ABSTRACT
An unprecedented outbreak of dengue occurred during 2017 in Kerala. Thiruvananthapuram was worst affected. We carried out a joint investigation with the Health department of the State, to understand the epidemiological and entomological factors involved in this outbreak, so as to develop strategies to contain it. Blood samples from suspected patients were collected from three worst affected areas and genomic analysis of the Dengue virus (DENV) was performed. Also, a cross sectional entomological survey was carried out in these areas. The data obtained was compared with the available secondary data of DENV in Kerala. The investigations revealed a genetic shift from the erstwhile predominant DENV2/DENV3 serotypes to the newly introduced DENV1 Asian genotype during the current outbreak. Breeding indices of Aedes aegypti, the predominant vector species was also found to be remarkably high. Asian genotype of DENV1 was detected in field collected Ae. aegypti also. The index cases of the Asian genotype of DENV1 in Kerala were detected from Erumeli village (gateway to the famous Sabarimala shrine) among two plantation workers migrated from the neighbouring Karnataka state, during 2013. This introduced virus strain attained an epidemic proportion in 2017 in Thiruvananthapuram, owing to immunologically naïve population and high receptivity.
ABSTRACT
Unused and discarded latex collection containers (LCCs) are the major breeding habitats of Aedes albopictus in the rubber plantations of Kerala, India. Platynectes sp. (Family: Dytiscidae) was observed to invade these habitats during the monsoon season and voraciously devour the larval instars of this major vector species of arbo-viral diseases. Field observations showed a reduction of 70.91% (p = 0.0017) and 100% in Aedes larval density, on the first and four days post release of eight beetles per LCC respectively. In laboratory, a beetle was found to devour 17.75 + 5.0 late larval instars of Ae. albopictus per day. Our findings indicate Platynectes sp. could be a potential bio-control agent against Ae. albopictus, the vector of chikungunya/dengue fevers, in rubber plantations.
ABSTRACT
India was affected by a major outbreak of chikungunya fever caused by Chikungunya virus (CHIKV) during 2006-2007. Kerala was the worst affected state during 2007 with a contribution of 55.8 percent suspected cases in the country. However, except for clinically reported case records, no systematic information is available on infection status of CHIKV in the region. Hence, we carried out a post-epidemic survey to estimate seroprevalence status [immunoglobulin G (IgG)] in the community using commercially available indirect immunofluorescence test. This methodology had been reported to be highly specific and sensitive for CHIKV infection. The study area selected was the worst affected mid-highlands region of Kerala which harbour vast area of rubber plantations. The study evidenced 68 percent of the population to be seropositive for CHIKV IgG. Males were found more affected than females (χ2 = 9.86; p = 0.002). Among males, prevalence was significantly higher in the age classes 21-30 (χ2 = 5.46; p = 0.019) and 31-40 (χ2 = 5.84; p = 0.016) years. This may be due to high occupational risk of the male population engaged in plantation activities exposed to infective bites of Aedes albopictus. The current study provides an insight into the magnitude of CHIKV outbreak in Kerala.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Alphavirus Infections/epidemiology , Antibodies, Viral/blood , Chikungunya virus/immunology , Disease Outbreaks , Immunoglobulin G/blood , Alphavirus Infections/diagnosis , Cross-Sectional Studies , India/epidemiology , Prevalence , Reagent Kits, Diagnostic , Sensitivity and Specificity , Seroepidemiologic StudiesABSTRACT
Lymphatic filariasis has a wide spectrum of clinical manifestations with asymptomatic parasite carriers at one end and irreversible lymphoedema of extremities at the other. Irreversible lymphoedema of extremities is one of the disabling conditions that drive the affected patients to seek treatment from various systems of medicines and health care providers. This study attempts to map the care seeking pattern and behaviour of patients with chronic filarial lymphoedema of lower limbs in an urban area. Consecutive filarial lymphoedema patients from the VCRC filariasis clinic were recruited for the study. A pre-tested semi-structured questionnaire was used for interrogation of the patients. A total of 56 lymphoedema patients participated in the study. Majority (94.6%) of the patients sought medical management only. There was no difference (P>0.05) between the proportion of patients attending government (37.5%) and private (44.3%) medical care facilities There was also no difference in the proportion of patients' first consultations in private or government health care facilities. About 57.1% patients approaching governmental institutions opted for primary/secondary health care system. No particular sequential pattern of seeking health care was observed and the 56 study subjects followed 40 treatment-seeking routes by switching from one care provider to the other. The causes of not coming to the clinic for further check-up were 'no acute attacks' (30.4%), 'reduction in oedema volume' (21.7%), 'advised treatment being taken at home' (26.1%) and 'loss of daily wages' (21.7%). The study highlights the need to involve the private medical sector in morbidity management of filarial lymphoedema and to make governmental health facilities more accessible and user-friendly.
