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Indian Journal of Community Medicine

Prevalence and Pattern of Disability in a Rural Community in Karnataka

Author(s): R. R. Pati

Vol. 29, No. 4 (2004-10 - 2004-12)

Abstract

Research question: What is the prevalence and pattern of disability in a rural community in Karnataka?

Objective: To assess the magnitude and pattern of disability in a rural community in Karnataka.

Study design: Cross-sectional.

Setting: Two villages in the field practice area of Kasturba Medical College, Manipal, Karnataka.

Participants: People between 5 to 60 years of age.

Statistical Analysis: Proportions, Chi-square test.

Results and conclusions: The prevalence of disability was 2.02%. The prevalence was higher among females (2.14%) than among males (1.89%). The prevalence was higher in the 45-59 years age group. Locomotor disability was the commonest.

Key Words: Disability, Rural community, Prevalence

Introduction

Among the many social problems, that of the disabled stands out prominently. Disabled persons are perceived only in the light of their infirmities. Around 10% of the world population is disabled. Some studies show more prevalence, others using stricter definitions show less prevalence. Usually only 4-7% of a developing country's population is listed as disabled in national surveys. Many studies based on census results give a rate of as little as 1%. Worldwide attempts to classify disability also pose problems. Causes overlap. So, studies of single factor may lead to double or triple counting. Very few studies have been conducted in India with regards to the magnitude of the prevalence of disability. Studies of such nature will be useful in developing appropriate intervention programmes. It was in this context that the present study was undertaken in a rural area.

Material and Methods

This study was carried out in the rural field practice area of Kasturba Medical College, Manipal. Two villages (Kadekar and Udyavava) were covered. People between 5-60 years of age were studied. Children above 5 years of age go to schools. Sometimes disability affects their studies. It is also difficult to assess all disabilities in children below five years of age in field conditions.

A door to door survey of disabled was undertaken. 1m315 houses in the two villages were visited within a period of four months. 38 houses were found to be locked. So, a total of 1,277 houses could be covered. People between age of 5-60 years were clinically examined to assess the nature and extent of abnormality as per the criteria laid down by WHO1. Detailed medical history was taken. Information regarding demographic, housing, education, occupation and socio-economic particulars was collected from all the households visited. A person was considered to be having partial visual impairment if the visual acuity was more than 6/60 after the best possible correction. Profound visual impairment was taken as visual acuity less than 6/60 in the better eye. Modified version of Udai Parikh socio-economic status scale2 was used.

Results

The prevalence of disability was highest in the 45-59 years age group which was significantly higher than the prevalence in other age groups (p<0.001). Among 67 cases of locomotor disabilty, 21 had paralysis and 26 had disabling arthirits. 70% of the arthritis patients were females. Total population covered was 8162. Number of people between 5 to 60 years of age was 6,708 [Males : 3,266 (48.70%), Females : 3,442 (51.30%)]. Total number of disabled people was 136, of whom 62 were males and 74 were females. The difference in prevalence of disability seen in males (1.89%) and in females (2.14%) (Total I) was not statistically significant. (Chi square = 0.53, p>0.05). The overall prevalence of disability was 2.02%.

Locomotor disabilities were the commonest, followed by visual disability.

Table I: Prevalence of Disability According to Age, Sex and Socio-economic Status.

  Population Surveyed Disabled Prevelance (%)
Sex
Male 3,266 62 1.89
Female 3,442 74 2.14
Age Group in Years
5 - 14 1,543 25 1.62
15 - 44 4159 37 0.88
45 - 59 1006 74 7.35
Socio-Economic Status
Low 4883 84 1.72
Middle 1616 50 3.09
High 209 2 0.95
Total 6,708 136 2.02

Males and females showed almost similar pattern of disability distribution.

The prevalence of disability was lowest among high socio-economic group except in case of special disability, which was higher in high socio economic group. The lower prevalence in this group was found to be statistically significant (c2 = 12.78, p<0.001). More females had visual disabilities compared to males. Females constituted 60% of visually disabled. Visual disability showed association with socio-economic status. None of the 46 visually disabled were from high socio-economic status group. Chronic suppurative otitis media was the leading cause of hearing disability accounting for seven out of thirteen cases. Four of the hearing disabled were also dumb.

Discussion

Well documented studies to determine the prevalence and pattern of handicaps are few and far between. Most studies have been conducted in urban areas. The widely differing prevalence rates of disability found in these studies are due to wide difference in the samples and definitions used. Some studies included only totally blind and completely deaf people as handicapped. In some studies, the data was collected by workers who because of their limited knowledge and training on the topic could not detect mild degrees of disability.

The overall prevalence of disability in this study was 2.02%. Anand Pandit et al3 had reported a prevalence rate of 10.01%. But their survey team included specialists like audiologists etc. and audiometry screening and IQ tests were also done. The prevalence of disability was highest in the 45 to 59 years of age group (Table I). This was mainly because cataract and arthritis - the two common causes of disability in this study, were more common in this age group. The prevalence of disability was lowest among high socio-economic group. Disabilities like cataract which are liable to be corrected might have been promptly attended to in this group. Kumar et al4 also found that locomotor disability was the commonest disability. Prevalence of visual disability among females was higher compared to males. Similar findings were recorded in other studies5. This has been attributed to higher prevalence of trachoma, conjunctivitis and cataract among females than males.

If meaningful rehabilitation is to follow a survey of this sort, it is of utmost importance to detect disabilities early. Many of the disabilities in rural people are correctable, viz. cataract. Medical intervention supported by educational and social integration of disabled people should be started early.

References

  1. International classification of impairments, disabilities and handicaps: A manual of classification relating to the consequences of the disease. Geneva, WHO 1980.
  2. Parikh U and Trivedi G. Manual of the socio-economic scale (Rural), Publishers Manasa N. New Delhi, 1980.
  3. Pandit P, Bhave S. Prevalence and pattern of handicaps in a rural area. Indian Paediatr 1981; 18 : 35-9.
  4. Kumar R et al. An epidemiological study of disability in rural India. Indian Journal of Disability and Rehabilitation 1992;6:69-74.
  5. Sharma KL, Prasad BG. An epidemiological study of blindness in Banki block of Barabanki district, Uttar Pradesh, Indian J Med Res 1962;50:842.

Department of Public Health Administration,
All India Institute of Hygiene and Public Health,
110, C.R. Avenue, Kolkata-73

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