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   2013| July-September  | Volume 2 | Issue 3  
    Online since October 29, 2013

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Surveillance data analysis of revised national tuberculosis control program of Kangra, Himachal Pradesh
Surender Nikhil Gupta, Naveen Gupta, Shivani Gupta
July-September 2013, 2(3):250-255
DOI:10.4103/2249-4863.120730  PMID:24479092
Background: The annual risk of tuberculosis infection is 1.9% in Himachal Pradesh against a national average of 1%. Revised national tuberculosis control program (RNTCP) in Kangra was introduced in October, 1998. We analyzed the 5-year (2001-2005) RNTCP secondary data from Kangra to evaluate the performance of the program. Materials and Methods: We collected data from all the five tuberculosis units the district. We calculated the following indicators-case detection rate, tuberculosis cases by category-new smear positive (or smear negative but seriously ill) defaulters, relapses and failures, extra-pulmonary, and new smear negative cases. We compared the results with Himachal Pradesh and India. We employed the standardized program indicators-sputum positivity, cure, death, failure and default rates. Results: Extra pulmonary cases ranged in between 56% and 73%, normal being 15-20%. The highest category-1 varies from 42% to 48%. New smear positive case detection rates (78-90%) and cure rates (88-91%) were the highest as compared to figures of the state and country. Failure rate was maximum in Kangra Tuberculosis Units (TU)-6.5% and the default rate was 7.2% in TU Palampur. The tuberculosis cases have fallen down from 6,462/100, 000 in 1999 to 2,195/100, 000 in 2005 following the introduction of RNTCP in 1999. Age specific (15-55 years) and sex-wise males were more affected than the females (59-64%). Conclusions: Continue investment in the program to sustain progress achieved. Investigate the cause of high proportion of extra-pulmonary tuberculosis. Investigate Kangra TU unit with a high default rate.
  6,083 292 3
Job satisfaction of primary health-care providers (public sector) in urban setting
Pawan Kumar, Abdul Majeed Khan, Deep Inder, Nandini Sharma
July-September 2013, 2(3):227-233
DOI:10.4103/2249-4863.120718  PMID:24479088
Introduction: Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. Materials and Methods: Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. Results: Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01). Age and education level of health care providers don't show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. Conclusion: Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi.
  3,535 518 7
Etiology and anti-microbial sensitivity of organisms causing community acquired pneumonia: A single hospital study
Resmi U Menon, Abraham P George, Unnikrishnan K Menon
July-September 2013, 2(3):244-249
DOI:10.4103/2249-4863.120728  PMID:24479091
Objective: The objective of this study was to identify the common etiological pathogens causing community acquired pneumonia (CAP) in our hospital and sensitivity patterns to the common antibiotics used. Materials and Methods: This study was undertaken in a 750 bedded multi-specialty referral hospital in Kerala catering to both urban and semi-urban populations. It is a prospective study of patients who attended the medical out-patient department and those admitted with a clinical diagnosis of CAP, during the year 2009. Data were collected based on detailed patient interview, clinical examination and laboratory investigations. The latter included sputum culture and sensitivity pattern. These were tabulated and percentage incidence of etiological pathogens calculated. The antimicrobial sensitivity pattern was also classified by percentage and expressed as bar diagram. Results: The study showed Streptococcus pneumoniae to be the most common etiological agent for CAP, in our hospital setting. The other organisms isolated in order of frequency were Klebsiella pneumoniae, Pseudomonas aeruginosa, Alpha hemolytic streptococci, Escherichia coli, Beta hemolytic streptococci and atypical coli. S. pneumoniae was most sensitive to linezolid, followed by amoxicillin-clavulanate (augmentin), cloxacillin and ceftriaxone. Overall, the common pathogens causing CAP showed highest sensitivity to amikacin, followed by ofloxacin, gentamycin, amoxicillin-clavulanate (augmentin), ceftriaxone and linezolid. The least sensitivity rates were shown to amoxicillin and cefoperazone. Conclusion: In a hospital setting, empirical management for cases of CAP is not advisable. The present study has shown S. pneumoniae as the most likely pathogen and either linezolid or amikacin as the most likely effective antimicrobial in cases of CAP, in our setting.
