Rural Delhi Research Articles

Effectiveness of Structured Teaching Programs in Preventing Uterine Prolapse among Multipara Women in Rural Delhi

Effectiveness of Structured Teaching Programs in Preventing Uterine Prolapse among Multipara Women in Rural Delhi

A qualitative study to assess dynamics of major injuries in children and adolescents of a rural area of Delhi

Background: Childhood injury constitutes a grave public health problem. Most of the unintentional injuries and their consequences are preventable. Present study highlights the dynamics related to major injuries in children. Methods: This is part of a prospective research conducted over 16 months, on 397 children and adolescents of rural Delhi. Present report includes those with major injuries. Data was collected by in-depth interview of subjects with major injuries, and their guardians. Results: Five major injuries occurred during study period. Thus incidence of major injuries was 1.26/100 children/year and proportion of major injuries out of total injury events was 2.89%. There was no fatality or disability. Socio-demographic risk score was high for 4 out of the 5 children. All subjects were adolescents, of whom 3 were boys and 2 girls. All injuries were of locomotor system, with two cases having multiple glass-cut injuries in addition. All injury events had occurred when subjects were away from home, of which three occurred on road, due to unclean surroundings in one case and two by motor vehicle accidents due to inexperienced drivers, of less than legal age for driving, and on alcohol. Treatment was taken from secondary care hospitals by all injured subjects. Mean cost of treatment was Rs.5,009/-, with total out-of-pocket expenditure being Rs.7,212/- (mean=Rs.2,404/-). Mean time to recovery was a little over 1 month (32 days). Conclusions: All the major injuries that occurred in the study population could have been prevented by taking responsibility at various levels.

How much do we follow birth preparedness? A community-based snapshot study from rural Delhi, India.

Maternal healthcare remains a challenging public health problem in low and middle-income countries like India. The comprehension and services regarding practices related to birth preparedness and its complications in rural areas of India remain poor and underused. In view of this, we conducted this study to explore the preparedness of the pregnant women in the community residing in rural settlements of Delhi. This cross-sectional community-based study was carried out in 165 currently pregnant women selected through proportionate sampling from rural Delhi. A semi-structured questionnaire adapted from Birth Preparedness and Complication Readiness (BPCR) tool kit was used. Binary and multivariate regression analysis was applied to identify the predictors of BPCR. In our study, BPCR index was found to be 25.78%. Only 17.6% pregnant women were well prepared. Multigravida, literacy, and higher socioeconomic status were found significant predictors for well preparedness for child birth and complication readiness in bivariate analysis. In multivariate logistic regression, multigravida and literacy were found to be predictors for well preparedness. The skill and knowledge level of the mother-in-laws and other women along with husband in the family needs to be improved in context of pregnancy and child birth. Frontline health workers can assist the to-be mothers and their family members in informed decision-making for better feto-maternal outcomes.

Depression Among Patients With Tuberculosis at a Directly Observed Treatment Short-Course (DOTS) Center in Rural Delhi.

Background Psychiatric disorders, particularly depression is prevalent among patients with tuberculosis (TB) and affect their treatment compliance. Patients with tuberculosis can develop depression due to multiple factors like longer treatment duration, social stigma, lack of family support, etc.In this study, depression and its associated factors were examined among patients with tuberculosis enrolled in a directly observed treatment short-course (DOTS) center in North Delhi. Methods In this DOTS center-based, cross-sectional study, 320 patients with pulmonary and extra-pulmonary TB above 18 years old were included. Basic socio-demographic information was gathered using a Hindi questionnaire, and depression was identified using the patient health questionnaire-9. People who received a score of 10 or higher were deemed to have depression. The Statistical Package for Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY, USA) was used for data analysis. Analysis between depression and no-depression groups was done by the chi-square test and a p-value< 0.05 was considered statistically significant. Results The study involved 320 patients in all, 193 (60.3%) of whom were men. The median age was 38 years, and the interquartile range (IQR) was 24 to 52 years. Depression was found to be present in half of the patients. Patients with a higher proportion of depression were male, belonged to the middle or below socio-economic status, were currently unemployed and literate, had monthly family income less than 8000 rupees, weight below 45 kg, used alcohol and tobacco, and were undergoing intensive phase (IP) of TB treatment (p-value< 0.05). Depression was not found to be associated with age, site of TB, previous history of anti-tubercular treatment (ATT) intake, marital status, and family size. Conclusion Depression among patients with TB is common and affects half of the patients afflicted with it. When evaluating patients with TB, physicians and DOTS providers should have a high index of suspicion for depression.

