RESUMO
Background: State-specific disability-adjusted life years (DALYs) are seldom calculated. Understanding the health and disease trends in groups of states is useful for finding the heterogeneity of disease epidemiology in the country. Objective: The objective of the study was to assess dengue burden in Kerala state, using DALY. Methods: DALY was computed using the DALY package of R. Incidence was derived using reported and estimated dengue cases for 2006–2016. Mortality was calculated using reported deaths. We computed DALYs using the mortality estimates for the South-East Asia region (SEAR) also. Sensitivity and scenario analyses were done. Results: The highest estimated relative DALY for dengue is 7.22 (95% confidence interval [CI]: 6.66–7.72) per lakh population. The DALY obtained using the mortality rates of SEAR ranged from 19.89 (95% CI: 8.44–29.45) per lakh population to 28.56 (95% CI: 17.04–38.05). We observed a cyclical pattern of increase in DALY every 2–3 years. The DALY in lower age groups is lesser. DALY in females was higher than males. Conclusions: The dengue-related DALY for the state of Kerala is lower than that of the global burden of disease due to lower mortality rates. Mortality reduction becomes the key to reducing burden, especially in areas of low incidence. The study also forms the benchmark for evaluating and implementing cost-effective measures for dengue control in the state.
RESUMO
Background: Compliance to medications and lifestyle modifications is important in the management of hypertension. Aims and Objectives: The purpose of this study was to measure the compliance and its determinants to pharmacological management of hypertension. Material & Methods: A population based cross sectional survey was conducted among 221 known hypertensives in medical college health unit area of urban Trivandrum. Results: Mean age of the study subjects was 64.6 yrs (SD 10.6). The overall compliance with antihypertensives was 62.4%. Male gender, joint/extended family type, family support, co-morbidities, once daily regimen, awareness about the BP control status and adequacy of BP control were the predictors of good compliance. The barriers to compliance were alcohol abuse, out of pocket expenditure and more number of pills/day. Conclusion: Drug compliance among the study population was low compared to previous studies. Low drug compliance and poor blood pressure control among the hypertensives in the area warrants immediate actions to prevent the development of complications. The burden of morbidity and mortality due to hypertension and related complications on the family and health system will be immense if the situation is left unattended.