Prevalence of tuberculous lymphadenitis in children in Wardha district, Maharashtra State, India.

SETTING: Rural area of Wardha district, Maharashtra State, Central India. OBJECTIVE: To determine the prevalence of tuberculous lymphadenitis in children aged 0-14 years in the study area and to assess factors that may contribute towards the prevalence. DESIGN: House to house survey of a population of 23,229 in 35 neighbouring villages with 7900 children aged 0-14 years from May 1993 to May 1994 and from March 1995 to February 1996. RESULTS: The prevalence of tuberculous lymphadenitis/1000 children was 4.43. The maximum prevalence was in the 5-9 years age group. The prevalence was 34 times higher in children with positive family history of tuberculosis than in those without a history. There was an association between prevalence and the living standards of the children, with a higher prevalence in families that belonged to an underprivileged social class living in thatched, improvised houses. Multiple cervical lymph nodes >2 cm and with matting and fluctuation were found to be characteristic clinical features. CONCLUSION: The prevalence of peripheral lymphadenopathy was 27.2/1000 children and that of tuberculous lymphadenitis was 4.43/1000. Positive history of contact in the family was a significant epidemiological indicator of tuberculous glands.     

A study of gender disparities towards COVID-19 vaccination drive in Maharashtra State,India

Background and aimsIndia officially launched the world's biggest COVID-19 vaccination drive on January 16, 2021, operating 3006 vaccination sites at the beginning. At present 21872 sites conducting vaccination as on August 24, 2021. The process of vaccination is not yet mandatory in India. Vaccination is conducted free of cost at 20242 Government sites and paid at 1630 private sites. This study involves Hypothesis Testing for analyzing the gender disparities towards COVID-19 vaccination.MethodsFor this study, we have used Maharashtra States district wise COVID-19 vaccination data. Using Hypothesis Testing method Pearson's Chi-square test for independence compares two variables gender disparities and vaccination in a contingency table to see if they are related. To test the Effect size of gender disparities is small, medium or large Cohen Cramer's rule is used.ResultsOur result shows that, just 84 women were vaccinated for every 100 men in Maharashtra State, India. This ratio is even lower than India's gender ratio i.e. 90:100. Men were more aware and ahead of women in COVID-19 Vaccination Drive. Effect size shows that size of gender disparities is small.ConclusionAs per the result it is seen that COVID-19 Vaccination awareness is slightly less amongst the women in Maharashtra, India. To improve this statistics of COVID-19 Vaccination, Authorities should start the awareness campaign amongst the citizen towards the importance of vaccination.     

Descriptive epidemiology of haemophilia in Maharashtra, India

Secondary data on haemophilia cases in the state of Maharashtra, India were compiled and analysed. A total of 2192 haemophiliacs could be accounted from case papers and pedigrees, representing approximately 60% of the estimated number of cases in the state. Ratio of haemophilia A to haemophilia B was 4.2:1. Severe haemophiliacs constituted the majority of haemophilia A and B cases. About 70% of patients did not report any family history. Age distribution of cases suggested that the longevity of severe haemophiliacs was less than 30 years. Geographical distribution revealed clustering of cases around three established haemophilia clinics, with large parts of the state showing no cases. Although the cumulative number of cases showed an ascending trend, there was a 90% decrease in the number of cases registered between 1989 and 2000, suggesting that case recruitment from areas around the facilities had been achieved. Most cases showed delayed diagnosis, as the majority of severe haemophiliacs was being diagnosed at around 11-15 years of age. However, increasing awareness about haemophilia was reflected in a four-fold increase in referrals of severe cases over a 10-year period and increased registration of cases under 5 years of age. This study highlights that haemophilia services in India are still in their infancy, and increased awareness among healthcare providers as well as expansion of treatment facilities are still the primary areas for improvement of treatment.     

