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Background: Visceral leishmaniasis has remained a public health problem in Kenya despite Ministry of Health’s numerous efforts. This is associated with absence of a multidisciplinary response to outbreaks. We intended to analyze community’s prioritization of causes of Visceral leishmaniasis as well as community awareness on the disease prevention and control. Methods: This was a descriptive cross-sectional study design conducted between September 2023 to December 2023. 433 households’ heads, 23 community leaders and health workers were study informants. Results: Study findings showed clear proximity of human settlements and socioeconomic activities to the vector sandfly breeding sites. Environmental factors augmented by effects of climate change including flooding and high temperatures have sustained transmission including emergence of the disease in new foci. Low socio-economic status, environmental factors and climate change effects showed highly significant correlations with the disease and interplay with one another. Study results show lack of strategies and policies that promote effective prevention and control of Kala-azar. Stakeholders’ analysis revealed limited community awareness regarding roles played by different individuals in Kala-azar prevention, control, and elimination. Conclusions: There is a major gap in cooperation of partners in human, animal, and environmental health for achievements in public health strategies, therefore One Health approach should be adopted for integrated prevention, control, and elimination. The approach will sustainably improve and promote health while addressing the entire spectrum of disease control, including detection, preparedness, response, and management in addition to disease prevention averting this terrible disease from resurfacing in the future.
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Background: National TB Programme of India launched Nikshay Poshan Yojana (NPY) through Direct Benefit Transfer (DBT) in April 2018, to provide financial support for additional nutritional requirement during TB treatment. This study aims to understand the enabling attributes in availing Nikshay Poshan Yojana (NPY) through Direct Benefit Transfer (DBT) among notified TB patients from the Indian state of Jharkhand for the year 2019. Methods: This is a retrospective cross sectional descriptive study using secondary data obtained from Nikshay web portal for the Indian state of Jharkhand in the year 2019. State level data on TB Notification and NPY DBT scheme is downloaded from the Nikshay portal in excel format and analysed using Excel 2016 version. Odds Ratio and P value are calculated and analysed to prove any statistically significant associations. Results: The study found higher odds (1.08, 95% CI: 1.03, 1.14; P value 0.004) of having patients who belong to 15 to 65 years, female sex (odds ratio 1.05, 95% CI: 1.01, 1.09; P value 0.018), seeking care in public sector (odds ratio 4.05, 95% CI: 3.83, 4.27; P value <0.00001) and with drug sensitive TB (DS TB) (odds ratio 1.39, 95% CI: 1.1, 1.59; P value <0.00001), among those who received at least one instalment of DBT. Conclusions: TB patients belonging to productive age group, female sex, seeking care in public sector and with DS TB have higher odds of receiving NPY among the study population.
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Background: National TB programme of India implemented Nikshay Poshan Yojana (NPY) through direct benefit transfer (DBT) in April 2018. This is to address the dual evils of under nutrition and unfavourable outcomes among tuberculosis patients in the country. This study aimed to understand the impact of Nikshay Poshan Yojana (NPY) through direct benefit transfer (DBT) on the outcomes of notified TB patients from the Indian state of Jharkhand for the year 2019. Methods: This was a retrospective cross sectional descriptive study using secondary data obtained from Nikshay web portal for the Indian state of Jharkhand for the year 2019. State level data on TB notification and NPY DBT scheme was downloaded in excel format and analysed using Excel 2016 version. Results: The study found higher odds (odds ratio 3.14, 95% CI: 2.97, 3.33; p value <0.00001) of having successful outcomes, among those who received at least one instalment of NPY. The risk of lost to follow up (LTFU) was 2.44 times (95% CI: 2.2-2.8, p value: 3.9×10-43) higher among those who did not receive any DBT payments as compared to those who received at least one DBT instalment. Conclusions: The ‘individual and health system enablers’ have a crucial role to play in successful TB treatment outcomes than NPY. However, LTFU rate reduces significantly with timely payment of NPY. This would facilitate improved treatment adherence and thus a favourable outcome.
