Abstract Objective To determine the acceptability of keeping a self-written health diary among me... more Abstract Objective To determine the acceptability of keeping a self-written health diary among members of low-income communities, with the aim of generating needed health data. Methods We identified three different types of impoverished communities (tribal, inner-city slum and rural) in north India, and conducted a baseline survey to establish the sociodemographic properties of the members of 595 (tribal), 446 (slum) and 51 (rural) households. We designed health diaries with a single page to fill in per month, each with a carbon duplicate, and distributed diaries to willing participants. Health volunteers visited households each month to assist with diary completion and to collect duplicate pages for a period of one year. We compared the frequency of illnesses reported in health diaries with baseline survey data. Findings A total of 4881 diary users (tribal: 2205; slum: 2185; rural: 491) participated in our project. In terms of acceptability, 49.6% (1093/2205), 64.7% (1413/2185) and 79.0% (388/491) at the tribal, slum and rural sites, respectively, expressed satisfaction with the scheme and a willingness to continue. In the tribal and slum areas, we observed increased reporting of illnesses from health diaries when compared with baseline data. We observed that influenza-like illnesses were reported with the highest frequency of 58.9% (2972/5044) at the tribal site. Conclusion We observed high levels of acceptability and participation among the communities. From our initial field studies, we have observed the benefits to both our study participants (timely preventive education and referrals) and to service providers (obtaining health data to allow improved planning).
Scrub Typhus is emerging as an important cause of fever of unknown origin and needs to be differe... more Scrub Typhus is emerging as an important cause of fever of unknown origin and needs to be differentiated from other causes of febrile illnesses. During March to June 2014, a systematic search on ‘Scrub typhus’ was conducted to determine epidemiology and factors causing re-emergence of this disease in India. Scrub typhus is an acute, febrile, infectious illness caused by Orientia tsutsugamushi , transmitted to humans through bites of the trombiculid mites. The infection can range from a mild, self-limiting disease to a fatal illness in 35-50% of cases, with multi-organ dysfunction, if not promptly diagnosed and appropriately treated. The reports of the disease were rare for several decades, but currently a clear re-emergence has been documented from several states in India. This resurgence may be attributed to changes in the human behavior-unplanned urbanization, deforestation and rapid transport leading to displacement of vectors as well the rodents from one place to another. There ...
BACKGROUND Tuberculosis (TB) is a major public health problem in India. The Revised National Tube... more BACKGROUND Tuberculosis (TB) is a major public health problem in India. The Revised National Tuberculosis Control Programme (RNTCP), started in 1997, involved medical colleges in the control of TB on a high priority. We assessed whether patients with TB referred from a tertiary care hospital in Delhi reached the desired peripheral health institution and had their treatment initiated. METHODS This descriptive, retrospective study was done at a tertiary care hospital and included all patients with a diagnosis of TB (pulmonary or extrapulmonary) who were seen at the referral centre during the year 2011. Data were collected from various records of the referral centre and analysed for availability of feedback of the referred patients. Information regarding their registration and initiation of treatment was also collected. Postcards were used for the first time to trace referrals in patients with TB. RESULTS The majority (94%) of patients with TB seen in the referral centre at a tertiary ...
Background: Quality of services shows a variation between the client and the provider. Therefore,... more Background: Quality of services shows a variation between the client and the provider. Therefore, it needs to be explored whether the quality of care or the lack of quality can explain the utilization of government health care. Objectives:This paper attempts to assess the utilization of health services and client satisfaction for services provided by a Primary Health Centre (PHC) at Delhi, India. Setting and design: The study was a facility based cross sectional study. Exit interviews were conducted among 400 patients seeking outdoor patient department (OPD) services of thePHC Palam, New Delhi from May 2010 to November 2010. Material and Methods: Exit interviews were conducted among the patients at each of the service delivery points in the PHC to assess the utilization of services and the satisfaction of clients with the available services. Results: Most respondents rated the services to be of good quality on various parameters of health delivery. The PHC was the preferred health f...
