To develop a public private partnership model of disease notification as a part of integrated disease surveillance project (IDSP) for private medical practitioners in Mumbai City, India

Background The main objective of Integrated Disease Surveillance Project (IDSP) was early detection of disease outbreaks. This could be possible only when the public health authorities have a strong and effective surveillance system in collaboration with Private Health Sector. Objectives 1) To assess knowledge, attitude & practice about notification of diseases amongst Private Medical Practitioners (PMPs). 2) To find out barriers experienced by PMPs in reporting of diseases under surveillance. 3) To assess feasibility of various alternative ways of reporting convenient for PMPs. 4) To develop a Public Private Partnership Model of disease notification based on feasible options obtained in the study. Materials and Methods This study was a cross-sectional descriptive study conducted in the F South Municipal ward of Mumbai city during April-May 2011. Two stage simple random sampling was used to select 104 PMPs for the study. Results and Conclusions Nearly 98% PMPs felt importance of notification in health system, but only 46% had practiced it. Most common reason for non-reporting was lack of information about reporting system. The convenient way of reporting for PMPs was to report to the nearest health post personally or to District Surveillance Unit through SMS/phone call and both at weekly interval

Assessing Dietary Intake Patterns Through Cluster Analysis Among Adolescents in Selected Districts of Bihar and Assam From India : A Cross-Sectional Survey

Background: In the recent decade, dietary pattern assessment has evolved as a promising tool to describe the whole diet and represent inter-correlations between different dietary components. We aimed to derive the dietary patterns of adolescents (10–19 years) using cluster analysis on food groups and evaluate these patterns according to their socio-demographic profile. Methods: This community-based cross-sectional study was conducted in two districts, each from Bihar and Assam in India. Adolescents (10–19 years) were enrolled from both rural and urban areas. The dietary intake was assessed through a pre-validated single food frequency questionnaire. Cluster analysis was performed by a 2-step procedure to explore dietary patterns, pre-fixed at 2 clusters. Clusters were analyzed with respect to socio-demographic characteristics using binomial logistic regression. Results: A total of 826 girls and 811 boys were enrolled in the study. We found two major dietary patterns, namely a low- and high-mixed diet. The low-mixed diet (76.5% prevalence) had daily consumption of green vegetables, including leafy vegetables, with less frequent consumption of other foods. The high-mixed diet (23.5% prevalence) had more frequent consumption of chicken, meat, egg, and milk/curd apart from green vegetables. Adolescent boys had 3.6 times higher odds of consuming a low-mixed diet compared to girls. Similarly, adolescents with lower education grades and from marginalized social classes had two times higher odds of taking a low-mixed diet than their respective counterparts. Conclusions: The high consumption of a low-mixed diet and relatively less milk consumption limit the comprehensive growth of adolescents. Improvement in dietary intake of adolescents from marginalized sections of society can prove to be an important deterrent in mitigating India's nutritional challenges

A longitudinal study to assess the cost incurred by patients undergoing treatment for tuberculosis in an urban slum community

Objectives: The objective of the study was to estimate direct medical/nonmedical and indirect costs incurred by patients diagnosed with tuberculosis (TB) residing in an urban slum of Mumbai. Subjects and Methods: A longitudinal study of 16 months duration (June 2013-September 2014) was undertaken in a directly observed treatment short-course (DOTS) center of an urban slum area. The method of sampling was universal sampling and thus all the patients who were registered in the period June 2013 to December 2013 were enrolled as study participants. These subjects were then followed for their completion of treatment. All the subjects were interviewed using a semistructured questionnaire to obtain the desired information. Permission from the Institutional Ethics Committee was obtained. Statistical analysis was performed using SPSS software version 19. Results: Of the 232 patients enrolled in the study, 176 (75.9%) completed the entire course of treatment. The median direct, indirect, and total costs for 176 patients were: pretreatment direct medical cost, direct nonmedical cost, and pretreatment indirect cost was Rs. 1200 ($20), Rs. 800 ($13.3), and Rs. 1250 ($20.8), respectively. However, during the course of treatment direct medical cost, direct nonmedical cost, and indirect cost were nil, Rs. 360 ($6) and Rs. 400 ($6.6), respectively. Conclusion: Despite the free availability of diagnostic and treatment component of TB in India, the majority of the tuberculosis patients still have to spend a significant amount of money