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068 |
PREVALENCE OF CHEST SYMPTOMS AND ACTION TAKEN BY
SYMPTOMATICS IN A RURAL COMMUNITY |
Radha Narayan, Susy Thomas, S Pramila Kumari, S Prabhakar,
AN Ramaprakash, T Suresh & N Srikantaramu: Indian J TB 1976,
23, 160-68. |
A study was conducted in 55 randomly selected villages
of Nelamangala taluk, Bangalore district in 1975 (1) to estimate
the prevalence of symptoms in the general population during the
two months prior to the epidemiological survey, (2) to study the
nature of action taken by these symptomatics and, (3) to find out
through sputum examination as to how many of them suffer from pulmonary
tuberculosis. The entire population was interviewed and sputum was
collected from those aged five years and above having symptoms continuously
for seven days and more. A coverage of 98.8% was obtained. Symptomatics
among the directly interviewed were almost double (32.3%) of those
who had to be interviewed by proxy (16.8%). Proportion of symptomatics
were higher in the age groups twenty years and above. 24.8% were
symptomatic during the reference period of two months and 16.7%
had symptoms on the day of interview. ll.1% were found to have chest
symptoms. The prevalence rate of tuberculosis was found to be 21
per 1000, (for males 28 and females 14). Cough was the most prevalent
and the symptom of longest duration.
The findings suggest that symptoms questioning
should focus more on cough and its combination with other symptoms.
Symptoms questioning as a tool to detect cases has less potential
than X-ray, but data reveal that leading questions can elicit more
information on symptoms and action taking. The manner of action
taking was the same for chest symptoms as for other symptoms and
the proportion taking action is also the same for males and females.
Government health facilities are found to be the most important
source of relief, indigenous medicine having some importance marked
second and the private practitioners ranking only third.
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KEY WORDS: SYMPTOMS, ACTION TAKING, RURAL POPULATION. |
069 |
INTERVIEW AS A TOOL FOR SYMPTOM SCREENING IN PULMONARY
TUBERCULOSIS |
Radha Narayan, Susy Thomas, S Prabhakar & N Srikantaramu:
Indian J Soc Work 1978, 38, 367-74. |
Persons suffering from pulmonary tuberculosis generally
experience symptoms such as cough, chest pain, fever and haemoptysis.
It is possible to identify the symptomatics by interviewing them
during community health surveys. The symptom survey was carried
out in 62 villages and 4 town blocks of Tumkur district in Karnataka
as a sequel to an epidemiological survey undertaken to estimate
the prevalence of tuberculosis. The data was collected through structured
schedule. The interviewers were given the identification details
of individuals having X-ray shadows suggestive of tuberculosis and
an equal number of matched controls within 4 weeks of the survey.
A total of 1752 persons were taken into the study of whom 875 had
x ray shadows and 877 were normals. Of the total persons under study
89.7% were satisfactorily interviewed. It was observed that 42.6%
of the total symptomatics gave history of one symptom at the
first general question, 13% responded having symptoms after
being asked specific questions. In conclusion a 42.6% affirmative
response to the initial question of 'How is your health' is noteworthy
that an investigator is acceptable health agency as the interviewee
is willing to confide in him regarding his health problems. Additional
number of persons responded to direct specific questions.
It must be pointed out that interview is a generic
term applied to a tool that may be used for obtaining information
through verbal communication. As a tool in surveys for screening
for tuberculosis it is amenable to divese techniques and has great
potentialities of being applied to different situations and various
categories of respondents. Hence, it is necessary to identify the
nature of data to be obtained and to decide on the technique that
would be most suitable. Proper training, skill and supervision of
the interviewer can obviate any possible bias and subjectivity that
could vitiate an interview. As compared to many of the tools of
social science research, the interview is simple, easy and amenable
to being used in live situations. It is also of prime importance
among populations for whom vocalisation is the most important medium
of communication. Hence, in a community survey for the estimation
of the prevalence of chest symptomatics the interview can be
a valuable tool. It also shows that the interview is adequate
as a tool of community survey in tuberculosis.
