An Inter District Analysis of Public Healthcare Infrastructure Disparities in Assam.

Background: Sufficient and quality healthcare services are basic requirement for overall development of a nation. Public healthcare infrastructure is one of the major determinants of health outcomes in a country, and public healthcare services have a considerable impact on people's health status. The rural population primarily relies on public healthcare services. Assam is not an exception in this regard, where the insufficiency of public healthcare services is still an issue. 86 % of the population of Assam lives in rural areas. Objectives: The present work attempts to study the inter-district variation regarding public health infrastructure in 33 districts of Assam. Methods: The Inter district variation is estimated with a composite index of public health infrastructure. Principal Component Analysis (PCA) is adopted to construct a composite index using nine health infrastructure indicators. Results: The study has observed variations in health infrastructure among the various districts of Assam, reflecting the shortage of health infrastructure-physical and human in rural and remote areas of the state. The study finds inter-district variations in the state.

Molecular detection of drug-resistant Plasmodium falciparum mutants in Assam

Background & objectives: The spread of drug-resistant Plasmodium falciparum ( Pf) poses a serious threat to the control and elimination of malaria. The objective of this study was to detect the molecular biomarkers of antimalarial drug resistance in Pf in patients visiting a tertiary care hospital in Assam. Methods: Malaria was first detected in fever cases using microscopy and a rapid diagnostic test (RDT), and then confirmed using PCR. Pf chloroquine resistance transporter (Pfcrt), Pf multidrug resistance-1 (Pfmdr-1), and single-nucleotide polymorphisms linked to delayed parasite clearance after treatment with artemisinin MAL 10-688956 and MAL 13-1718319 and Kelch-13 propeller (PfK-13) genes were evaluated by PCR-restriction fragment length polymorphism (RFLP). Results: Sixty nine cases of malaria were found among 300 cases of fever. Of these, 54 were positive for Pf, 47 of which were confirmed by PCR. Pfcrt-K76T mutation was seen in 96.6 per cent and Pfmdr1-N86Y mutation in 84.2 per cent of cases. Mutation was not detected in MAL10 and MAL13 genes. Sequence analysis of Kelch-13 gene showed the presence of a novel mutation at amino acid position 675. Statistically, no significant association was found between the molecular biomarkers and demographic profile, clinical presentation and outcome of the cases. Interpretation & conclusions: Molecular surveillance is essential to assess the therapeutic efficacy of the drugs against circulating Pf isolates in Assam which are found to be highly resistant to CQ. The role of the new mutation found in the Kelch-13 gene in the development of artemisinin resistance in Assam needs to be thoroughly monitored in future research.

Cohort profile of the largest health & demographic surveillance system (Dibrugarh-HDSS) from North-East India

Dibrugarh Health and Demographic Surveillance System (Dibrugarh-HDSS), was started in the year 2019 with the objective to create the health and demographic database of a population from a defined geographical area and a surveillance system for providing technical assistance for the implementation of programmes and formulating intervention strategies for reducing disease morbidities and mortalities in the population. Dibrugarh-HDSS adopted a panel design and covered 60 contiguous villages and 20 tea gardens. Line listing of all the households was conducted and a unique identification number detailing State, district, village/tea garden and serial number was provided along with geotagging. Detailed sociodemographic variables, anthropometric measurements (subjects ?five years) and blood pressure data (subjects ?18 yr), disease morbidity and mortality were collected. All data were collected in pre-designed and pre-tested questionnaires using a mobile application package developed for this purpose. Dibrugarh-HDSS included a total of 106,769 individuals (rural: 46,762, tea garden: 60,007) with 52,934 males (49.6%) and 53,835 females (50.4%). The number of females per thousand males were significantly higher (1042 in tea garden vs. 985 in rural populations) in the tea-garden community as compared to the village population. More than one-third (35.1%) of tea populations were illiterate compared to the rural population (17.1%). Villagers had significantly higher body mass index than the tea-garden community. The overall prevalence of hypertension (adjusted for age) was 29.4 vs. 28.2 per cent, respectively, for the village and tea-garden population. For both these communities, males (village=30.8%, tea garden=31.1%) showed a higher prevalence of hypertension (adjusted for age) than females (village=28.2%, tea garden=25.8%). The findings of the present study give an insight into the profile of the native rural and tea-garden populations that will help to identify risk factors of different health problems, review the effectiveness of different ongoing programmes, implement intervention strategies for reducing morbidity and mortality and assist the State health authorities in prioritizing their resource allocation and implementation strategies.

