Malaria control in a forest fringe area of Assam, India: a pilot study

A study was conducted to evaluate the preventive efficacy of insecticide-treated mosquito nets (ITMNs) and mosquito repellent (MR) in a malaria-endemic foothill area of Assam, India, with forest ecosystem. During the first year, a survey was conducted in four demarcated sectors (A-D) to observe the malaria endemicity and vector prevalence patterns before implementing intervention measures. All four sectors were endemic for malaria. The prevalence of established malaria vectors such as Anopheles dirus, A. minimus and A. philippinensis was observed. During the second year, intervention measures were implemented in the four sectors as follows: A, ITMN + MR; B, ITMN; C, MR; D, no intervention. The most effective intervention was in sector A, followed by sectors B and C. Sectors A and B exhibited significantly higher (P < 0.001) malaria protective efficacy during both the first and second years of intervention compared with sector D. The total vector population in the three intervention sectors decreased significantly compared with that of the non-intervention one. Information-education-communication activities motivated the residents to participate actively in the intervention programme. The finding could be an effective model for containment of high malaria morbidity in inaccessible forest fringe areas of the northeastern region of India.     

中国百日咳行动计划专家共识

分析杭州市2010 — 2022年百日咳流行特征,构建自回归移动平均（autoregressive integrated moving average,ARIMA）模型对杭州市百日咳发病率进行预测,为百日咳防控工作提供参考依据。

分别通过中国疾病预防控制信息系统中传染病监测系统和杭州市统计局发布的《统计年鉴》（   

Rapid spread of chikungunya virus following its resurgence during 2006 in West Bengal, India

Re-emergence of chikungunya virus (CHIKV) in West Bengal was detected after almost 40 years when an outbreak of fever occurred in Baduria village (West Bengal, India) in October 2006. The symptoms of CHIKV infection are similar to those of dengue virus (DENV) infection. Serum samples were tested for detection of IgM antibody to CHIKV and DENV and the aetiological agent was detected as CHIKV. RT-PCR was carried out for confirmation of CHIKV infection. By 2009, CHIKV had spread rapidly within ten districts of West Bengal. Middle-aged women (age group 31-40 years) were predominantly affected. Here we report the analysis of 2134 serum samples collected during 2006-2009 from the different districts of West Bengal, among which IgM antibody to CHIKV and DENV was detected in 403 and 199 samples, respectively. This report highlights the gradual dominating activity of CHIKV with dengue-like clinical features in dengue-endemic regions such as West Bengal.     

The Summary Index of Malaria Surveillance (SIMS): a stable index of malaria within India

Background  

Malaria in India has been difficult to measure. Mortality and morbidity are not comprehensively reported, impeding efforts to track changes in disease burden. However, a set of blood measures has been collected regularly by the National Malaria Control Program in most districts since 1958.     

The COPD critical pathway: a case study in progress

Patients with chronic obstructive pulmonary disease (COPD) consume many health care resources and require complex coordination of care among multiple caregivers. In this report, we share our experiences at Fletcher Allen Health Care, Burlington, Vermont, in developing and implementing a critical pathway for these patients. The COPD pathway has resulted in measurable improvements in the quality of care and has provided us with lessons that will enhance our use of critical pathway methods.     

Malaria persistence in Kumaon foothills of District Nainital, Uttarakhand, India

Clinic data depicted a high incidence of malaria in a forest ecotype in the Kumaon foothills of District Nainital, Uttarakhand, India. A study was therefore conducted to determine the risk factors associated with the transmission of malaria from 2002 to 2004. The man-hour densities of Anopheles culicifacies and An. fluviatilis varied from 2 to 139 and 1 to 69, respectively. The sporozoite rate of 0.24% was recorded in An. culicifacies. Sibling species investigation revealed prevalence of species B (53.8%) and C (46.2%) of An. culicifacies and of species T (100%) of An. fluviatilis complexes. The slide positivity rate and slide falciparum rate were 50.4% and 28.3%, respectively. The infant parasite rate was 42.9% and the enlarged spleen rate among the children was 25.95%. The findings revealed the persistence of malaria in the area mainly due to indigenous transmission through the malaria vector An. culicifacies and the inadequacy of intervention measures. Transmission could be curtailed by indoor residual application of malathion.     

Kala-azar in north-western India: a study of 24 patients.

Twenty-four sporadic cases of kala-azar diagnosed over an 11-year period in a referral medical centre in north-western India are reported. Most of the patients were residents of non-endemic areas or where endemicity was low. Certain unusual clinical and laboratory features were seen in some of the cases, namely, lymphadenopathy, nasopharyngeal growth, acute and chronic hepatic involvement and portal hypertension. Awareness of the occurrence of the disease and of its protean modes of presentation was found to be an important factor in early diagnosis.     