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Objective To analyze the diagnostic quality of imported malaria in Hubei Province from 2019 to 2022, and to further improve the diagnostic level and consolidate the achievements in eliminating malaria. Methods The samples of reported malaria cases in Hubei were collected by the provincial reference laboratory (PRL) from 2019 to 2022. The microscopy and fluorescent PCR were performed to confirm the infection of plasmodium species of each case．The positive coincidence rate and species coincidence rate were analyzed and compared． Results A total of 257 imported malaria cases were reported in Hubei Province from 2019 to 2022. Among 229 malaria cases were confirmed, the overall coincidence for malaria diagnosis was 91.24% (229/251), and the overall coincidence rate for parasite species identification was 86.03% (197/229). The difference in species coincidence rate among different years was statistically significant (χ2=10.458, P2=29.283, P2=81.275, P2=19.777, P<0.05). Conclusion The quality of the qualitative diagnosis of malaria cases reported online from 2019 to 2022 is generally high. However, the ability of Plasmodium typing needs to be improved. In the future, technical training and quality control should be strengthened to improve the malaria surveillance capability during the post-elimination stage.
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@#Objective: To describe the situation of measles in Sri Lanka from May to November, 2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the outbreak. Methods: This retrospective study analyzed all samples tested for measles from 1st of May to 30th of November, 2023 at National Measles Rubella Laboratory, Sri Lanka. According to the World Health Organization (WHO) algorithm, serum and oropharyngeal/ nasopharyngeal swabs were tested with WHO recommended kits for anti-measles IgM and measles virus specific RNA, respectively. Selected RNA positive samples were sequenced at reference laboratory, India. Analysis of sequencing data and construction of phylogenetic tree were carried out at National Measles Rubella Laboratory. Data was analyzed using descriptive statistics. Results: Of the total 1 132 serum samples and 497 oropharyngeal/ nasopharyngeal swabs from 1 326 patients, 657 (49.5%) patients were confirmed as measles by anti-measles IgM, measles virus specific RNA or both. Males (55.6%, n=365) and the age group from >20 to ≤30 years (33.0%, n=217) predominated positive patients. All provinces reported measles positive cases. All samples sequenced (100%, n=42) were genotype D8 with 95.2% (n=40) bearing Victoria.Australia origin. Conclusions: We described resurgence of measles in an eliminated country, confirming the genotype to be D8, one of the two genotypes currently circulating globally. Further, the study strongly convinced the importance of a strengthened virological surveillance system in an eliminated country, despite its eliminated status.
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There are still multiple challenges in China during the malaria post-elimination phase, including a large number of imported malaria cases with widespread distribution, low awareness of timely healthcare seeking, insufficient malaria diagnosis and treatment capacity of medical institutions and insufficient malaria surveillance and response capability of disease control and prevention institutions. As the core technical institutions for preventing the re-establishment of malaria transmission, both medical institutions and disease control and prevention institutions are required to enhance the collaboration between clinical and public health services, improve the malaria diagnosis and quality management system, intensify case identification and epidemiological investigations, and improve the management mechanism of antimalarial drug reserves. In addition, doctors are encouraged to become the main force in the health education and promotion of malaria prevention to improve the public health literacy. These approaches are recommended to improve the overall capability of timely identification, standardized treatment and effective response of imported malaria cases, so as to continuously consolidate the malaria elimination achievements in China.
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The goal of achieving elimination of schistosomiasis across all endemic counties in China by 2030 was proposed in the Outline of the Healthy China 2030 Plan. On June 16, 2023, the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030) was jointly issued by National Disease Control and Prevention Administration and other 10 ministries, which deployed the targets and key tasks of the national schistosomiasis elimination programme in China. This article describes the progress of the national schistosomiasis control programme, analyzes the opportunities to eliminate schistosomiasis, and proposes targeted recommendations to tackle the challenges of schistosomiasis elimination, so as to accelerate the process towards schistosomiasis elimination and facilitate the building of a healthy China.