Molecular epidemiology of Japanese encephalitis in pigs and risk factors associated with causing Japanese encephalitis in pigs of Lakhimpur, the first case reported in the district of North East India

Background & objectives: Japanese encephalitis (JE) is a major public health problem in India. The first outbreaks of JE have been reported from the North-eastern regions of Assam, particularly from the Lakhimpur district of Assam between July–August 1989. In Assam every year many people died due to JE. This study was performed to investigate the molecular epidemiology of JE in pigs in Lakhimpur district of Assam and the risk factors associated with causing Japanese encephalitis in pigs. This study will help to map out the endemic regions and to know where and when to apply the most control strategies towards the prevention and control of the disease. Methods: A total of 342 serum samples from pigs were collected from 10 organized and 20 unorganized farms from 9 blocks and recorded to age, sex and breed and tested by RT-PCR. Pig farms and the surrounding environment were studied for assessment of farm-level risk factors responsible for JEV infection in pigs. Results: Out of 342 samples tested for detection of the E gene of JEV, 14 samples were found to be positive with a prevalence rate of 4.09%. Age, sex and breed-wise higher cases were found in at the age group above 12 months, sex wise female and breed-wise local pigs. Pig farms less than 500 meters from risk factors like rice field, stagnant water source, wild bird exposure to farm and mosquito exposure at farm/ bite to pigs, found to be more numbers of JE cases. Interpretation & conclusion: Molecular epidemiology of JE in pigs, and humans; positive at Lakhimpur recommend the need for uninterrupted surveillance of this virus in pigs specially those areas where pig population is more and all risk factors are present.

Correlates of Breastfeeding in Villages and Tea-Gardens in Assam, India

Objective: To observe and compare breastfeeding practices in villages and tea-gardens. Methods: Analytical cross-sectional study among mothers of infants in a health and demographic surveillance site in Dibrugarh, Assam. Results: 1435 mothers (855 from teagardens, 580 from villages); and 1437 infants (857 from tea-gardens, 580 from villages), were included in study. Mean maternal age was 25.1 (4.4) years in tea-gardens and 25.8 (4.9) years in villages. Timely initiation of breastfeeding was higher in villages (82.6%) than teagardens (76.4%). Feeding colostrum was higher in villages (71.2%) than tea-gardens (60.8%). Discussion: Factors affecting breastfeeding were different in villages and teagardens. Timely initiation of breastfeeding was associated with nuclear family in villages and joint family in tea-gardens. Hence, interventions promoting breastfeeding practices should be tailored instead of one-size-fits-all approach.

Genetic diversity analysis of specialty glutinous and low-amylose rice (Oryza sativa L.) landraces of Assam based on Wx locus and microsatellite diversity

The sticky rice of Assam is traditionally classified as bora (glutinous) and chokuwa (semi-glutinous) basedon their stickiness after cooking. The Waxy (Wx) gene encodes for granule-bound starch synthase (GBSS)that controls the synthesis of amylose, which is a key determinant of rice end-use quality attributes. In thisreport, we analysed the level of variation in grain quality traits in a collection of bora and chokuwacultivars, and examined the nucleotide diversity at the Wx locus of selected rice accessions to identify thepossible cause of low-amylose in these rice cultivar groups. The Wx gene sequencing from 24 bora andchokuwa cultivars revealed several nucleotide variations that can explain the variation in the amylosephenotypes. The nucleotide polymorphisms in the downstream intron regions were similar to those reportedin Bangladeshi Beruin cultivars. Among the Wx polymorphisms, the CTn microsatellite in exon 1 and G/TSNP in intron 1 (G/T-Int1) should be considered for marker assisted breeding involving bora cultivars. TheWx gene tree, classified the bora accessions possessing the G/T-Int1 SNP as japonicas. However, clusteranalysis using microsatellite markers classified the bora and chokuwa cultivars as indica, and intermediateof indica-aus. The findings of this study supplemented our understanding on the evolution of the Wx geneunder human selection. The results will assist plant breeders to effectively improve the bora and chokuwalandraces.