Sir, The history of television (TV) can be dated back to early 1960’s when TV first came to India... more Sir, The history of television (TV) can be dated back to early 1960’s when TV first came to India by the name of “Doordarshan” commonly named as “DD,” the so-called national TV network of India. It became an important means of mass media communication channel because of its unique feature of combining both audio as well as video technology. After around 50 years it has entered each and every home thus, serving as an important medium for disseminating information to its viewers. As it serves multiple functions of providing entertainment, information and education, it has a great influence on children’s overall development right from a very early age. (1) On one side it makes children aware of healthy habits, on the other hand, excessive TV watching leads to physical inactivity and consequently increased incidence of obesity. (2) Time spent in watching TV may be utilized in reading, outdoor games, etc. Since, adolescents form the most vulnerable and habitforming stage of life, the pre...
Background- The burden of diabetes in India is expected to worsen in the coming years. Indian Dia... more Background- The burden of diabetes in India is expected to worsen in the coming years. Indian Diabetes Risk Score (IDRS) is a validated and cost‑effective tool to identify risk of developing diabetes among population. Objectives- To assess the risk of Type 2 Diabetes mellitus using the IDRS in adults aged 30 years and above and to study the association of risk of diabetes with other factors. Material & Methods- A cross-sectional study was conducted in Kalyanpuri area of East Delhi. Data collection was done from August to December, 2018. 494 residents aged 30 years and above were included in the study. Data was collected using a semi-structured questionnaire. SPSS version 23 was used for data analysis. Results- 43.7 % of the study subjects were aged 50 years or above and majority (65.38%) were females. More than half (59.31%) of the subjects were found to have high risk of diabetes. Age and central obesity were found to be significantly associated with risk of diabetes (p<0.05). R...
Indian Journal of Community and Family Medicine, 2018
Introduction: As urbanisation is increasing, the problem of communicable as well as non-communica... more Introduction: As urbanisation is increasing, the problem of communicable as well as non-communicable diseases (NCDs) is also increasing. Hypertension, diabetes, obesity, cardiovascular diseases constitute most of the NCDs whose risk factors are almost similar. They could be modifiable like physical activity, waist circumference, diet, smoking, alcohol intake . Objective: To study the magnitude of shared risk factors for Non-communicable diseases in adults of an urban resettlement colony of Delhi. Material and Methods: A cross sectional survey was conducted on adults >30 years (n=580) in both genders in an urban resettlement colony of Delhi in 2014. A Semi-structured interview schedule consisting of Socio-demographic characteristics, risk factor profile was used. Data was entered and analyzed in SPSS 12 Results: Out of the total 580 subjects (313)53.96% were women and 267(46.03%) were men. Majority 405(69.8%) of the study subjects were taking inadequate fruits and vegetables (<5 times/day) and 212 (36.6%) were taking >5 gm salt per day. About 181(31.2%) of the study subjects were sedentary workers, the proportion was more among women 99(31.6%). 223(83.5%) men had waist circumference within normal limits whereas 178 (56.9%) women had waist circumference more than 88 cm. One in four men were smokers. Nearly 49(18.4 %) of the men were current tobacco chewers as compared to 17(1.6%) of women. Only 33 (12.4%) men were currently consuming alcohol. Results of multiple logistic regression showed increasing age, education and marital status as significant socio demographic factors for increased prevalence of risk factors for NCDs. Conclusion: Promotion of lifestyle change to address these risk factors that can be modified including weight reduction, increased physical activity and healthy eating should be encouraged along with changing of behavioural factors like quitting smoking and alcohol.
