Serologic and molecular characterization of rotavirus from children with acute gastroenteritis in Chennai, Tamil Nadu, India

Background: Rotavirus gastroenteritis is the leading cause of diarrhea in infants and young children worldwide. Although, Rotavirus vaccine has been introduced in 2017 in states like Tamil Nadu, there are reports of the role of Rotavirus as one of high disease burden agents with genetic variants arising, especially from low-income countries like India.Methods: Authors evaluated stool samples from 507 children with acute gastroenteritis Rotavirus A among the hospitalized children (>5 years) to provide baseline information on changing profile in this state. The stool samples were collected and screened for Rotaviral Antigen by Enzyme Immuno Assay and use of semi-multiplex RT PCR technique was conceded out in order to conclude the P and G genotypes of human rotavirus in rotavirus-positive samples from January 2014 to December 2016 in and around Chennai, India.Results: Of 507 samples collected 213 (42.01%) were positive for rotavirus antigen by Enzyme Immuno Assay (EIA). The maximum positivity (75%) was in the age group of one to two years. Rotavirus positives were subjected to further VP7 and VP4 molecular characterization and the predominant genotypes identified were G9P[4] followed by G9P[8], G1P[8], G3P[8], G2P[4] and mixed types of G2G9 with P[4] and G4P[6][11] with few untypable strains.Conclusions: This study had demonstrated the Rota Virus Gastro Enteritis (RVGE) is a common disease affecting the pediatric population and G9P[4], G9P[8] circulating types among the gastroenteritis cases reported in the city and its suburban area. This study in comparison to previous ones shows that the dominant serotypes and circulating genotypes changes from time to time within country. The results have reemphasized the need of rotavirus vaccines with broad serotype coverage which may help in decreasing the disease burden in this region of the country.

Amenities that can Attract Skilled Birth Attendants (SBAs) to Practice in Rural Areas of a Developing Country.

The attainments of the Millennium Development Goal 5 (MDG 5) targets by 2015 in most developing countries are unlikely when large numbers of poor, illiterate, and vulnerable rural women do not have access to skilled care. To review progresses in MDG 5 targets and evaluate amenities that can influence SBAs to accept to practice in the rural areas of Enugu State. This was a questionnaire study administered to SBAs in private health facilities in Enugu metropolis from April 1 to 3o, 2014. Data on demographic profile and the amenities that can attract SBAs to live and practice in rural areas were extracted from the respondents. Out of 145 questionnaires administered 138 were completely filled, and analyzed using Excel 2007 software, and presented using percentages and figure. Majority of the SBAs were of ages between 20-30 years (69/138, 5o.0%). Staff nurse midwife were 91(65.9%) while medical doctor were 47(34.14 Ninety (65.2%) of the SBAs had no rural practice experience, and 7o (5o.7%) wish to practice in developed countries. The 5 top amenities that can attract SBAs to the rural area include: security of lives and property 134(97.a), pipe borne water supply 130(94.2%), equipped hospital 130(94.24 market with regular food supply 130(94.24 and higher staff salary and other motivations 129(93.54 There were high demands of amenities by SBAs for them to accept to live and practice their crucial services in the rural areas. The 5 top amenities that can attract SBAs to practice in the rural area include: security of lives and property, pipe borne water supply, equipped hospital, market with regular food supply, and higher staff salary and other motivations. SBAs services in the rural areas are crucial for attainments of the MDG 5 targets in developing countries by 2015.

Achieving the 6th MDG: An Evaluation Drug Treatment of Malaria in Selected PHC in Osun State.

Introduction: The burden of malaria in Nigeria and Africa is well documented. The current Nigeria anti-malaria drug policy has recommended artemisinin-based combination therapy (ACT) as the first-line drug treatment for uncomplicated malaria since 2005. It is now 8 years since the adoption of ACT and two years to the set time for the achievement of the MDGs. Objective: To assess the adherence of the PHC to the new policy on drug treatment for uncomplicated malaria. Methods: Using a pro-forma, relevant information about drug prescription of malaria cases between January 2008 and December 2009 was extracted from patients’ folders in the 3 comprehensive health centres being used by LAUTECH Teaching Hospital, Osogbo. Additional data were also collected through the use of in-depth interviews. Data were analyzed with Epi-Info software 3.4.2. Results: A total of 8881 episodes of malaria were analyzed of which male children (0-5years) constituted the highest number. The commonest prescribed anti-malaria was oral Chloroquine (21.6%) for the 3 CHC combined. However, for each CHC, CQ was the commonest drug prescribed for Ilie and Atelewo CHC (41.6% and 25.5% respectively), while for Akogun CHC alone, it was Artesunate + SP. Akogun CHC was found to have the highest prescribed pre-packaged ACT. Factors responsible for inappropriate prescription were non-availability and perceived patients' nonaffordability and unwillingness to buy drugs. Conclusion: Prescription of CQ and SP as mono-therapy continues to prevail in the CHC. There is urgent need for ensuring compliance to the current and acceptable treatment for malaria. Other means of sustaining availability of anti-malaria drugs should be considered.