Burden of Musculoskeletal Disorders in Adults of Rural Areas of Delhi: A Cross-sectional Study

Background: Musculoskeletal disorders (MSDs) are disabling chronic conditions prevalent worldwide. However, there is paucity of literature of such disorders from India.Objective: To study the epidemiology of Musculoskeletal disorders in adult population of rural areas of Delhi.Materials and Methods: The study was a descriptive, cross sectional, community-based study and conducted in a rural area of Delhi. Modified Nordic musculoskeletal questionnaire (NMQ-E) was used to determine the prevalence of MSDs. Data were summarized using frequencies, proportions and appropriate statistical tests were applied for significance. Binary logistic regression was used.Results: The lifetime prevalence of MSDs in the present study was found to be 57% (114) of the study participants, 53% (106) participants had history of MSDs in the past 12 months, 48% (96) participants had history of MSDs in the past 4 weeks while 35% (70) participants had history of MSDs at the time of interview. Lower backache was the most common complaints (54.2%). MSDs were found to be more associated with female gender, increasing age, being overweight or obese, and having a history of trauma.Conclusion:One in three adults was suffering from MSDs in rural Delhi and more so in females and elderly.

Impact of newer initiatives on treatment compliance and outcome in tuberculosis patients of rural Delhi and rural Ghaziabad – a comparative study

Background: India has the highest burden of Tuberculosis in the world, having about one-fourth of the total global incident cases of the disease in 2017. The RNTCP program started many newer initiatives in 2015 to improve compliance and treatment outcomes, reduce the incidence of resistance and control the TB-HIV co-infection. Objectives: To assess the improvement in patient compliance, to find out and compare the improvement in nutritional status of the patients after initiation of treatment and Direct Benefit Transfer and to compare the treatment outcomes of the enrolled subjects in the two areas. Material and Method: Data was collected from the DOTS centers under CHC, Muradnagar and TB and Chest Hospital Karawal Nagar, between January 2019 to September 2019. Details of the enrolled patients were taken from the centers and these patients were contacted individually. Of the registered patients, 59 patients from Muradnagar, Ghaziabad and 70 from Karawal Nagar, Delhi had completed treatment at the time of data collection and they were further evaluated for different parameters. Results: 62% of the registered patients at DOTS centre, Muradnagar, had completed treatment, 35.1% were cured, 1.7% died during treatment while only 1.2% of the patients did not show good compliance. 54% of the registered patients at DOTS centre of Karawalnagar, East Delhi, had completed treatment, 25.5% were cured, 2.7% of the patients had died during treatment while only 2.7% of the total patients did not show good compliance. More number of patients registered at Ghaziabad had either completed the treatment or were cured (97.1%) as compared to Delhi (79.5%). The mean gain in weight was 5.39 kg and 5.04 kg for Ghaziabad and Delhi respectively. This gain in weight had no relationship with Direct Benefit Transfer.

Unintentional Injuries Among Under-five Children in a Rural Area in Delhi

To determine the prevalence of unintentional injuries and its associated factors among under-five children in Rural Delhi. This community based cross-sectional study was conducted in Pooth Khurd village of Delhi during 2018 among under-five children and their care givers. Primary caregivers of the child in the randomly selected households were interviewed using a semi-structured pretested questionnaire. Data related to unintentional injuries in past 12 months and its associated factors were collected. Unintentional injuries were prevalent in 29.3% (95% CI: 25.8-32.9) of the 650 under-five children included. Male children had 1.4 times increased prevalence of injuries (aPR=1.4, 95% CI: 1.1-1.7). As the age increases from 2 years to 5 years the prevalence of injuries increased constantly from 29% to 50%. The prevalence of unintentional injuries was significantly higher among children of working mothers (aPR=1.7, 95% CI: 1.4-2.1), family with more than 3 children (aPR=1.6, 95% CI:1.1-2.4), household without a separate kitchen (aPR=1.6, 95% CI:1.2-2.2) and household with inadequate lighting (aPR=1.8, 95% CI:1.4-2.3). The factors significantly associated with unintentional injuries were male gender, higher age of the children, maternal occupation, increased number of children in the family, not having a separate kitchen and inadequate lighting.