Indian Journal of Community and Family Medicine, 2018
Introduction: Blindness is one of the major public health problems in India. Visual rehabilitatio... more Introduction: Blindness is one of the major public health problems in India. Visual rehabilitation by corneal transplantation remains a major treatment option in those who are already blind due to corneal diseases. To combat with shortage of corneal donation in India, spreading awareness among masses regarding eye donation becomes important. Objectives: (1) To determine the awareness regarding eye donation amongst adults (>20 years) in an urban re-settlement colony of Delhi. (2) To assess their willingness to pledge for eye donation. (3) To determine the factors influencing their decision for eye donation. Material and Methods: This was a cross sectional study, conducted in the urban health centre attached to a medical college of Delhi between October to December 2013. Systematic random sampling was used and every alternate adult patient >20 yrs attending the UHC was recruited. Data entry and analysis was done using SPSS by a single investigator. Results: Majority (84.4%) had heard of eye donation. Only 21.2% were aware about contraindications for donating eyes. A little over quarter (27.6%) had heard of eye bank facility. When asked whether the retrieved eye can be stored before transplantation, majority (59.2%) didn’t know. More than half (54%) didn’t know which part of eye is removed. Mass media was major source of information in three forth respondents (74.9%). 45.5% were willing to pledge their eyes, a similar proportion was not willing (44.1%), five (2.4%) had already pledged and 17 (8.1%) were yet undecided to pledge. Conclusion: While majority of participants had heard of eye donation, but their knowledge regarding certain aspects of eye donation was found to be poor.
Abstract With increasing life expectancy the prevalence of osteoporosis is on rise and it poses a... more Abstract With increasing life expectancy the prevalence of osteoporosis is on rise and it poses a major public health issue. Bone Mineral Density (BMD) measurement by Dual Energy X-ray Absorptiometry (DEXA) is now widely available and is considered as a gold standard. Bone density measured by DEXA is obtained in grams/cm2, but in clinical practice these values are standardized and are expressed as T and Z scores. These scores are used for diagnosis and management of osteoporosis, but assessment with these scores alone is not without pitfalls. Any health care provider without complete awareness of these pitfalls could make an inappropriate diagnosis. Lumbar spine, proximal femur and wrist are the most common sites for BMD assessment. Degenerative changes a spine or hip, healed fractures, avascular necrosis, benign or metastatic bone forming lesions present as a false positive increase in BMD, while laminectomy defects and lytic lesions result in false negative decrease in BMD. Also the scores are dependent on age, gender, race and the machine used. Thus for follow up, it is important use the same scanner with same software version. In case of any discrepancy, it is necessary to compare the raw BMD values.
Abstract Objective To determine the acceptability of keeping a self-written health diary among me... more Abstract Objective To determine the acceptability of keeping a self-written health diary among members of low-income communities, with the aim of generating needed health data. Methods We identified three different types of impoverished communities (tribal, inner-city slum and rural) in north India, and conducted a baseline survey to establish the sociodemographic properties of the members of 595 (tribal), 446 (slum) and 51 (rural) households. We designed health diaries with a single page to fill in per month, each with a carbon duplicate, and distributed diaries to willing participants. Health volunteers visited households each month to assist with diary completion and to collect duplicate pages for a period of one year. We compared the frequency of illnesses reported in health diaries with baseline survey data. Findings A total of 4881 diary users (tribal: 2205; slum: 2185; rural: 491) participated in our project. In terms of acceptability, 49.6% (1093/2205), 64.7% (1413/2185) and 79.0% (388/491) at the tribal, slum and rural sites, respectively, expressed satisfaction with the scheme and a willingness to continue. In the tribal and slum areas, we observed increased reporting of illnesses from health diaries when compared with baseline data. We observed that influenza-like illnesses were reported with the highest frequency of 58.9% (2972/5044) at the tribal site. Conclusion We observed high levels of acceptability and participation among the communities. From our initial field studies, we have observed the benefits to both our study participants (timely preventive education and referrals) and to service providers (obtaining health data to allow improved planning).
Scrub Typhus is emerging as an important cause of fever of unknown origin and needs to be differe... more Scrub Typhus is emerging as an important cause of fever of unknown origin and needs to be differentiated from other causes of febrile illnesses. During March to June 2014, a systematic search on ‘Scrub typhus’ was conducted to determine epidemiology and factors causing re-emergence of this disease in India. Scrub typhus is an acute, febrile, infectious illness caused by Orientia tsutsugamushi , transmitted to humans through bites of the trombiculid mites. The infection can range from a mild, self-limiting disease to a fatal illness in 35-50% of cases, with multi-organ dysfunction, if not promptly diagnosed and appropriately treated. The reports of the disease were rare for several decades, but currently a clear re-emergence has been documented from several states in India. This resurgence may be attributed to changes in the human behavior-unplanned urbanization, deforestation and rapid transport leading to displacement of vectors as well the rodents from one place to another. There ...