Home-based newborn care voucher initiative in Assam: An evaluation

Background: An innovative home-based newborn care (HBNC) voucher system has been introduced in Assam to improve home visits of accredited social health activists (ASHAs), make them more accountable, and empower the community. Objective: This study aimed to evaluate the effectiveness of HBNC voucher initiative in Assam. Methods: A mixed methodology study was conducted in 2018 including 4 districts of Assam. A quantitative study was done among a sample of 836 lactating mothers by interviewing them through house-to-house visits. A qualitative study was done by in-depth interview of various health-care service providers. Results: Of 836 lactating mothers, 65% received HBNC voucher; 45.6% received at the time of discharge, and 5.3% during antenatal care. The purpose of HBNC vouchers as a tool of validating ASHAs' home visits was explained to only 14.5% of lactating mothers. Examination of newborn (44.6%), counseling on breastfeeding (57.1%), counseling on care of baby (39.2%), and counseling on immunization (49.2%) were the services commonly provided by ASHA during HBNC visits. Voucher system improved incentive payment system, but uninterrupted supply was a problem area as stated by ASHAs. Auxiliary nurse midwives and ASHA supervisors told that voucher system had improved ASHA home visits, payment system, and increased identification of danger signs of newborns. Conclusions: HBNC voucher system as an innovative approach was found to be effective. Coverage of services varied among different districts. Uninterrupted supply of the vouchers, periodic resensitization of health workers on its use, and increasing awareness among the community is needed to be sustained.

Factors associated with inter-district variation of maternal mortality in Assam

Background: Maternal mortality is an important indicator of the health and socioeconomic status of a nation. Assam has the highest maternal mortality ratio (MMR) in the country. Although maternal death is a biomedical event, the contributory factors are many. Objectives: The objectives of the study were to assess the role of demographic, socioeconomic, nutritional, health service availability, and utilization indicators in inter-district variation of maternal mortality in Assam. Materials and Methods: We conducted an analysis of maternal mortality using district-level secondary data of 27 districts of Assam. The dependent variable was the MMR, while independent variables were demographic, socioeconomic, nutritional, health service availability, and utilization indicators. Pearson correlation and linear regression analysis were done to assess the relationship between MMR and 14 indicators at the district level using SPSS version 20. Results: MMR decreased linearly with increase in proportion of rural population and accounted for 20% variability (P = 0.018). Proportion of households with access to safe drinking water had a significant negative linear association with MMR and accounted for 27% of variability (P = 0.005). MMR increased linearly with increase in proportion of pregnant women with anemia at the district level (P = 0.019). Community health centers (CHCs) per million populations were found to have a negative linear association with MMR and accounted for 15% of variability in MMR at the district level. Conclusions: Proportion of rural population, households with access to safe drinking water, pregnant women with anemia, and CHCs per million populations were associated with inter-district variation of maternal mortality in Assam.

Survey and documentation of anthelmintic plants used in traditional medicine system of tribal communities of Udalguri district of Assam, India

The present study was aimed to survey and document the anthelmintic medicinal plants traditionally used by the tribalcommunities of Udalguri district of Assam. The survey was conducted in different villages of the district followinga face-to-face interview and a readymade questionnaire. The study found that a total of 75 plant species belonging to67 genera and 44 plant families were used as deworming agents. The result showed that Andrographis paniculata,Ananas comosus, Hydrocotyle sibthorpioides, and Centella asiatica were the most popular plant species. Acanthaceaefamily was found to be most common among the traditional healers. The leaves were found to be commonly used plantparts for herbal preparation. Decoction, infusion, and raw preparations were found to be the most commonly usedtraditional formulation methodologies. The present study could be used to identify the potential anthelmintic plantsand in designing new anthelmintic drug having better property and efficacy

Pathology of Wild Strain (DP/As-Km/0019) of Duck Plague Virus Infection Revived in Ducklings

Duck plague is an acute highly contagious disease of duck, geese and swan of all ages caused by Anatid Herpesvirus-1. The disease is characterized by significant decrease in growth, egg production and sudden death along with high morbidity and mortality which results into significant economic losses in duck industry. In present study, the pathology of wild strain (DP/As-Km/0019) of duck plague virus (DPV) was experimentally studied in 2 months old ducklings. The prominent clinical signs observed were depression, loss of appetite, greenish diarrhoea, ruffled feathers, nasal discharge, lacrimation and pasted eyelids with periorbital ring formation. The significant gross lesions were observed in spleen, oesophagus, liver, heart, brain and intestine. Vascular and degenerative changes like congestion, haemorrhages, necrosis and diphtheritic membrane formation were noticed in various parenchymatous organs. Microscopically, focal to diffuse areas of haemorrhages, coagulative necrosis, and fatty changes in liver, focal emphysema in lungs, formation of diphtheritic membrane on the mucosal surface along with presence of numerous infiltrating cells in oesophagus were recorded. Presence of Anatid Herpesvirus-1 viral DNA in liver and spleen tissue samples was detected by PCR.

