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Socio-Demographic Profile and Morbidity Pattern of Patients in A Rural Field Practice Area of Government Medical College, Miraj, Maharashtra

2019, National journal of community medicine

Introduction: The shifting trend of diseases from communicable to non-communicable diseases pose a dual threat in India will also add to the burden of morbidity. In view of this, the present study was conduct-ed to assess the common morbidity pattern among the rural population of Maharashtra. Material and methods: A cross sec-tional study were conducted among the rural population of field practice area of Government Medical Col-lege, Miraj, Maharashtra. The study was conducted from 1st January 2018 to 31st December 2018. Patients attending Out Patient Department (OPD) services of Rural Health Training Centre and willing to par-ticipate in the study were included. Data on the current morbidity among the patients attending OPD services was gathered by the health workers. Analysis was conducted using the percentages. Results: It was observed that majori-ty of patients attended the OPD ser-vices were females i.e. 54.3% and 45.7% patients were males. The most common morbidity observed am...

ORIGINAL RESEARCH ARTICLE pISSN 0976 3325│eISSN 2229 6816 Open Access Article www.njcmindia.org Socio-Demographic Profile and Morbidity Pattern of Patients in A Rural Field Practice Area of Government Medical College, Miraj, Maharashtra Vikas D Kshirsagar1, Shekhar S Rajderkar2, Shivaji Aldar3, Sonali Wetam3 Financial Support: None declared Conflict of Interest: None declared Copy Right: The Journal retains the copyrights of this article. However, reproduction is permissible with due acknowledgement of the source. How to cite this article: Kshirsagar VD, Rajderkar SS, Aldar S, Wetam S. Socio-Demographic Profile and Morbidity Pattern of Patients in A Rural Field Practice Area of Government Medical College, Miraj, Maharashtra. Natl J Community Med 2019; 10(5): 308-311 Author’s Affiliation: 1Associate Professor; 2Professor; 3Junior Resident, Community Medicine, Govt. Medical College, Miraj, Miraj Correspondence Dr. Shekhar S Rajderkar rajderkar1957@yahoo.co.in Date of Submission: 15-03-19 Date of Acceptance: 12-04-19 Date of Publication: 31-05-19 ABSTRACT Introduction: The shifting trend of diseases from communicable to non-communicable diseases pose a dual threat in India will also add to the burden of morbidity. In view of this, the present study was conducted to assess the common morbidity pattern among the rural population of Maharashtra. Material and methods: A cross sectional study were conducted among the rural population of field practice area of Government Medical College, Miraj, Maharashtra. The study was conducted from 1st January 2018 to 31st December 2018. Patients attending Out Patient Department (OPD) services of Rural Health Training Centre and willing to participate in the study were included. Data on the current morbidity among the patients attending OPD services was gathered by the health workers. Analysis was conducted using the percentages. Results: It was observed that majority of patients attended the OPD services were females i.e. 54.3% and 45.7% patients were males. The most common morbidity observed among the participants was respiratory infections i.e. 29.8%. Other morbidities seen were musculoskeletal diseases in 17.3% participants, nutritional problems in 17.1% participants and non-communicable diseases in 13.6% study subjects. Conclusion: The study revealed dual burden of communicable as well as chronic and non-communicable diseases in the rural population. Key words: Socio-demographic profile. Morbidity INTRODUCTION As per WHO, health has multidimensional concepts. The spectral concept of health emphasizes that the health of an individual is not static; it is a dynamic phenomenon and a process of continuous change, subject to frequent subtle variations. A direct relationship has been observed between the health of an individual and human resources development and economic development of a nation. From the time of Alma Ata declaration to achieve "Health for All by 2000", lot of planning, effort and public expenditure had been devoted to improve the health of the people both in rural and urban areas in India. In spite of taking many efforts, India is having a high burden of morbidity1. Due to industrialization and the persisting inequality in health status of different states, India currently face a “Triple burden of diseases”, which are the unfinished agenda of communicable diseases, emerging non-communicable diseases related to lifestyles and emerging infectious