Tick-borne rickettsioses in Pune district, Maharashtra, India

An extensive study on tick-borne rickettsioses in the Pune district of Maharashtra revealed that Indian tick typhus exists as a zoonosis, which only occasionally causes disease in man. By sero-conversion in guinea pigs, presumptive isolates of Rickettsia conori and Coxiella burnetii were recovered from 4 of the 11 species of ticks examined. Boophilus microplus and Rhipicephalus haemaphysalis were found to be harbouring R. conori whereas C. burnetii was isolated from Haemaphysalis intermedia and Hyalomma hussaini in addition to the above mentioned 2 tick species. Complement fixation tests carried out on sera from various species of rodents and gerbils revealed the presence of antibodies against the R. conori antigen in the sera of Rattus blanfordi, R.r. rufescens and Suncus murinus. In the case of large mammals, similar antibodies were detected in the sera from dog, cow, horse and sheep. C. burnetii infection was found to exist in both the sylvan and domestic cycle, as evidenced from the involvement of ticks, large and small mammals and man in its natural history.     

Cultural concepts of tuberculosis and gender among the general population without tuberculosis in rural Maharashtra, India

Gender-specific patterns of experience, meaning, and behaviour for tuberculosis (TB) require consideration to guide control programmes. To clarify concepts of gender, culture, and TB in a rural endemic population of Maharashtra, India, this study of 80 men and 80 women employed qualitative and quantitative methods of cultural epidemiology, using a locally adapted semi-structured Explanatory Model Interview Catalogue (EMIC) interviews are instruments for cultural epidemiological study of the distribution of illness-related experiences, meanings, and behaviours. This interview queried respondents without active disease about vignettes depicting a man and woman with typical features of TB. Emotional and social symptoms were frequently reported for both vignettes, but more often considered most distressing for the female vignette; specified problems included arranging marriages, social isolation, and inability to care for children and family. Job loss and reduced income were regarded most troubling for the male vignette. Men and women typically identified sexual experience as the cause of TB for opposite-sex vignettes. With wider access to information about TB, male respondents more frequently recommended allopathic doctors and specialty services. Discussion considers the practical significance of gender-specific cultural concepts of TB.     

Snake bites in Moyen Chari district, Chad: a five-year experience

Snake bites are of major public health importance in Africa as a cause of morbidity and mortality. Echis ocellatus is responsible for the majority of envenomation cases in West Africa. Antivenom immunotherapy is the only specific treatment available for envenomed patients. From January 1997 to December 2001, 325 patients suffering from snake bites were enrolled in a survey undertaken at Goundi Hospital, Chad. We analysed the percentage of envenomed patients, sex distribution, distribution along the year, lethality, hospital stay and recovery clotting time. Two hundred and ninety-eight patients showed signs of envenomation and were treated with antivenom immunotherapy with three different sera in consecutive periods. Young males were more frequently involved. The overall lethality was 8%. Lethality and hospital stay were significantly different in the differently treated patients. Most of the data in our series were similar to those from other sub-Saharan countries but, overall, the percentage of snake bite victims who were admitted to hospital was higher.     

Tuberculosis notification: An inquiry among private practitioners in Pimpri-Chinchwad municipal corporation area of Maharashtra,India

BackgroundThe Government of India implemented mandatory TB notification policy since 2012. After that India's TB notifications from the private sector steadily increased; however, less is known about private practitioners' (PP's) experiences with TB notification. The present study aims to fulfil this gap.MethodsWe conducted a cross-sectional study during November 2019 to March 2020 in Pimpri-Chinchwad Municipal Corporation (PCMC) area of Maharashtra State. We used a mixed methods approach which involved a survey of 200 PPs and in-depth interviews (IDIs) with 7 PPs and 8 National TB Elimination Program (NTEP) staff. The data were presented in the form of frequencies and percentages and thematic analysis was performed on the qualitative data.ResultsThe study revealed that most PPs (194 of 200; 97%) were aware of TB notification and 75% reported that they notify TB cases to the NTEP. Of those who notify, majority (129 of 145; 89%) reported that they use paper-based notification being the convenient method due to in-person visit and help by the NTEP staff. Only a third of PPs were aware of electronic notification methods. The main reasons behind low utilization of web based and mobile application were unfamiliarity and technical issues such as poor network connectivity. A third of PPs were aware about monetary incentives for notification and only 17% reported actual receipt of incentive at some point.ConclusionsOur study identifies several areas where the NTEP can undertake interventions to strengthen the implementation of mandatory TB notification policy. Low awareness about electronic notification methods and preference for paper-based notification in this Study area suggest that more efforts are necessary for successful transitioning from paper-based to electronic notification system.     

