RESUMO
AIM: To empower and bring the underprivileged senior citizens in the rural areas to the mainstream of life through setting up of model "senior citizens' recreation centers" that can be replicated in the other parts of the country. MATERIALS AND METHODS: Six senior citizens' recreation centers are run in six villages under a community health program of a leading Medical College in South India, which were started by looking into their perceived needs and in a location where organized self-help women groups (SHGs) showed willingness to take the role of caretakers. Together there are 140 members in 6 centers and the most deserving members were identified using a participatory rural appraisal (PRA) method. These centers are open for 5 days a week and the main attraction of the center has been provision of one good, wholesome, noon-meal a day, apart from several recreational activities. The members were also assessed for chronic energy deficiency (CED) and quality of life at the beginning of enrolment using body mass index (BMI) and WHO-BREF scale. RESULTS: The attendance to these centers was nearly 90% of the enrolled beneficiaries. A statistically significant improvement was noticed in quality of life in the physical, psychological, social, and environmental domain (P < 0.05). There was also a significant increase in the average BMI after 1 year of the intervention (P < 0.05). CONCLUSION: Care of underprivileged senior citizens is a growing need in the rural areas and the "Recreation centers" proved to be a beneficial model that can be easily replicated.
RESUMO
BACKGROUND: Streptococcus pneumoniae is a leading cause of invasive disease in developing countries like India. Although the 13 valent pneumococcal vaccine has already been introduced in the country, there is very little epidemiological data regarding S. pneumoniae colonization and antibiotic susceptibility in Indian infants. METHODS: We studied serogroup/serotype (SGT) distribution and antibiotic susceptibility pattern of S. pneumoniae in unvaccinated Indian infants by performing monthly nasopharyngeal swabbing of a birth cohort for 2 years. RESULTS: Colonization began soon after birth and was complete in the first year of life in the majority of those colonized. Carriage rates increased during winter (p<0.01) and in those with upper respiratory infection (URI) (p<0.01). The most frequently (76.1%) isolated SGT were 19, 6, 15, 23, 9, 35 and 10. Vaccine SGT accounted for 60.5% of all colonizers. Antibiotic resistance was maximum for cotrimoxazole (94.3%) and least for erythromycin (11.2%) with no penicillin resistance. Ten of the commonest SGT which cause invasive disease among Indian infants comprised 46.9% of the colonizers. Serogroups 1, 5, 45 and 12 which cause invasive disease in under-fives were not seen in this birth cohort in the first year. CONCLUSIONS: S. pneumoniae colonization in Indian infants commences soon after birth and chiefly occurs in the first year of life. The 13 valent vaccine may protect against a little less than half the commonly seen invasive SGT of S. pneumoniae.