Menstrual hygiene: knowledge and practices during menstruation among adolescent girls in urban slums of Jorhat district, Assam, India

Background: Menstruation is still clouded by taboos and socio-cultural restrictions resulting in adolescent girls remaining ignorant of the facts of menstruation and hygienic practices, which sometimes results in adverse health outcomes. The present study was carried out to assess the knowledge and practices regarding menstrual hygiene, to find out the disorders during menstruation and to determine the factors associated with existing practices of menstrual hygiene among adolescent girlsMethods: A community-based cross-sectional study was conducted in two randomly selected urban slums of Jorhat district from March to August 2017 among 110 adolescent girls using predesigned pretested proforma. Data were analyzed using SPSS; association was determined using chi-square test with Yates correction or Fisher’s exact test, as appropriate.Results: 47.27% girls were aware about menstruation prior to menarche. Mother was the first informant in 65.38% of them. 69.09% were ignorant about the source of menstrual bleeding. Sanitary pads were used by 59.09% of girls. Majority (97.27%) practiced some form of restriction during menstruation. Dysmenorrhoea was the most common complaint (53.63%). Type of absorbent used was significantly associated with literacy status of girls and their mothers, socio-economic status, religion and prior knowledge about menstruation. Educational status of girls and their mothers were also significantly associated with satisfactory cleaning of external genitalia during menstruation.Conclusions: Ignorance and unsafe practices regarding menstruation, menstruation related problems and traditional beliefs and restrictions are quite common among adolescent girls in urban slums. Literacy status and awareness are the most important factors affecting the menstrual behaviours

A demographic study of urolithiasis in patients attending tertiary urological hospital in Dibrugarh, Assam, India

Background: Urolithiasis is a common disease entity seen in medical practice. Various studies from different areas of the world indicates higher male preponderance. Our study was done to find out the gender, age and area of distribution of Urolithiasis in a tertiary urology centre in upper Assam.Methods: Our study was a retrospective study done between January 2018 to June 2018. Data was collected from the records. A total of 1041 patients were examined during this period, out of which 307 patients were diagnosed and treated for urolithiasis.Results: Out of 307 patients, 228 were males and 79 were females. Male to female ratio was 2.9:1. The maximum number of patients in the age group was between 30-39 years. Majority of the patients were from the Dibrugarh district of upper Assam. Most of the positive urolithiasis cases was fund in patients consuming a non-vegetarian diet.Conclusions: Urolithiasis is a disease with preponderance in adult males. Geographical distribution, age and diet are factors that affect the occurrence of the disease.

Bioassay and molecular study for detection of insecticide resistance dengue causing mosquito vectors

Nowadays, dengue infection creates a major problem across the country. The vector species carrying dengue infection has progressively started to developed resistance against most of the currently used insecticides. Hence, a study was carried out in dengue-endemic areas of Assam and Arunachal Pradesh to find the current situation of insecticide susceptibility status of dengue vectors. Based on the previous history of dengue incidence, Aedes mosquitoes were collected from Dibrugarh, Kamrup, Sivasagar, Tezpur and Tinsukia districts in Assam and Pasighat district in Arunachal Pradesh to test the insecticide resistance status through bioassay and molecular methods. The WHO standard bioassay test kits were used to detect insecticide susceptibility status among dengue vectors. In molecular study, allele-specific polymerase chain reaction (PCR) method was done for the detection of mutations in paratype voltage-gated sodium channel gene of Aedes aegypti and Aedes albopictus mosquitoes. In bioassay method, 100% A. aegypti mosquitoes were found to be resistant towards dichlorodiphenyltrichloroethane (DDT), 8% towards pyrethroid and 4% towards malathion. Similarly, 92% A. albopictus mosquitoes have shown resistance competency towards DDT, 12% towards pyrethroid and 8% towards malathion. In allele-specific PCR methods, V1016G heterozygous mutations were detected from the field collected A. aegypti and A. albopictus mosquitoes of Tinsukia, Dibrugarh and Sivasagar district. Similarly, F1534C heterozygous mutations were observed from A. aegypti mosquitoes of Tezpur, Tinsukia and Sivasagar district and A. albopictus mosquitoes of Tinsukia, Dibrugarh and Sivasagar district. From the study, it was concluded that the Aedes mosquitoes have progressively started to developed resistance towards commonly used insecticides.

