Evaluation of the effect of Block Level Awareness Campaign on performance indicators of National Leprosy Elimination Program in Vadodara district, Gujarat, India.

Background: Leprosy is probably the oldest disease affl icting mankind and a public health problem for centuries. Many cases are hidden or undiagnosed, especially due to social stigma, and neglect of painless patches. Between years 2001 and 2005, during which time active surveillance for detection of leprosy was in practice, a steep fall in the prevalence rate (PR) of leprosy was observed. However, during later years, leprosy program discontinued active surveillance for detection of leprosy cases. Presently block level awareness campaign (BLAC) is a special measure undertaken in a campaign mode during September–November in priority areas, (PR > 1/10000 population), during which information, education and communication (IEC) activities and active surveillance of leprosy cases is done. Aims: To evaluate the effect of Block Level Awareness Campaign on performance indicators of national leprosy elimination program (NLEP) in Vadodara district. Methods: The campaign was carried out for 6 days in 12 talukas of Vadodara district by the district leprosy offi ce, Vadodara. Trained teams of health workers carried out information, education and communication (IEC) activity and active surveillance by undertaking house to house survey in each primary health centre (PHC) area. Suspected cases were identifi ed by the team and confi rmed clinically by medical offi cers in the primary health centre of the corresponding areas. A district nucleus team (DNT) validated these confi rmed cases. These data were compared with the district’s national leprosy eradication programme (NLEP) data for the same year, 2012 and the previous year, 2011. Results: A total of 1,574,586 persons, comprising 76%of the population surveyed, were screened for leprosy, which resulted in detection of 358 clinically confi rmed new cases of leprosy, out of which 225 (62.8%) were paucibacillary (PB) and 133 (37.2%) were multibacillary (MB) leprosy. Of these cases, 14 (4%) had deformities, and 37 (10.3%) were children. Limitations: Only 76% of the population could be covered. Histopathological confi rmation of the diagnosis was not undertaken. Because of the large number of health workers invovled, variations in their skills may have infl uenced the diagnosis of suspected cases. Conclusions: Active surveillance linked to focused block level campaigns can be useful tools to detect new hidden leprosy cases.

Outbreak investigation of epidemic dropsy in Panchmahal district of Gujarat, 2012.

Background: Epidemic dropsy is food born disease. The etiological agent responsible for epidemic dropsy is sanguinarine and found in seeds of argemone mexicana. Epidemic dropsy has been reported from time to time in various parts of India. This outbreak of epidemic dropsy was reported in Panchmahal district of Gujarat in 2012. Aims & Objective: (1) To identify etiological agent, source of outbreak and mode of transmission; (2) To propose control measures based on the outbreak investigation. Material and Methods: A community based cross section study in Dholkhakhara village was carried out by rapid response team (RRT) of medical college Vadodara. Data was collected through (1) In-depth interview of cases. (2) Case records from government and private health facilities provided health services to dropsy cases. (3) A house to house survey of Dholkhakhara village. Results: Attack rate of epidemic dropsy was 9.12 per 1000 population. Highest attack rate was 19.46 per 1000 population in 11-20 years of age group. Case fatality rate was 7.69%. Conclusion: It was sudden onset; common source outbreak of epidemic dropsy. Cause of outbreak was ingestion of contaminated mustard oil with poppy seeds (argemone mexicana).

Serostatus Disclosure and Safer Sex in HIV-positive Man: Case Study.

Disclosure of one’s human immunodeficiency virus (HIV)-positive serostatus to a spouse or sex partner is important, particularly to inform the partner of the need to take precautions to prevent HIV transmission. Thus, understanding the process of disclosure is important to facilitating it to occur more often. Such understanding can best be achieved through a qualitative study (in-depth-interview) that elicits and systematically explores individuals’ stories of what has happened to them after disclosure of HIV.

Challenges of collaborative research.

In 2009, as a supplement to a National Institutes of Health (NIH) -funded collaboration between the Indian Council of Medical Research (ICMR) and the NIH, a formative study was conducted with 30 HIV-positive people and 18 HIV-related service providers to understand sexual risk-taking, HIV-related disclosure, and other behavioural patterns among HIV-positive individuals in Baroda, Gujarat. One goal of this research was to determine how to adapt a counselling intervention which had been tested in the United States, in order to make it culturally and linguistically relevant for PLWHA(People living with HIV/AIDS) here.