Prevalence of psychiatric morbidity among urban elderlies: Lucknow elderly study.

BACKGROUND: Paucity of systematic studies in elderly mental health in an aging population is an urgent need, which is required to address services and planning issues for health. AIM: The present study aims to investigate the distribution of physical, neuropsychiatric, and cognitive disorders of a community sample of elderlies with certain socioeconomic data. MATERIALS AND METHODS: A door-to-door household survey was conducted to identify houses with elderlies (≥55 years) in two urban localities of Lucknow. Mini mental state examination (MMSE), Survey Psychiatric Assessment Schedule (SPAS)/Mood Disorder Questionnaire (MDQ) and physical and neurological examination were used for screening all consenting elderlies. MMSE positive participants were assessed on Cambridge Mental Disorders of the Elderly Examination-Revised for diagnosis of cognitive disorders; SPAS/MDQ positives were assessed on Schedule for Clinical Assessment in Neuropsychiatry based clinical interview for diagnosis of neuropsychiatric disorders other than cognitive disorders (using ICD-10 criteria). Routine and indicated laboratory/radiological investigations on all and on MMSE/SPAS (organic section) positive/physically ill participants respectively were done to confirm organic and/or physical illness. Only percentages were calculated to find the distribution of morbidity. RESULTS: The sample had proportionate age structure as that of the surveyed population and had balanced gender representation in each age deciles. Prevalence of neuropsychiatric disorders (with/without comorbidities) was 11.8% in the elderlies (60 years and above) highest being in the 60-69 years age group. Being women and of lower socioeconomic status was more commonly associated with a neuropsychiatric diagnosis. 7.6% of the elderlies had cognitive impairment. Overall findings suggest a prevalence rate of 17.34% of total psychiatric morbidity among elderlies. A significant number had comorbid physical illness diagnoses. CONCLUSION: More than half the elderlies had some diagnosable physical or mental ailment. The study familiarizes us to the significant amount of physical and psychiatric comorbidity in the particular age group. About one-fifth was found to suffer from psychiatric morbidity, which any health services for the elderly should be oriented towards.

The burden of malaria in Ahmedabad city, India: a retrospective analysis of reported cases and deaths.

Owing to the paucity of accurate information on the burden of malaria in urban India, a retrospective, epidemiological study was carried out in Ahmedabad city, which has a population of about 3 million. Surveillance data for the years 1965-1998 showed a gradual resurgence of malaria between 1967 to 1976, followed by waves of low and high incidences. Plasmodium vivax always predominated but the proportion of cases attributed to P. falciparum increased markedly from 1983. When the surveillance data and health records of the major public and private health facilities in the city were analysed, for the period between 1991 and 1998, P. vivax was found to account for 69% of all malaria cases and P. falciparum for the other 31%. The incidence of infection with each Plasmodium species showed seasonal variation, with that of P. vivax increasing from January to September but then declining as the incidence of P. falciparum increased. The age-specific differences seen in incidence were not statistically significant (P=0.7). The annual numbers of malaria-attributable deaths were strongly correlated with the incidence of P. falciparum (r=0.88). The malaria incidence detected (37431 cases, representing a mean annual incidence of 12.2 cases/1000) was nine times greater than that officially reported (4119 cases, or 1.3 cases/1000 each year). Similarly, the annual malaria-attributable mortality detected (22 deaths/million) was far higher than that officially notified (0.3 death/million). The results of the retrospective analysis not only provide a more accurate, baseline estimate of the burden of malaria in an urban area of India but also clearly indicate the need for a much more efficient health-information system, for recording and managing malaria in such a setting.

Dynamics of malaria transmission under changing ecological scenario in and around Nanak Matta Dam, Uttaranchal, India.

To understand the transmission dynamics of malaria in three different ecotypes, namely watershed (forest), seepage (Nanak Matta Dam) and plain (non-forest, non-dam) areas of Nainital and Udham Singh Nagar districts of Uttaranchal, entomological and parasitological investigations were carried out from July 1996 to June 1997. In the three ecotypes, average per man hour densities of adult vector species in human dwellings and cattlesheds recorded were high for Anopheles culicifacies from April to September and October to March for An. fluviatilis. Prevalence of both An. culicifacies and An. fluviatilis was higher in the forest area as compared to other two areas. Observations on gonotrophic condition revealed endophilic tendency of both vector species. Higher number of both vector species were found in outdoor than indoor during night human bait collections. Out of 864 specimens of An. fluviatilis dissected, one showed natural infection of sporozoites in salivary glands in the month of November from the forest area only. Sibling species study of An. fluviatilis revealed the presence of species S for the first time in the forest area. Parasitological investigations also depicted high incidence of malaria in the forest area as compared to other two areas. Overall results from the study indicated active malaria transmission in the forest area.