Serotyping of dengue viruses circulating during 2014–2015 in Assam, India

Dengue has become endemic in India with outbreaks caused by all the four serotypes occurring almost every year. Dengue cases have been increasing alarmingly in Assam also. This study aimed to identify the dengue serotypes circulating in Assam. Clinically suspected dengue fever cases were included in the study. Viral RNA was extracted using QIAamp Viral RNA Mini Kit (Qiagen). Nested reverse transcriptase polymerase chain reaction was done for serotyping. The frequency of dengue was 25.23% with a peak during the period from September (22.56%) to October (26.22%). Two serotypes were detected, DEN-1 (72.7%) and DEN-2 (12.1%) and dual infection in 15.1%.

Cervical Ribs: A Study On Radiographs In A Tertiary Care Hospital Of Assam

Introduction: Cervical rib is the extra rib arises from the seventh cervical vertebra. The prevalence of cervical ribdepends on the population. Cervical ribs are usually asymptomatic but may cause compression of subclavianartery and brachial plexus. Aim is to study the prevalence of cervical rib with associated gender, age group andlaterality (body sides).Materials and Methods: 8000 plain chest radiographs were studied from the month of January to March, 2017,in which 63 chest radiographs were found with cervical ribs. The particulars of the patients were recorded anddata were tabulated and analysed.Results: prevalence of the cervical rib was found to be 0.79% and female outnumbered male.Discussion: cervical rib is a less studied topic in this part of North-East India and thus, this study was conductedon chest radiographs of the patients of a tertiary hospital of this part of India.

Diversity of plankton population of manas river, assam, india

The present study was carried out to investigate the plankton diversity of Manas River, Assam from January 2015 to November 2017. A total of 57 genera of plankton were recorded from the river. Population of phytoplankton was represented by 42 genera belongs to the family Bacillariophyceae (14 genera), Chlorophyceae (21 genera), Cyanophyceae (5 genera) and Xanthophyceae (1 genera) and Phaeophyceae (1 genera). Zooplankton population was represented by 15 genera belong to Copepoda (4 genera), Cladocera (6 genera) and Rotifera (5 genera). The population density of plankton varied from season to season and found maximum (88800 u/l) in retreating monsoon and minimum in pre monsoon (54800 u/l). The Shannon-Weiner diversity index of plankton population of the river was recorded 2.957 which indicates moderate to high diversity. Present study revealed that pH, water temperature, water velocity, total hardness and chloride were the most driving force for annual variation in both phytoplankton and zooplankton structure

Preliminary phytochemical screening, in vitro antioxidant activity, total polyphenolic and flavonoid content of Garcinia lanceifolia Roxb. and Citrus maxima (Burm.) Merr.

Garcinia lanceifolia and Citrus maxima are two indigenous fruits of East India, particularly Assam; which has been used in various folkloric medicines to treat disorders ranging from diarrhea and jaundice to stomach and heart problems. The main aim of this study was to establish and compare the antioxidant potential of these two plants. The methanolic extracts of the bark of G. lanceifolia and C. maxima were tested for their antioxidant potential using various established in vitro assay procedures. The estimation of the total phenolic and total flavonoid content were also carried out. The phytochemical screening was also done prior to these assays, and it revealed that both the extracts were found to contain tannins and phenolic compounds and flavonoids along with other phytoconstituents. The results reveal that both these plants have a considerable amount of antioxidant activity which can be compared with each other and also the standards.

Clinicomycological profile of pityriasis versicolor in Assam.

