RESUMEN
BACKGROUND: The past decade has seen a decline in the disability-adjusted life years (DALYs) contributed by communicable diseases while lifestyle changes and rapid urbanization have led to an increase in DALYs contributed by non-communicable diseases. We studied the causes of death in a low socioeconomic area over 11 years to help identify changes in the pattern of disease. METHODS: We did this study in Gokulpuri, a resettlement colony in East Delhi. All deaths occurring from 1994 to 2004 were analysed using a verbal autopsy questionnaire completed by trained health workers during their home visits in the area. RESULTS: A total of 515 deaths occurred during the period; 340 in men (66%) and 175 in women (34%). The six commonest causes of death were tuberculosis (24.8%), chronic obstructive pulmonary disease (11.6%), pneumonia (8.7%), accidents and poisoning (8.6 %), coronary heart disease (8.2%) and cancer (4.6%). The age-specific mortality rate was highest among people > 45 years of age. The cause-specific mortality rate due to communicable diseases showed a decline while that due to non-communicable diseases showed a rising trend in all age groups. CONCLUSION: Our study shows the coexistence of communicable and non-communicable diseases in a low socioeconomic area with a rising trend in non-communicable diseases. Surveillance for risk factors of non-communicable diseases should be done even in predominantly low socioeconomic areas. The coexistence of communicable and non-communicable diseases and the increase in non-communicable diseases among the economically deprived sections of our society suggest the need to re-prioritize components of healthcare among these sections.
Asunto(s)
Enfermedad de la Arteria Coronaria/mortalidad , Estilo de Vida , Neumonía/mortalidad , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Características de la Residencia , Tuberculosis/mortalidad , Enfermedad Aguda/mortalidad , Adolescente , Adulto , Anciano , Autopsia , Causas de Muerte , Niño , Preescolar , Enfermedad Crónica/mortalidad , Enfermedad de la Arteria Coronaria/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , India/epidemiología , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Neumonía/epidemiología , Vigilancia de la Población , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Factores de Riesgo , Factores Socioeconómicos , Encuestas y Cuestionarios , Tuberculosis/epidemiologíaRESUMEN
Nutritional status of 1661 children aged 6 months to 2 years who attended the Well Baby Clinic of UHC Gokulpuri, Delhi during the year 2000 was studied. 60.7% of them were malnourished. Undesirable practices of discarding the colostrum, not exclusively breast feeding the child till at least 4 months of age, delayed weaning, dilution of top milk, use of bottle and nipple for feeding the children are still widely prevalent.
Asunto(s)
Emigración e Inmigración/estadística & datos numéricos , Trastornos Nutricionales/epidemiología , Factores de Edad , Femenino , Humanos , India/epidemiología , Lactante , MasculinoRESUMEN
A survey conducted among the lower-class urban population of Delhi, India to describe the heterosexual behaviour, condom usage and awareness about STDs/AIDS revealed that 4.4% respondents had sex outside/before marriage. Female commercial sex workers, friends and neighbours were the important sexual partners. Heterosexual activity was significantly higher among males, unmarried, literates and middle/higher income groups. Almost half of those who had sex before/outside marriage never used a condom during the sexual encounter. Though only a small fraction of the population was found to be engaged in extra-/pre-marital sex, the overall impact of this may be multifold, given the nature and modes of HIV transmission. The superficial and inadequate knowledge regarding STDs/AIDS among this population, especially among those having extra-/pre-marital sex, indicates an urgent need for appropriately targeted health education and condom promotion activities in the community with an endeavour to increase awareness about STDs and HIV/AIDS and motivate people towards healthy sexual lifestyles.
PIP: Patterns of premarital and/or extramarital sex and condom use were investigated in a random sample of 1805 male and female residents of a lower-class urban resettlement colony in East Delhi, India, in 1993. The mean age of male respondents was 30.3 years, while that of females was 29.0 years. In the year preceding the survey, 80 respondents (4.4%) reported having premarital (n = 27) or extramarital (n = 53) sex. Such encounters were reported significantly more often by men, Hindus and Muslims, literates, and those with higher incomes. 70% of those reporting pre- or extramarital sex had heard of AIDS compared with 31.8% of those who had not engaged in these behaviors, but there was no difference between groups in knowledge of how to prevent AIDS and other sexually transmitted diseases. 48.8% of those who reported pre- or extramarital sex in the past year had never used a condom; more than three-quarters of the remaining respondents acknowledged irregular condom use, both with their spouse and other sex partners, including commercial sex workers. These findings indicate an immediate need for IEC campaigns in this population focused on the heterosexual transmission of AIDS and the importance of consistent condom use.
Asunto(s)
Condones/estadística & datos numéricos , Conducta Sexual , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Femenino , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Encuestas Epidemiológicas , Humanos , India , Masculino , Persona de Mediana Edad , Factores Sexuales , Parejas Sexuales , Enfermedades de Transmisión Sexual/prevención & control , Factores SocioeconómicosRESUMEN
Two hundred thirteen teachers of one secondary and four primary schools of East Delhi were interviewed to assess their knowledge and attitudes about AIDS and their opinions regarding school based AIDS education. Observations revealed that majority of the teachers were aware of various aspects of HIV/AIDS. However, they also had some misconceptions regarding transmission of the disease. Though, most of the teachers opined that they could play an important role in educating the students as well as the community regarding AIDS/STDs, three fourths of them had never discussed AIDS/STDs with their students. Majority of teachers were in favour of starting class room based education on AIDS/STDs, beginning from secondary classes onwards, and more than half opined that class teacher could educate the students better than the doctors or parents. The results suggest that after being properly trained, teachers can be effectively utilized for educating the students.