Background: Diabetes mellitus (DM) is associated with high morbidity and mortality. It has various complications. Risk factor control is effective way of prevention. Current study was conducted to know demographic profile including risk factors related to diabetes mellitus in patients attending a tertiary health care institute of Rajasthan.Methods: This cross-sectional study was conducted for the duration of six months. In the study 623 diabetes mellitus type 2 patients were included and subjected to evaluation of various demographic parameters and risk factors like age, sex, economic status, area of residence, obesity, hypertension (HTN), lack of exercise, smoking, dyslipidemia and positive family history.Results: Mean age of diabetic population was 62 years. Male-female, urban-rural ratios were nearly 1:1 and 3:2 respectively. Nearly 7 % patients were found to be below poverty line (BPL). On risk factor evaluation of 623 diabetic patients it was found that 598 (96%) patients had lack of exercise, 406 (65.2%) patients had age more than 60 years, 394 (63.2%) patients had dyslipidemia, 210 (33.7%) patients were smoker as per the mentioned criteria, 144 (23.1%) patients were obese, 118 (19%) patients had HTN before emergence of DM and 90 (14.4%) patients had positive family history.Conclusions: High prevalence of risk factors in Indian community is alarming. Health education, promotion of exercise, favourable life style, dietary modification, cessation of smoking, screening programmes for early detection of derange blood pressure, blood sugar, lipid profile can be effective prevention strategies.
Introduction: 'Out-of-pocket expenditure' (OOPE) is the expenditures at the point of receiving health care directly by households which affects the economic stability of the household. When the expenditure on immunization of under-five children results in OOPE, it affects the motivation of parents for vaccination inversely. Aim: This study was planned to evaluate the out-of-pocket expenditure and to assess predictors of OOPE on routine immunization practices. Settings and design: This was a cross-sectional community-based study conducted from May to August 2019 at one of the immunization sites at primary health centers under a tertiary care institute of southern Rajasthan. Material and methods: At the selected health facility, randomly 75% of beneficiaries of routine immunization were enrolled for the study. Data were collected using a pre-designed, pre-tested semistructured questionnaire about direct and indirect expenses during the process of immunization incurred by the parents of the vaccinee by interview technique. Results: In the study, 72.36% were infants, and 56.10% had first birth order. Mother accompanied nearly half of the vaccinee (49.6%) to the vaccination centre and the most used mode of transportation was the personal vehicle (63%). Mean loss of wages among parents/caretakers was 0.58 (±0.66) USD (median = 0.69; interquartile range (IQR) = 0.69; 95% confidence interval (CI) = 0.42-0.73) while average cost of transportation worn was 0.16 (±0.20) USD (median = 0.07; IQR = 0.21; 95% CI = 0.12-0.19) and mean duration of travelling to reach health facility was 11.87 (±7.53) minutes (median = 10; IQR = 10; 95% CI = 10.53-13.20). Vaccination at the centre was free of cost (zero USD) and no cost was incurred for drugs or registration. Average OPPE was 0.74 (±0.97) USD (median = 0.35; IQR = 0.62; 95% CI = 0.56-0.91) and regression analysis predicted significant contributors as age of vaccinee (p = 0.00; OR = 0.11; 95% CI = 0.04-0.34), religion (p = 0.04; OR = 0.34; 95% CI = 0.12-0.97) area of residence (p = 0.00; OR = 6.77; 95% CI = 2.37-19.32), birth order of vaccinee (p = 0.02; OR = 0.3; 95% CI = 0.11-0.85), longer waiting time (p = 0.03; OR = 0.16; 95% CI = 0.03-0.85), travelling time (p = 0.00; OR = 3.47; 95% CI = 1.49-8.09) and long distances (p = 0.00; OR = 10.40; 95% CI = 2.56-42.03) travelled to reach vaccination centre. Conclusion: The hidden cost of vaccination in the form of loss of wages and time, travel cost due to stretched distance traveled by family members to accompany vaccinee to immunization facility is experienced as OOPE by the families and could be one of the impediments in vaccination coverage. Amendments in the existing policies are required to reduce this invisible cost of vaccination.
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