diseases2. India has experienced improvements in the nutritional status, health infrastructure, social development and control of major killer diseases. But inter-state, urban- National Journal of Community Medicine│Volume 10│Issue 5│May 2019 Page 308 Open Access Journal │www.njcmindia.org rural, male-female inequalities are clearly viewed as a major public health challenge in this country3. Due to such different diversities, the morbidity pattern among the population varies in different geographic areas. At the same time, the shifting trend of diseases from communicable to non-communicable diseases pose a dual threat in India will also add to the burden of morbidity4. Life expectancy at birth for males and females will increase by 10 years and 11 years respectively from 2006– 2051 as per “Morbidity and health care” schedule of NSSO 60th round survey and the proportion of elderly are expected to increase at a rapid pace than younger population because of slow decline rate5. Whether the years added to life due to increased life expectancy also attribute to the increased burden of morbidity in our population is a concern for policy makers in India. In view of this, the present study was conducted to assess the common morbidity pattern among the rural population of Maharashtra. MATERIAL AND METHODS A cross sectional study was conducted among the rural population of field practice area of Government Medical College, Miraj, Maharashtra. The rural health training centre caters services to a population near about 19,550. The study was conducted from 1st January 2018 to 31st December 2018. Patients attending the Out Patient Department (OPD) of Rural Health Training Centre and willing to participate in the study were included. A written informed consent was taken from the participants. The patients who attended OPD for receiving preventive services like immunization services and antenatal care were excluded from the study. A pre-tested, pre-designed questionnaire was used to interview the participants and gather information about the socio-demographic variables by the healthcare workers. The questionnaire was developed; pilot testing was carried out and then used in the study to gather information about the participants. Data on the current morbidity among the patients attending OPD services was gathered by the health workers. The socio-economic status of the patients was classified according to modified B.G. Prasad classification6. The other socio-demographic parameters were gathered from the study participants. The data was entered in the Microsoft Excel sheet and analysis was done using the Epi –info software. RESULTS A total number of 13,279 patients attended the OPD services for various morbidities during the period from 1st January 2018 to 31st December 2018. The pISSN 0976 3325│eISSN 2229 6816 socio-demographic parameters of the study participants were depicted in Table 1. It was observed that majority of patients attended the OPD services were females i.e. 7210 i.e. 54.3% and 6069 i.e. 45.7% patients were males. In the present study, a large number of patients i.e. 3774 (28.4%) were in the age group of 60 years and above followed by under five children i.e. 2727 (20.5%) and 2017 (15.18%) in age group from 25 to 34 years. Majority of the patients in the study belong to lower middle socio-economic status i.e. 4701 (35.4%) whereas 3280 (24.7%) patients were in middle socioeconomic status, 2602 (19.6%) participants in lower socio-economic status followed by 744 (5.6%) participants in upper socio-economic status. Table 1: Demographic variables of study population Socio-demographic variable Gender Male Female Age in years Under 5 5-14 15-24 25-34 35-44 45-59 60 and above Socio-economic status Upper Upper middle Middle Lower middle Lower Patients (%) 6069 (45.7) 7210 (54.3) 2727 (20.53) 1882 (14.2) 946 (7.12) 881 (6.63) 1052 (7.92) 2017 (15.2) 3774 (28.4) 744 (5.6) 1952 (14.7) 3280 (24.7) 4701 (35.4) 2602 (19.6) Table 2: Disease pattern among different age groups Morbidity Respiratory infections Diarrhoeal diseases Nutritional problems Skin infections Musculoskeletal diseases Gynaecological and obstetric conditions Non communicable diseases Ocular conditions Injury Other conditions Cases (%) 29.8 5.9 16.6 1.3 17.3 2.6 13.6 1.4 2.4 8.6 As seen from table 2, the most common morbidity observed among the participants was respiratory infections in 3957 i.e. 29.8%. In the study, other morbidities seen were musculoskeletal diseases in 2295 i.e.17.3% participants, nutritional problems in 2272 i.e. 17.1% participants and non-communicable diseases in 1819 i.e. 13.6% study subjects. National Journal of Community Medicine│Volume 