Prevalence and associated risk factors of hypertension among people aged 50 years and more in Banepa Municipality, Nepal.

BACKGROUND: Hypertension is a cardiovascular disorder rapidly emerging as a major public health problem in developing countries and is the most widely recognized modifiable risk factor for cardiovascular diseases. OBJECTIVE: The objective of this study was to find out the prevalence and associated risk factors with hypertension among people aged 50 years and more in Banepa Municipality, Kavre, Nepal. METHODS: It is a cross- sectional, population based study which was carried out in Banepa Municipality from May 15 to June 15, 2009. Among total 11 wards of Banepa municipally, wards number 1, 3, 5, 6, 7, and 10 were selected by using Simple Random Sampling Technique and 405 subjects of people aged 50 years and more were selected for study from the selected wards by using Cluster Sampling. The structured interview method was used for collection of data. Mercury sphygmomanometers with standard cuff were used to measure the indirect auscultatory arterial blood pressure. Two consecutive blood pressure readings were taken and average of them was calculated to determine single value of blood pressure. RESULTS: The prevalence of hypertension was 44.9 percent (47.75% in male and 42.73% in females). Among them, only 32.9 percent (60/182) were previously diagnosed as hypertension. The higher proportion of hypertensive cases were in age > 65 years (55.49%) than in the age group < 65 years (36.32%). The prevalence of hypertension was seen positively associated with non vegetarian eating habits, alcohol consumption, and > 25 Body max index. Taking green leafy vegetable at least once a week was negatively associated with the prevalence of the hypertension. CONCLUSION: These findings provide important information on the prevalence, associated factors of hypertension in Banepa Municipality. Effective public health measures and strategies are needed to improve prevention, diagnosis and access to treatment of these 50 years and above population.

The prevalence of and risk factors for hypertension in adults living in central development region of Nepal.

BACKGROUND: Hypertension is the commonest cardiovascular disorder and now regarded as major public health problem. It is a precursor to major diseases like myocardial infarction, stroke, renal failure etc. There are very limited community based data on hypertension in Nepal, so, information on the prevalence of hypertension in the population is desirable. OBJECTIVES: To estimate the prevalence of hypertension and to explore the risk factors associated with hypertension. METHODS: In a cross sectional study , a total of 527 subjects (males n=214 and females n=313) participated in our study (age =18 years). The participants underwent anthropometric measurement and blood pressure and answered a pretested questionnaire. Hypertension was defined as per JNC VII criteria. RESULTS: Overall prevalence of hypertension was 22.4% (males: 32.7% and female: 15.3%). Age specific prevalence of hypertension showed significant progressive increase in blood pressure ranging from 8% to 35%. Almost 40% of hypertensives did not know about their status. Bivariate analysis showed significant relationship of hypertension with gender, age, literacy, physical inactivity, body mass index (BMI), smoking and alcohol consumption. Multivariate analysis excluded literacy but all other risk factors continued to show positive association with hypertension. CONCLUSION: Being elderly, less physical activity, obese/overweight, smoking and alcohol consumption are significant risk factors of hypertension. Therefore, intervention measures are warranted emphasizing on modifiable risk factors such as smoking, alcohol consumption, physical activity and obesity to prevent hypertension.

Pattern of organophosphorous poisoning: a retrospective community based study.

BACKGROUND: Pesticide poisoning is very common in Nepal. Hospital based studies from various parts of Nepal have shown that poisoning with organophosphorus compounds is the most common type of poisoning. Current study is undertaken to see the pattern of organophosphorus poisoning and to identify the common risk factors among the cases. If the risk factors are modifiable, attempts in addressing the risk factors and decreasing the likelihood of poisoning will certainly be fruitful in reducing the morbidity and mortality associated with organophosphorus poisoning. OBJECTIVES: To assess the risk factors of organophosphorus poisoning which is major public health problem in Nepal. METHODS: A community based retrospective study of 75 cases of organophosphate poisoning who were brought to the emergency department of Dhulikhel hospital over the period of 3 years. Basic information was collected from hospital records and home visits were made to study the risk factors. Data were collected through interviews of the study population and their family members using a pre-designed questionnaire. RESULTS: In this study 75 cases and their families were interviewed of which there were 59% males and 42% females (M/F ratio of 1:1.4). The majority (40%) of the poisoning cases were in the age group 25-34 years. Lower literacy level showed positive association with the incidence of poisoning. Occupation wise vast majority (80%) of the cases were engaged in agricultural work. Suicidal attempts by ingesting organophosphate compounds were high in farmers and females. CONCLUSION: In this study, majority of the poisoning were attempts of intentional self harm. Agriculture workers and females are high risk groups and may be associated with the fact that they have easy access to the poison. Interventions directed towards health education, counseling, and enforcement of laws restricting the availability and use of harmful pesticides may help in reducing such events in future.