Prevalence of disability using rapid assessment of disability toolkit among adult residents of rural Delhi, India

Background: India is committed to ensure development inclusive of persons with disability. Recently a sensitive and specific Rapid Assessment of Disability toolkit has been developed to assess the disability prevalence by United Nations Convention on Disability. Studies using this toolkit in India are inadequate leading to paucity of data regarding disability. The present study was conducted to assess the prevalence of disability among adults of a rural area of Delhi.Methods: A community-based, cross-sectional study, carried out among adults of Fatehpur Beri village, Delhi. A total of 660 participants were assessed using the rapid assessment of disability toolkit. Descriptive statistics were used to calculate the prevalence, Chi-square and Fischer’s exact test was used for bivariate analysis.Results: The prevalence of disability was found to be 8.6% and was similar among both genders. A higher proportion of persons with disability belonged to lower socioeconomic class, were likely to be unmarried, widow/widower, separated/divorced also either illiterate or had studied till primary school only and more often unemployed as compared those without disability.Conclusions: Persons with disability had a significantly lower educational, occupational, socioeconomic attainment. Large scale studies are needed to provide data for planning inclusive development.

Pre-Diabetes - Prevalence and Co-Variates in Rural Delhi

Pre-diabetes is a continuum of condition where blood sugar levels lies in a range lesser than that of overt diabetes mellitus but higher than normal range. This study was done to find prevalence of pre-diabetes and its relationship with socio-demographic factors and other behavioural and metabolic risk factors of non communicable diseases in rural areas of Delhi. It was a cross-sectional study conducted in two rural areas in Delhi among 959 subjects aged above 18 years. WHO STEPS approach was used to collect data about socio demographic details. Blood pressure, Body mass index, blood sugar and lipid profile were measured. The overall prevalence of pre diabetes was 3.3%. There was significant difference (p<0.05) in prevalence of pre diabetes in individuals more than 35 years (5.0%) than less than 35 years (1.1%). The proportion of subjects with hypercholesterolemia and raised triglycerides having pre-diabetes were significantly higher than those having normal cholesterol and triglycerides levels (p<0.05).

A0610 Prevention of cardio-metabolic syndrome – current perspectives in rural Delhi, India

Objectives: To determine practices for Cardio-Metabolic Syndrome prevention and control and related factors in Delhi. Methods: A community based study was conducted in rural areas in Delhi, India. A total of 1005 subjects were selected using systematic random sampling method. Study population was constituted by all individuals above 18 years of age residing in the study areas. Data was collected using World Health Organization (WHO) – STEPS approach. All anthropometry and biochemical analysis was done using validated methods. Data was also collected for prevalent practices of participants for prevention of Cardio-Metabolic Syndrome like dietary habits, physical activity etc. Those who were diagnosed to have Cardio-Metabolic Syndrome were excluded from the analysis. Data analysis was done using SPSS version 17. Results: 77 (7.7%) participants were diagnosed to have Cardio-Metabolic Syndrome and were excluded from further analysis. About lifestyle factors, 26 (2.8%) participants were using tobacco in either smoking/smokeless form; out of which, 19 (2.0%) participants reported daily use of tobacco. 61 (6.6%) participants reported use of alcohol in the past one year. Regarding use of cooking oil, 93 (10.0%) participants reported use of saturated oil and 207 (22.3%) mixed type of oil. Only 21 (2.3%) participants reported doing physical activity as per WHO recommendations while 124 (13.4%) participants reported intake of 5 servings of fruits and vegetables per day. 42 (4.5%) participants were aware of importance of limited salt intake in diet. Use of alcohol, tobacco and salt intake was significantly higher among males (p < 0.05) participants. Conclusion: Community should be made aware about importance of Cardio-Metabolic Syndrome prevention and control using approaches of behaviour change communication (BCC).

Beliefs Supporting Violence, Attitudes and Aggressive Behavior Among School Adolescents in Rural Delhi.

Violence and aggression amongst adolescents is increasing across the globe. However, the research on adolescent violence in India is limited. The present study was undertaken to study aggressive beliefs, attitudes, behavior rural schools in north district of Delhi. It was a cross-sectional study conducted among adolescents studying in grade VIII-X in three rural schools in Delhi, selected by non-probability sampling. The data was collected using a questionnaire adapted from CDC Compendium of tools measuring aggression. Out of the total 270 adolescents, there were 119 boys (44.1%) and 151 (55.9%) girls. The mean score of beliefs, attitude aggressive behaviour for private co-ed school was highest while all girls' school had lowest (p < 0.001). Being male (p < 0.001), studying in private co-ed school (p < 0.001) and having attitude towards violence (p = 0.02) contributed significantly to total aggression score. The study highlighted that type of school, gender and attitudes influence adolescents' behavior towards aggression.