Vaccination coverage among older adults: a population-based study in India

ObjectiveTo estimate the prevalence and explore the predictors of vaccine uptake among older adults in India.MethodsWe used data from the national Longitudinal Ageing Study in India, a national household survey conducted during 2017–2018. Based on interviewees’ self-reports, we calculated population-weighted estimates of the uptake of influenza, pneumococcal, typhoid and hepatitis B vaccines among 64 714 Indian adults aged 45 years or older. We performed multivariable binary logistic regression analysis to examine the sociodemographic and health-related predictors of uptake of the vaccinations.FindingsThe coverage of each of the studied vaccinations was less than 2%. The estimated percentages of respondents reporting ever being vaccinated were 1.5% (95% confidence interval, CI: 1.4–1.6) for influenza, 0.6% (95% CI: 0.6–0.7) for pneumococcal disease, 1.9% (95% CI: 1.8–2.0) for typhoid and 1.9% (95% CI: 1.8–2.0) for hepatitis B. Vaccine uptake was higher among respondents with cardiovascular disease, diabetes or lung disease than those without any of these conditions. Uptake of influenza vaccine was higher among those with lung disease, while hepatitis B vaccine uptake was higher among those with cardiovascular disease or diabetes. Male sex, urban residence, wealthier household, more years of schooling, existing medical conditions and sedentary behaviours were significant predictors of vaccine uptake.ConclusionTargeted policies and programmes are needed for improving the low vaccination coverage among older adults in India, especially among those with chronic diseases. Further research could examine vaccine access, vaccine hesitancy, and vaccine-related information and communication channels to older adults and their health-care providers.     

Prevalence of Salmonella serotypes in India: a 16-year study

During the period 1958-73, 8 027 strains of Salmonella were tested at the National Salmonella and Escherichia Centre: 3 834 strains from man, 3 018 from animals, 839 from sewage and water sources, and 336 of unknown origin. A total of 99 serotypes were identified: 47 from man, 83 from animals, and 35 from sewage and water sources. S. typhi was the commonest serotype in man, followed by S. weltevreden and S. paratyphi A. S. typhimurium was the commonest serotype isolated from animals, followed by S. weltevreden and S. anatum. In sewage and other water sources S. weltevreden was the commonest serotype identified followed by S. typhimurium and S. bareilly. Infection due to S. weltevreden in both man and animals increased considerably after 1970. Out of a total of 99 serotypes isolated from different sources, 13 were isolated from man only, 49 from animals only, 34 from both man and animals, 30 from both animals and water sources, and 22 from man, animals, and water sources.     

Malaria: a reemerging disease in Africa.

A recent upsurge of malaria in endemic-disease areas with explosive epidemics in many parts of Africa is probably caused by many factors, including rapidly spreading resistance to antimalarial drugs, climatic changes, and population movements. In Africa, malaria is caused by Plasmodium falciparum and is transmitted by Anopheles gambiae complex. Control efforts have been piecemeal and not coordinated. Strategies for control should have a solid research base both for developing antimalarial drugs and vaccines and for better understanding the pathogenesis, vector dynamics, epidemiology, and socioeconomic aspects of the disease. An international collaborative approach is needed to build appropriate research in a national context and to effectively translate research results into practical applications in the field. The Multilateral Initiative for Malaria in Africa can combine all of the above strategies to plan and coordinate partnerships, networking, and innovative approaches between African scientists and their Northern partners.     

Service quality in the public sector hospitals: a study in India

Most studies on service quality have been conducted in the context of the private sector of the economy. In fact, in the healthcare setting, for a long time, public-sector hospitals were not expected to excel in the provision of service quality. In a country such as India, even now, public-sector hospital staffs enjoy relatively higher salaries, flexible work schedules, and secure employment until retirement. Because patients do not pay for most services, normally they are concerned only about the quality of the core product. The authors indicate that, even in the public sector context, the quality of the physician and that of the clinical support staff significantly impact patient satisfaction. However, the quality of nonclinical support staff is not found to have any significant effect on patient satisfaction.     

Tuberculosis in a rural population of South India: a five-year epidemiological study

Tuberculosis is a serious health problem in India, but because of inadequate facilities for diagnosis in many parts of the country clinical data are incomplete. However, data on prevalence are available from a few sample surveys conducted in the general population during the last two decades. The study reported here provides information on the incidence of infection and disease as well as on the source and fate of cases. The information was obtained by means of surveys, repeated at intervals during 1961-68 in a randomly selected rural population of South India. In each survey, a tuberculin test was given and X-ray and sputum examinations were made. There were virtually no tuberculosis control facilities in the study area, since this was not covered by the national tuberculosis programme at the time.     

Malaria and its implications for public health in Far North Queensland: a prospective study

This prospective study's objectives were to describe the features of all episodes of malaria diagnosed in Far North Queensland (excluding the Torres Strait) and to assess how much of a threat they posed to the area's public health.
Over a three-year period, 216 episodes of malaria were diagnosed (158 Plasmodium vivax and 68 P. falciparum infections). Most (82%) of the infections were acquired in Papua New Guinea (PNG). Approximately 70% of the episodes occurred in Australian citizens, about half of whom were in malaria-endemic countries for work; the remainder travelled abroad for recreation. Three-quarters of the Australian citizens with malaria had taken either no or inadequate prophylaxis. Australian citizens who had taken adequate prophylaxis were much less likely to develop P. falciparum than other types of malaria compared to those who took either no or inadequate prophylaxis (p=0.01). Gametocytes were present in 121 (56%) of the episodes of malaria. Mosquito surveillance was carried out in response to 38 (31%) of these gametocytaemic episodes. Significant numbers of Anopheles farauti sensu lato mosquitoes were found close to the residence of a patient in 4 (11%) of these episodes. Only two occasions when local transmission could have possibly occurred were recognised. We do not believe malaria poses an important threat to the healthof the public in Far North Queensland. Nevertheless, it remains an important problem for those who travel abroad to malarious areas.