  2,730 464 5
Seat belt sign and its significance
Amit Agrawal, Praveenkumar Ishwarappa Inamadar, Bhattara Vishweswar Subrahmanyam
July-September 2013, 2(3):288-290
DOI:10.4103/2249-4863.120769  PMID:24479100
Safety belts are the most important safety system in motor vehicles and when worn intend to prevent serious injuries. However, in unusual circumstances (high velocity motor vehicle collisions) these safety measures (seat belts) can be the source and cause of serious injuries. The seat belt syndrome was first described as early by Garrett and Braunste in but the term "seat belt sign" was discussed by Doersch and Dozier. Medical personnel's involved in emergency care of trauma patients should be aware of seat belt sign and there should a higher index of suspicion to rule out underlying organ injuries.
  2,589 379 2
Morbidity pattern and personal hygiene in children among private primary school in urban area: Are the trends changing?
Mayavati S Mhaske, Deepak S Khismatrao, Fernandez Kevin, Harshal T Pandve, Ritesh P Kundap
July-September 2013, 2(3):266-269
DOI:10.4103/2249-4863.120753  PMID:24479095
Introduction: School health is an important intervention as a great deal of research tells us that schools can have a major effect on children's health, by teaching them about health and promoting healthy behaviors. Aims: The aim of this study is to determine common health problems and assess personal hygiene status among primary school children. Settings and Design: A cross-sectional study was conducted in academic years 2009-2010 and 2010-2011, with three health check-up camps organized in private primary school of Pune city. Materials and Methods: A total of 450 students were assessed for health problems and composite score of personal hygiene status was calculated ranging from 0 to 5 by examination of hairs, nails, skin and clothes. Statistical Analysis Used: Proportions calculated with application of Chi-square test and Pearson co-efficient applied to observe the relation between two quantitative variables. Results: Out of 450 students examined, 56.2% were boys and 43.8% were girls with age ranging from 5 to 10 years. The major morbidities observed were dental caries (65.1%), upper respiratory tract infections (38.2%), ear wax (29.9%) and myopia (10.0%). Mean hygiene score was significantly higher in girls (4.32) than boys (3.95) and poor hygiene observed in older boys. Conclusion: Increasing myopia and poor dental hygiene denotes a changing morbidity pattern in private primary school of the urban area. The hygiene status of the girls is significantly better than boys.
  2,399 423 3
Rhodococcus equi: A pathogen in immunocompetent patients
Meena Dias, Pratibha Bhat, Sagar Chandrakar, Hilda Pinto
July-September 2013, 2(3):291-293
DOI:10.4103/2249-4863.120770  PMID:24479101
Rhodococcus equi is an uncommon human pathogen known to cause lung infections in immunocompromised patients. We report two cases of Rhodococcus infections in immunocompetent individuals, who were treated successfully.
  2,533 271 2
Family medicine: A solution for career inequalities among doctors in India
Gaurav Beswal
July-September 2013, 2(3):215-217
Career in medicine is challenging. Medical education system is a ever evolving entity. Due to certain bottle necks in the medical education system, young medical graduates in India are facing difficulties in career progression. Author draws from the experience of Britain and explores how family medicine could be answer to many question which the Indian health system is challenged with.
  2,425 288 -
Diabetic neuropathy: Rare presentation as a painful pseudoabdominal mass
Suresh R Kumar, Anand A Kumar, Arun Grace Roy, Usha Menon
July-September 2013, 2(3):298-299
DOI:10.4103/2249-4863.120773  PMID:24479104
Diabetic neuropathy has varied clinical presentations. As clinicians we should be aware of the common as well as rare manifestations of this syndrome. Diabetic truncal neuropathy presenting as a painful pseudoabdominal mass can easily mislead clinicians who are unaware of this problem. Subsequently, this can lead to unnecessary investigations and discomfort to the patient. A good blood sugar control and judicious use of drugs for neuropathic pain along with physiotherapy usually gives good relief. It is mostly a self-limiting condition.