Comparative study of community medicine practice in MBBS curriculum of health institutions of Nepal.

BACKGROUND: A revolution in health care is occurring as a result of changes in the practice of medicine and in society. Medical education, if it is to keep up with the times, needs to adapt to society's changing attitudes. Presently medical education has been criticised for its orientation and insensitivity to people's need. The MBBS curriculum of medical institutions of Nepal has been focusing on community-based approaches and is still guided by the same notion. The question put forward is whether it has been appropriate to nurture the present health needs and aspiration of people. OBJECTIVE: The objective of the present study is to review the existing community based medical education in health institutions of Nepal to strengthen the components of community care. MATERIALS AND METHODS: Qualitative study was done by reviewing the curricula and existing community medicine courses/activities in MBBS curriculum of Institute of Medicine (IoM)/Tribhuvan University, BP Koirala Institute of Health Sciences (BPKHIS) and Kathmandu University School of Medical Sciences (KUSMS). FINDINGS AND DISCUSSION: The curriculum of all the health institutions have addressed significantly on community medicine practice. As per Institute of Medicine, the community medicine practice is achieved through community based learning experiences like community diagnosis, concurrent field with families of sick members and district health system management practice. In BP Koirala Institute of Health Sciences, community medicine practice is undertaken through exposure to community diagnosis program, health care delivery system, family health exercise, applied epidemiology and educational research methodology, management skills for health services and Community Oriented Compulsory Residential Rotatory Internship Program (COCRRIP). In KUSMS, community medicine module is carried out as- community diagnosis program, community health intervention project, school health project, occupational health project, health delivery system functioning, family health care activities and Compulsory Residential Rotatory Internship Program in outreach clinics. In the practice the practical aspects are largely unstructured that waste too much time in non-educational activities and rely on learning and doing. Meanwhile, expectation of the community is increasing and the challenge of nurturing their demands has come in forefront. Community has perceived that the medical schools are concentrating on fulfilling the demand of their curriculum rather directing on their health care need. CONCLUSION: Health institutions need to be accountable to take the responsibility of strengthening the health status of the community of their catchments areas. The practice of community medicine need to be done in an innovative way and these schools should execute continual intervention activities and complement other institutions working in their areas.

Environmental health in primary schools in a developing country.

In an effort to elucidate the environmental health in developing countries, the environmental and sanitary conditions of Riyadh primary schools were assessed by use of a scoring evaluation sheet for 20 schools representative of primary schools of Riyadh. 20% of schools have been found to be ideally situated and only one fourth of schools with proper building. As regards class rooms, only 25% of them have adequate floor area, window area and are suitably illuminated. Drinking fountains per pupil were inadequate. Overall, environmental rating of 10% excellent, 30% good, and 60% bad were detected in present study. The bad situation of almost two-thirds of primary school buildings in Riyadh is alarming. Remedial suggestion have been forwarded.

Measles in children under six months-of age: an epidemiological study.

This study was carried out in 989 cases of measles attending the communicable diseases clinic. University of Benin Teaching Hospital in the year 1977. It was found that measles is a disease of under 5 years and is more frequent amongst infants. Out of the total cases, a sub-group of children suffering from measles under 6 months of age were followed to their homes to study some of their socio-economic factors. It was observed that multiparity and a higher age group of mothers are probable factors. Poor environmental hygiene and low socio-economic status had a role in the transmission of the disease, but malnutrition was not found to be a contributory factor.