BACKGROUND Tuberculosis (TB) is a major public health problem in India. The Revised National Tube... more BACKGROUND Tuberculosis (TB) is a major public health problem in India. The Revised National Tuberculosis Control Programme (RNTCP), started in 1997, involved medical colleges in the control of TB on a high priority. We assessed whether patients with TB referred from a tertiary care hospital in Delhi reached the desired peripheral health institution and had their treatment initiated. METHODS This descriptive, retrospective study was done at a tertiary care hospital and included all patients with a diagnosis of TB (pulmonary or extrapulmonary) who were seen at the referral centre during the year 2011. Data were collected from various records of the referral centre and analysed for availability of feedback of the referred patients. Information regarding their registration and initiation of treatment was also collected. Postcards were used for the first time to trace referrals in patients with TB. RESULTS The majority (94%) of patients with TB seen in the referral centre at a tertiary ...
Background: Quality of services shows a variation between the client and the provider. Therefore,... more Background: Quality of services shows a variation between the client and the provider. Therefore, it needs to be explored whether the quality of care or the lack of quality can explain the utilization of government health care. Objectives:This paper attempts to assess the utilization of health services and client satisfaction for services provided by a Primary Health Centre (PHC) at Delhi, India. Setting and design: The study was a facility based cross sectional study. Exit interviews were conducted among 400 patients seeking outdoor patient department (OPD) services of thePHC Palam, New Delhi from May 2010 to November 2010. Material and Methods: Exit interviews were conducted among the patients at each of the service delivery points in the PHC to assess the utilization of services and the satisfaction of clients with the available services. Results: Most respondents rated the services to be of good quality on various parameters of health delivery. The PHC was the preferred health f...
Sir, The history of television (TV) can be dated back to early 1960’s when TV first came to India... more Sir, The history of television (TV) can be dated back to early 1960’s when TV first came to India by the name of “Doordarshan” commonly named as “DD,” the so-called national TV network of India. It became an important means of mass media communication channel because of its unique feature of combining both audio as well as video technology. After around 50 years it has entered each and every home thus, serving as an important medium for disseminating information to its viewers. As it serves multiple functions of providing entertainment, information and education, it has a great influence on children’s overall development right from a very early age. (1) On one side it makes children aware of healthy habits, on the other hand, excessive TV watching leads to physical inactivity and consequently increased incidence of obesity. (2) Time spent in watching TV may be utilized in reading, outdoor games, etc. Since, adolescents form the most vulnerable and habitforming stage of life, the pre...
Background- The burden of diabetes in India is expected to worsen in the coming years. Indian Dia... more Background- The burden of diabetes in India is expected to worsen in the coming years. Indian Diabetes Risk Score (IDRS) is a validated and cost‑effective tool to identify risk of developing diabetes among population. Objectives- To assess the risk of Type 2 Diabetes mellitus using the IDRS in adults aged 30 years and above and to study the association of risk of diabetes with other factors. Material & Methods- A cross-sectional study was conducted in Kalyanpuri area of East Delhi. Data collection was done from August to December, 2018. 494 residents aged 30 years and above were included in the study. Data was collected using a semi-structured questionnaire. SPSS version 23 was used for data analysis. Results- 43.7 % of the study subjects were aged 50 years or above and majority (65.38%) were females. More than half (59.31%) of the subjects were found to have high risk of diabetes. Age and central obesity were found to be significantly associated with risk of diabetes (p<0.05). R...