  2,212 278 -
Comparison of body mass index on children with functional constipation and healthy controls
Zohreh Kavehmanesh, Amin Saburi, Ali Maavaiyan
July-September 2013, 2(3):222-226
DOI:10.4103/2249-4863.120715  PMID:24479087
Background: Constipation is one of the most common pediatric disorders, especially in developed population, which categorized to organic or functional (non-organic) constipation. Furthermore, obesity is a growing chronic pediatric problem that could cause any compromise in weight and height. The aim of this study is the evaluation of probable relation between obesity and pediatric functional constipation. Methods: This study was conducted as a case-control investigation on 2-14-years-old children those referred to Baqiyatallah University clinic during 2009-2011. The constipated children with organic causes were excluded. The control group of children was those who had not any disorders affecting on height and weight. Quantitative variables were expressed by mean and standard deviation and the correlation was tested with chi2 through SPSS version 17. Results: A total of 259 children (male 51.7%) consisting 124 cases and 135 controls were enrolled. The mean age in constipated and normal children was 69.47 ± 35.03 and 74.15 ± 39.68, respectively. BMI over 95% in the control group was 11.9% and in the constipated group was 17.7% that the difference was not statistically significant either (P = 0.188). The only significant association was found between obesity and the duration of constipation and also age (P = 0.008, 0.042, respectively). Conclusion: Although we found a significant relationship between duration of constipation and obesity, there was not a clear association between obesity and presence of constipation. Furthermore, we suggest extended cohort or clinical trial study regarding to the regional nutritional and growth patterns to confirm weight decrease or increase the effect on defecation.
  2,039 435 -
Quality-of-life among elderly with untreated fracture of neck of femur: A community based study from southern India
John D Prasad, Asha K Varghese, Dimple Jamkhandi, Arup Chakraborty, PS Rakesh, Vinod J Abraham
July-September 2013, 2(3):270-273
DOI:10.4103/2249-4863.120755  PMID:24479096
Background and Objectives: Owing to the high prevalence of osteoporosis and falls, elderly people are at risk of developing hip fractures. The objective of the current study is to assess the quality-of-life (QOL) of elderly (>60 years) with untreated hip fractures in a rural developmental block in Southern India. Methodology: Twenty-one elderly with an untreated fracture neck of femur were identified with the help of community level health workers. EuroQol (EQ-5D) was administered to assess the QOL before and after the event. QOL was also assessed among a comparison group, matched for age and sex among neighborhood people. Wilcoxon signed rank test and Mann-Whitney U test were used to compare EQ-5D mean scores with before the event scores and the comparison group scores respectively. Results: Of people with hip fracture, 57.1% (12/21), 76.2% (16/21), 81% (17/21), 52.6% (11/21) and 85.7% (18/21) reported severe problems with mobility, pain, usual activity, self-care and anxiety respectively. The EQ-5D mean score among the elderly with fracture neck of the femur was 0.08 (SD 0.27). It was low when compared with the same subjects before the occurrence of the event (Z –4.05, P < 0.001) and as compared with the comparison group (Z –5.77 P < 0.001). Conclusion: The QOL scores assessed using EQ-5D index scores was poor among people with untreated fracture neck of the femur as compared with the comparison group and also as compared to their status before the occurrence of the event. A vast majority of study participants reported severe problems with mobility, pain, usual activity and self-care and anxiety domains of EQ-5D questionnaire.
  2,042 331 2
Diagnosing chronic fatigue syndrome in south asians: Lessons from a secondary analysis of a UK qualitative study
R Erandie Ediriweera De Silva, Kerin Bayliss, Lisa Riste, Carolyn A Chew-Graham
July-September 2013, 2(3):277-282
DOI:10.4103/2249-4863.120765  PMID:24479098
Background: Chronic fatigue syndrome/myalgic encephalitis (CFS/ME) is rarely diagnosed in South Asia (SA), although the symptoms of this condition are seen in the population. Lessons from UK based South Asian, Black and Minority Ethnic (BME) communities may be of value in identifying barriers to diagnosis of CFS/ME in SA. Objectives: To explore why CFS/ME may not be commonly diagnosed in SA. Settings and Design: A secondary analysis of qualitative data on the diagnosis and management of CFS/ME in BME people of predominantly South Asian origin in the UK using 27 semi-structured qualitative interviews with people with CFE/ME, carers, general practitioners (GPs), and community leaders. Results: CFS/ME is seen among the BME communities in the UK. People from BME communities in the UK can present to healthcare practitioners with vague physical complaints and they can hold a biomedical model of illness. Patients found it useful to have a label of CFS/ME although some GPs felt it to be a negative label. Access to healthcare can be limited by GPs reluctance to diagnose CFS/ME, their lack of knowledge and patients negative experiences. Cultural aspects among BME patients in the UK also act as a barrier to the diagnosis of CFS/ME. Conclusion: Cultural values and practices influence the diagnosis of CFS/ME in BME communities. The variations in the perceptions around CFS/ME among patients, carers, and health professionals may pose challenges in diagnosing CFS/ME in SA as well. Raising awareness of CFS/ME would improve the diagnosis and management of patients with CFS/ME in SA.