Short Review Of Fourteen Years Maternal Mortality In Achieving Mdg5 In UKMMC

Worldwide maternal mortality rate had reduced tremendously including Malaysia. At the 2000 Millenium Summit, eight Millenium Development Goals (MDGs) were established with target for the year 2015. Three years remained until the dateline to achieve MDG5, which comprised of two targets and one being reducing the maternal mortality ratio by 75%. This review compared the trend of maternal mortality and its causes in our centre to the national data. The national data had shown a reduction from 44 to 27.6 in 100 000 live births in1991 and 2008 respectively. The subsequent rate had stabilized for the past seven years. In contrast the UKM Medical Centre (UKMMC) data in the past 15 years had not been stable. The target of MDG5 seemed to be achievable by our country but may require longer time as we have yet to find ways to overcome medical care inadequacy in remote areas.

Trend of Stillbirths and Neonatal Deaths in University Kebangsaan Malaysia Medical Centre (UKMMC) From 2004-2010

The aim of the Fourth Millennium Developmental Goal is to reduce mortality among children less than 5 years by two thirds between 1990 and 2015. Efforts are more focus on improving children’s health. The aim of this study was to describe the trend of stillbirth and neonatal deaths in University Kebangsaan Malaysia Medical Centre from 2004 to 2010. A retrospective cross-sectional study was conducted using hospital data on perinatal mortality and monthly census delivery statistics. There were 45,277 deliveries with 526 stillbirths and neonatal deaths. More than half of the stillborn cases were classified as normally formed macerated stillbirth and prematurity was common in neonatal deaths. The trend of SB and NND was found fluctuating in this study. However, by using proportionate test comparing rate, there was a transient significant decline of stillbirth but not neonatal deaths rates between 2004 and 2006. On the other hand, the neonatal deaths rate showed significant increment from 2006 to 2008. When both mortality rates were compared using proportionate test, from the start of the study, year 2004 with end of the study, year 2010, there was no significant decline noted. Trends of stillbirth and neonatal death rates in University Kebangsaan Malaysia Medical Centre within 7 years study period did not show the expected outcome as in Millennium Developmental Goal of two thirds reduction.

Battling malaria iceberg incorporating strategic reforms in achieving Millennium Development Goals & malaria elimination in India.

Malaria control in India has occupied high priority in health sector consuming major resources of the Central and State governments. Several new initiatives were launched from time to time supported by foreign aids but malaria situation has remained static and worsened in years of good rainfall. At times malaria relented temporarily but returned with vengeance at the local, regional and national level, becoming more resilient by acquiring resistance in the vectors and the parasites. National developments to improve the economy, without health impact assessment, have had adverse consequences by providing enormous breeding grounds for the vectors that have become refractory to interventions. As a result, malaria prospers and its control is in dilemma, as finding additional resources is becoming difficult with the ongoing financial crisis. Endemic countries must contribute to make up the needed resources, if malaria is to be contained. Malaria control requires long term planning, one that will reduce receptivity and vulnerability, and uninterrupted financial support for sustained interventions. While this seems to be a far cry, the environment is becoming more receptive for vectors, and epidemics visit the country diverting major resources in their containment, e.g. malaria, dengue and dengue haemorrhagic fevers, and Chikungunya virus infection. In the last six decades malaria has taken deep roots and diversified into various ecotypes, the control of these ecotypes requires local knowledge about the vectors and the parasites. In this review we outline the historical account of malaria and methods of control that have lifted the national economy in many countries. While battles against malaria should continue at the local level, there is a need for large scale environmental improvement. Global Fund for AIDS, Tuberculosis and Malaria has provided huge funds for malaria control worldwide touching US$ 2 billion in 2011. Unfortunately it is likely to decline to US$ 1.5 billion in the coming years against the annual requirement of US$ 5 billion. While appreciating the foreign assistance, we wish to highlight the fact that unless we have internal strength of resources and manpower, sustained battles against malaria may face serious problems in achieving the final goal of malaria elimination.

Risk Factors of Neonatal Mortality in Bangladesh.

Introduction: To address United Nations Millennium Develop ment Goal 4 (MDG 4) on reducing childhood mortality rates by two-thirds by 2015, there is a need for better population-based data on the rates and causes of neonatal death. This study aims to identify the risk factors of neonatal mortality in Bangladesh. Materials and Methods: The study used data from the nationally representative 2007 Bangladesh Demographic and Health Survey. The survey gathered information regarding socioeconomic, demographic, environmental and maternal and child health care of 10,996 ever married women and 6,058 children. Both bivariate and multivariate statistical analyses were used to assess the relationship between neonatal mortality and contextual factors. Results: The prevalence of neonatal mortality was 37/1,000. The statistical analyses yielded quantitatively important and reliable estimates of neonatal death. The multivariate logistic regression analysis yielded significantly increased risk of neonatal mortality for children with mother who had no formal education, the Muslims, whose mother were adolescents of age 15-19, first ranked birth and twin babies. Conclusion: Emphasis should be given to improve female education in Bangladesh for a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.