10│Issue 5│May 2019 Page 309 Open Access Journal │www.njcmindia.org pISSN 0976 3325│eISSN 2229 6816 Table 3: Disease pattern among different age groups Morbidity Age group (Years) Under 5 5-14 Respiratory infections 1034 (37.9) 987 (52.4) Diarrhoeal diseases 431 (15.8) 119 (6.3) Nutritional problems 892 (32.7) 543 (28.8) Skin infections 54 (2) 21 (1.1) Musculoskeletal diseases 49 (1.8) 86 (4.6) Gynaecological & obstetric conditions __ __ Non communicable diseases __ __ Ocular conditions 9 (0.3) 9 (0.5) Injury 121 (4.4) 38 (2.0) Other conditions 137 (5) 79 (4.1) Total 2727 1882 15-24 453 (47.9) 33 (3.5) 137 (14.5) 39 (4.1) 57 (6.0) 12 (1.3) 7 (0.7) 14 (1.5) 79 (8.3) 115 (12.2) 946 25-34 184 (20.9) 28 (3.2) 216 (24.5) 14 (1.6) 113 (12.8) 194 (22.0) 13 (1.5) 18 (2.0) 14 (1.6) 87 (9.9) 881 35-44 238 (22.6) 49 (4.6) 32 (3.0) 7 (0.7) 284 (27) 57 (5.4) 117 (11.1) 17 (1.6) 18 (1.7) 233 (22.1) 1052 45-59 290 (14.4) 21 (1.0) 14 (0.7) 23 (1.1) 643 (31.9) 49 (2.4) 784 (38.9) 14 (0.7) 5 (0.2) 174 (8.6) 2017 60 & above 771 (20.4) 102 (2.7) 438 (11.6) 14 (0.4) 1063 (28.2) 33 (0.9) 898 (23.8) 109 (2.9) 43 (1.1) 303 (8.0) 3774 Figure in parenthesis indicate percentage. diseases peak was observed in June and July months i.e. monsoon months. 800 700 600 500 DISCUSSION 400 300 200 100 Respiratory infections Dec Nov Oct Sept Aug July June May April March Jan Feb 0 Diarrhoeal diseases Figure 1: Trend of respiratory infections and diarrhoeal diseases in study subjects As seen from table 2, the most common morbidity observed among the participants was respiratory infections in 3957 i.e. 29.8%. In the study, other morbidities seen were musculoskeletal diseases in 2295 i.e.17.3% participants, nutritional problems in 2272 i.e. 17.1% participants and non-communicable diseases in 1819 i.e. 13.6% study subjects. The other morbidities observed in the study were diarrhoeal diseases, gynaecological and obstetric conditions, skin diseases, injury, ocular conditions and other diseases. The common morbidities seen in childhood were respiratory infections, nutritional problems, diarrheal diseases, injuries etc. In the geriatric age group, the most common morbidities observed were musculoskeletal diseases, non-communicable diseases. Figure 1 shows the seasonal trends of respiratory infections and diarrhoeal diseases in the study participants. It was observed that the peak for respiratory tract infection was more in November and December months i.e. winter months whereas diarrhoeal The present study was carried out to observe morbidity pattern among the participants which revealed that there were a greater number of female participants as compared to male participants. In a study carried out by Mane V et al 7 in a study carried out at Vadodara found that male participants were more in the age group less than 15 years and older age whereas female participants outnumbered in all other age groups. The similar findings were found in the study carried out by Mane V et al7 and Datta A et al1 in Tripura. Some studies found the proportion of male participants were more as compared to female participants on the contrary to our findings8,9. A large number of geriatric participants contributed to the present study whereas the other study by Mane V et al6 revealed that 75% of the participants were in the age group from 15-59 years which is considered as economically productive age group. In a study carried out by Datta A et al 1 and Mane V et al 6, it was found that majority of the participants were in the lower middle class and our study participants were consistent to the present study. The present study also revealed communicable diseases to be the commonest type of morbidity, majority (29.8%) suffering from respiratory infections. Although non-communicable diseases were also not far having the proportion being 13.7% and this dual burden of diseases is similar to the national picture.10,11 The dual burden of communicable diseases and non-communicable diseases is seen in developing countries due to globalization and epidemiological transition12. Similar findings were observed in the present study showing double burden of diseases. In a study carried out by Hameed S et al13 in Rural Karnataka showed Major morbidities of the elderly population were impaired vision National Journal of Community Medicine│Volume 10│Issue 5│May 2019 Page 310 Open Access Journal │www.njcmindia.org followed by hypertension and joint problems. In the present study, common morbidities seen in geriatric population were musculoskeletal diseases, noncommunicable diseases and such findings were in consistent with the studies carried out by Jacob et al, Gaur et al and Padda et