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On June 16, 2023, National Disease Control and Prevention Administration of the People’s Republic of China, in collaboration with other ministries, formulated and issued the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030). The implementation of this plan provides an important basis for achieving the targets set in the “Healthy China 2030” action plan and the implementation of the rural revitalization strategy. This paper describes the background, principles, targets, control strategies, safeguard measures and effectiveness evaluation of the plan, in order to guide the scientific and standardized implementation of actions for schistosomiasis elimination at the grassroots level, and facilitate the progress towards elimination of schistosomiasis in China with a high quality.
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Objective To understand the current status of capacity building in schistosomiasis control institutes in schistosomiasis-endemic provinces (municipality, autonomous region) of China. Methods The responsibilities and construction requirements of various schistosomiasis control institutions were surveyed by expert discussions, and field interviews and visits during the period between May and June, 2023, and the questionnaire for capacity maintenance and consolidation in schistosomiasis control institutions was designed. An online questionnaire survey was conducted in county-, municipal-, and provincial-level institutions that undertook schistosomiasis control and surveillance activities through the Wenjuanxing program. The distribution of schistosomiasis control institutions, the status of institutions, departments and staff undertaking schistosomiasis control activities and the translation of scientific researches on schistosomiasis control in China were analyzed. The laboratories accredited by China National Accreditation Service for Conformity Assessment (CNAS) were considered to be capable for testing associated with schistosomiasis control, and the testing capability of schistosomiasis control institutions was analyzed. Results A total of 486 valid questionnaires were recovered from 486 schistosomiasis control institutions in 12 endemic provinces (municipality, autonomous region) of China, including 12 provincial-level institutions (2.5%), 77 municipal-level institutions (15.8%) and 397 county-level institutions (81.7%). Of all schistosomiasis control institutions, 376 (77.4%) were centers for disease control and prevention or public health centers, 102 (21.0%) were institutions for schistosomiasis, endemic disease and parasitic disease control, and 8 (1.6%) were hospitals, healthcare centers or others. There were 37 713 active employees in the 486 schistosomiasis control institutions, including 5 675 employees related to schistosomiasis control, and the proportions of employees associated with schistosomiasis control among all active employees were 5.9% (231/3 897), 5.5% (566/10 134), and 20.6% (4 878/23 682) in provincial-, municipal-, and county-level institutions, respectively. There were 3 826 full-time employees working in schistosomiasis control activities, with 30.5% (1 166/3 826), 34.6% (1 324) and 34.9% (1 336/3 826) at ages of 40 years and below, 41 to 50 years and over 50 years, and there were 1 571 (41.0%) full-time schistosomiasis control employees with duration of schistosomiasis control activities for over 25 years, and 1 358 (35.5%) employees with junior professional titles and 1 290 with intermediate professional titles (35.5%), while 712 (18.6%) full-time employees working in schistosomiasis control activities had no professional titles. The three core schistosomiasis control activities included snail control (26.3%, 374/1 420), epidemics surveillance and management (25.4%, 361/1 420) and health education (18.8%, 267/1 420) in schistosomiasis control institutions. The Kato-Katz method, miracidium hatching test with nylon gauzes, and indirect haemagglutination assay (IHA) were the most commonly used techniques for detection of schistosomiasis, and there were less than 50% laboratories that had capabilities or experimental conditions for performing enzyme-linked immunosorbent assay (ELISA), dipstick dye immunoassay (DDIA), dot immunogold filtration assay (DIG-FA), loop-mediated isothermal amplification (LAMP) and polymerase chain reaction (PCR) assays. During the period from 2018 to 2022, schistosomiasis control institutions had undertaken a total of 211 research projects for schistosomiasis control, with a total funding of 18.596 million RMB, published 619 articles, participated in formulation of 13 schistosomiasis control-related criteria, and applied for 113 schistosomiasis control-related patents, including 101 that were granted, and commercialized 4 scientific research outcomes. Conclusions The proportion of independent specialized schistosomiasis control institutions is low in schistosomiasis control institutions in China, which suffers from problems of unsatisfactory laboratory testing capabilities, aging of staff and a high proportion of low-level professional titles. More investment into and intensified schistosomiasis control activities and improved capability building and talent cultivation in schistosomiasis control institutions are recommended to provide a powerful support for high-quality elimination of schistosomiasis in China.
