ABSTRACT
Background: Hypertension is widely prevalent across India. The rule of halves is commonly used to describe the attrition and gaps in the care cascade of hypertension management across detection, availing treatment, and having controlled blood pressure (BP) on treatment. Objectives: Using nationally representative data, we aimed to assess the rule of halves in hypertension management in different states of India and across sociodemographic, health system, and personal factors. Methods: A descriptive analysis of secondary data from the National Family Health Survey?4 was conducted. We included 770,662 individuals(112,122 men and 658,540 nonpregnant women) of 15–49 years of age. The proportion of individuals not aware of hypertension status among those with high BP, known hypertensives not availing of treatment, and uncontrolled BP among those on treatment were expressed as percentage with a 95% confidence interval (CI). Results: Of those with high BP, 48.5% (95% CI: 47.8%–49.3%) were not aware of their hypertensive status. Among known hypertensives, 72% (95% CI: 71.2%–72.8%) had not availed treatment for hypertension. Among those on treatment, 39.8% (95% CI: 38.7%–40.9%) had uncontrolled hypertension. Conclusion: The rule of halves of India shows that the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke has made relatively good progress with the detection of hypertension and achieving BP control among those on treatment. However, with three?fourth of known hypertensives not availing treatment, more dividends from the detection of hypertension efforts could be realized. The program needs to especially focus on ensuring the treatment for those detected with hypertension.
ABSTRACT
Background: The present study was conducted with objectives to elucidate the existence of sylvatic cycle of plague and to document the changing pattern of relationship between rodents and fleas. Methods: Collection of samples was done from 15 sites (25 locations) from plague affected areas of Shimla district of Himachal Pradesh, India during 5 visits between June 2011 to July 2012, which were thereafter entomologically investigated in a BSL-3 laboratory Results: 57 fleas (3 species) from 243 rodents (3 species) were collected in domestic (n=16), peridomestic (n=3) and wild (n=6) locations. Rattus rattus (n=197) and Nosopsyllus fascitus (n=43) was most frequently trapped rodent and flea species respectively. Rattus rattus (domestic rodent species) was also trapped from wild areas and Nosopsyllus fascitus (domestic flea species) was also isolated from Rattus norvegicus (wild rodent species). One rare rodent species Cornilurus albipes was also found. Most common rodent-flea association was Rattus norvegicus-Nosopsyllus fascitus. The recovery of rodents and flea was higher in months of June and December respectively. Conclusions: The study concluded that sylvatic cycle persisted in study area and rodent and flea mixing was widely prevalent between domestic and wild area. This demands regular and intensive surveillance in plague prone hilly areas of Himachal Pradesh.