An epidemiological study of cannabis abuse among college students of Varanasi.

A study of 4326 students, selected by stratified random sampling and using a self administered questionnaire, revealed that overall cannabis abuse among them was 4.5%. It amounted to a considerable decline in prevalence compared to 10.2% observed in 1976. However, it was noted that this reduction was mainly in occasional users and the proportion of regular users has actually increased in 1986. The prevalence has also shown an increase among girl students. The regular users were mainly from professional colleges, hailing from metropolitan cities and with relatively higher amount of pocket money at their disposal. It was concluded that the observed trends could be due to peer pressures. It was also considered that health education of such students at entry point may help reduce the problem.

MCH record maintenance at primary health centre level.

Scrutiny of MCH records of 1977-78 and 1988 at PHC level revealed glaring deficiencies in their maintenance e.g. missing of entries., duplicate entries etc. Extent of supervision of service records was extremely low. Record linkages could be poorly established and thus present mechanism of health care delivery could not ensure continuity of care. The level of record maintenance has almost remained same over a decade period. This can be avoided by modifying the information system, making records at the PHC level simple, action oriented with built in system of evaluation and involving community in its maintenance and utilisation.

A profile of diarrhoea in an urban slum area.

PIP: Researchers followed 90 households (445 people) in Sunderpur slum in Varanasi in Upper Pradesh, India for 1 year and collected stool samples when people were ill with diarrhea to determine diarrhea incidence and causes of diarrheal disease. The water supply consisted of a well, public tap, or house tap with 30 households in each group. They noted 106 diarrheal episodes for an incidence of around 23%. Incidence decreased significantly with age (p.001). For example, it was 62.9% for children 5 years old, 34% in the school age population, and 8.7% in people =or 15 years old. Improved resistance to infection and/or improved personal hygiene could have accounted for this difference. Diarrheal incidence was considerably lower in the autumn (9.3%) and winter months (11.1%) than the spring (49.1%) and summer months [rainy season] (30.5%) (p.001). Researchers found at least 1 parasite in the stool sample of 81.5% of cases. The leading causative agents included Ascaris lumbricoides (42.1%), Entamoeba histolytica (35.2%), hookworm (7.9%), and Escherichia coli (5.7%). Diarrhea incidence was much higher in persons whose water supply was a well (35.8%) compared to 23.2% for those with a public tap, and 12.8% for those with a private tap. These results concerning the water supply corroborated those of the Planning Research and Action Institute's (Upper Pradesh) pilot piped water supply program in the areas of Banki, Parendra, and Mokhampur in which incidence was highest in Banki where the water supply was an open well. The next highest and the lowest incidences were among those whose water supply consisted of public taps and private taps respectively.^ieng

A study on some diarrhoea related practices in urban Mirzapur.

In an operational research on the improvement of sanitation and water supply by an Indo-Dutch project at Mirzapur, UP, diarrhoeal morbidity was taken as an intermediate outcome variable for measuring the impact of the proposed intervention. In this study 350-410 under-five children were selected from 200 urban families of 3 slums and surveyed during 3 different seasons for 2 weekly recall of morbidity, treatment and feeding practices during diarrhoea. The prevalence of diarrhoea varied between 8.7% to 33%. Breast feeding was not restricted while other forms of feeding was continued in 57.1% to 66.3% of cases. Use of ORT increased significantly from 0% to 39.62% possibly as a result of health education. Reorientation of private practitioners to avoid use of unnecessary drug is suggested.

