ABSTRACT
Introduction?Chronic obstructive pulmonary disease (COPD) and bronchial asthma are the most common chronic respiratory illnesses. COPD is one of the three most common causes of death worldwide. The main burden of mortality from COPD is seen in Latin America, sub-Saharan Africa, India, China, and South-East Asia. Absence of true prevalence values and mortality burden hinder planning and operationalization of public health interventions for prevention, control, and treatment of the disease. Further, the aggregated value of prevalence estimates calculated for a whole city or a larger geographical area does not provide the location of patients and presence of locally prevalent risk factors. The objective of this study was to understand the spatial distribution of COPD in a large, highly polluted city of a developing country. Materials and Methods?A cross-sectional community-based study was conducted in the National Capital Territory of Delhi (NCTD). All surveyed households were geocoded. GOLD screening criteria and pulmonary function tests using portable digital spirometer were used for diagnosis of COPD. Results?Results are presented as a series of maps depicting spatial epidemiology. Overall prevalence rate was 9.8/1,000 population. Highest prevalence was seen in industrial area. Most of the spatial hotspots were seen in industrial and slum areas. Similarly, Kernel density was also highest in industrial area. Conclusion?In the city of NCTD, we found the COPD being distributed in all types of habitations but spatial distribution helped us understand clustering of cases and compare prevalence rates in subunits of residential clusters within a metropolitan city.
ABSTRACT
Background: The under-5 mortality rate in India has shown a decline in the last few decades. However, there is still a lot of work to be done for our country to achieve sustainable developmental goals. One of the factors contributing to child survival is immunization coverage, but high coverage does not mean timely vaccination. ‘On time’ immunization is an important yet little researched factor shielding a child from susceptibility to vaccine preventable diseases. This study aims at assessing the extent of timely immunization and predictors of intentional delay in vaccination of children.Methods: A cross-sectional study was conducted in East Delhi among caregivers having a child in the age group of 13-24 months. Sample size was calculated at 95% confidence limit and 3.5% absolute precision. The final sample size obtained was 350.Results: The percentage of fully and timely vaccinated children is 67.1%, whereas children fully vaccinated but with a delay of 4 weeks from the recommended age of administration is 19.7%. Partial vaccination was found in 11.2% of children and 2% of children were found to be not vaccinated. The most common reason for delay in immunization was pain at the time of administration leading baby cries and fear of needles (26.1%), followed by bad experience with previous vaccination (11.6%). Fear of side effects (14.5%) and being denied vaccination without card (11.6%) were other reasons.Conclusions: The immunization program should include timely completion of vaccination as a quality indicator. Delayed immunization can lead to epidemics in the community and threaten the goal of elimination of vaccine preventable diseases. Improving timeliness can be successfully achieved if the reasons for delay are taken into account.