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Dec 2024 DOI 10.14302/issn.2641-4538.jphi-24-5358
Background Injuries, particularly unintentional ones, are a neglected public health concern and are preventable or avoidable. Children in urban slums are especially vulnerable due to hazardous living conditions, inadequate supervision, and lack of safe sojourns or play areas. Since these injuries result in seeming spontaneous recovery, appropriate care being initiated by the primary care giver is questionable. Objective To assess the burden of unintentional injuries of unintentional injuries in pre-school going children aged 2-6 years in urban slums of Bhubaneswar, Odisha. To compare the knowledge of the 1st level care post-injury among the primary care givers against standardized prescribed care. Methods A cross-sectional descriptive observational study was conducted for over 2 years in urban slums under the Bhubaneswar Municipal Corporation (BMC), the capital city of Odisha. A total of 285 children aged 2-6 years, whose mothers consented to participate, were included in the study. Data regarding the type of injury and its management, as well as, associated socio-demographic factors, were collected using a pre-designed, pre-tested questionnaire. Descriptive statistics was used to derive the burden of unintentional injuries in children. The knowledge of the 1st level of care to be given after the common injuries was assessed among all the primary caregivers to detect the treatment and care gap. Results The majority of primary respondents were mothers aged 21-30 years (82.1%), The frequency of an episode of unintentional injury (occurrence in last 3 months) in the study population was found to be 58%. The most common type of injury reported was skin lacerations or tears, common site being in the upper and lower limbs. Males were more affected as compared to females (54.64 %) The reporting of unintentional injuries among the children was found to have significant association with the occupation of the father. Fathers who were unemployed or working as unskilled labor, their child’s probability of reporting an unintentional injury was found to be high, with p value coming to be statistically significant. Conclusion The study highlights the complex interplay of sociodemographic factors influencing unintentional injuries among children in urban slums and the need to create awareness among the primary caregivers, about the immediate management, so that chronic complications may be averted. It is difficult to avert injury as this age group is agile and nowadays supervision is challenging. Still, the knowledge of management would not just empower the caregiver, but also the growing child, who can attend to their younger siblings or themselves, whenever they get injured next. Further research with larger sample sizes is warranted to validate these findings and develop effective prevention strategies.
May 2023 DOI 10.14302/issn.2691-5014.jphn-23-4555
Severe ascorbic acid (Vitamin C) deficiency, commonly known as “scurvy,” continues to be a problem in malnourished populations across the world but is relatively rare in the United States. Early features of this condition include general weakness, fatigue, and aching limbs. An extremely rare and late feature of this condition is subgaleal hemorrhage. Scurvy has such a low prevalence in First World countries that it is often misdiagnosed or not diagnosed at all. The subject in this case report presented acutely and is one of few to involve a subgaleal hemorrhage to be documented in medical literature to date. Laboratory studies and clinical improvement through treatment established the diagnosis. Ascorbic acid deficiency should be considered when evaluating children with poor nutrition despite socioeconomic status, living conditions, or access to health care. This case also reminds us that neurodivergent children are a vulnerable population and more research will need to be conducted to determine just how detrimental the pandemic has been to patients with ongoing problems who were lost to follow up.
May 2022 DOI 10.14302/issn.2641-4538.jphi-22-4167
Objectives This study aims to evaluate the challenges of implementing non-pharmaceutical interventions, assess adherence, accessibility to prevention materials and identify requirements for the control of the spread of COVID-19 among individuals living in a slum-setting in Lagos, Nigeria. Methods This is a five-month cross-sectional study conducted in Makoko, Lagos an urban-slum community. Data on sociodemographic characteristics, living conditions and adherence to COVID-19 prevention strategies were obtained with a semi-structured questionnaire. Logistics-regression model was used to determine factors associated with adherence to COVID-19 preventive measures. Results There was a total of 357 participants who had a mean age of 45.8 ± 12.9 years. Majority were males (62.2%), married (83.8%), self-employed (66.4%), and had secondary education (31.4%). Most participants (93.8%) had no space for self-isolation as majority lived in a one-room apartment (72.8%), shared toilets/kitchen space (64.4 %), had no constant source of water supply (61.9%) and buy water (62.5%). About 98.8% are aware of the COVID-19 pandemic but only 33.9% adhered. Most of the participants disclosed inability to purchase face masks/ hand sanitizers (68.9%). After adjusting for covariates, the ability to afford facemasks/hand sanitizers (P < 0.0001, aOR 6.646; 95% CI: 3.805-11.609), living alone (P < 0.0001, aOR 3.658; 95% CI: 1.267-10.558), and ability to buy water (aOR: 0.27; 95% CI: 0.14-0.50), had greater odds of association with adherence to the non-pharmaceutical COVID-19 preventive measures. Conclusion The lack of isolation space among majority of the respondents calls for concern. Inability to purchase prevention materials is a major factor influencing poor compliance to COVID-19 prevention strategies.
Jan 2016 DOI 10.14302/issn.2381-862X.jwrh-15-801
Objectives: To measure the horizontal inequity in the uptake of hospital delivery and quantify the contribution of various social determinants of health (SDH) to such inequity in China from 1993-2008 Methods: With four national representative surveys in China conducted in 1993, 1998, 2003 and 2008, we measured horizontal inequity in the uptake of hospital delivery using indirect standardized concentration indices (CIs). By decomposing Cis into components, we explored the contributions of income, health insurance, education, living conditions to such inequities. Oaxaca type decomposition was further used to explain the role for each SDH on the changes of inequities between 1993 and 2008. Results: We found that horizontal inequity in the coverage of hospital delivery approached equal line in the urban areas and shrank by 90% in rural China in 1993-2008. The data also showed that dramatic socio-economic achievement was made across the 16 years, including education, income, health insurance and living conditions, which contributed substantially to the reduction of the inequities in the uptake of hospital delivery. Income’s contribution was mainly made by its protection effect, while health insurance’s role was mainly played by its equal distributions in the rural areas. Conclusions: The horizontal inequity in the uptake of hospital births vanished in urban China and decreased in the rural. The leading contributors to such inequity were income, health insurance, living conditions and education. Decomposition analysis suggests that more investments are warranted for financial risk protection and targeted demand side subsidies may make a difference.