First outbreak of Japanese encephalitis in two villages of Dharmapuri district in Tamil Nadu.

BACKGROUND & OBJECTIVES: Three cases of Japanese encephalitis (JE) were reported for the first time from two villages in Krishnagiri Health Unit district of Tamil Nadu during November 1999. Two children died and one developed neurological sequelae. A serological survey was conducted in these villages to find out the prevalence of JE antibodies among children below 15 yr of age in addition to the epidemiological investigations. METHODS: The prevalence of haemagglutination inhibiting (HI) antibodies to JE virus (JEV), West Nile virus (WNV) and dengue-2 virus (DEN-2) was detected by HI test and IgM antibody capture ELISA (MAC ELISA) was performed to determine recent infections with JE virus. Adult mosquitoes were collected in the study villages and females of Culex pseudovishnui, C. tritaeniorhynchus and C. vishnui were tested for the presence of JE viral antigen by ELISA. RESULTS: Out of 146 sera samples from children below 15 yr, the prevalence of HI antibodies to JEV, WNV and DEN-2 virus was found to be 8.9, 3.4 and 6.85 per cent respectively and three children had IgM antibodies to JEV. Of the 13 species of mosquitoes identified, C. tritaeniorhynchus (30.8%) was the most abundant species in the study villages. Two pools of female C. tritaeniorhynchus were found to be positive for JEV antigen. Fogging with 2 per cent pyrethrum and residual spray with 10 per cent cyfluthrin were effective in reducing vector density. INTERPRETATION & CONCLUSIONS: Serological investigations revealed that the JE virus was predominant in the study villages. In addition, DEN-2 and WN viruses were also prevalent. Detection of JE virus specific IgM antibodies in three specimens and the presence of JE viral antigen in 2 pools of C. tritaeniorhynchus emphasized the need for constant surveillance and monitoring so as to prevent future large outbreaks.

Cost of mass annual single dose diethylcarbamazine distribution for the large scale control of lymphatic filariasis.

Economic analysis of the revised strategy to control lymphatic filariasis with mass annual single dose diethylcarbamazine (DEC) at 6 mg/kg body weight launched in one of the districts of Tamil Nadu in 1996 was carried out. This exploratory study, proposed for five years in 13 districts under 7 states on a pilot scale through the Department of Public Health is an additional input of the existing National Filaria Control Programme in India. A retrospective costing exercise was undertaken systematically from the provider's perspective following the completion of the first round of drug distribution. The major activities and cost components were identified and itemized cost menu was prepared to estimate the direct (financial) and indirect (opportunity) cost related to the implementation of the Programme. The total financial cost of this Programme to cover 22.7 lakh population in the district was Rs. 22.05 lakhs. The opportunity cost of labour and capital investment was calculated to be Rs. 7.98 lakhs. The total per capita cost was Rs. 1.32, with Rs. 0.97 and Rs. 0.35 as financial and opportunity cost respectively. Based on these estimates, the implementation cost of the Programme at Primary Health Centre (PHC) level was calculated and projected for five years. The additional financial cost for the existing health care system is estimated to be Rs. 27,800 per PHC every year. DEC tablets (50 mg) was the major cost component and sensitivity analysis showed that the cost of the Programme could be minimized by 20 per cent by switching over to 100 mg tablets. The analysis indicates that this Programme is a low-cost option and the results are discussed in view of its operational feasibility and epidemiological impact.

Impact of deltamethrin spraying on malaria transmission in Rameshwaram Island, Tamil Nadu State - India.

The impact of spraying Deltamethrin 2.5% w.d.p. @ 20 mg/m2 and its comparison with Malathion 25% w.d.p. @ 2 gr./m2 was assessed in Rameshwaram Island, Tamil Nadu. Monitoring of entomological and parasitological indices revealed that due to deltamethrin spray malaria transmission could be effectively interrupted and a significant reduction in malaria cases was achieved. P. falciparum cases also showed a significant reduction whereas in the comparison malathion areas reduction in malaria cases or in pf cases was not recorded.