Chronic obstructive pulmonary disease case finding by community pharmacists: a potential cost‐effective public health intervention

In this work, a mobile application is developed to assist patients suffering from chronic obstructive pulmonary disease (COPD) or Asthma that will reduce the dependency on hospital and clinic based tests and enable users to better manage their disease through increased self-involvement. Due to the pervasiveness of smartphones, it is proposed to make use of their built-in sensors and ever increasing computational capabilities to provide patients with a mobile-based spirometer capable of diagnosing COPD or asthma in a reliable and cost effective manner. Data collected using an experimental setup consisting of an airflow source, an anemometer, and a smartphone is used to develop a mathematical model that relates exhalation frequency to air flow rate. This model allows for the computation of two key parameters known as forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) that are used in the diagnosis of respiratory diseases. The developed platform has been validated using data collected from 25 subjects with various conditions. Results show that an excellent match is achieved between the FVC and FEV1 values computed using a clinical spirometer and those returned by the model embedded in the mobile application.

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External Environment, Enabling Factors and Predisposing Characteristics of Fully Immunised Children in Nepal

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v39i2.26287 ◽

2019 ◽

Vol 39 (2) ◽

pp. 79-86

Author(s):

Kanchan Thapa ◽

Bhim Raj Suwal ◽

Pratik Adhikary

Keyword(s):

External Environment ◽

Public Health Intervention ◽

Secondary Data ◽

Cost Effective ◽

Enabling Factors ◽

Working Mother ◽

Child Morbidity ◽

Full Immunisation ◽

Effective Public Health ◽

Immunisation Status

Introduction: Immunisation is a cost-effective public health intervention worldwide responsible for the reduction of infant and child morbidity and mortality. Full immunisation is a state of obtaining all vaccination according to the Immunisation schedule of Nepal. Methods: The secondary data of Nepal was downloaded from the DHS Program. A total of 1709 children aged 16-23 months were analysed for descriptive statistics. All the analyses were weighted by its sampling weight. The full immunisation status indicates those who completed 1 dose of BCG, 3 doses of Polio, 3 doses of DPT and 1 dose of Measles. The independent variables are further subdivided into enabling, predisposing and external environmental factors. Results: Over half of children (52.6%) were from Terai, nearly a quarter (23.0%) from province 2. More males (53.5%) and the majority of (86.1%) children with birth order one to three were immunised. Mother aged < 20 years (62%), working father (96.1%), working mother (59.7%), educated father (87.3%) and educated mother (70.7%) had children with complete immunisation. Non-smoker mother (94.6%) had fully immunised children. Nearly three quarters (73.5%) from a middle and rich family, those with PNC within 3 days (35.9%), delivered at a health facility (64.2%), and had PNC check from the skilled provider (12.1%) had completely immunised their children. Conclusions: Significant differences based on external environment, enabling factors and predisposing factors for full immunisation status was observed. Specific interventions based on these factors are recommended.

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