Economic burden of hypertension care on households of Malwani slum of Mumbai: a cross-sectional study

Background: Hypertension is a chronic non-communicable disease that effects adversely on heart, brain and kidney. Nearly 2/3rd of all hypertensive patients live in low and middle income countries, so the economic burden of hypertension is huge. India is one of those countries which spent more than 1/3rd of all income on CVD and hypertension. This study was conceptualized to study the disease and economic burden of hypertension.Methods: A cross-sectional study was conducted in New Collector Compound (NCC) of Malwani. Five plots of NCC were selected by simple random sampling. A list of hypertensive patients was prepared by house-to-house survey. Fifty per cent patients were selected randomly for studying economic burden.Results: The study covered 447 households and 2360 persons. Eighty participants (3.4%) were found hypertensive. The average annual total cost of hypertension and related disorders was Rs. 7154. It was Rs. 6073 and Rs. 8235 for government and private respectively. Only 7.50% households were not incurring any cost of illness. The average annual out of pocket expenditure (OOPE) was Rs. 4042 and Rs. 7621 for government and private facilities respectively. Fifteen per cent households were incurring catastrophic expenditure at highest threshold of 40%. The catastrophic spending led to impoverishment of 34.2% households.Conclusions: High prevalence of hypertension, high OOPE, high incidence of catastrophic spending and impoverishment among households intensively reflect the need of interventions. Early preventive measures may be a key in controlling economic and disease burden. There is need to provide the financial risk protection against the OOPE for outpatient care.

Knowledge, Attitude and Practices regarding tuberculosis among slum pockets of western Mumbai: a cross sectional study

Background: Tuberculosis (TB) is a major public health problem prevailing in the rural and urban areas of India. A study was conducted to assess the Knowledge, Attitude, and Practices regarding tuberculosis among slum pockets of western Mumbai. Material and methods: Cross sectional quantitative study conducted using a pre-validated WHO KAP questionnaire. Random walk technique stratified by daytime was used. Descriptive analysis and inferential statistics (Chi-square test) were used. Result: A total of 140 participants were interviewed. Knowledge received from friends, neighbors reported more (58%) in NCC and squatters colony as compared Ambujwadi (48.6%). People held compassion and desire to help people living with TB (59.3%), but only 1.4% participants had reported actual support to TB patients in need. Stigma of TB (80.0%) is one of the most difficult challenges which attributed to hiding of TB disease status. Almost all respondents agreed that people hide TB status because of “fear that people will avoid them”.BMC corporation hospital (82.9 %) is the first choice of health seeking among the study participants however only 7.9 % of people knew about DOTs. Gender (p<0.005) and educational status (p<0.05) were found significantly associated with the knowledge of TB. Conclusion: Knowledge towards tuberculosis within the population is poor. It suggests that specialized educational programs should be developed for community to promote awareness regarding TB. The findings regarding attitude and stigma indicate need to address “stigma related to TB” by health care facilitators and community people at the time of health education