Prevalence of Dyslipidemia and Its Determinants in Rural Delhi

Introduction: Dyslipidemia is a known risk factor for cardiovascular diseases. For planning future strategies and approaches for prevention of cardiovascular diseases, it is essential to know the burden of dyslipidemia in the community. Objective: To find prevalence of dyslipidemia and its associated factors in a rural area of Delhi, India. Materials and Methods: It was a community-based cross-sectional study conducted in two rural areas in Delhi among 1005 subjects, selected using systematic random sampling method. WHO STEPS approach was used to collect data. Blood pressure, body mass index, blood sugar and lipid profile were measured. Data analysis was done using SPSS version 16. Odds of dyslipidemia among subjects with risk factors were calculated. P value less than 0.05 was considered significant. Results: The overall prevalence of hypercholesterolemia, raised triglycerides and reduced HDL was 31.2%, 21.8% and 95.7% respectively. Dyslipidemia was significantly higher in individuals more than 35 years than less than 35 years and among males. It was significantly higher in those who take alcohol, among overweight/obese and in subjects with diabetes mellitus Type 2. In multivariate analysis, age, occupation, tobacco use, BMI and diabetes mellitus Type 2 were independently associated with dyslipidemia. Conclusion: There is significant burden of dyslipidemia in rural areas in Delhi. Age, occupation, tobacco use, BMI and diabetes mellitus Type 2 were independent risk factors of dyslipidemia.

Prevalence of Hypertension and Determination of Its Risk Factors in Rural Delhi.

Introduction. Hypertension is an important public health challenge in both economically developing and developed countries. It is one of the risk factors for cardiovascular mortality. Data is available on hypertension in urban population but few studies are reported in rural areas. Materials and Methods. It was a community based cross-sectional study conducted in two rural areas in Delhi among 1005 subjects selected using systematic random sampling method. WHO STEPS approach was used to collect data. Blood pressure, body mass index, and blood sugar were measured. Data analysis was done using SPSS version 16. Odds of hypertension among subjects with risk factors were calculated. p value less than 0.05 was considered significant. Results. The prevalence of hypertension was 14.1% among study subjects. Hypertension was significantly higher in individuals more than 35 years than those less than 35 years. Hypertension was significantly higher in those who take alcohol and in subjects with raised total cholesterol level but in multivariate analysis only age, education, and cholesterol levels were independently associated with hypertension. Conclusion. There is significant burden of hypertension in rural areas in Delhi. Age, education, and cholesterol levels were independent risk factors of hypertension.

A comment on "Occupational hazard exposure and general health profile of welders in rural Delhi".

A comment on "Occupational hazard exposure and general health profile of welders in rural Delhi".

Assessment of a Secondary Level Hospital in Rural Delhi as per the Indian Public Health Standards for 200 Bedded Hospital

Government of India is committed to strengthening the health sector for improving health status of the population. In order to ensure these, Indian Public Health Standards (IPHS) were laid down with the overall objective to provide healthcare that is quality oriented and sensitive to needs of the people. The present study was carried out to assess how far a 200-bedded hospital conformed to IPHS. A cross-sectional study was done at Satyawadi Raja Harishchandra hospital, Narela to assess four important domains as per the IPHS i.e. manpower, equipment, procedures performed and diseases treated using standardized checklists. Out of 26 sanctioned posts of doctors only 11 were filled. Nearly all equipments for imaging, labor room, operation theatre and laboratory were in place. Only 50% of medical and dermatological procedures while no ophthalmic procedure were being performed. Huge gap exists between sanctioned and filled positions of specialists and utilization of resources in the hospital.

Occupational hazard exposure and general health profile of welders in rural Delhi

Background:Welding is a common industrial process associated with various health hazards. The aspect of duration of hazard exposure among welders at their workplace has been studied to limited extent in India.Objective:To assess the duration of occupational hazard exposure and its association with symptoms among the welders.Materials and Methods:A cross-sectional study was conducted amongst 106 welders in North Delhi. Data was collected using a questionnaire containing items to assess the socio-demographic profile, their medical history and individual hazard exposure.Results:Majority of them were involved in skilled/semi-skilled job (n = 99; 93%). The predominant nature of work for majority was manual. More than half reported their work to be physically hard (n = 56; 53%), involves much lifting of weight (n = 61; 57%), and is dangerous (n = 59; 56%). Dust/smoke followed by noise was reported to be most common hazards at the workplace by them. Most of them were suffering from eye related symptoms (n = 63; 59%) followed by skin conditions (n = 28; 26%). Skin diseases were reported to be significantly common among group of welders who were exposed to dust and radiation for ≥4 hours in a day (P < 0.05).Conclusions:Nearly half of the welders found their job to be dangerous and were being exposed to at least one hazardous substance at their workplace. Majority of them complained of eye symptoms. There is a need for health and safety training of this economically productive group.

