RESUMEN
BACKGROUND: Globally, occupational hazards are a concern, especially in waste management. With 31.2% of its population in urban areas, India is confronted with escalating waste management challenges. People worldwide generate about two-thirds of a kilogram of waste daily. Effective solid waste management is crucial due to population growth, changing waste patterns, and rapid urbanisation. It profoundly impacts environmental, resident, and worker health. Rag picking is an informal profession undertaken by a marginalised population of the society, which involves collecting waste from trash cans, streets, and household waste. To assess the burden and the pattern of morbidity, and the occupational factors associated with it, as well as their health-seeking behaviour, the present study was carried out among women rag pickers in Mumbai, India. METHODOLOGY: A cross-sectional descriptive study was conducted through a mixed-method approach in Mumbai's Chembur and Govandi areas, focusing on women rag pickers aged 15 to 49 years. The research was conducted over a period of three months, during which a total of 150 female rag pickers from individual families were identified and included in the study through purposive sampling. The structured questionnaires gathered quantitative data on socio-demographics, health-seeking behaviour, morbidity, and monthly expenses. The qualitative data were collected through focus group discussions with rag pickers, analysing themes related to rag picking as occupational preference and substance usage factors. Ethical approval from the institute and informed consent from each participant were obtained prior to data collection. RESULTS: Among the cohort of 150 women rag pickers, 67.3% were aged between 15 and 30 years, with 82% belonging to the lower socio-economic class. A notable 43.4% of these women engaged in significant tobacco use, primarily through oral consumption, while about 56.7% of their family members exhibited high substance use, including pan, tobacco, and alcohol. In terms of health-seeking behaviour, 51% refrained from seeking treatment for minor ailments, 29% resorted to home remedies or self-medication, and 20% sought care at hospitals. A morbidity analysis over the past three months revealed prevalent health issues, informing potential interventions. Examination of monthly expenditure patterns unveiled an average income of 9000 INR (130 USD), with a significant 61% allocation towards food and grocery expenses. Qualitative insights indicated that the preference for rag picking was driven by limited alternatives and substance use was influenced by peers and served as a means to cope with stress. These findings underscore distinct health-seeking behaviours, and the unique needs of women rag pickers, providing valuable guidance for targeted policies to enhance their well-being. CONCLUSION: These findings underscore the need for targeted interventions to improve the well-being and socio-economic conditions of women rag pickers in India. Universal healthcare coverage, community-based initiatives, and social inclusion are vital for addressing their unique challenges and enhancing their quality of life.
RESUMEN
Background The incidence of diphtheria cases has declined significantly from 1,00,000 cases in 1980 to 2500 in 2015 globally. India contributed to half of the diphtheria cases reported globally from 2001 to 2015. The disease has higher case mortality and morbidity rate due to various geographic-specific factors. The current study aims to outline the characteristics and outcomes of the diphtheria-reported patients of Gujarat, a western state of India. Method A record-based, descriptive retrospective study was undertaken in the western state of India by analyzing district-wise reported diphtheria cases in diphtheria, tetanus, and pertussis (DPT) surveillance program format during 2020-2021. Result Out of 446, most patients were reported from selected geographies of Gujarat state in 2020-2021. The 424 (95%) reported cases were from 0-14 years of age. Only 9 (2%) subjects had a travel history, and 369 (82.7%) patients were reported from rural areas. The time trend analysis showed that 339 (76%) patients were reported from September to December. The case-fatality ratio was 5.4%, and 300 (67.2%) cases didn't take the DPT (DPT3)/pentavalent 3rd dose vaccine and subsequent doses during their lifetime, emphasizing the role of the vaccine in preventing diphtheria disease. Conclusion Increased vaccination coverage and completing all doses of the DPT vaccine are crucial to avert deaths due to diphtheria. An effective surveillance system will aid in early disease detection and provide more information on the factors that lead to disease occurrence for prompt action by the authority.
