Study of Immunization Status and Outcome of Diphtheria Patients.

Background: With advent of EPI and UIP, most of the vaccine preventable diseases have shown a decline; however, Diphtheria continues to remain an endemic disease and has also shown resurgence nationally as well as internationally. Aims and Objectives: To study Diphtheria morbidity and mortality trends. To note variation with respect to age, sex, immunization status, seasonal variation and outcome. Materials and Method: A retrospective analysis of hospital records over the period of 3 years from Jan/2008 to Dec/2010 obtained with permission of hospital superintendent Dr. Jhala from infectious disease hospital in Ahmedabad, Gujarat. Details of 247 cases regarding age, sex, immunization status were taken as per the hospital case records. Results: Of 247 cases, 114 were male (46%), 133 (54%) Females, 71 (29%) were under 5 Years, 103 (42%) were in 6 – 12 years and 35 (14%) were in 13- 20yrs, 38 patients (15%) were noted within 21-60yrs group, a total of 73 (29.5%) patients were observed in adult and adolescent group. Mortality was 0.47%. Incidence was more in months of September to March. In the present study, 85 (34.4%) were completely immunized, 31 (12.55%) were partially immunized and for 18 (7.3%) vaccination status was unknown. 113 (45.75%) were not immunized. Conclusion: Diphtheria continues to remain a major public health concern in spite of being a vaccine preventable disease, though common in pediatric age it is increasingly common in adoloscent and adults. High level of clinical suspicion needed to keep the mortality rates on lower side. A strict implementation of vaccination programmes with follow up booster dose is necessary which will increase the herd immunity, leading to decrease in diphtheria prevalence.

Factors influencing infant deaths in a tribal area of South Gujarat.

Backgroud: : Background & objectives: With decrease in infant mortality rate, it becomes important to find out various types of determinants and their interplay leading to the infant deaths. This study was carried out with objective of finding out prevalence of environmental factors, factors influencing nutritional status and vaccination among infant deaths in a tribal block of south Gujarat. Methods: The study incorporated all the infant deaths, which occurred during selected one year period in all 51 villages of 3 selected Primary Health Centres. Data collection was done through house to house visits in the study area and analyzed with Epi Info 6.04 version software. Results: Out of total 48 infant deaths, in 81.3 % cases type of house was Kutcha and adequate ventilation was only in 16.7 % cases. Environment and sanitation was overall poor in majority of cases. Overcrowding was present in 87.5% cases. 27.1% mothers were enrolled in Anganwadi and half of them received food supplementation. Only 37.5 percent were fully vaccinated for age. Interpretation & conclusion: Awareness regarding importance of environmental and other factors in preventing infant deaths should be raised through health education programmes. Anganwadi workers should be sensitized regarding their work.

Profile of drowning autopsies at rajkot civil hospital: a two year study.

Background: Gujarat registered 40.7 % of accidental deaths in 2007 and nearly 10% of them are due to drowning. For implementing preventive measures, research related drowning data and its implicating factors are required. So we attempted to carry out this study with objective of generating profile for all drowning autopsies. Methods: The study was conducted at Rajkot from 1st November 2004 to 31st October 2006. Out of total 2934 autopsies, drowning was found in 100 cases. Detailed and complete postmortem examination of corpses was done and a proforma was filled in. Data were entered and analyzed with SPSS 15.0 version software. Results: Out of total 100 drowning cases, 58% were from urban area. 43% deaths were suicidal and 36 % were accidental in nature. Out of 88 identified cases, 60.2 % were unmarried. 67% cases were in 15-30 years of age group and male: female ratio was 2.7:1. Literacy rate was 69.3% with higher education only in 2.2% cases. Most frequent occupations were study (31.8%) and labor work (22.7%) with 59.1% belonged to lower socio-economic class. Factors affecting mental status and behavior like addiction, family problem and mental illness were found in 33%, 35% and 10.2% cases respectively. Injuries and animal or aquatic animal bites over the body were in 5% and 12% victims respectively. Conclusion: The high rates of drowning deaths in Rajkot and their specific circumstantial profiles suggest that drowning deaths could beneficiate from basic prevention programs and legislation.