Knowledge about the existing disease pattern and health seeking behavior is essential to provide need based health care delivery to any population and to make the health care system more pro-poor. A community based cross sectional study was conducted among 493 systematically selected households in the Modhukhali Upazilla of Faridpur District to determine the prevailing disease pattern and health seeking behavior in rural Bangladesh. Data were collected through face-to-face interview of the selected respondents. More than half of the respondents gave history of illness of her or her family members during the preceding 15 days. Fever (33.2%), gastrointestinal diseases (24.9%) and respiratory diseases (17.8%) were the most reported complaints. Overall, there were no discernible differences in the likelihood of seeking traditional or any kind of care considering socio-demographic variables and prevailing disease types. Occupation of household head as day labor or in agriculture and suffering from gastrointestinal diseases positively predicted use of para-professionals. Use of un-qualified allopths was negatively predicted by the male gender or literacy of the household head and presence of gastrointestinal, respiratory and other types of diseases and positively predicted by occupation of the household head in agricultural field or as day labor. Use of qualified allopaths was positively predicted by respiratory, skin/eye/ENT and other types of diseases and also by standard of living and relationship of the respondents with household head and negatively predicted by agricultural or day labor work of the household head. Existence of several distinct therapeutic systems in a single cultural setting was found to be an important feature of health care system in the study area. This study concluded that it is important to develop a need based health care delivery system and actions should be taken to improve the overall scenario of health system of rural Bangladesh. Key words: Disease pattern; health seeking behavior; rural area; Bangladesh DOI: 10.3329/fmcj.v6i1.7408 Faridpur Med. Coll. J. 2011;6(1): 32-37
e19029 Background: CML, although a disease of middle age, is not uncommon in younger age groups in developing countries like Pakistan. Methods: In this single center, cross sectional study, all patients diagnosed with CML below 30 years of age were enrolled. After collection, data was analyzed using Spss version 23.Quantitative variable were presented as mean and percentages. Chi-square was used for correlation between variables with p<0.05 considered significant. Results: Total 101 patients, with age range 7-30 years (mean 21.99±6.3), including 18(17.8%) below 15 years, were enrolled. Fever was most common presenting symptoms seen in 61(60.4%) followed by fatigue, abdominal distension in 40(39.6%) and 33(32.7%).Mean presenting TLC was 158.9±136.95. Of these, 97(96.03%) patients were in chronic phase, 3(2.97%) had accelerated and 1(1%) in blast phase. As per SOKAL score, 27 (26.73%), 51(50.49%) and 23(22.77%) had low, intermediate and high risk disease respectively. Imatinib was started in 80.19% while Nilotinib in 19.80% as 1st line TKI. Among these, 88.1% achieved CHR by end of 3rd month. After 1st year, 60.8% achieved a molecular response (MR≥3). 1(1%) transformed from chronic to blast phase.2nd line TKI was started in 13.8% due to lack of response. Grade ¾ thrombocytopenia and grade ½ per-orbital edema were main toxicities seen in 10.7% and 9.6% respectively. Co-relation of increasing age with high TLC (p=0.039) and better response to TKI (p=0.014) was statistically significant. Conclusions: Distinct clinical behavior of CML in children and young adults necessitates further studies to ensure better disease management.[Table: see text]
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