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Background: Child mortality is a major public health issue. The studies on under‑five mortality that ignore the hierarchical facts mislead the interpretation of the results due to observations in the same cluster sharing common cluster‑level random effects. Objectives: The present study uses a multilevel model to analyze under‑five mortality and identify the significant factors for under‑five mortality in Manipur. Methods: National Family Health Survey‑5 (2019–21) data are used in the present study. Amultilevel mixed‑effect Weibull parameter survival model was fitted to determine the factors affecting under‑five mortality. We construct three‑level data, individual levels are nested within primary sampling units (PSUs), and PSUs are nested within districts. Results: Out of the 3225 under‑five children, 85 (2.64%) died. The three‑level mixed‑effects Weibull parametric survival model with PSUs nested within the districts, the likelihood‑ratio test with Chi‑square value = 10.98 and P = 0.004 < 0.05 indicated that the model with random‑intercept effects model with PSUs nested within the districts fits the data better than the fixed effect model. The four covariates, namely the number of birth in the last 5 years, age of mother at first birth, use of contraceptive, and size of child at birth, were found as the risk factor for under‑five mortality at a 5% level of significance. Conclusions: In the random‑intercept effect model, the two estimated variances of the random‑intercept effects for district and PSU levels are 0.27 and 0.31, respectively. The values indicate variations (unobserved heterogeneities) in the risk of death of the under‑five children between districts and PSUs levels.
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Introduction: Patients with end-stage renal disease (ESRD) are treated with hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD).Non-infectious complications of CAPD are increasing in relative importance due to success in decreasing the rate of peritonitis. Aims and objectives: Our aim was to study the non-infectious complications in patients of ESRD on CAPD and to study the impact of the non-infectious complications in the survival of CAPD catheters. Materials and Methods: A prospective study has been conducted at Regional institute of medical science, Imphal in a total of 71patients of ESRD who are already on CAPD or newly diagnosed ESRD who have undergone CAPD catheter implantation. Their detailed history, clinical examination and relevant laboratory investigations were done and the different non-infectious complications were identified and analysed. Result: Out of the 71 patients studied 39 patients had complications like hypokalemia (15 patients), omental wrap (10 patients), catheter tip migration (6 patients), haemoperitonium (2 patients), hydrothorax (2patients), exit site leak(2patients), abdominal wall edema (1patient), catheter block(1patient). Conclusion: In our study the most common non-infectious complication was hypokalemia followed by omental wrap and catheter tip migration. Knowledge about the common prevalent non-infectious complications of CAPD alerts the treating doctor to take up the specific corrective steps at an earlier stage, thus preventing the morbidity associated with the same. We conclude that the majority of non-infectious complications in these patients were treatable and did not interfere with the catheter survival.
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Background and Objective: Japanese encephalitis (JE) surveillance is not well established in many countries, and laboratory confirmation is challenging, the true extent and prevalence of the virus and burden of disease are not well understood. It is estimated that 67,900 clinical cases of JE occur annually despite the widespread availability of vaccine, with approximately 13,600–20,400 deaths and an overall incidence rate of 1.8/100,000 in the 24 countries with JE risk. The present study aimed at determining the prevalence rate (PR) and distribution (time, place and person) of JE cases in Manipur. This descriptive study was conducted over 24-month period (2016–2017). Materials and Methods: A total of 1770 cases of acute encephalitis syndrome tested for JE including 251 confirmed JE were diagnosed by IgM antibody-capture enzyme-linked immunosorbent assay. Results: The JE cases were most commonly reported in the age group of >15 years. Most of JE prevalence was seen in rural distribution in our study. There is a strong seasonal pattern of JE occurrence in Manipur which peaked in July–August and declined by October each year, which corresponds to the monsoon season. The JE cases were reported in all the districts of the state expanding in the plains and hill regions. Conclusions: The changing pattern of JE cases among different age groups was also observed in our study. The present study reveals the changing pattern of the prevalence of JE in the State of Manipur and initiated a systematic approach of JE surveillance also highlights the need for further expanding of surveillance across the state.