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IntroductionCatastrophic health expenditure during COVID-19 hospitalization has altered the economic picture of households especially in low resource settings with high rates of COVID-19 infection. This study aimed to estimate the Out of Pocket (OOP) expenditure and the proportion of households that incurred catastrophic health expenditures due to COVID-19 hospitalisation in Kerala, South India. Materials and MethodsA cross-sectional study was conducted among a representative sample of 155 COVID-19 hospitalised patients in Kottayam district over four months, using a pretested interview schedule. The direct medical and non-medical costs incurred by the study participant during hospitalisation and the total monthly household expenditure were obtained from the respective COVID-19 affected households. Catastrophic health expenditure was defined as direct medical expenditure exceeding 40% of effective household income. ResultsFrom the study, median and mean Out of Pocket (OOP) expenditures were obtained as USD 93.57 and USD 502.60 respectively. The study revealed that 49.7% of households had Catastrophic health expenditure, with 32.9% having incurred Distress financing. Multivariate analysis revealed being Below poverty line, hospitalisation in private healthcare facility and presence of co-morbid conditions as significant determinants of Catastrophic health expenditure. ConclusionHigh levels of Catastrophic health expenditure and distress financing revealed by the study unveils major unaddressed challenges in the road to Universal health coverage.
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INTRODUCTION: Adolescent age group is the window of opportunity to correct nutritional status of children. If we intervene correctly during this period we can prevent future consequences of nutritional deficiencies. Very few studies have been conducted in kerala regarding adolescent anaemia. AIM: To estimate prevalence of anaemia and its associated factors among adolescent girls of central Kerala, India. MATERIALS AND METHODS: A cross-sectional study was conducted among 257 adolescent girls of ettumanoor panchayat, the field practice area of Government Medical College, Kottayam. A pre-designed and pre-tested proforma was used to obtain data regarding socio-demographic details and factors associated with anaemia. Relevant clinical examination of participants were done. Blood samples were analysed using an auto-analyser and stool examination for ova or cyst was done under microscopy. Diagnosis of anaemia was established when haemoglobin was less than 12gm/dl. Data analysis was done using SPSS 16.0. Association between Categorical variables were tested with Chi-square test and continuous variables independent t-test was used. Logistic regression was used to find out independent risk factors. The level of significance was fixed at p-value of < 0.05. RESULTS: The prevalence of anaemia was 21%. Risk factors associated with anaemia in the univariate analysis were presence of ova or cyst in stool (p = 0.003, OR = 2.94) and number of pads per day during menstruation (p = 0.004). Protective factors were hand washing after toileting (p = 0.021, OR = 0.311), hand washing before food intake (p = 0.026, OR = 0.5), foot wear usage (p = 0.022, OR = 0.25) and jaggery consumption (0.042). The factors which were significant in logistic regression were worm infestation, number of pads per day, washing hands before food intake and foot wear usage. CONCLUSION: Worm infestation and number of pads per day during menstruation were found to be risk factors for anaemia. Personal hygiene practices like hand washing and foot wear usage were found to be protective factors.
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Quantitative estimation of proteinuria done by the refractometric method was compared with that done by the sulphosalycilic acid method and biuret method in 102 urine samples. The analysis of results by students' t test showed no statistically significant difference between the three methods. It is concluded that quantitative estimation of urinary protein excretion by refractometric method is a simple cheap and reliable method and can be performed easily in the outpatient clinic. The instrument is quite handy and can be carried in the pocket.