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To understand the progress of national schistosomiasis elimination program of China in 2023 and summarize the lessons and experiences, data on the endemic status of schistosomiasis and national schistosomiasis surveillance results in the People’s Republic of China were collected and analyzed at a national level. By the end of 2023, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan and Hubei provinces were identified to achieve the criteria of transmission interruption in 2020, and Anhui, Jiangxi and Hunan provinces achieved the criteria of transmission interruption in 2023. A total of 451 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2023, including 26 250 endemic villages covering 73 034 500 residents at risk of infections. Among the 451 endemic counties (cities, districts), 78.49% (354/451) achieved the criteria of schistosomiasis elimination and 21.51% (97/451) achieved the criteria of transmission interruption, respectively. In 2023, a total of 4 216 643 individuals received immunological tests, with 47 794 sero-positives identified, and a total of 184 216 individuals received parasitological examinations, with 4 egg-positives detected. A total of 27 768 cases with advanced schistosomiasis were documented in China by the end of 2023. In 2023, 539 548 bovines were raised in schistosomiasis-endemic areas of China, and 125 440 bovines received immunological tests, with 124 sero-positives detected, while no egg-positives were identified among the 133 508 bovines receiving parasitological examinations. In 2023, snail survey was performed at an area of 641 339.53 hm2 and 184 819.77 hm2 snail habitats were identified, including 51.53 hm2 emerging snail habitats and 642.25 hm2 reemerging snail habitats. In 2023, there were 20 198 schistosomiasis patients receiving praziquantel chemotherapy, and 598 183 person-time individuals and 283 954 herdtime bovines were given expanded chemotherapy. In 2023, snail control with chemical treatment was performed in 116 347.95 hm2 snail habitats, and the actual area of chemical treatment was 65 690.89 hm2, while environmental improvements were performed in snail habitats covering an area of 1 334.62 hm2. The national schistosomiasis surveillance results showed that the mean prevalence of Schistosoma japonicum infections were both zero among humans and bovines in 2023, and no S. japonicum infection was detected in snails. These data demonstrated that transmission interruption of schistosomiasis had been achieved across all endemic provinces in China in 2023, and the endemic status of schistosomiasis tended to be stable, while advanced cases were predominant among all schistosomiasis cases. However, the areas of snail habitats remained high and cattle re-raising was very common in some regions. Intensified schistosomiasis surveillance and forecast and snail control in high-risk areas are needed.
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Malaria is one of the most serious mosquito-borne infectious diseases in the world. The global malaria control progress has stalled in recent years, which is largely due to the biological threats from the malaria pathogen Plasmodium and the vector Anopheles mosquitoes. This article provides an overview of biological threats to global malaria elimination, including antimalarial drug resistance, deletions in the malaria rapid diagnostic test target P. falciparum histidine-rich protein 2/3 (Pfhrp2/3) genes, vector insecticide resistance and emergence of invasive vector species, so as to provide insights into malaria and vector research and the formulation and adjustment of the malaria control and elimination strategy.
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Malaria is an infectious disease that seriously threatens human health. Currently, malaria control mainly depends on antimalarial chemotherapy. However, antimalarial drug resistance is becoming increasingly severe, which poses a great challenge to malaria control, notably treatment of Plasmodium falciparum malaria. To address this challenge, there is a need to facilitate development of novel antimalarial drugs and innovation of treatment strategies, as well as reinforce surveillance and research on antimalarial drug resistance. This article reviews the main categories and use guidelines of current antimalarial agents, summarizes the current status and monitoring methods of antimalarial drug resistance, and proposes the response to antimalarial drug resistance, so as to provide insights into the use of antimalarial drugs and response to antimalarial drug resistance, and contribute to global malaria elimination.
