Browsing by Author "Lukumar, P."

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    Factors associated with home deliveries in Thampalakamam, Trincomalee
    (Sri Lanka Medical Association, 2006) Lukumar, P.; Pathmeswaran, A.
    INTRODUCTION: In Sri Lanka, more than 95% of women deliver in hospital. There is regional variation in the rate of home deliveries, and in some areas a significant number of mothers deliver at home. OBJECTIVE: The objective of the present study was to identify the factors associated with home deliveries in Thampalakamam, Trincomalee. METHODOLOGY: Ours was a community based, exploratory type of case control study. Cases were home deliveries during the period from Jan 1, 2000 to Dec 31, 2002 in Thampalakamam Divisonal Director of Health Services (DDHS) area. Controls were institutional deliveries among women residing in Thampalakamam DDHS area during the same period. A total of 139 cases and 278 controls were identified for this study. Data was collected at the household level using an interviewer-administered questionnaire. RESULTS: The following factors were found to have strong association with home deliveries: being a Muslim (OR = 33.0, 95% CI 16.8-64.8), low (< grade 5) maternal education (OR = 3.5, 95% CI 1.8-6.6), parity more than 3 (OR = 3.2, 95% CI 1.5-6.6) not being visited by a public health midwife (OR = 2.4, 95% CI 0.8-6.9), not being seen by a medical officer during the antenatal period (OR = 7.0, 95% CI 0.6-83.3). Lack of transport (35.5%) was mentioned as main reason for home deliveries by the women. Of the home deliveries 95% were assisted by a traditional birth attendant. CONCLUSIONS: Poor education of women and deficiencies in the delivery of antenatal care were found to be important risk factors for home deliveries.
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    Factors associated with home deliveries in Thamplakamam, Trincomalee: a case control study
    (Sri Lanka Medical Association, 2004) Lukumar, P.; Pathmeswaran, A.
    OBJECTIVES: To identify the risk factors for home deliveries in Thampalakamam, Trincomalee. Methodology: This is a community based case control study. Cases were home deHveries that occurred during the period from Jan 1, 2000 to Dec 31, 2002 in Thampalakamam Divisional Director of Health Services (DDHS) area. Controls were institutional deliveries among women residing in Thampalakamam DDHS area during the same period. A total of 139 cases and 260 controls were selected for this study. Interviewer administered structured questionnaire was used to collect information. RESULTS: Majority of the home deliveries were Muslims (86.3%). The following factors were found to have strong association with home deliveries: low (< grade 5) maternal education (OR= 2.4, 95%CI 1.6- 3.7), no clinic visit compared with at least one clinic visit (OR =6.5, 95% CI4.1- 10.4), no home visit by the public health midwife compared with at least one visit (OR=7.5, 95%CI 4,7- 12.0), multi parity (OR=3.9, £5%CI 2.4- 6.6), maternal age >34years (OR=3.1, 95% CI 1.7- 5.7), and low (<500Rs) per capita income (OR=3.8, 95%CI 2.3- 6.3). Lack of transport (35.5%), premature delivery (20.3%), no one to accompany to hospital (11.6%), civil unrest (10.9%). and fear of hospital (10.9%) were mentioned as reasons for home deliveries by the mother. CONCLUSION: Poor standard of living including low educational level and deficiencies in the health care delivery system are strongly associated with home deliveries in Thampalakamam. Improvement of living condition and strengthening maternal and child health services can reduce the number of home deliveries in this area.
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    Prevalence of cancer in Jaffna, a population based study
    (Sri Lanka Medical Association, 2006) Lukumar, P.; Surinthirakumaran, R.; Kumarendran, B.; Pradeepan, B.M.
    BACKGROUND: Cancer is a disabling and in many cases fatal illness. The prevalence of cancer varies from one geographical area to the other. The objective of this study was to describe the prevalence of cancer in Jaffna district. METHODOLOGY: The present study was carried out in six out of seven Medical Officer of Health areas in Jaffna district. One hundred and twelve family health workers (FHW) were utilized to screen the population in the initial stage. Whenever FHW visited a home for her routine work she recorded total members living in the household, number of diagnosed cancer patients and number of suspected cancer patients. For each diagnosed and suspected cancer patient more details were recorded. This procedure was followed fromApril to July 2004. Each one of the suspected and diagnosed cases of cancers identified by the FHW was subsequently visited by a medical officer to confirm or exclude the diagnosis. Doubtful cases to the medical officers were seen by the oncologist. RESULT: A total of 251 987 persons were screened by 112 FHWs and 447 cancer patients (diagnosed in a tertiary care center) were identified. Prevalence of cancer in Jaffna district was 177.4 (per 100 000 populations). Breast cancer was the commonest cancer (50.8). Lip, oral cavity and pharynx (37.7) and female genital tract (22.62) were the second and third leading site for cancer respectively. CONCLUSIONS: High prevalence of cancer was observed in Jaffna. Breast, oral cavity, and female genital tract account for majority of the cancers.