Myths and unhealthy wound practices regarding animal bite among subjects attending anti rabies clinic in a South Delhi municipal corporation polyclinic in Mehrauli, Delhi

Background: Rabies is one of the highly fatal diseases, with nearly fifty nine thousand deaths annually globally and almost one third of these are in India. Higher rates of dog bites are common in our country, due to large stray dog population. Despite a preventable disease, unhealthy wound practices are still prevailing in the community due to lot of myths related to the disease. The objectives of the study were to assess the magnitude of unhealthy wound practices and to assess the knowledge regarding health seeking behaviour following animal bite.Methods: The present study was a cross sectional study conducted at SDMC Polyclinic, Mehrauli, Delhi from January to December 2015. A total of 160 cases of animal bite that attended OPD and consented were analysed for knowledge, practices and health seeking behaviour towards animal bite.Results: Out of total 160 respondents almost all were bitten by dogs of which 2/3rd was stray dogs and most common site of bite was lower limb. 55% of the subjects did not wash or clean the wounds after bite. 27% of subjects applied chilli powder or its paste with oil and 2.5% used oil and turmeric paste and 1.9% oil on the wound. Only 41.9% of the subjects believed that vaccination is the treatment of the choice following animal bite.Conclusions: Intensive health education through mass media and mid media can be used to create awareness about the disease transmission and preventive measures like wound management and post-exposure prophylaxis. Also, pet vaccination should be made mandatory for all those who keep pets.

Aural hygiene practices among underprivileged children of Delhi.

Background. Though ear hygiene is important for proper hearing, it is usually neglected. Improper ear care practices may have serious consequences such as loss of hearing. In childhood, loss of hearing may affect learning and development. There is scarcity of information on ear care practices in the community in India. We aimed to ascertain the magnitude of problems related to aural hygiene and assess ear care practices among children of schoolgoing age in a resettlement colony of Delhi. Methods. A cross-sectional community-based survey was done among 1398 children 5–14 years of age. The houses were selected by systematic random sampling and all eligible children in the selected house were interviewed and examined. The data were analysed using SPSS version 12 and chi-square test was used to ascertain significance between two variables. Results. Almost two-thirds (60%; 834) of the children gave a history of themselves or an elder cleaning the ear using unhealthy methods. Earbuds were used by 21.7% (304) of children. Match and broomsticks were used for cleaning by 18.3% (256) and 3% (43) of children, respectively. One hundred and fifty-nine children (11.3%) were applying oil to clean the ear canal. Ear cleaning with unhealthy means was significantly higher (56% v. 44%, p<0.03) among children belonging to low socioeconomic strata. There was a significant association between unhealthy ear cleaning practices and middle ear infection (p<0.001). Conclusion. A majority of children practised unhealthy/ not recommended methods for cleaning their ear. There is a need to raise awareness about healthy ear cleaning practices in the community. Natl Med J India 2015;28:280–1

Economic burden of tuberculosis in patients attending DOT centres in Delhi.

Tuberculosis inflicts a negative impact on global socioeconomic prosperity. Though India carries one third of the global burden of the disease, few studies have focussed in the country on this aspect. The present study was therefore, framed to estimate economic loss amongst TB patients. A total of 156 patients attending two DOT centres were interviewed in depth, regarding economic loss due to tuberculosis, using a semi structured pretested interview schedule during a period of 5 months. More than 75% of the subjects belonged to the age group of 15-44 years of which 71.6% were males. 34.6% of patients were housewives and 10.9% were students. Mean expenditure before registration in DOT centre was Rs. 3385.5 irrespective of all socioeconomic classes. The upper lower socio-economic class of patients incurred maximum mean expenditure of Rs. 9782.0. Mean duration of wage loss was found to be 47.1 days. Study participants incurred economic loss both in terms of direct and indirect costs, more so in lower socio-economic group, besides delay in attending DOT centres for treatment. Awareness campaign focussing on treatment availability and DOT centre could help in reducing such economic loss.

Out-of-pocket expenditure on healthcare in a north Indian village.

BACKGROUND: Information on healthcare expenditure at the family or household level is important for the planning and management of health services. It is particularly relevant for health insurance agencies to estimate the amount of premium for initiating a universal health insurance system. METHODS: Of 800 families in a village, 160 were selected by systematic random sampling. Of these, 156 families were followed up for a period of 12 months (September 1998 to August 1999) by making monthly visits. Responses from each family, as given by the head of the family, were recorded with the help of an interview schedule administered in the local language. The interview schedule covered any morbidity among the family members in the past one month and the out-of-pocket expenditure incurred on the same. RESULTS: The private health sector was utilized in 59.4% of total episodes. Utilization of the private sector was directly associated with a higher socioeconomic status (p = 0.002). Of the total expenditure on non-hospitalized cases, 83.6% was incurred in the private sector. The mean per capita annual out-of-pocket expenditure on health was Rs 131. The median expenditure per episode was Rs 15. CONCLUSION: Our study shows that out-of-pocket expenditure is more than the government expenditure on health. There is a need for systems such as health insurance to protect the poor from high medical costs.