PIP: In 1988, researchers conducted an operations research study of an improved sanitation and water supply project which included health education in the slums of Sabari, Armanganj, and Katwaru Ka Pura in Mirzapur, Uttar Pradesh in India to examine diarrhea related practices. Diarrhea prevalence was significantly higher in the rainy season than either the summer or winter months (32.3% vs. 12.9% and 8.65% respectively; p.001). Drugs were used significantly more often in the rainy season (97.65%) than in the winter and summer months (67.86% and 81.63% respectively; p.001). Private practitioners treated most cases of diarrhea regardless of the season (94.1% in rainy season, 53.6% and 75.5% in winter and summer months respectively). On the other hand, government health facilities treated relatively few cases (3.5%, 17.9%, and 0 respectively). Use of home available fluids increased significantly from 0-39.62% (p.001). So did use of oral rehydration packets 2.7-32%; p.001). The researchers accredited this improvement to educational activities. Women tended to continue breastfeeding and giving other foods to children during diarrheal episodes. Nevertheless there was room for improvement. These results revealed the need for educational efforts to encourage caretakers to use home available fluids and oral rehydration solution and to reorient private practitioners to avoid using drugs and to use oral rehydration therapy.

An action research in the delivery of primary health care through community based distribution.

PIP: In adhering to the spirit of primary health care (PHC), the Varanasi District in India began its community based distribution (CBD) project of oral rehydration solution (ORS) packets in Chiraigaon block in 1979. The CBD later included Cholapur, Kashi Vidyapith, Sewapuri, Araijiline, Haurah, Pindra, and Niyamatabad during 1980-1981. In 1989, an honorary project director headed the project and its cadre of regular paid staff. At the main office, staff included a project coordinator, technical consultant medical officer, field supervisors, and field assistants. 754 depot holders or kendra kalyan sanjojak (KKS) worked at the community level. They came from all segments of the society, e.g., farmers, teachers, individuals in business, etc. The KKS implemented the CBD and its policies. Individuals at the headquarters prepared ORS packets using the standard WHO formula. They included health information brochures about ORS written in the local language in each packet. Field assistants delivered these packets to the KKS each month at a no profit no loss cost. The depot holders then sold the packets at a marginal profit. From 1980-1983, the number of packets increased from 1725-9660. From 1980-1985, CBD workers distributed a total of 29.862 packets to all 8 blocks. Rigid social marketing criteria adopted in 1984 brought about a downturn in distribution, however. The number of families trained in ORS preparation varied from 80 in 1980 to 1688 in 1985. The number of families totaled 6919. Health education activities, such as group discussion and individual contracts, flourished at the community level which stimulated demand for ORS packets.^ieng

An epidemiological study of goitre in two rural communities of Varanasi.

A cross sectional study was conducted in two rural communities of Varanasi during the period from January to December 1978 to find out the problem of endemic goitre. The overall prevalence of goitre was as high as 28.44% with 9.45% of adolescent (13-18 years) population having grade I enlargement. The highest prevalence was observed in 7-12 years of age group, the females being consistently more affected in all the age groups. The prevalence of goitre and iodine level of drinking water found to have an inverse relationship.

Microbial agents in stools of infants and young children with and without acute diarrhoeal disease.

A study on the microbial agents in the stools of 344 infants and young children (206 diarrhoeal and 138 nondiarrhoeal) was carried out. The diarrhoeal group comprised of 120 hospitalised cases and 86 from a community. The numbers of nondiarrhoeal subjects of matching age taken from the same hospital and community were 50 and 88 respectively. It was revealed that bacteria (50-9%), parasites (11-7%), and C. albicans (2-4%) accounted for 65 per cent of the diarrhoea cases, 6-8 per cent having mixed infections. The largest number of cases had EEC followed by P. aeruginosa, Shige-la, V. cholerae, and A, hydrophila and of the parasites G. intestinalis was followed by E. histolytica in order of frequency. Enteropathogenic bacteria and parasites were encountered in 13-0 per cent and 34.8 per cent of the nondiarrhoeal subjects respectively, 7-2 per cent having mixed infections. This group also had EEC as the commonest bacteria and A. lumbricoides was the most prevalent parasite. Except for V. cholerae, A. hydrophila and C. albicans no significant difference was observed in the microbial spectra amongst the diarrhoeal cases in the hospital or community. In the nondiarrhoeal subjects both groups showed a similar prevalence pattern. Incidence of bacterial pathogens was significantly higher in children below two years and intestinal parasites were three times more common in older children.