al14,15,16. A study conducted in Government Medical College, Chandigarh17, revealed similar seasonal variation as most cases of ARI being reported in winter, ADDs (38.89%) in the monsoon season. In the present study the findings observed were peak of respiratory tract infections was more in winter months and that of diarrhoeal diseases in winter months and similar observations were found in the study carried out by Kumari R et al18. A larger study population observed over a longer period of time would provide us a clearer picture, and such data on the seasonality of the diseases would assist in the planning and implementation of control measures. CONCLUSION The study revealed dual burden of communicable as well as chronic and non-communicable diseases in the rural population with females being more affected with various morbidities. Further evaluation of factors responsible for the burden of diseases is required so that preventive measures can be taken in future. REFERENCES 1. Datta A, Nag K, Karmakar N, Datta S. A study to assess common morbidity pattern of an urban population of Tripura. Int J Community Med Public Health 2017;4: 4613-6. 2. Report of the Working Group on Disease Burden for the 12th Five Year Plan WG3 (1): Communicable Diseases. Report (30-07-2011) Government of India Planning Commission. http://planningcommission.nic.in/aboutus/committee/ wrkgrp12/health/WG_3_1communicable.pdf Accessed on 15 December 2018. 3. C Aparajita, AV Ramanakumar. Burden of Disease in Rural India: An Analysis Through Cause Of Death. The Internet Journal of Third World Medicine. 2005;2 (2):43–48. 4. Park K. Park’s Text book of Preventive and Social Medicine. 23rd ed. Jabalpur: M/s Banarasidas Bhanot Publishers.2015; 212. 5. Barik D. Longevity and shift in morbidity pattern among states in India. Available at: https://iussp.org/ sites/ pISSN 0976 3325│eISSN 2229 6816 default/files/event call _for _papers/IUSSP%20 Morbidity.pdf. Accessed on 1 September 2018. 6. Pandey VK, Aggarwal P, Kakkar R. Modified BG Prasad’s Socio-economic classification-2018: The need of an update in the present scenario. Indian Journal of Community Health 2018;30 (1):82-84 7. Mane V, Markam J, William RF, Vidya DC. Socio-demographic profile and pattern of illness among patients attending outpatient department of a tertiary care hospital in Tamil Nadu. International Journal of Community Medicine and Public Health 2016; 3: 476-81. 8. Patel MV, Desai GJ, Bhavsar BS. Profile of patients attending a general practitioner’s clinic in Vadodara city, Gujarat. International Journal of Health Sciences Research. 2014;4 (2):1215. 9. Khan MAI, Sakib MAM, Podder MK, Mainuddin M, Tarafdar BK. Socio-demographic profile of patients attending in outpatient department in a General hospital-An observational study. KYAMC Journal. 2013; 3 (2): 294-297. 10. Key indicators of social consumption in India: Health. NSS 71st Round (2014 Jan – Jun). National Sample Survey Office. 2015 Jun. p1-99. Available at http://mail.mospi.gov.in/index.php/catalog/161. Accessed on 13th December 2018. 11. Paul K, Singh J. Emerging trends and patterns of self reported morbidity in India: Evidence from three rounds of national sample survey. J Health Population Nutrition. 2017; 36 (32):113. 12. Maher D, Smeeth L, Sekajugo.Health transition in Africa:practical policy proposals for primary care. Bulletin World Health Organ 2010;88:943-948 13. Hameed S, Kumar N, Naik PM, Sachidananda K, Prasanna K S. Morbidity Pattern Among the El-derly Population in a Rural Area of Dakshina Kannada, Karnataka - A Cross Sectional Study. National Journal of Community Medicine 2015; 6 (2):89-92. 14. Jacob AP, Bazroy J, Vasudevan K, Veliath A, Panda P. Morbidity pattern among the elderly population in the rural area of Tamil Nadu, India. Turk J Med Sci. 2006;36: 45-50. 15. Gaur DR, Goel MK, Goel M, Das A, Arora V. A Study of Morbidity Profile of Elderly in Urban Areas of North India. Int J Epidemiol. 2008; 5 (2):1-4. 16. Padda AS, Mohan V, Singh J, Deepti SS, Singh G. Dhillon HS. Health Profile of Aged Persons in Urban & Rural Field Practice Areas of Medical College, Amritsar. Indian Journal of Community Medicine 1998; 23 (2):72-6. 17. Sharma MK, Bhatnagar T, Goel NK, Verma A, Swami HM. Operationalisation of surveillance of communicable diseases in Chandigarh. J Commun Dis. 2005;37:197–202 18. Kumari R,Nath B,Midha T,Vasvani ND, Lekhwani S, Singh B. Morbidity profile and seasonal variation of diseases in a primary health centre in Kanpur district: A tool for the health planners. Journal of Family Medicine and Primary care 2012; 1 (2):86-91 National Journal of Community Medicine│Volume 10│Issue 5│May 2019 Page 311