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KEY WORDS: SYMPTOMS, SCREENING TOOLS, INTERVIEW,
CONTROL PROGRAMME, RURAL POPULATION. |
070 |
A SOCIOLOGICAL STUDY OF AWARENESS OF SYMPTOMS AND
ACTION TAKING OF PERSONS WITH PULMONARY TUBERCULOSIS (A RESURVEY) |
Radha Narayan, S Prabhakar, Susy Thomas, S Pramila
Kumari, T Suresh & N Srikantaramu: Indian J TB 1979, 26, 136-46. |
A study on awareness of symptoms of pulmonary tuberculosis
and action taking was repeated in the 62 villages and 4 town blocks
of Tumkur district of Karnataka after an interval of 12 years. In
the earlier study, 2106 persons formed the study population. In
the present study, 1752 were intaken to obtain a comparison of these
1752 intaken persons who were eligible for interview, 875 were X-ray
positive and 877 X-ray normal (matched control).
The study showed that 95% of patients having radiologically
active tuberculosis by both X-ray readers, 70% by one reader, 49.5%
inactive by both readers, were aware of symptoms. According to the
bacteriological status 79.5% had symptoms among those who were sputum
positive by both microscopy and culture, 62.2% among those positive
by culture alone and 73.7% among patients sputum positive by any
method. Regarding action taking it was observed that 49.5% of the
bacteriologically positive patients took some action compared by
70% of those found to have radiologically active disease by both
X-ray readers. Thus action taking was higher among the latter category
in both the studies. It may be due to the fact that extent of lesions
are less advanced among those bacteriologically positive than among
those who were in radiologically positive stage.
The findings of the study are similar to the earlier
awareness study carried out in 1963 in the same area (Tumkur). This
also indicates that in spite of having advantage of DTP for a decade
actual and total benefits have not reached the people.
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KEY WORDS: SOCIAL AWARENESS, ACTION TAKING,
SYMPTOMS, RURAL POPULATION, URBAN POPULATION, INTERVIEW, CONTROL PROGRAMME. |
072 |
ILLNESS PERCEPTION AND MEDICAL RELIEF IN RURAL COMMUNITIES |
Radha Narayan, Susy Thomas, N Srikantaramu & K
Srikantan: Indian J TB 1982, 29, 98-103. |
Illness is mostly a subjective awareness of an
individual, the relief of which may be sought within or outside
medical or health facilities. Perception of illness vary from people
to people depending upon cultural, ethnic and socio-economic differences.
Perception of symptoms by persons suffering from tuberculosis is
very high yet only half of them approach modern medical facility
for alleviation of their suffering. A survey was carried out in
rural area of Hoskote taluk, Bangalore district to determine perceived
morbidity and accessible medical relief in 1433 households belonging
to 18 villages; of them, 1393 (97%) were successfully interviewed.
Selected households belonged to three types of villages i.e., those
being within 3 kms of a i)PHC, ii)taluk headquarters hospital and
non- Governmental health centre.
Of the 9286 individual belonging to 1393 households
satisfactorily interviewed regarding health, 1201 (12.9%) were found
to be ill at some point of time during the reference period of one
month. No differences were observed in the perception of morbidity
or in the health seeking behaviour in the three groups of villages.
Persons with symptoms/disease accounted for 88.8% of the total sickness,
3.4% for injuries and 9.3% for disabilities, while action taking
was 61.6%, 90% and 13.5% respectively. Age sex distribution showed
no difference in illness occurrence. Sputum was collected from 147
chest symptomatics and seven were found to be sputum positive. Government
health facilities were utilized by 37.6% of the sick persons, private
doctors by 36.4%, nature medicine by 10.6% and home remedies by
only 9.9%. In conclusion, the services at the government health
facilities were acceptable and were utilized if accessible. Prompt
and adequate relief for injuries and acute indispositions ensures
confidence of the people and better utilization.
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KEY WORDS: ILLNESS PERCEPTION, RURAL COMMUNITY,
MEDICAL RELIEF, HEALTHSERVICES, UTILIZATION. |
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