Prevalence of sputum-positive pulmonary tuberculosis in tribal and non-tribal populations of the Ashti and Karanja tahsils in Wardha district, Maharashtra State, India.

SETTING: Ashti and Karanja tahsils, Wardha district, Maharashtra State, Central India. OBJECTIVE: To find and compare the prevalence of bacillary positive pulmonary tuberculosis amongst the different tribes and in the non-tribal population. DESIGN: Prevalence study of pulmonary tuberculosis by house-to-house survey of symptoms among tribal (n = 20596) and non-tribal (n = 93 670) populations aged 5 years and over, between September 1989 and November 1990. RESULTS: The prevalence of smear and/or culture-positive tuberculosis/100000 population was 133 in the tribal and 144 in the non-tribal population. The difference in prevalence of symptomatic individuals and sputum-positive cases among the tribal and the non-tribal populations was statistically significant only in the symptomatic individuals/100000 (P = 0.01). The prevalence of cases in both groups was higher in males than females; however this difference was significant only in the tribal group (P = 0.05). Only two of the 46 tribes encountered, the Mana and Pawara tribes, showed a high prevalence, of 730 and 612/100000, respectively. The three other tribes with positive cases (the Gond group) had prevalences comparable to that of the nontribal population. CONCLUSION: The prevalence of tuberculosis in tribal people was comparable to that of the non-tribal population.     

Endemic fluorosis in an isolated village in western Maharashtra, India

We surveyed 76 residents of a small village in Mahad Taluka, where the first index case of dental fluorosis was detected. Thirty-three (43.42%) cases of dental fluorosis were identified. The source of drinking water was a bore well with a fluoride content of 5.37 parts per million.     

Prevalence of chronic respiratory diseases from a rural area in Kerala,southern India

Background

Chronic lung diseases are one of the leading causes of morbidity in developing countries. A community based survey was undertaken with an objective to estimate the prevalence of chronic respiratory diseases and to describe the profile of people with CRDs in the rural area Nilamel health block in Kollam district, Kerala, southern India.

Prevalence of HIV infection in pregnant women in remote rural areas of Maharastra State, India

In a study of 304 pregnant women, the prevalence of HIV infection in remote rural areas of western India was 0.7% (confidence interval 0.08-2.3%). It is nearly 2(1/2) times higher than the presumed prevalence for this part of the country.     

Prevalence of hemoglobinopathies in rural Bengal, India

India is in the thalassemia belt of the world. Both α- and β-thalassemia (α- and β-thal) are found in West Bengal, a state in the eastern part of India. There was no systematic large published study to investigate the prevalence rates of different hemoglobinopathies in West Bengal. This study was conducted in school and college students, newly married couples and pregnant women after proper counseling in the rural areas of five districts of West Bengal state in eastern India. Thalassemia testing was done using high performance liquid chromatography (HPLC). A total of 35,413 individuals were screened for hemoglobinopathies. β-Thalassemia trait was found in 10.38%, Hb E [β26(B8)Glu→Lys] trait in 4.30%, sickle cell trait in 1.12%, borderline Hb A(2) value 0.73%, low Hb A(2) 0.68% and Hb D trait 0.37%. This is the first study that addresses the prevalence of different hemoglobinopathies in rural areas of West Bengal. The prevalence of β-thal trait is higher in West Bengal than other parts of India. This data is likely to be helpful in planning screening programs in rural areas of West Bengal, India.