Background: Geographical variation in the distribution of Malassezia species associated with pityriasis versicolor (PV) has led to the necessity of studying epidemiological, mycological, and clinical characteristics of PV. Aims: To study the epidemiological, mycological, and clinical characteristics of PV in a tertiary care hospital. Settings and Design: The study was carried out with a cross‑sectional design. Materials and Methods: Two hundred and sixty‑two consecutive PV patients were subjected to detailed history, clinical examination, and investigations. Skin scrapings were processed by direct microscopy and culture. Isolates were identified by phenotypic characteristics and polymerase chain reaction‑restriction fragment length polymorphism. Association of Malassezia species with clinical and epidemiological characteristics was studied. Statistical analysis of the data was done using statistical software. Results: Maximum number of PV cases (33.9%) belonged to the age group of 21–30 years with a male preponderance. 61.4% of the patients had a sedentary lifestyle, 70.2% showed the gradual onset of the disease, 51.1% presented with pruritus and in 66.4% of the patients symptoms were continuous. Most commonly involved body site was neck (27.8%), 77.09% of the lesions were bilaterally asymmetrical, 87.4% were macular, and 89.3% were hypopigmented. Malassezia furfur (77.3%) was the predominant species. Sedentary lifestyle (61.4%) and increased sweating (48%) were the most commonly associated predisposing factors. Conclusion: PV is more common in males. Distribution of Malassezia species varies significantly from those reported in other parts of India. M. furfur was the most common species responsible for PV in our region. Hence, further studies are required to evaluate the exact cause of this variation.

Salmonella Weltevreden food poisoning in a tea garden of Assam: An outbreak investigation.

Background: Salmonella enterica serovar Weltevreden has been a rare cause of acute gastroenteritis occurring worldwide. Here, we report an outbreak of food poisoning in a tea garden. Objectives: To determine the aetiological agent and risk factors responsible for the outbreak and to take necessary steps for prevention of future outbreaks. Materials and Methods: Affected area was visited by a team of microbiologists for collecting stool samples/rectal swabs from affected patients. Samples were processed by culture followed by confirmation of the isolates biochemically, automated bacterial identification system, conventional serotyping and molecular typing. Water samples were also processed for detection of faecal contamination. Antimicrobial susceptibility testing was performed by Kirby–Bauer disc diffusion technique according to the Clinical Laboratory Standard Institute guidelines. Results: The isolates were confirmed as S. enterica subspecies enterica serovar Weltevreden. They were found sensitive to ampicillin, amoxycillin‑clavulanic acid, ciprofloxacin, ofloxacin, norfloxacin, cefotaxime, ceftriaxone, co‑trimoxazole and doxycycline. Water samples showed high‑level faecal contamination. Source of outbreak was found to be drinking water contaminated with dead livestock. House to house visit was made for early diagnosis and treatment of the cases, awareness campaigning and chlorination of drinking water. Conclusions: This report emphasises the geographical distribution of this organism in Assam. As S. Weltevreden is widely distributed in domestic animals, people should be made aware of immediate reporting of any unusual death among the livestock and their safe disposal which can significantly reduce the incidence of non‑typhoidal salmonellosis in the country.

Population genetic study of Plasmodium falciparum parasites pertaining to dhps gene sequence in malaria endemic areas of Assam.

Plasmodium falciparum malaria parasite had developed resistance to almost all the currently used antimalarial drugs. The purpose of the study was to come across the genetic distances in P. falciparum dhps gene sequences circulating in Assam. A partial fragment of P. falciparum dhps gene containing major single nucleotide polymorphisms associated with sulphadoxine resistance were amplified and sequenced. Thereafter specific bioinformatics tools like BioEdit v7.0.9, ClustalW in Mega 5, DnaSP version v.5.10.01 etc were used for the analysis. A total of 100 P. falciparum positive cases in different malaria endemic areas of Assam were included for the study. Based upon the mutation analysis, a total of seven different P. falciparum dhps genotypes were observed with five variable sites. Maximum five haplotypes were found in the P. falciparum isolates from Jorhat district of Assam. Four polymorphic sites were observed in the P. falciparum dhps gene sequences in Karbi Anglong, NC Hills, Chirang and Jorhat whereas the isolates from other study areas had three polymorphic sites. A statistically significant positive value of Tajima’s D were observed among the P. falciparum field isolates in Assam indicating that there is an excess of intermediate frequency alleles and can result from population bottlenecks, structure and/or balancing selection. Extensive gene flow took place among the P. falciparum population of Jorhat with Sivasagar, Chirang with Sivasagar and Chirang with Karbi Anglong. However, large genetic differentiation was observed among the P. falciparum isolates of NC Hills with Lakhimpur, Tinsukia, Dibrugarh and Golaghat and also the parasite population of Karbi Anglong with Lakhimpur and Tinsukia signifying little gene flow among the population. This finding has shown that mutant Pfdhps gene associated with sulphadoxine resistance is circulating in Assam. It is believed that, the parasite population may have undergone high level of breeding.