Studies on bionomics of Anopheles fluviatilis and its sibling species in Nainital district, U.P.

A study on the bionomics of Anopheles fluviatilis sensu lato was carried out in two physiographic regions, viz. Bhabar and Terai of District Nainital, Uttar Pradesh. In both areas, An. fluviatilis was found resting indoors predominantly in cattlesheds. Cytological examination of An. fluviatilis revealed that species T and U were sympatric in Bhabar and Terai villages with predominance of species T. These two sibling species appear to be poor vectors of malaria.

Biting rhythms of some anophelines in central Gujarat.

A total of 41,552 anophelines comprising 16 species were collected during 70 all-night bovine-bait collection carried out in six villages of Kheda district, Gujarat. Anopheles subpictus, An. varuna, An. culicifacies, An. stephensi and An. vagus had unimodal biting rhythms. Most feeding occurred during the early night with occasional increase during pre-dawn/dawn hours. An. pallidus exhibited bimodal biting rhythm with two well-defined peaks. An. turkhudi, An. tessellatus, An. fluviatilis, An. aconitus, An. annularis; An. barbirostris and An. nigerrimus had multimodal biting rhythms or were arthymic. An. culicifacies, An. varuna, An. aconitus and An. tessellatus exhibited a marked seasonal shift in feeding activities with most biting occurring at dusk in colder months and late at night during warmer months.

Bionomics of vector anophelines in District Naini Tal, Uttar Pradesh.

Breeding behaviour and seasonal prevalence of vector anopheline in different habitats associated with rice land agroecosystem of terai and bhabar area of District Naini Tal was studied from July 1992 to June 1994. Adult prevalence in both the areas shows two distinct An. fluviatilis peaks in the months of March and October and the breeding places for the species were pokhars in bhabar and stream and irrigation drains in terai. Prevalence of adult An. culicifacies was observed during July to August in bhabar and April and August in terai. In bhabar high immature density of An. culicifacies was noted mainly in tanks, pokhars and paddy fields (early transplantation period). In terai high immature density of An. culicifacies was noted in stream, while low in paddy fields. Higher prevalence of immatures and adult anopheline vectors coincide with peak malaria incidence in both the areas. In bhabar in the months of August and September large number of malaria cases were contributed by An. culicifacies and in November by An. fluviatilis. In terai, malaria cases in April and from June to September were contributed by An. culicifacies, whereas An. fluviatilis might be responsible for transmission in October.

Biting rhythms of malaria vector Anopheles culicifacies in Kheda district, Gujarat.

All night collections on bovine baits were made in 6 villages of Kheda district, Gujarat. During 70 all night bait collections from January to December 1989, a total of 2290 An. culicifacies were collected. An. culicifacies mostly exhibited bimodal rhythms with a seasonal shift in peak biting activities. During the cold season most biting occurred just after dusk and during the warm season late at night. An. culicifacies was more active during moonless hours and its activity showed no correlation with temperature and humidity during most part of the year.

Interspecific associations among anophelines in different breeding habitats of Kheda district, Gujarat. Part I: Canal irrigated area.

In a study covering two years, 1306 samples of immatures were collected from 7 different breeding habitats of canal irrigated villages of Kheda district in Gujarat. Out of the samples belonging to 8 anopheline species, 14396 adults emerged. Breeding of An. culicifacies was associated with An. annularis in ponds, paddy fields, small pools and with An. stephensi in paddy fields. Maximum association was observed between An. barbirostris and An. nigerrimus in irrigation canals and An. culicifacies and An. subpictus in intradomestic containers. An. annularis, An. stephensi and An. subpictus were strongly associated in paddy fields. Strong interspecific repulsion was observed between An. subpictus and An. stephensi in intradomestic containers and An. barbirostris and An. subpictus in ponds.