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Door-to-door screening in Old City slums for Oral Potentially Malignant Disorders
A city-based NGO, Helping Hand Foundation (HHF), which launched the randomised population-based screening for Oral Potentially Malignant Disorders (OPMD), earlier this year in May, has now turned this into a door-to-door outreach programme for active case findings (ACF) of OPMDs.
Bahadurpura: A city-based NGO, Helping Hand Foundation (HHF), which launched the randomised population-based screening for Oral Potentially Malignant Disorders (OPMD), earlier this year in May, has now turned this into a door-to-door outreach programme for active case findings (ACF) of OPMDs.
According to the Foundation, the reason for starting outreach programme was poor compliance to their counselling and medication due to stigma and misconception about the disease in the 'randomised screening model' taken up in the slums for past six months. "We came to know that only 11% of cases in the list of 120 OPMDs cases from a sample size of 2,105 turned up at the dental clinic run by the NGO at Masjid-e-Ishaq in N S Kunta from where the programme is being run," said Mujtaba Hasan Askari who is leading the Foundation.
This prompted HHF to relaunch its initiative through a massive door to door 'active case finding model', wherein oral health is being assessed across household covering 22 slums to identify oral potentially malignant disorders.
"So far, 578 households have been covered in mainly N S Kunta, Teegal Kunta, Tadban, Vatapally, Jahanuma, AR Nagar slums and 71 active case findings of OPMDs have been recorded. Of this, almost 55 OPMDs are now getting counselling and Oral Prophalaxsis at their doorsteps. Three have been referred to ENT for a biopsy and the rest are still evasive," he noted.
The NGO is now taking up counselling and oral prophylaxis to the door of the patients and this is showing better results. The team comprises dental and palliative care physician, dental hygienist, mental health counsellors and spiritual counsellors from the local masjid.
Counselling is being done to the patients at their home and family counselling is done in the event of the patient not cooperating for medicines and counselling. A local mufti is also now part of the team and is visiting selected cases where counsellors are failing to convince the patient and the family for compliance to treatment and cessation of consumption of non-smoke tobacco.
Dr Akbar Ali Khan, palliative care physician at HHF, who is undergoing training on national fellowship program in palliative medicine from Institute of Palliative Medicine, Kozhikode, said that spiritual counselling is now a critical part of the protocol in Palliative care and, "hence, we are attaching lots of importance for better patient compliance as many patients are in denial mode.
"By way of door-to-door outreach, we are able to counsel the patient and his family in a multi prong approach through doctors, counsellors and spiritual leaders and this is showing better compliance," added Mujtaba.