  2,078 266 -
Challenges for healthcare in the 21 st century: How family medicine can help
AM Michael Kidd
July-September 2013, 2(3):211-214
DOI:10.4103/2249-4863.120712  PMID:24479084
  1,746 448 2
End of life discussion in an academic family health team in Kingston, Ontario, Canada
Reta French, Wenli Zhang, Kelly Parks, Sarah Ashton, Matt Dumas, Atika Haider, Lawrence Leung
July-September 2013, 2(3):263-265
DOI:10.4103/2249-4863.120749  PMID:24479094
Background: End-of-life (EOL) discussions remain difficult in non-terminal patients as death is often perceived as a taboo and uncertainty. However, the call for proper EOL discussions has recently received public attention and media coverage. Evidence also reveals that non-terminal patients are more satisfied with health-care encounters when EOL has been discussed. Objectives and Methods: The objective of this study was to explore the prevalence of EOL discussions in non-terminal adult patients, the perceived barriers to such discussions and suggested methods for improvement. A study mixed-methods study was performed by a group of PGY1 family medicine residents in an academic health team in Kingston, Ontario. Results: EOL discussion was performed in a very small proportion of non-terminal patient encounters. Compared with attending physicians, residents were less likely to discuss EOL issues and reported more perceived barriers. Conclusion: Our findings reflect the need for an early and open approach in conducting EOL discussion for non-terminal healthy patients.
  1,806 263 1
Early birth registration at a center in rural India
Sandeep Sachdeva, Mukesh Nagar, Ajay Tyagi, Ruchi Sachdeva, Vijay Kumar
July-September 2013, 2(3):234-237
DOI:10.4103/2249-4863.120722  PMID:24479089
Background: Registration of birth is mandatory in India however due to various issues compliance for timely birth registration has been poor. Objective: The objective of this study was to determine time elapsed between birth and registration and describe the socio-demographic profile of registered births at a rural center. Materials and Methods: A cross-sectional descriptive study was undertaken and all births registered at a primary health center of a block during the period 2010 and 2011 were retrieved and data collection carried using structured proforma based on birth formats under civil registration system (CRS). House to house visit was undertaken to identify births without registration. Results: A total of 340 and 276 births were registered during 2010 and 2011 respectively. Time elapsed between birth and registration was computed to be lower, i.e., 9.38 days (±7.46) during 2011 in-comparison with 10.52 days (±8.73) in 2010. On a positive note, higher level of education and marriage of women beyond legal age of 18 years was noticed in 2011 in comparison with 2010. Overall, institutional birth stood at a very encouraging note (66.2%). All (100%) births during the study period were registered at this (rural) or higher center (urban) depending on the place of delivery. An omission/commission of birth format is highlighted that needs urgent attention of the authorities. Discussion: Majority (>92%) of birth registration occurred with-in the stipulated period of 21 days as prescribed under CRS and our study indicates early birth registration in a rural area of Haryana, India.