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The global malaria epidemic is still severe. Because of simple procedures, rapid detection and accuracy results, rapid diagnostic test (RDT) has become the most important and the most widely used diagnostic tool for malaria prevention and control. However, deletions in the RDT target Plasmodium falciparum histidine-rich protein 2/3 (Pfhrp2/3) genes may cause false-negative results of RDT, which has been included as one of the four biological threats to global malaria elimination. This article reviews the applications of RDT in the global malaria diagnosis, analyzes the threats and challenges caused by Pfhrp2/3 gene deletion, proposes methods for monitoring Pfhrp2/3 gene deletion, and summarizes the causes and countermeasures of negative RDT detections, so as to provide insights into consolidation of malaria elimination achievements in China and contributions to global malaria elimination.
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The insecticide resistance is becoming increasingly severe in malaria vectors and has become one of the most important threats to global malaria elimination. Currently, malaria vectors not only have developed high resistance to conventional insecticides, including organochlorine, organophosphates, carbamates, and pyrethroids, but also have been resistant to recently used neonicotinoids and pyrrole insecticides. This article describes the current status of global insecticide resistance in malaria vectors and global insecticide resistance management strategies, analyzes the possible major challenges in the insecticide resistance management, and proposes the response actions, so as to provide insights into global insecticide resistance management and contributions to global malaria elimination.
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Driven by international exchanges and climate changes, the invasion and spread of vector Anopheles mosquitoes posed a new challenge to achieving global malaria elimination. Taking the invasion of An. stephensi to exacerbate the malaria epidemic in Africa as an example, this article summarizes the current situation of global Anopheles invasion, and estimates the potential risk of vector Anopheles mosquitoes to unravel the difficulties and challenges in the global malaria elimination program, so as to provide insights into improved early earning and precision control of vector Anopheles mosquito invasion across the world.
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ObjectiveTo analyze the epidemic characteristics of measles and rubella in Pudong New Area of Shanghai from 2013 to 2022， and to provide data support for the elimination of measles and rubella. MethodsEnzyme linked immunosorbent assay was used to detect IgM antibodies in serum samples. The sequence of 630 nucleotides at the C-terminal of N gene of measles virus was amplified by reverse transcription-polymerase chain reaction and the phylogenic tree was constructed. ResultsA total of 1 529 suspected cases of measles were detected from 2013 to 2022， among which the positive rate of measles IgM antibody was 33.55% （513/1 529）. The highest positive rate （20.73%） was from March to May ， and the positive rate of rubella IgM antibody was 6.80% （104/1 529）. The positive rate of both IgM was higher in males than that in females （P<0.05）. The IgM against measles was mainly detected in 0‒ years old （63.16%， 96/152） and 20‒ years old （45.61%， 161/353）. The IgM against rubella was mainly detected in 10‒20 years old （27.27%， 18/66）. The IgM antibody could be detected more easily from 4 to 28 days after eruption， and the IgM antibody positive rate of measles/rubella from 2020 to 2022 was significantly lower than previous years （2013‒2019）. There were 2 D8 genotype strains， and the rest were H1a gene subtypes. ConclusionThe positive rate of IgM antibodies against measles/rubella in Pudong New Area of Shanghai decreased significantly. People aged 0‒ years and 20‒ years old are more susceptible to measles， and rubella is concentrated in 10‒ years old. It is necessary to strengthen the vaccination of school-age children， in order to achieve the goal of eliminating measles. The age group with high risk of exposure should be checked for vaccination status to ensure the enhanced immunization， and the surveillance of imported measles cases should be strengthened.