Perception of Causes, Consequences and Solutions to Global Warming among School Children in Delhi

Background: Global warming has emerged as one of the most important environmental issues ever to confront humanity having wide health & environmental implications. Awareness especially among children and youth is necessary to combat this challenge. Objectives: To study the perceptions of school students with regard to climate change, its potential health & environmental impacts and their behaviour towards tackling the issue. Setting and Design: This observational study was conducted in a government boys school in rural Delhi. Material and Method: All students of classes 9th, 10th and 11th who were willing to participate were included in the study. A self-administered, semi-structured questionnaire was used and responses were evaluated. Statistical Analysis Used: Proportions, percentages and chi-square test. Results: In all, 290 students participated in the study. Majority (78.9%) had heard about global warming and most students correctly attributed it to decreasing green cover (57.6%) and rising pollution (53.1%). Majority were aware of the increased chances of epistaxis but only some knew of its other health implications. Majority (96.5%) felt the need to take action and suggested increasing the green cover as a possible solution (85.1%). However, there were gaps in knowledge of students and some misconceptions were also observed. Further, knowledge did not necessarily translate into students' actions. Eleventh graders were better informed regarding global warming than lower two grades. Conclusion: It is imperative to include the issue of global warming at all levels in school curriculum with emphasis on its health impacts and focusing on early years of schooling.

Pattern and distribution of ocular morbidity in primary school children of rural Delhi.

A total of 679 primary school children drawn from developed southern parts and underdeveloped eastern parts of Delhi were examined for ocular morbidity. Their age range was 5-15 years and both sexes had almost equal representation. The prevalence of eye diseases was relatively high. Over 40 percent of all the children studied had one or more ocular problems. Trachoma (18%) was the most common ocular morbidity followed by vitamin A deficiency (10.6%), visual acuity < 6/9 (7.4%) and apparent/latent squint (7.4%). In most of these eye disorders, the majority of the children came from the underdeveloped eastern parts of Delhi. Ocular morbidity seems to be unevenly distributed in rural Delhi with a significantly worse picture in the underdeveloped eastern parts, across the river 'Yamuna'. Though blinding trachoma may cease to be a major problem in India, the country continues to have endemic pockets of its non-blinding form. One puzzling observation was that children with protein-energy malnutrition (PEM) did not show any specific vulnerability to ocular diseases. In fact, those with normal weight-height index were having a higher share of eye diseases. Though this issue needs to be explored further in the light of biological plausibility, it appears that children who do not have PEM are also exposed to ocular diseases at least with comparable risk.

Prevalence of dental caries and associated teeth cleaning habits among children in four primary schools.

A study was conducted in four primary schools of Mehrauli block of rural Delhi. Four hundred and fifty eight primary school children of both sexes in the age group of 5-14+ were medically examined in daylight using a mouth mirror and probe. The children came from low socioeconomic backgrounds. Presence of clinical caries was recorded by naked eye examination. Dental caries prevalence was 33.19% and DMF index was 0.52. Teeth cleaning habits of the school children in terms of regularity and associated caries prevalence was also noted. The 'Regular' teeth cleaning group showed significantly less caries prevalence while 'Not Regular' and 'Never Cleaning' groups had higher caries prevalence. Since childhood is such an impressionable age all students were made aware of the need for proper oral hygiene to minimize the incidence of caries among them.

Ecoclimatic modification of Delhi due to urbanization

Temperature, humidity and wind fields at the surface over Delhi during winter period are presented. The temperature analysis suggests several warm pockets and cold pools. The humidity field indicates an inverse relation with temperature except close to water surfaces or green vegetation. Wind fields tend to be anticyclonic. Climograms for urban and rural Delhi point out the differences in comfort at both the localities. During daytime rural Delhi is comfortable in February, March and December but at urban Delhi January, February and December are comfortable. Similarly, during nighttime while rural Delhi is comfortable in May and June only, urban Delhi is comfortable in April, October and November. Remaining months in each case are uncomfortable either on the hotter side or colder side.