  1,791 243 1
Role and influence of the patient's companion in family medicine consultations: "The patient's perspective"
Marie Andrades, Samreen Kausar, Aisha Ambreen
July-September 2013, 2(3):283-287
DOI:10.4103/2249-4863.120767  PMID:24479099
Background: Companions often accompany the patient in family medicine clinics and may influence the consultation. This study aims to determine the patients' perspective regarding the role and influence of the companion in the consultation process. Materials and Methods: A cross-sectional study was conducted at the family medicine clinics of a university hospital. Adult patients accompanied by companions during the consultation were interviewed through a structured questionnaire. Attributes with respect to role and influence of companion on the consultation were assessed. Data was entered and analyzed through IBM Statistical Product and Service Solutions (SPSS) software version 18 using the Chi-square test. Results: A total of 100 patients accompanied by companions participated in the study. Majority of companions were present to either provide company (90%) and/or emotional support (90%). Immediate relatives had a role in mobility (P = 0.016) and decision making (P = 0.006). Most companions remained passive and did not contribute to the doctor patient relationship (P = 0.058). Male companions were relatively helpful (54% vs. 25%, P = 0.008) in achieving the expectations from the visit. The companion played a supportive role in 62% of the consultations. Conclusion: This study signifies a supportive role of companion in a consultation which emphasizes the need of consultation models to include the "companion."
  1,697 333 8
Hemichorea-hemiballism in a nonketotic diabetic patient
Ahmed Al Montasir, Mainul Hasan Sadik
July-September 2013, 2(3):296-297
DOI:10.4103/2249-4863.120772  PMID:24479103
Hemichorea-hemiballism can be the solely presentation of a wide range of non-neurological clinical pictures, such as metabolic or hydro-electrolyte derange­ments. Hemichorea-hemiballism as the first presentation of type 2 diabetes mellitus has been described. The case depicted herein reinforces this association highlighting that especially in elder patients with new­ly diagnosed hemichorea-hemiballism, non-ketotic hyperglycemia should promptly be recognized.
  1,735 292 -
Utility of consensus statement in assessment of obesity: A study among undergraduate medical students from rural northwest India
Shailja Sharma, Sunil Kumar Raina, Ashok Kumar Bhardwaj, Vishav Chander, Dinesh Kumar, Sushant Sharma
July-September 2013, 2(3):274-276
DOI:10.4103/2249-4863.120759  PMID:24479097
Introduction: In India, obesity is emerging as an important health problem particularly in the urban areas, paradoxically coexisting with under nutrition. Almost 30-65% of adult Indians are either overweight or obese or have abdominal obesity. Materials and Methods: A cross-sectional study design was used to assess the prevalence of obesity among undergraduate medical using consensus statement for obesity in India. Results: The results of the body mass index (BMI) calculations show 26 females and 4 males (29.79% of total students) with a BMI of <18 kg/m 2 as underweight, whereas 13 boys and 4 girls (15.54% of total students) as obese with a BMI of 25 kg/m 2 and above. A total of 18 boys and 6 girls (21.26% of total students) were overweight with a BMI between 23 and 24.9 kg/m 2 . Discussion: It is estimated that by application of these guidelines, additional 10-15% of Indian population would be labeled as obese or overweight. We see this very clearly in our study, where we see an increase of 14.53% of students classified as obese and 5.93% students as overweight on using the guidelines of the consensus statement.
  1,758 267 1
Proximate family biosocial variables associated with severe malaria disease among under-five children in resource-poor setting of a rural hospital in eastern Nigeria
Gabriel Uche Pascal Iloh, Abali Chuku, Agwu Nkwa Amadi, John Nnaemeka Ofoedu
July-September 2013, 2(3):256-262
DOI:10.4103/2249-4863.120739  PMID:24479093
Background: Malaria threatens the life of under-five in rural Nigerian families. Although, factors that influence malaria in under-five are manifold. However, family biosocial factors may contribute to the variability of the clinical picture. Aim: To determine proximate family biosocial variable associated with severe malaria among under-five children in a resource-poor setting of a rural hospital in Eastern Nigeria. Materials and Methods: A cross-sectional study carried out on the families of under-five managed for malaria. Data extracted included family biosocial variables and diagnosis. An under-five child was defined to have malaria if the mother gave complaints of fever, vomiting, and other symptoms suggestive of malaria, had body temperature exceeding 37.5°C with the asexual forms of Plasmodium falciparum detected on the peripheral blood film. Severe malaria is the malaria that presents with life-threatening features like severe anemia and cerebral malaria. Results: The prevalence of severe malaria was 31.8% The family biosocial variables significantly associated with severe malaria were maternal low level of education (P = 0.031), family size >4 (P = 0.044), low social class of the family (P = 0.025), nonliving together of parents (P = 0.011), and poor access to health facilities (P = 0.038). The most significant predictor of severe malaria was nonliving together of parents (P = 0.000, odds ratio = 3.08, confidence interval = 1.64-5.10). Conclusion: This study has demonstrated that some family biosocial variables are associated with severe malaria. These families should constitute at risk families that could be targeted for malaria interventional programs.
