Health information management: an introduction to disease classification and coding.

Morbidity and mortality data constitute an important component of a health information system and their coding enables uniform data collation and analysis as well as meaningful comparisons between regions or countries. Strengthening the recording and reporting systems for health monitoring is a basic requirement for an efficient health information management system. Increased advocacy for and awareness of a uniform coding system together with adequate capacity building of physicians, coders and other allied health and information technology personnel would pave the way for a valid and reliable health information management system in India. The core requirements for the implementation of disease coding are: (i) support from national/institutional health administrators, (ii) widespread availability of the ICD-10 material for morbidity and mortality coding; (iii) enhanced human and financial resources; and (iv) optimal use of informatics. We describe the methodology of a disease classification and codification system as also its applications for developing and maintaining an effective health information management system for India.

Gel purified LipL32: a prospective antigen for detection of leptospirosis.

BACKGROUND: Leptospirosis, a zoonosis, is a re-emerging disease, affecting populations across the globe. However, the current methods of diagnosis are time- consuming, cumbersome, imprecise or expensive. AIM: To develop an assay for differential and early diagnosis of Leptospirosis. METHODS AND MATERIAL: IgG based ELISA for evaluation of three antigens, namely, a gel-purified recombinant protein (rLipL32), secreted proteins and whole organism sonicates of Leptospira spp. The antigens were evaluated using, rabbit polyclonal antiserum and human sera samples. RESULTS: Studies with a rabbit polyclonal antiserum indicated the utility of these antigens in differentiating Leptospira from other common pathogenic organisms. Evaluation of these antigens with fifteen representative human serum samples indicated gel-purified rLipL32 to be a potentially useful antigen for detection of leptospirosis. The results obtained with IgG ELISA were correlated with the results of microscopic agglutination test (MAT). CONCLUSION: Gel-purified rLipL32 is a valuable antigen for early and accurate diagnosis of leptospirosis. Further evaluation of this assay in field conditions and larger sera samples will indicate its suitability in case of an epidemic.

An in vivo chloroquine sensitivity study in relation to low transmission potential and imported malaria in Kerala.

The study highlights the presence of chloroquine resistant Plasmodium falciparum strains in Kerala state, India for the first time. The emergence of chloroquine resistant P. falciparum in a low transmission area is dependent on the imported cases while build up of resistance is mainly due to persistence of resistant parasites which have more opportunities for transmission.

An in-vitro profile of the action of four antimalarials on indigenous cases of Plasmodium falciparum malaria in Karnataka.

In view of the emergence of chloroquine resistant Plasmodium falciparum from more and more geographical areas profiling of the responses to other available antimalarials by in vitro methods have become essential. A preliminary study undertaken in two Primary Health Centres of Karnataka State, India show the presence of strains of P. falciparum resistant to chloroquine and amodiaquine. The response for amodiaquine was poor as compared to chloroquine. The isolates were, however, sensitive to mefloquine and quinine.

Localization of the focus of origin of resistance in Plasmodium falciparum.

An attempt has been made to identify the focus of origin of Plasmodium falciparum resistance. Several factors have been analysed and the importance of mean parasite recrudescence time (M.P.R.T.) in the identification of focus of origin of resistance is highlighted.

A longitudinal study of P. falciparum response to chloroquine in relation to the epidemiology.

An attempt has been made to study the dynamics in the epidemiology of a locality where the local strains of Plasmodium falciparum have developed resistance to the antimalarial chloroquine. Increase in the transmission rate and prolonged drug pressure with chloroquine have been noted in association with the development of resistance. The importance of the study is on the mean parasite clearance time and mean parasite recrudescence time which appear to be related with the process developing resistance of chloroquine.