Problem

When consulted about their health problems, people from the tribal and rural regions of Gadchiroli reported back and limb pain as one of their top health problems.

Furthermore, patients with other chronic diseases such as high blood pressure and diabetes have become more frequent in our rural hospital indicating a need to study the burden of these disorders in rural and tribal regions of Gadchiroli.

Tobacco and alcohol use are important risk factors for chronic diseases including cancers and both of them are heavily used in Gadchiroli district.

Actions

In collaboration with the Spine Foundation, Mumbai and the Department of Rheumatology, Hinduja Hospital, Mumbai, studies were conducted to assess the burden of musculoskeletal back and joint pain in rural Gadchiroli.

Monitoring causes of death in a community gives important information about the disease priorities. We evaluated the burden of chronic non-communicable diseases by evaluating the causes of death in a population of 100,000 in rural Gadchiroli using a method called verbal autopsy. Stroke emerged as a leading cause of death and accounted for one out of every seven deaths in the entire population.

To measure the problem of stroke in further details, a study was conducted to enumerate the survivors of stroke in a population of 45,000. This was the first study to be conducted in rural regions of India after a gap of 20 years and showed that stroke is common in rural Gadchiroli. There were four patients of stroke for every 1000 population, higher than that seen with common public health problems such as tuberculosis.

Although stroke causes many deaths and leads to disability, it is also a preventable disease. Controlling blood pressure among those with high blood pressure has resulted in decrease in stroke deaths in developed countries. Can this also be done in rural Gadchiroli where there are very few healthcare facilities and doctors? We are conducting a community-based study to evaluate the effect of an intervention to control hypertension, diabetes and risk reduction for stroke on stroke deaths. The study is funded by the Wellcome Trust/Department of Biotechnology India Alliance.

Tobacco use is very common in Gadchiroli and about 70% adults using tobacco in some form. This increases the risk of cancer. In order to measure the burden of cancer we have started a population-based cancer registry in collaboration with the Tata Cancer Hospital, Mumbai , the leading cancer research centre in India.