Subject(s)
Adult , Choice Behavior , Chronic Disease , Elephantiasis, Filarial/drug therapy , Female , Health Care Surveys , Health Personnel , Humans , India , Lymphedema/drug therapy , Male , Patient Acceptance of Health Care , Physical Therapy Modalities , Private Sector , Public Sector , Surveys and QuestionnairesABSTRACT
Knowledge on infectious diseases encompasses a vast and constantly changing arena; and consistent research work is imperative to understand and combat the new problems resulting from emerging infectious diseases. Public health workers and epidemiologists aim at lowering morbidity and mortality due to diseases by preventing infections. For the rapidly expanding majority of the world's population; who live in the largely tropical areas of Africa; Asia and Latin America; the greatest threats to health remain tropical infectious diseases. Emerging infectious diseases are new; emerging or drug-resistant infections; whose incidence in humans may increase in the near future. With rapidly increasing international travel; the globalization and industrialization of food supply and exploding populations; infectious diseases pose unprecedented threats around the globe. Thus the imperative need is to promptly recognize; isolate and appropriately manage tropical infectious diseases. This review paper has attempted to provide the much needed insight into the different aspects of the major tropical infectious diseases affecting humans throughout the world
Subject(s)
Bacterial Infections , Communicable Diseases/etiology , Review , Tropical MedicineABSTRACT
Knowledge on infectious diseases encompasses a vast and constantly changing arena; and consistent research work is imperative to understand and combat the new problems resulting from emerging infectious diseases. Public health workers and epidemiologists aim at lowering morbidity and mortality due to diseases by preventing infections. For the rapidly expanding majority of the world's population; who live in the largely tropical areas of Africa; Asia and Latin America; the greatest threats to health remain tropical infectious diseases. Emerging infectious diseases are new; emerging or drug-resistant infections; whose incidence in humans may increase in the near future. With rapidly increasing international travel; the globalization and industrialization of food supply and exploding populations; infectious diseases pose unprecedented threats around the globe. Thus the imperative need is to promptly recognize; isolate and appropriately manage tropical infectious diseases. This review paper has attempted to provide the much needed insight into the different aspects of the major tropical infectious diseases affecting humans throughout the world
Subject(s)
Communicable Diseases , Communicable Diseases, Emerging , Communicable Diseases, Imported/transmissionABSTRACT
Annual and biannual mass single dose diethylcarbamazine citrate (DEC) at 6 mg/kg body weight was administered to people in a Brugia malayi endemic area in Shertallai part of Kerala, India, in 1987 and 1988. The coverage of population ranged between 41.33% and 66.01% in different rounds. The highest percentage of treated population developing side reactions was 8.4%. Both annual and biannual regimens were effective in reducing the microfilaria prevalence significantly from 4.90% to 1.23% and from 6.27% to 0.62% respectively and the incidence of infection was minimal in the adult population and zero among children. There was significant reduction in mean microfilaria count in both annual (81.08%) and biannual (98.00%) areas. Marked reduction in the proportion of high density carriers and infectivity index of the population after DEC therapy was also observed. Beneficial effect of mass single dose DEC on clinical cases of filariasis was evident from the reduction in the prevalence of acute manifestations, recent edema cases and the proportion of chronic cases with acute episodes. Results obtained from mass treatment areas were compared with those of the control area.