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Introducción: la intoxicación por paracetamol puede producir falla hepática aguda. El pronóstico depende del diagnóstico precoz e inicio oportuno de las medidas terapéuticas. Objetivo: sensibilizar acerca del adecuado abordaje diagnóstico-terapéutico de la intoxicación aguda por paracetamol. Casos clínicos: se trata de 10 adolescentes de sexo femenino, mediana de edad 13,5 años, con intoxicación aguda intencional. Presentaban psicopatología 9; intentos de autoeliminación (IAE) previos 5, y seguimiento por equipo de salud mental 7. Cuatro recibían tratamiento con psicofármacos. Mediana de dosis de paracetamol 10 g (5 - 40). Se realizó carbón activado en ocho, asociado a lavado gástrico en seis pacientes. Mediana de tiempo entre ingesta y rescate 2,5 horas (1 - 3,5). Presentaron síntomas digestivos seis, fueron asintomáticas tres. Se dosificó el paracetamol luego de las 4 horas y en las primeras 24 horas de la ingesta en siete, siendo indetectable en una paciente. En las restantes, el riesgo de toxicidad hepática fue: posible en dos, probable en tres y sin riesgo en una. Se administró dosis carga de n-acetil cisteína a siete pacientes y tratamiento completo de mantenimiento a seis. Nueve ingresadas a cuidados moderados y una paciente a cuidados intensivos. No hubo complicaciones, ni fallecimientos. Se abordaron junto al toxicólogo. Conclusiones: la intoxicación aguda por paracetamol en adolescentes es habitualmente secundaria a IAE. La prevalencia de los problemas de salud mental y de IAE en esta población constituye una alerta para los profesionales de la salud que deben conocer el perfil de los fármacos utilizados y el abordaje diagnóstico-terapéutico de las posibles intoxicaciones. Dado el riesgo de hepatotoxicidad severa es necesario actuar rápidamente considerando dosis ingerida, tiempo desde la ingesta y factores de riesgo de hepatotoxicidad.
Introduction: Paracetamol poisoning can produce acute liver failure. Its prognosis depends on early diagnosis and timely initiation of specific therapeutic measures. Objective: To make health professionals aware of the appropriate diagnostic-therapeutic approach to acute paracetamol poisoning. Clinical cases: These are ten female adolescents, median age 13.5 years, with acute and intentional poisoning. 9 presented psychopathology, 5 previous self-elimination attempts (AEIs), and 7 were monitored by a mental health team. 4 received treatment with psychoactive drugs. Median dose of paracetamol 10 g (5-40 g). Drug rescue was performed with activated charcoal in 8, associated with gastric lavage in 6. The median time between intake and rescue was 2.5 hours (1-3.5 hours). They presented digestive symptoms 6 and were asymptomatic 3. Paracetamol was dosed after 4 hours and in the first 24 hours of ingestion in 7, being undetectable in 1. In the remainder, the risk of liver toxicity was classified as: possible 2, probable 3 and 1 without risk. A loading dose of n-acetyl cysteine was administered to 7 and full maintenance treatment to 6. 9 were admitted to moderate care and 1 to intensive care. There were no complications or deaths. Discussion/Conclusions: Acute paracetamol poisoning in adolescents is usually secondary to AEI. The prevalence of mental health problems and AEI in this population constitutes an alert for health professionals who must know the profile of the drugs used and the diagnostic-therapeutic approach to possible poisoning. Given the risk of severe hepatotoxicity, it is necessary to act quickly considering the dose ingested, time since ingestion, and risk factors for hepatotoxicity.
Introdução: O envenenamento por paracetamol pode levar à insuficiência hepática aguda. O prognóstico depende do diagnóstico precoce e do início oportuno das medidas terapêuticas. Objetivo: Aumentar a conscientização sobre a abordagem diagnóstica e terapêutica adequada para a intoxicação aguda por paracetamol. Casos clínicos: Dez adolescentes do sexo feminino, com idade média de 13,5 anos, com intoxicação agudada intencional. Nove apresentavam psicopatologia, 5 haviam feito tentativas anteriores de automutilação (SAI) e 7 tinham acompanhamento pela equipe de saúde mental, 44 recebiam tratamento com drogas psicotrópicas. Dose média de paracetamol 10 g (5 - 40 g). O carvão ativado foi usado em 8, associado à lavagem gástrica em 6. O tempo médio entre a ingestão e o resgate foi de 2,5 horas (1 a 3,5 horas). O paracetamol foi dosado após 4 horas e dentro de 24 horas da ingestão em 7, sendo indetectável em 1 caso. Nas demais pacientes, o risco de toxicidade hepática foi: possível em 2, provável em 3 e sem risco em 1. Uma dose de ataque de n-acetilcisteína foi administrada a 7 e o tratamento de manutenção completo a 6. Nove foram admitidas em cuidados moderados e 1 em cuidados intensivos. Esses dados foram discutidos com o toxicologista. Discussão/Conclusões: A intoxicação aguda por paracetamol em adolescentes geralmente é secundária a tentativa de autoextermínio (TAE). A prevalência de problemas de saúde mental e TAE nessa população é um alerta para os profissionais de saúde, que devem estar cientes do perfil dos medicamentos utilizados e da abordagem diagnóstica-terapêutica de possíveis intoxicações. Dado o risco de hepatotoxicidade grave, é necessário agir rapidamente, considerando a dose ingerida, o tempo decorrido desde a ingestão e os fatores de risco para hepatotoxicidade.
