Implementation of revised strategy of filaria control-baseline clinico-parasitological survey.

A clinico-epidemiological study of filariasis was carried out in Varanasi District in October and November, 1997 to generate baseline data for assessing the impact of Mass Drug Administration (MDA) in the district. Disease rate was found to be 6.6% (9.9% in males and 3.0% in females) and microfilaria rate was 5.3% (5.2% in males and 5.5% in females). Mean microfilaria density was found to be 9.86 per 20 Cu.mm blood. Genital manifestations (77.5%) outnumbered all other forms of clinical manifestations. Vector infectivity rate was found to be 0.93%.

Widespread outbreaks of measles in rural Uttar Pradesh, India, 1996: high risk areas and groups.

OBJECTIVE: To describe outbreaks of measles which affected many districts in Uttar Pradesh (UP) during 1996. DESIGN: Outbreak investigations. SETTING: The state of Uttar Pradesh, India. METHODS: The reported data on measles morbidity, mortality and vaccine coverage from 1991 through 1996 were reviewed. Reported vaccine coverage levels were compared with the results of coverage surveys carried out in UP from 1992 through 1996. Line lists on measles cases were analyzed to ascertain the age, immunization status, geographical distribution, and age and sex-specific fatality ratios during the outbreaks. A community survey was organized in 7 affected villages to estimate vaccine effectiveness. RESULTS: Fifty one of 68 districts in UP reported 6922 measles cases and 281 deaths in 1996. The majority of cases and deaths occurred in June and July which are usually low transmission months. Overall cases fatality ratio (CFR) was 4.1%. CFRs were significantly higher in females and young children. The median age of cases was found to be below 5 years. There was heavy clustering of cases and deaths in rural areas. About 85% of the cases and virtually all the measles associated deaths occurred in unvaccinated children. Published documents on statewide coverage surveys revealed that the measles vaccine coverage levels ranged between 26% and 36% during 1992-96. Large gaps were found between reported coverage and survey results. Nevertheless, epidemiological studies indicated a vaccine effectiveness of more than 90%. CONCLUSIONS: The outbreaks occurred due to poor vaccine coverage levels and an inefficient surveillance system which failed to generate early warning signals. The study highlights the urgent need to raise the vaccine coverage levels rapidly in all districts to achieve measles control and prevent future outbreaks in UP.

Persistence of Vibrio cholerae in inter epidemic period--preliminary observations on analysis of water.

Out of the 61 water samples collected from hand pumps and wells from cholera endemic areas of Varanasi City, Vibrio cholerae non 01 was detected in only one sample. However, seven (18.9 per cent) samples out of 37 samples of river water were positive for V. cholerae non 01. None of the samples showed Vibrio cholerae. These observations indicate transmission and dilution of Vibrio cholerae bacillus in environment.

Kala-azar in Varanasi (UP)--preliminary observations.

An epidemiological and entomological survey was conducted in Badohi town of Varanasi district of Uttar Pradesh (India) from where an outbreak of kala-azar was reported. Serological and clinical results showed 83 cases who responded to sodium antimony gluconate. Phlebotomus argentipes and P. papatasi could be detected in area of outbreak. An active transmission of kala-azar is strongly indicated.

Larvivorous fishes in controlling mosquito breeding from draw wells.

Culex quinquefasciatus have been found to breed in about 29 per cent of the wells in semi-urban area and 14 per cent of the wells in rural areas of Varanasi at one time or other. Majority of such wells are used-ones. Effectiveness of Poecillia reticulata, Esomus danrica and Trichogaster fasciatus in controlling well breeding is evaluated in the present study with successful results.

Epidemiology of measles--a thirteen years prospective study in a village.

A prospective study on measles was undertaken during 1974 to 1986 in Hiramanpur village, Varanasi having an initial population of 1538 which rose to 2101 in 1986 enabling to register a total of 23,221 (all population) person years of observation and a total of 9191 (0-14 years) person years of observation. The entire population was covered regularly through domicilliary visits by trained para-medical personnel under direct supervision of medical officers. All cases were verified by doctors. A total of 411 measles cases were detected, which gave average annual incidence rates of 17.7 and 44.7 per thousand population and per thousand children (0-14 yrs), respectively. The maximum number of cases occurred in Ist quarter of the year (69.7 per cent). The Kolmogorov-Smirnov Statistical method validated the seasonal character of the disease (Vn = 5.18, p less than 0.01). The maximum measles cases occurred in children 1-4 yrs (57.4 per cent). Males (54.9 per cent) were affected slightly more than females (45.1 per cent). A total of 246 (59.9 per cent) cases developed complications. The most frequent was respiratory infections (42.2 per cent) followed by infection of gastrointestinal system (32.2 per cent). The complication rates were found higher in infants and older children (greater than 5 yrs.) in both the sexes. Three-fourth of the cases did not get any treatment. The overall case-fatality rate was 2.2 per cent. Females had higher rate (3.3 per cent) than males (1.3 per cent) and the highest case fatality rate was observed in infants, particularly in females.

Clinico-epidemiological profiles of post-kala-azar dermal leishmaniasis in Varanasi.

Twenty-seven cases of Post Kala-Azar Dermal Leishmaniasis (P. K. D. L.) were detected in an endemic focus of Kala-azar in Sujabad village in Varanasi Distt. Male-Female ratio of cases was 4.4:1. Majority (66.6 per cent) of cases had macular lesions. Histopathology of one case showed Leishmania donovani (L. D.) bodies. Densities of sand fly were more in pockets where P. K. D. L. cases were detected. All the 13 cases, which were treated with sodium antimony gluconate, responded well to therapy.