Retrospective study of chikungunya outbreak in urban areas of India.

Background & objectives: A retrospective study on chikungunya outbreak in India in five States viz. Delhi, Madhya Pradesh, Orissa, Maharashtra and Kerala was conducted in 2007-2008 to know the distribution and determinants of chikungunya fever outbreak in India. Methods: On the basis of high and low incidence of chikungunya fever, two districts from each State and two wards from the selected district were taken for random selection of 1000 households from 10 districts and 5 States. Semi-structured questionnaires were administered to individuals, patients, qualified health professionals and to stakeholders for collecting information. Results: The educational background and occupation of the respondents showed variations across the study States. Only in high incidence ward of Maharashtra, water storage period for 3-6 days and emptying, drying of water containers on weekly basis was noted. The study through knowledge, attitude, belief, practice (KABP) obtained individual's perception of chikungunya fever, its prevention and control. Patients’ expenditure on treatment was mainly recorded less than Rs 500 across study States. Health facility survey obtained an overview of the capacity of local health facilities. Stakeholders’ perception regarding chikungunya fever was also noted. Interpretation & Conclusions: The study revealed differences in awareness of chikungunya, cause of the disease, vector responsible, mode of transmission, biting time and elimination of breeding of mosquitoes statistically significant among high and low incidence wards of all the States. Expenditure on treatment was independent of economically active status and loss of man-days across all the States. Education and occupation did not have any relation with emptying/drying of water containers in high incidence wards. Strengthening of surveillance, information, education and communication (IEC) activities along with case management facilities may be provided by the State health department for prevention of chikungunya outbreaks in future. Stakeholders should be more involved in outbreak management and future planning.

NLEP--current situation and strategy during the 11th plan period (2007-2012).

National Leprosy Control Programme was established in 1955 based on dapsone domiciliary treatment. The multidrug therapy came into wide use from 1982. Based on the recommendations of the high power committee established by the Government of India, the NLEP was launched in 1983 with the objective to arrest the disease activity in all the known cases of leprosy. In order to strengthen the process of elimination of the disease in this country, the first World Bank supported project was introduced in 1993. The 2nd phase of the elimination project was started in 2001-02 and ended in December 2004. The prevalence rate of leprosy was found to be 0.95/10,000 population by December 2005, a success in the elimination of leprosy. On 30th September 2006 the rate on record is 0.89/10,000 population, a further decline. During 2005-06 the annual new case detection rate was 14.27 per 100,000 population which was 23.4 during 2004-05, a reduction of 39.0%. During the 11th plan period (April 2007 to March 2012) the government proposes to carry on the leprosy programme with the same intensity further to achieve annual new case detection rate less than 10 cases per 100,000 population.

National Leprosy Eradication Programme and progress towards elimination of leprosy in India.

The World Health Assembly in May 1991 made the declaration to eliminate leprosy at global level by the year 2000. Complete coverage of all the districts with MDT was possible in the year 1996. Very good results were obtained and the case lead came down to 0.51 million by December 2000. A new goal has been set to reach leprosy elimination at national level in India by December 2005. The challenges to eliminate leprosy and to bring prevalence rate 0.9/10,000 by December 2005 are to be taken at epidemiological, operational and at administrative levels.