  1,747 277 -
Pulmonary tuberculosis presenting acutely as paraplegia: An unusual presentation
Apurva Pande
July-September 2013, 2(3):294-295
DOI:10.4103/2249-4863.120771  PMID:24479102
Extrapulmonary tuberculosis most commonly involves the bones and the spine. The present case is that of a young boy who presented with acute onset paraplegia without any pre-existant complaints of cough with sputum, fever, night sweats or weight loss.
  1,672 234 -
Primary care in a rural set up in Nepal: Perspectives of a generalist
Amogh Basnyat
July-September 2013, 2(3):218-221
DOI:10.4103/2249-4863.120714  PMID:24479086
This article deals with the author's personal perspectives while having to serve as a generalist in a rural hospital in one of the most underdeveloped and far away regions of Nepal. Having been deputed in Kalikot District Hospital (KDH) through Nick Simons Institute's (NSI) Rural Staff Support Program (RSSP), the author mentions the technical hardships and resource constraints of the government hospital. Highlighting the improvement in the hospital profile after the arrival of the RSSP, the article cursorily mentions the modalities of primary care spanning the common clinical presentations. Particularly, the difficulties related to the provision of Comprehensive Emergency Obstetric Care (CEOC) services are highlighted. Also, a brief introduction as to the NSI, Kathmandu is provided.
  1,648 231 1
Neuro-ocular cysticercosis causing total retinal detachment and cataract
Chandrashekhar A Sohoni
July-September 2013, 2(3):300-301
DOI:10.4103/2249-4863.120766  PMID:24479105
  1,656 199 1
Yoga in promotion of health: Translating evidence into practice at primary healthcare level in India
S Ganesh Kumar
July-September 2013, 2(3):301-302
DOI:10.4103/2249-4863.120768  PMID:24479106
  1,405 307 2
Factors associated with psychosocial services in ogun state, Nigeria
Olorunfemi Emmanuel Amoran
July-September 2013, 2(3):238-243
DOI:10.4103/2249-4863.120725  PMID:24479090
Background: Belonging to a social network group may influence a person's decisions to engage in desired behavior. Aim: The objective of our study was to determine factors associated with utilization of psychosocial group services among people living with human immunodeficiency virus acquired immunodeficiency syndrome (PLWHAs) in a Teaching Hospital in Sagamu, Southwestern Nigeria. Settings and Design: This was an analytical cross-sectional study. All consenting PLHAs who attended the anti-retroviral clinic (ART) clinic during the study period were recruited into the study. Materials and Methods: A structured self-administered questionnaire was used to collect relevant information and a total of 205 PLWHAs were interviewed. Statistical Analysis Used: The data analysis focused on univariate frequency table and bivariate cross tabulations that identify important relationships between the variables. Odds ratio (OR) at 95% confidence level (CI) and Chi-squared and t-tests were also computed. Results: The overall point utilization of psychosocial services among the PLWHAs was 23.4%. Utilization of psychosocial services was statistically significantly associated with religion (χ2 = 11.74, P = 0.003), disclosure of human immunodeficiency virus status (χ2 = 9.18, P = 0.01) and satisfactory self-reported health-related quality-of-life (HRQOL) (χ2 = 5.67, P = 0.017) while sex (χ2 = 0.02, P = 0.96), education (χ2 = 4.67, P = 0.32) tribe (χ2 = 1.46, P = 0.48) adherence to ART drugs (χ2 = 0.44, P = 0.51), mental health status (χ2 = 0.64, P = 0.42) and occupation (χ2 = 3.61, P = 0.61) were not. The only predictor of utilization of psychosocial group services was religion (OR = 0.44, CI = 0.23-0.84). Conclusion: This study shows the effectiveness of the psychosocial networks group in improving the overall HRQOL of the PLWHAs.
  1,390 196 -