ABSTRACT
Background & objectives: Non-communicable diseases (NCDs) and cancers of breast, oral cavity and cervix contribute to around 5.87 million (60%) deaths in India. Despite this, there is limited evidence on preparedness of the tribal health system in mitigating these conditions. This mixed-methods study aimed at identifying enablers and challenges using a multistakeholder approach for the screening of NCDs and common cancers in a tribal block of Maharashtra, India. Methods: This study was conducted in a tribal community of Dahanu taluka in Palghar district of Maharashtra. A total of nine focus group discussions (FGDs) among tribal women and accredited social health activists (ASHAs), 13 key informant interviews (KIIs) among auxiliary nurse midwives (ANMs) and community health officers (CHO) and facility surveys of five public health facilities were conducted. The FGDs and KIIs were conducted using guides, recorded digitally, transcribed, analyzed and triangulated to identify emerging themes. Results: The tribal women had limited knowledge about NCDs and common cancers. Paucity of health facilities, out-of-pocket expenditure, misconceptions, belief on traditional healers and inability to prioritize health were identified as major challenges. The ASHAs were recognized as a key connecting link between health system and community while provision of culturally appropriate IEC materials and adequate training were recognized as critical enablers by healthcare providers in implementing screening for NCDs and common cancers. Interpretation & conclusions: The study recommends incorporating socioculturally relevant strategies in the tribal population and strengthening health facilities in terms of infrastructure and training with involvement of ASHAs for successful implementation of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) through health and wellness centres.
ABSTRACT
Background: Extrapulmonary tuberculosis (EPTB) still constitutes an important clinical problem. We aimed to evaluate the site prevalence of extrapulmonary tuberculosis. Methods: We retrospectively evaluated 187 extrapulmonary tuberculosis patients diagnosed between 1st June 2013 and 31st May 2015 in a tertiary care hospital, Kanpur, Kerala, India. Results: Among the extra pulmonary tuberculosis 112 (59.9%) were males. About 170 (90.9%) patients received CAT1 treatment and 17 (9%) patients received CAT2 treatment. Overall, the total number of different types of EPTB cases included Lymph node (n=55, 29.41%), GIT (n=45, 24.04%), Pleura (n=44, 23.53%), Skeletal (n =14, 7.49%), CNS (n=7, 3.74%) EPTB cases other site included mainly genitourinary (6), breast (6), skin (5), pericardium (3), Psoas (4) a vocal cord (1) and eye (1). Conclusions: EPTB still constitutes an important clinical problem. In the current study, we assessed the site of predilection of EPTB patients. In this study, EPTB cases constituted 52.08% of all tuberculosis cases presented to our center in the study period. Lymph node tuberculosis is the most common type.
ABSTRACT
Background: Screening of high risk individuals with weak immunity as in diabetics for active tuberculosis is of great public health importance. The prevalence of diabetes in tuberculosis is high and the data regarding the same is necessary for strengthening TB control activities. Methods: This study was conducted to know the prevalence of diabetes mellitus in tuberculosis patients diagnosed from the hospital. This was a hospital based descriptive study conducted in Department of Respiratory medicine, Academy of Medical Sciences, Northern Kerala in association with DOTS center during a one year period from August 2014 to July 2015. All patients diagnosed as a case of tuberculosis from our institution were included for the study. All patients were screened for diabetes mellitus using Fasting Plasma Glucose value. Additional information regarding age, body mass index (BMI), sputum smear positivity and treatment category of tuberculosis were collected. Results: There was a higher prevalence of diabetes in tuberculosis patients than in general population and the rate was found to be 19.6%. There was a statistically significant association of diabetes with older age, higher BMI and sputum positivity. Conclusions: Routine screening for diabetes needs to be intensified in the community and more importantly in Tuberculosis patients.