Role of migratory population in keeping up endemicity of malaria in metropolitan cities of India.

Urbanisation is rapidly taking place in India. A sizeable number of people migrate to metropolitan cities to take up casual labour jobs and settle in pockets scattered all over the city. They generally pay frequent visits to their native place with a higher malarial endemicity and are believed to be important reservoirs of infection for the native population of metropolis. To investigate this problem, a survey was conducted in 1987-88 to compare the prevalence of chronic malaria in two such pockets of migrant population with that of local population of Delhi from nearby villages. Ninetyone out of 701 (12.84 per cent) immigrants investigated had fever clinically diagnosed as malaria at the time of survey, while in the native population 45 out of 646 (6.97 per cent) had such a history. The difference is statistically significant. Splenomegaly was also significantly higher in migrants (15.41 per cent) than in natives of Delhi villages (3.10 per cent). Migrant population is not covered by active surveillance and live in poor environmental conditions conducive to mosquito breeding and malaria transmission. A special attention needs to be paid to the migratory population in the anti-malaria programme in order to control the transmission of the disease in the cities.

Childbirth spacing in a rural community of Delhi: profile in various marriage cohorts by decades.

Complete retrospective fertility histories of 843 ever married women of two villages in Delhi, obtained through house to house survey, were analysed to study various marriage cohorts by decades for trends of child birth spacing over a period of 60 years from 1921 to 1980. Spacing between consummation of marriage and first child birth gradually declined over the last 6 decades. For all other subsequent livebirths remained constant at an average of nearly 30 months. Irrespective of the reasons for such a trend, much more efforts are required to be put in to increase child spacing.

PIP: From March 1982 to April 1983, researchers from the University College of Medical Sciences in Delhi, India interviewed at least 843 women = or 15 years old and married between 1921-1980 from 2 villages near Delhi about their birth history and year of marriage. There were 3736 live births among the 843 women. 98.8% of the women married between 1921- 1970 had children. Only 182 of the 256 women married between 1971-1980 had already borne children. The spacing between consummation of marriage and the birth of the 1st child (1st birth order) decreased steadily over the 6 decades. For example, the average spacing fell from 44.86 months (1921-1930) to 40.11 (1951-1960) to 28.82 (1971-1980). During this time frame, the mean age at marriage rose gradually, but the mean age for 1st birth did not change. For each decade except 1971- 1980, the spacing for the 1st birth order remained significantly more than most of the other birth orders in that decade. The mean birth interval for all the marriage cohorts stood at 30 months. The average spacing of all births for the 1971-1980 marriage cohort was significantly lower than those of the 5 previous decades (p.05), however. This could be a result of the decline in breast feeding and sexual abstinence in urban areas of India. This trend appears to counteract the efforts of family planning programs. The results of this study indicate that the National Family Welfare Programme must more actively promote child spacing as a means to reduce family size.

Anthropometric indices independent of age for nutritional assessment in schoolchildren.

The merits of three indices based on weight (W) and height (H) were examined in the age group six to 15 years: W/H, W/H2, W/H3. The analysis was based ona survey of 1673 schoolchildren of both sexes from a rural housing block in Delhi. It showed that the index W/H2 was invariant with age in the range six to 15 years and that the other two indices were biased with respect to age. The index W/H2 was found to be of value for the proper assessment of nutritional status in the schoolchildren of a developing country.

Some epidemiological factors related to smoking among secondary school children of Delhi urban area.

The smoking habits of 1284 school children in Delhi Urban Areas (India) were studied. The prevalence of cigarette smoking was 8.7% overall, increasing from 5.4% amongst boys age 14 to 26.7% at age 19. Nearly 80% started smoking between the ages of 11 to 14 years. Smoking habit was associated with family income and presence of smokers in the family.

Controlled field trial of a high-dose oral killed typhoid vaccine in India.

A controlled field trial of a modified vaccine containing Salmonella typhi, TY 2 strain, in a dose of 400 x 10(9) killed organisms per capsule, was carried out in schoolchildren aged 6-17 years. The children were followed up for 6-8 months. There were 66 cases of typhoid fever in the vaccine group (7312 children) and 54 in the control group (7292 children who had received a placebo). This difference is not statistically significant. The results confirm that, as found in earlier trials, oral typhoid vaccine, in the dosages used so far, gives no protection.

Controlled field trials of three different oral killed typhoid vaccines in India.

Three vaccination trials against typhoid fever were carried out in 1968/69, 1970/71 and 1974 in New Dehli. The vaccine was generally administered in tablet form on three consecutive days. Each new trial consisted of a larger number of killed bacteria: 100.10(9), then 300.10(9) and finally 400.10(9) killed S. typhi. The placebo and vaccinated groups were composed of 6,000 to 7,000 persons, sometimes only children from 6 to 17 years. The number of typhoid fever cases which appeared under normal conditions of infection did not show significant difference between the vaccinated and non-vaccinated subjects during the 18 month period of observation.

Factors associated with utilisation of urban MCH/FP programmes--a record study of one centre.

PIP: The utilization and acceptance of different programs provided by an urban maternal and child health/family planning center in India was studied in relation to variables such as distance of residence from the center, age, parity and socioeconomic class. Conducted in March/April 1974 the only method used was that of record study. Use was made of household survey registers and program registers and case cards. The selected center served a population of 41,707. The following were among the study findings: 1) utilization of antenatal, child health and family planning programs was essentially the same by couples residing within a distance of 3.5 kilometers from the center, and any variations observed within this distance was because of other factors such as age or socioeconomic status; 2) beyond 3.5 kilometers, the utilization rate fell rapidly and regularly with increasing distance; 3) there was no association between distance from center and availing of domiciliary delivery facilities by registered antenatals; 4) there was no association between distance from the center and postnatal service to cases of domiciliary delivery; 5) all maternal child health/family planning programs were used mst by persons belonging to socioeconomic class 3 (20.37% of population) followed by socioeconomic class 2 (12.34% of population); 6) the least utilization of all programs was by couples having university education; and 7) the antenatal and child health programs were used most by the youngest wives aged less than 19 years.^ieng

Ineffectiveness of an oral killed typhoid vaccine in a field trial.

A field trial was carried out with a vaccine containing 300x10(9) killed S. typhi (strain Ty58) per tablet. A total of 12 564 children aged 1-15 years were given 3 tablets of the vaccine or a placebo at the rate of one tablet on each of 3 consecutive days. The results indicated that the vaccine, in its present form and at this dosage, gives no protection.