Nepal Journal of Epidemiology最新文献

The burden of cancer is estimated to be increasing in Nepal, whilst the country lacks national established guidelines or protocols for referral of cancer cases. Cancer patients are presenting many different health facilities throughout the country. In rural areas almost all cancer patients have their first diagnosis when visiting a health assistant or nurse at their nearest primary health care delivery service. If cancer is suspected, health care assistants or nurses will refer the patient to a medical doctor at the primary health centre, or refer the patient directly to the cancer treatment centre or oncology department of the closest hospital. Patients from urban areas will usually be seen for the first time by a medical doctor initially and then referred to either the cancer treatment centre or oncology department of the hospital. Both in rural and urban areas the referral for treatment is determined by both the patients' capacity to pay for treatment own healthcare, as well as their geographical location (i.e. availability and accessibility of cancer treatment services.

Background: It has been seen that very less attention has been given to the oral health of the geriatric population residing in old age homes and as the oral mucosal lesions are a matter of concern for this growing population. Therefore, a study was done with the objective of finding the prevalence of oral mucosal lesions and the distribution of oral mucosal lesions among 65-74 year old residents of old age homes in Delhi, India.

Materials and methods: A cross sectional study was done on 65-74 year old age group elders of old age homes in Delhi. A total of 464 subjects participated in the study. Oral Health Assessment Form, WHO was used for assessing oral mucosa. Clinical examination was performed using two mouth mirrors under natural illumination in a systematic manner. Data was processed and analyzed using SPSS version 23.

Results: Out of a total of 464 subjects, 291 (62.70%) were males and 173 (37.30%) were females. Oral mucosal lesions seen in the study subjects were malignant tumours, leukoplakia, lichen planus, ulcerations, ANUG, Abscess and candidiasis. Leukoplakia was seen in 70 subjects (15%) and was present on buccal mucosa in the majority. A malignant tumour was seen in 7 subjects (1.5%) and commonly seen area is floor of mouth.

Conclusion: Prevalence of oral mucosal lesions among residents of old age homes shows the need for increased preventive and diagnostic measures for prevention and early identification of oro-mucosal lesions. Taking adequate care for oro-mucosal health of elderly people residing in old age homes is necessary.

Background: Rapid urbanization has resulted in increased burden of communicable and non-communicable diseases, especially among urban poor population. In the absence of a well-functioning three tier health care system in urban India, health needs of urban poor are rarely fulfilled. The objective of this study was to assess primary health care services utilization pattern and its associated selected socio-demographic determinants in an urban population of Dakshinpuri Extension, South-east district of Delhi.

Materials and methods: A community based cross-sectional study was done from November 2013 to November 2014 with a sample size of 440 households through simple random sampling. Information was obtained regarding the socio-demographic characteristics and morbidity pattern of all the members of household in the preceding one year of the conduct of the present study through a pretested semi structured interview schedule. Association of various socio-demographic characteristics with primary and secondary health care facilities utilisation was studied with bivariate and multivariate logistic regression.

Results: In this study, 42% of the household members suffered from acute illnesses and symptoms in the preceding one year. Secondary/tertiary health care facilities were approached mostly for seeking treatment. Majority of the household members sought treatment from private health care facilities. Significantly higher utilisation of secondary/tertiary health care facilities was found by head of households and household members who are married.

Conclusion: Primary health care system needs to be revamped to improve healthcare delivery among urban population. Strategies to decongest secondary/tertiary health care facilities in urban India needs focus.

Background: HIV epidemic is mostly targeted adults and has numerous negative health, social, economic, cultural and political consequences. In this study Life Expectancy (LE) and Average Years of Life Lost (AYLL) in HIV/AIDS patients are estimated.

Materials and methods: In this descriptive study all the patients at the age of 18 and more under the care of BandarAbbas Behavioral Disorders Counseling Center (BBDCC) during 2005-2015 are included. The town of BandarAbbas is center of Hormozgan Province in southern Iran. LE and AYLL have been estimated based on Life Table.

Results: One hundred thirty four of the 426 eligible patients died during the study period. Compared to the general population LE for HIV/AIDS patients at age 20 is 46 years less in comparison with the general population of BandarAbbas. Moreover, a total of 8839 years of life lost during 2005-2015.

Conclusion: LE in HIV/AIDS patients is less than LE among BandarAbbas general population and AYLL among them is more than general population. Most of the years of life lost are preventable if the health care system seriously will implement programs to control HIV/AIDS.