Indian Journal of Community and Family Medicine, 2018
Introduction: As urbanisation is increasing, the problem of communicable as well as non-communica... more Introduction: As urbanisation is increasing, the problem of communicable as well as non-communicable diseases (NCDs) is also increasing. Hypertension, diabetes, obesity, cardiovascular diseases constitute most of the NCDs whose risk factors are almost similar. They could be modifiable like physical activity, waist circumference, diet, smoking, alcohol intake . Objective: To study the magnitude of shared risk factors for Non-communicable diseases in adults of an urban resettlement colony of Delhi. Material and Methods: A cross sectional survey was conducted on adults >30 years (n=580) in both genders in an urban resettlement colony of Delhi in 2014. A Semi-structured interview schedule consisting of Socio-demographic characteristics, risk factor profile was used. Data was entered and analyzed in SPSS 12 Results: Out of the total 580 subjects (313)53.96% were women and 267(46.03%) were men. Majority 405(69.8%) of the study subjects were taking inadequate fruits and vegetables (<5 times/day) and 212 (36.6%) were taking >5 gm salt per day. About 181(31.2%) of the study subjects were sedentary workers, the proportion was more among women 99(31.6%). 223(83.5%) men had waist circumference within normal limits whereas 178 (56.9%) women had waist circumference more than 88 cm. One in four men were smokers. Nearly 49(18.4 %) of the men were current tobacco chewers as compared to 17(1.6%) of women. Only 33 (12.4%) men were currently consuming alcohol. Results of multiple logistic regression showed increasing age, education and marital status as significant socio demographic factors for increased prevalence of risk factors for NCDs. Conclusion: Promotion of lifestyle change to address these risk factors that can be modified including weight reduction, increased physical activity and healthy eating should be encouraged along with changing of behavioural factors like quitting smoking and alcohol.
Indian Journal of Community and Family Medicine, 2018
Introduction: Blindness is one of the major public health problems in India. Visual rehabilitatio... more Introduction: Blindness is one of the major public health problems in India. Visual rehabilitation by corneal transplantation remains a major treatment option in those who are already blind due to corneal diseases. To combat with shortage of corneal donation in India, spreading awareness among masses regarding eye donation becomes important. Objectives: (1) To determine the awareness regarding eye donation amongst adults (>20 years) in an urban re-settlement colony of Delhi. (2) To assess their willingness to pledge for eye donation. (3) To determine the factors influencing their decision for eye donation. Material and Methods: This was a cross sectional study, conducted in the urban health centre attached to a medical college of Delhi between October to December 2013. Systematic random sampling was used and every alternate adult patient >20 yrs attending the UHC was recruited. Data entry and analysis was done using SPSS by a single investigator. Results: Majority (84.4%) had heard of eye donation. Only 21.2% were aware about contraindications for donating eyes. A little over quarter (27.6%) had heard of eye bank facility. When asked whether the retrieved eye can be stored before transplantation, majority (59.2%) didn’t know. More than half (54%) didn’t know which part of eye is removed. Mass media was major source of information in three forth respondents (74.9%). 45.5% were willing to pledge their eyes, a similar proportion was not willing (44.1%), five (2.4%) had already pledged and 17 (8.1%) were yet undecided to pledge. Conclusion: While majority of participants had heard of eye donation, but their knowledge regarding certain aspects of eye donation was found to be poor.
Abstract With increasing life expectancy the prevalence of osteoporosis is on rise and it poses a... more Abstract With increasing life expectancy the prevalence of osteoporosis is on rise and it poses a major public health issue. Bone Mineral Density (BMD) measurement by Dual Energy X-ray Absorptiometry (DEXA) is now widely available and is considered as a gold standard. Bone density measured by DEXA is obtained in grams/cm2, but in clinical practice these values are standardized and are expressed as T and Z scores. These scores are used for diagnosis and management of osteoporosis, but assessment with these scores alone is not without pitfalls. Any health care provider without complete awareness of these pitfalls could make an inappropriate diagnosis. Lumbar spine, proximal femur and wrist are the most common sites for BMD assessment. Degenerative changes a spine or hip, healed fractures, avascular necrosis, benign or metastatic bone forming lesions present as a false positive increase in BMD, while laminectomy defects and lytic lesions result in false negative decrease in BMD. Also the scores are dependent on age, gender, race and the machine used. Thus for follow up, it is important use the same scanner with same software version. In case of any discrepancy, it is necessary to compare the raw BMD values.
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Papers by Anita Acharya