Spread, establishment & prevalence of dengue vector Aedes aegypti (L.) in Konkan region, Maharashtra, India.

BACKGROUND & OBJECTIVE: Aedes aegypti (L.) (Diptera: Culicidae) was surveyed in the residential biotopes of Sindhudurg, Ratnagiri and Raigadh districts, Maharashtra State during dry (January-May & November- December) and wet (June-October) months in 2002 to update information on its distribution, to analyse post invasion establishment, and to study its prevalence. METHODS: The survey was designed to unfold Ae. aegypti distributions at landscape, habitat and micro-habitat levels. Risks of distribution and establishment due to differences amongst settlements, households and habitat attributes were analysed by univariate and multivariate methods. Demographic/transport changes were surveyed for its breeding refugia during dry months and prevalence during the wet seasons. Chi square tests for difference and relative risks of container types were applied to assess container habitats preferences for Ae. aegypti breeding, thus contributing to the risk of establishment and prevalence through seasons. RESULTS: Ae. aegypti was present in 16 out of total 28 settlements in dry season and 22 of 25 in wet season; the Breteau index (BI) varied from 1.25 to 57.33 and the container index (CI) was 0.6 to 25.81 in the dry season and BI from 1.25 to 110-00 and CI - 0.2 to 11.37 in the wet season, respectively. At macro-level, rural settlements and ports showed higher odds ratios (OR>1) for presence of Ae. aegypti. At meso-level, OR were 65.8, 24.8 and 4.9 for Ae. aegypti breeding in compact houses, clustered housing and in houses with tap water source respectively. At micro-level the plastic drums and small plastic containers were the important key habitats of its breeding. In the non-residential areas Ae. aegypti breeding was noted in one port during dry season; 10-road transport tyre dumps and scrap, 5 of 7 seaports and none of the two railway station areas during wet season. INTERPRETATION & CONCLUSION: At macro-geographic level Ae. aegypti distribution increased in 3 settlements, new establishment was seen in 7, new records in ten settlements and two were negative in past and present surveys. Logistic regression analyses indicated that the distribution was found to be more associated with ports and rural areas. At meso-geographic level the house aggregations and household drinking water supplies were of risk even at lower urbanization and rural levels. At micro-level, the site and potability were confounders; outdoor non potable water storage containers posed significant breeding risk, the potable water storage was significant but it contributed little to Ae. aegypti breeding. Further, Ae. aegypti breeding showed high preference to the plastic drums and other plastic miscellany. The results signified an expansion in the risk area of diseases borne by it in the context of urbanization, transport development and changing habitats.

Cervical intraepithelial changes & HIV infection in women attending sexually transmitted disease clinics in Pune, India.

BACKGROUND & OBJECTIVES: Cervical cancer is the most important cause of malignancy associated deaths among women in India. Western studies have reported higher risk of abnormal Pap smears in HIV infected women. A large burden of HIV infection and increasing HIV epidemic in India threatens to exacerbate incidence of cervical cancer. The objective of this study was to assess the frequency of Pap smear abnormalities and its association with HIV infection in women attending sexually transmitted disease (STD) clinics and to identify associated risk factors. METHODS: Between June 1996 and September 1999, women attending two STD clinics in Pune were screened for HIV infection, offered STD laboratory diagnosis and treatment and their Pap smears were evaluated. RESULTS: Squamous cell abnormality was detected in 10 per cent of HIV sero negative women attending STD clinics. This proportion was nearly double (19.2%) (Odds ratio = 2.14, 95% C.I. 1.03-4.48, P = 0.04) in HIV seropositive women. Having more than one life time partners and presence of STDs were also significantly associated with Pap smear abnormality in univariate analysis. In multivariate analysis, women presenting with STD and HIV infection both, were 2.8 times more likely to have inflammatory Pap smear and 3.5 times more likely to have abnormal Pap smear compared to HIV seronegative women presenting without STDs. INTERPRETATION & CONCLUSION: Pap smear abnormalities were common in women attending STD clinics in Pune. Presence of HIV infection further increased the risk two-folds. Therefore, women suffering from STDs should undergo periodic Pap smear screening for early detection of cervical abnormalities and should receive appropriate management to reduce morbidity and mortality.

Hepatitis G virus infection in India: prevalence and phylogenetic analysis based on 5' non-coding region.

OBJECTIVES: To determine the prevalence of hepatitis G virus (HGV) infection in western India and to carry out phylogenetic analysis of HGV isolates. METHODS: Reverse transcription-polymerase chain reaction (RT-PCR) assay was used to detect HGV RNA in serum samples obtained from paid plasma donors, patients with hemophilia and voluntary blood donors. Nine Indian and one Kenyan HGV RNA-positive samples were sequenced in the 5' non-coding region (5'-NCR). Phylogenetic analysis based on the comparison of a 101 nucleotide fragment from a large number of HGV isolates from 22 countries (including Indian and Kenyan sequences obtained during the present study) was carried out. RESULTS: HGV RNA positivity rates among paid plasma donors from a commercial plasmapheresis unit (7/43, 16.3%) and patients with hemophilia (5/44, 11.4%) were significantly higher than that in voluntary blood donors (0/51; p=0.003 and 0.019, respectively). Among patients with acute non-A to E hepatitis and fulminant hepatic failure, 1 of 50 and 1 of 28 were HGV RNA-positive, whereas 6 of 49 (12%) patients with chronic liver disease had circulating HGV RNA. All Indian isolates belonged to genotype 2, whereas the Kenyan isolate formed a distinct branch within genotype 1 consisting of African isolates. CONCLUSION: Our results suggest existence of parenteral transmission of HGV in the Indian population. HGV was not an important cause of acute non-A to E hepatitis or fulminant hepatic failure among the patients investigated. Genotype 2 seems to be the most prevalent genotype in western India.