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Humans , Adolescent , Suicide, Attempted , Acetaminophen/toxicityABSTRACT
Background: Life expectancy at birth is an indicator of mortality conditions and health conditions. Mortality happens due to many causes. The multiple-decrement life table is used widely in human actuarial literature and provides statistical expressions for mortality in which the cause elimination is used. Cause elimination life tables address the hypothetical question of what a cohort’s mortality experience would be if a particular cause of death were eliminated. The goal of this study is to estimate the potential gain in life expectancy after complete elimination of certain causes of death in Kerala, India for the year 2018. Methods: The data for the study was taken from annual vital statistic report, Kerala, 2018. Life table method was used for estimating the potential gain in life expectancy after eliminating certain causes of deaths. Results: The elimination of deaths due to heart diseases, cancer, respiratory diseases, accidents and suicides resulted a gain of 7.18 years, 6.90 years, 8.04 years, 6.72 years and 7.09 years respectively. The results show that in 2018, for Kerala, the highest gain in life expectancy was due to elimination of respiratory diseases, followed by other causes of death. The present study shows that heart diseases and respiratory diseases are the causes which are more affected among Keralites. Conclusions: Effective intervention needs to be implemented in Kerala so as to reduce the risk of the diseases, which would result in the increase of life expectancy at birth.
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Background: India has the highest burden of tuberculosis in the world. It is experiencing an increasing burden of noncommunicable diseases, thereby facing a dual disease burden. Recent evidence shows an association between TB and noncommunicable diseases like diabetes, CVD and chronic respiratory infections. Aims and Objectives: To assess the feasibility of screening for NCDs and risk factors for NCDs among patients with TB in DOTS centers of a medical college in Delhi and ascertain challenges for the same among providers and patients. Methodology: It was a mixed-methods study with a quantitative component (cross-sectional study using questionnaires, anthropometric measurements and records review) and a qualitative component (descriptive study using interview data). Results: Among the 139 patients screened, ten new cases of hypertension and six new patients were diagnosed with DM. Outof- pocket expenditure for tests was a concern of the patients. Health care providers found the screening tool easy to use but were apprehensive about increased workload Conclusion: The study provide useful visions for incorporating NCDs into routine TB care through DOTS centers under RNTCP/NTEP.
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Background: A substantial proportion of tuberculosis patients either take treatment from private care providers or first-time visit private hospitals to diagnose tuberculosis. Hence the role of private providers is too essential to ignore to realize the ambition of tuberculosis elimination in India. Aim and Objectives: To understand the perception of private practitioners of Sonepat district of Haryana state regarding. Setting and Design: A cross-sectional study was done among the private practitioners of the Sonepat district of Haryana Methods and Material: 78 randomly selected practitioners from the list provided by the district health authority were interviewed using a pretested semi-structured questionnaire. The ethics committee of the study institute approved the study. Statistical analysis used: Descriptive analysis in terms of proportion and percentages was conducted. Results: One-third of the study participants were in the age group of 30-40 years. Half of the practitioners were reportedly practicing medicine for less than twenty years. A significant proportion agreed that the government could not single-handedly eliminate tuberculosis without collaborating with private providers. Mostly agreed on the effectiveness of Tuberculosis regimens under the program; however, over-relying on the sputum examination was perceived as a negative component of the program. Conclusions: Private providers understand their pivotal role in tuberculosis-related programs. However, their full participation has not been realized in the program.