Biomedical subjects
Hans Rosling
Publications and source records attributed to Hans Rosling.
Attempted suicide in Hanoi, Vietnam.
BACKGROUND: Attempted suicide is a key predictor of suicide, which is among the dominant causes of young people's deaths worldwide. Very little is known about the characteristics of suicide attempters in Asia, especially in Vietnam. METHODS: Medical records of 509 patients (515 attempted-suicide events) admitted to Bach Mai General Hospital in Hanoi, Vietnam from 1 January 1999 to 30 April 2001 were analysed according to the criteria of the WHO Multicentre Study of Attempted Suicide. RESULTS: The suicide attempters' mean age was 28.3+/-12.9 years. Nearly half (48.7%) were aged 15-24. The female-to-male ratio of patients living in urban areas (2.1:1) was higher than in rural areas (1.2:1). In urban areas, students (32 %) and homeworkers (28%) and, in rural areas, farmers (56 %) and students (17%) were the salient occupational categories. Acute life stressors were the main causes (73.8%) of suicide attempts. Only in some 6% of cases had a psychiatric illness been diagnosed before the suicide attempts. As a means of attempting suicide, intoxication with analgesics and antipyretics (e. g. paracetamol) with low medical lethality scores was a frequent method among the urban patients, the majority of whom (81%) consequently stayed in hospital less than 24 h. Pesticide and rat poison, more commonly (57.2%) used by attempters in rural areas, had higher medical lethality scores and also necessitated more prolonged hospital treatment. CONCLUSIONS: Some suicide-preventive strategies used in the West for young people may be applicable in Vietnam. Reducing access to pesticides and rat poison is comparable to western efforts to make paracetamol or firearms less freely available. Skills in resolving family and other conflicts can be taught in schools according to WHO's suicide-prevention resources for teachers.
Economic burden on families of childhood type 1 diabetes in urban Sudan.
The aims of this study were to estimate the direct costs of childhood diabetes in a low income country, Sudan, and to assess the effectiveness of care paid for by the families. For this purpose, socio-economic and demographic data on families were obtained from the parents of 147 children with type 1 diabetes, attending public or private clinics in Khartoum State, Sudan. The median annual income of the families of diabetic children was US dollars (US$) 1222 (range 0-14,338) of which 16% was received as financial help from relatives and friends. The median annual expenditure of diabetes care was US$ 283 per diabetic child of which 36% was spent on insulin. Of the family expenditure on health, 65% was used for the diabetic child. Families of diabetic children who were attending private clinics had a significantly higher total expenditure on health and home blood glucose monitoring than those who were attending the public clinics. However, there was no difference in total income between the two groups and glycaemic control was poor in 86% of the patients, regardless of whether care was being given by private or public clinics. The occurrence of the disease and its poor control appeared to exert a negative impact on the school performance of the diabetic child. In conclusion, the low direct costs reflect the minimal care given to the diabetic patients. Under the present economic conditions, families pay a considerable part of their income to sponsor the health of their diabetic children and receive little support other than that from relatives and friends. The present organization of diabetes care does not provide the patient with empowerment, knowledge and self-care ability. Well-trained diabetic teams and education programs may improve this situation.
[New map of world health is needed. North and South is changed to healthy and ill and West to rich and poor].
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