Coverage, utilization and barriers to cataract surgical services in rural South India: results from a population-based study.

OBJECTIVES: To determine the cataract surgical coverage, utilization and barriers to cataract surgery in a rural taluk of south India. STUDY DESIGN: A cross-sectional, community-based survey. METHODS: A house-to-house survey was carried out in 15 villages that were selected by cluster sampling during January to October, 2002. A total of 1505 people aged 50 years and above were tested for visual acuity (VA) and their eyes examined. Cataract surgical coverage was calculated for people and eyes, and for VA levels of <3/60 and <6/60. Information about details of cataract surgery and barriers to cataract surgery were collected using a pre-designed proforma. RESULTS: Cataract surgical coverage was 63% (people) and 51% (eyes) for VA<3/60 compared with 49% (people) and 36% (eyes) for VA<6/60. Of 109 operated eyes, 51.2% of operations were carried out in private hospitals and 33.3% in voluntary/charitable hospitals. Inability to afford the operation (22.9%) and fear of the operation (19.2%) were the main barriers to cataract surgery. CONCLUSIONS: The reasons for underutilization of government hospitals are to be investigated. Awareness of low-cost cataract intraocular lens (IOL) non-governmental organization (NGO) surgery and free-of-cost NGO services available in the region needs to be raised. Barriers to cataract surgical services should be addressed by community-based health-education programmes to improve the uptake of existing services.

Prevalence of blindness and its causes among those aged 50 years and above in rural Karnataka, South India.

To estimate the prevalence of blindness and its causes among those aged 50 years and above in rural Karnataka. A total of 1505 people aged 50 years and above from 15 villages were examined. The participants were selected through a house-to-house survey by the cluster sampling method. Visual acuity was tested using a modified Snellen's chart, and eyes were examined to ascertain the cause of blindness. The prevalence of blindness was 6.6% (95% confidence interval: 5.3-7.8%). Bilateral cataract was the principal cause of blindness among 78.7% of the blind and 12.1% were operated for cataract. In conclusion, the study area has a high burden of cataract blindness. Cataract surgical services should be made readily accessible and available to this rural population.

The antibiotics of choice for the treatment of melioidosis in Indian set up.

Therapeutic options for the treatment of melioidosis caused by Burkholderia pseudomallei are limited due to the inherent resistance conferred by this pathogen to various groups of antibiotics. Witnessing an increase in the number of microbiological culture-confirmed cases of melioidosis at our settings in the past few years, we undertook this study to estimate the minimum inhibitory concentrations of clinical isolates of B. pseudomallei against the four commonly employed antimicrobial agents in the patient management at our settings, namely, ceftazidime, meropenem, trimethoprim-sulfamethoxazole and doxycycline. All isolates were susceptible to the antibiotics tested, except for one isolate which showed resistance to doxycycline (minimum inhibitory concentration [MIC]: 32 µg/ml). MIC50 and 90 for all the four antibiotics were estimated. From this study, we conclude that the clinical isolates of B. pseudomallei from the southern part of India are well susceptible to the commonly employed antimicrobial agents for therapy.

Socio-demographic and maternal determinants of low birth weight: a multivariate approach.

A community based study was conducted in the rural areas of Udupi taluk, Karnataka state of South India to identify the socio-demographic, maternal and obstetric determinants of low birth weight. All singleton live births that occurred in the study area during a one year period (October 1991 to September 1992) were included. A total of 2919 singleton child-mother pairs formed the basis of the analysis. Information about social, demographic and economic conditions of the families; maternal factors such as age, parity, quality of antenatal care and previous obstetric history were collected by interviewing the mothers and family members and verifying the available medical records through the field investigators especially recruited and trained for this purpose. Data was analyzed using multiple logistic regression model. Primis, elderly mothers and mothers who had not received good quality antenatal care were found to be more at risk of having low birth weight babies. Other significant determinants were family custom, socio-economic status and environmental sanitation.