Entomo-epidemiological investigations on chikungunya outbreak in the Lakshadweep islands, Indian Ocean.

Background & objectives: An outbreak of chikungunya fever characterized by prolonged incapacitation in the Lakshadweep islands in Indian Ocean occurred in November 2006. We undertook the entomological and epidemiological investigations on the Chikungunya outbreak in the Lakshadweep islands, Indian Ocean. Methods: Epidemic information in the affected places was obtained from the local hospital records. Entomological observations like larval survey and the adult resting/landing collections by the hand collection methods were individually conducted in the two affected islands Andrott and Kalpeni in November and December 2006. Results: The main breeding sources of the mosquitoes were the rodent-devoured coconuts, coconut shells, areca nut soaking mud and plastic pots, discarded containers, grinding stones, metal containers and plastic containers. Aedes albopictus was pre-dominantly present in the Lakshadweep islands. Interpretation & conclusion: It is concluded that the routine campaigns need to be organized regularly within the community highlighting the potential breeding grounds of mosquitoes and the possible control methods. Source reduction strategies like destruction of coconut shells and rodent-devoured coconuts by burning or by burying them inside the ground. Ae. albopictus played major role as the vector mosquitoes responsible for the chikungunya transmission.

Knowledge, attitudes and practices of newly diagnosed sputum positive cases of pulmonary tuberculosis.

Lack of awareness of risk posed to the community by a sputum positive case of Pulmonary Tuberculosis (PTB) is an impediment in the control of Tuberculosis. A study involving 212 newly diagnosed sputum positive patients aged 15 years or more, revealed that only 9% of the patients knew correctly the cause of PTB. Knowledge about mode of spread of the disease was not known to 49% of patients. Awareness regarding the investigations like chest X-ray and sputum examination was high as 70% but utility of sputum examination was known to only 29% of the patients. Awareness of harmful sequelae of inadequate and incomplete treatment was as high as 93% but knowledge per se of adequate duration of treatment was poor in a half (50%) of the subjects. Attitude towards domiciliary treatment was generally positive (88%) Practices regarding safe sputum disposal and preventive measures practised in the families were poor in nearly two third's of patients. Health education efforts need to be strengthened to create better awareness of these important aspects of tuberculosis diagnosis, treatment and control.

Epidemiology and control of malaria.

Malaria is essentially a local and focal disease since its transmission depends greatly on local eco-environmental conditions. In India, the incidence of total malaria cases has been contained to around 2-3 million cases per year. However, with the occurrence of outbreaks in different parts of the country since 1994, mortality due to malaria has increased. The challenges posed by changing epidemiological paradigms of malaria, occurrence of outbreaks, increasing trends of P. falciparum cases, spreading resistance to available anti-malarials and development of resistance of vectors to insecticides are areas for major concern. The National Anti-Malaria Programme has made necessary modifications/adjustments in the malaria control strategy with the adoption of the Global Malaria Control Strategy.

Incidence of diarrhoea and some related environmental and behavioural factors in Jhuggis of Delhi.

A total of 6285 persons residing in 1090 households in three Jhuggi clusters of Delhi were studied for incidence of diarrhoea by 2 weeks recall method and environmental and behavioural factors affecting it. Overall incidence of Diarrhoea was 29.1 per thousand persons, and was selectively predominant among under fives (60.2 per thousand). This low incidence of diarrhoea could be attributed to safe drinking water availability and common practice of handwashing by most of the people. But unsafe storage of drinking water at household level (70.5%) and peridomestic open air defaecation by children (22.9%) are potential threat for transmission of the disease.