion of Multi-drug resistant (MDR) TB defined as resistant to at least isoniazid and and rifampicin, was 3.3% in new cases (primary drug resistance) and 38.2% in old cases (acquired drug resistance), the later may be due to inadequate treatment, the the history of which was present in most cases. Adequate treatment of such cases with effective regimens is of vital importance to prevent the spread of MDR TB.

A study of forced vital capacity and its predictors among the sand stone quarry workers.

The study assesses the relationship of selected demographic, anthropometric, radiological, work-history and smoking-history related variables with Forced Vital Capacity (FVC) in a sample of 168 sand stone quarry workers in a desert environment. Except the variables related to smoking behaviour, all are found significantly associated with FVC. The predictors of FVC screened through the multiple regression analysis were age, weight, height, profusion of opacities in chest X-ray and duration of work. Mean FVC was found significantly lower as compared to the healthy adult population. On an average FVC% was 90% of predicted (Percentage deviation of 10%). A clear increasing trend in FVC% along age/duration of work was observed among the young workers, which may be due to building of muscles in this job. Percentage deviation of 20% or more in FVC was significantly associated with presence of radiological opacities suggestive of silicosis (odds Ratio = 3.3). The diagnostic utility of the same is also assessed.

Correlates of peak expiratory flow rate: a study of sand stone quarry workers in desert.

The study assesses the relationship between selected demographic, anthropometeric, radiological, work-history and smoking-history related variables with Peak Expiratory Flow Rate (PEFR) in a sample of 286 sand stone quarry workers from a desert region. Age, height, profusion of radiological opacities, age at beginning of work, duration of work and duration of smoking were found significantly associated with PEFR while duration of exposure to dust, nature of job and number of biries smoked per day failed to establish their significant association. Mean PEFR of these workers was found significantly lower than the same among healthy adults from the study area. The subset of predictors of PEFR only included age, height and profusion of radiological opacities as identified by multiple regression analysis.

Increased risk of tuberculosis in opium addicts.

In rural areas of desert of western Rajasthan crude opium is consumed with a social sanction by a notable proportion (7.1%) of adult males. It is believed that prevalence of opium addiction is high in TB cases as they may use it to suppress cough. Prevalence of opium addiction among TB cases from rural desert (16.1%) was compared with that in general population (7.1%) and the difference was found significant (X2 = 11.6, p > 0.001). The difference became a little more prominent after age adjustment. A case control analysis of matched pairs showed significant association between opium addiction and pulmonary tuberculosis (Odd's ratio = 2.61 and attributable risk = 0.099). Results were consistent in different age and ethnic groups. In cases with opium addiction, the addiction always preceded the pulmonary tuberculosis.

Entomological studies in a dengue endemic area, Jalore, Rajasthan.

Entomological studies on prevalence of adult and immatures of Aedes aegypti along with associated ecological factors have been conducted in a dengue endemic area of Jalore, Rajasthan from 1992 to 1993. Studies in two areas; reportedly affected and unaffected revealed more adults and higher breeding indices in the affected area as compared to the unaffected one. Mosquitoes harbouring dengue antigen were found only in the affected locality. Presence of dengue antigen in field caught mosquitoes in the affected locality was observed mainly during the months of January to April in both the years. Statistical analysis of data has shown a correlation to be significant between adult house index and breeding index in the affected area while this association was found insignificant in the unaffected locality. Water storage practices of the population due to irregular water supply in the affected area is the possible cause for a higher vector concentration in the locality. Seasonality of occurrence of dengue fever patients in a particular period of the year is associated with a relatively higher vector density and the presence of infected mosquitoes which is due to favourable temperature, relative humidity, water temperature and pH.

Nutritional status of school age children of salt-workers in Rajasthan.

Nutritional status of 1044 school age children (6-18 yr) of salt workers in various salt manufacturing sites of Rajasthan, was assessed using anthropometry. Heights and weights of girls were observed to be better than in boys in the menarcheal age groups. Children of the present study showed reduced growth in comparison to National Centre for Health Statistics (NCHS), World Health Organisation (WHO), well-to-do Indian children and Rajasthan reference values of the same age groups. The prevalence of stunted with severe wasting was 4.5 per cent in the children of salt workers. Higher prevalence of severe wasting was observed in girls than the boys (P < 0.01).

Morbidity profile of desert population engaged in salt production in Rajasthan.

A total 2120 salt workers were examined in 8 camps organised at different salt sites in Rajasthan. These camps were organised to find out the morbidity conditions among salt workers and to provide preventive and curative treatment for the ailments. The majority of salt workers who attended the camps were males (79.0%) in comparison to females (21.0%). The majority of workers belonged to Scheduled Castes followed by Backward Class and Scheduled Tribes at all sites. The major morbidity disorders observed during these camps were dermatological, respiratory, musculoskeletal, gastro-intestinal and ophthalmological in both the sexes. The prevalence of hypertension was 4.3% among both sexes. The morbidity pattern in male workers was agreeing among Sujangarh and Kuchaman and after that Pokran and Didwana were agreeing with highest rank correlation, whereas in female workers it was agreeing among Nawa and Sujangarh and after that Phalodi and Pokran were agreeing with highest correlation.