Precontrol observations on lymphatic filariasis & geo-helminthiases in two coastal districts of rural Orrisa.

BACKGROUND & OBJECTIVE: Lymphatic filariasis (LF) is a major public health problem in India, accounting for 40 per cent of the global burden. The World Health Organization has launched a global programme to eliminate LF by 2020 and India is a signatory to it. Orissa, an eastern Indian State has long been known to be endemic for LF. Prior to implementation of mass drug administration programme it is important to collect baseline data on filariasis and geo-helminthiases in the State. The present cross-sectional survey was therefore carried out between February and December 2001 to obtain baseline information on both LF and geo-helminthiases before application of the control measures. METHODS: The study was carried out in rural areas of Puri and Ganjam districts in two phases. In phase I, the distribution of microfilaraemia in two district was mapped out in randomly selected primary health centres (PHCs), and 12 microfilaraemic villages were identified in each district by cluster analysis for the phase II study. In phase II, detailed clinical and parasitological survey for LF and geo-helminthiases was carried out following the standard procedures. RESULTS: Wuchereria bancrofti was found to be widely prevalent in Puri district with certain pockets of Brugia malayi while W. bancrofti was the only species in Ganjam district. The microfilaraemia (Mf) rate was found to be 9.5 and 11.1 per cent; and circulating filarial antigenaemia (CFA) was 16.8 and 17.8 per cent in Puri and Ganjam respectively. The geometric mean intensity (GMI) of Mf per ml of blood among positive individuals was 387 in Puri and 454 in Ganjam. The overall disease rate in Puri was 7.9 and 8.9 per cent in Ganjam. The prevalence of chronic manifestations was found to be significantly higher (P<0.001) than the acute manifestations in both the districts. The prevalence of geo-helminthiases was 31.8 per cent in Puri and 42.1 per cent in Ganjam; and the heavy infection was found to be significantly higher (P<0.001) in Ganjam compared to Puri district. INTERPRETATION & CONCLUSION: The present study identified LF and geo-helminthiases as widely distributed health problem in rural areas of coastal Orissa which warrants intervention measures along the lines recommended by the global programme for elimination of LF and geo-helminthiases to reduce the disease burden.

Drug abusers - A new high risk population for HIV infection in Orissa.

The present study reports the prevalence of HIV infection among the drug addicts undergoing counselling and treatment in a drug deaddiction centre located in Bhubaneswar, during July 1996 to August 1997. All subjects were males. The coded serum samples were tested by ELISA and rapid spot test for the detection of HIV antibodies. The positive samples were finally confirmed by the line immunoassay for HIV infection. A high prevalence of 7% HIV infection was noticed among the drug addicts (n=100). Oral drug abusers and IDUs were positive for HIV-1 infection in 5.26% and 21.74% cases respectively. The present study reveals a high prevalence of HIV infection among the drug addicts for the first time from Orissa which needs a careful monitoring and surveillance.

An alternative approach for screening active bam HI variants: overexpression in T-7 RNA polymerase based system.

The type II restriction endonuclease, Bam HI, has been overexpressed in E. coli by cloning the Bam HI gene in frame with an E. coli Ribosome Binding Site (RBS) under the T7 promoter of an E. coli expression vector pRSET A. The expression level of Bam HI endonuclease using this construct was found to be higher than that reported of the overexpressing clone pAEK14. Our overexpressing clone, pAABRw in BL21 cells in presence of Bam HI methylase in pMAP6 following induction with IPTG yields about 9.2 x 10(6) units per gram wet cell paste. In vivo activity of the recombinant endonuclease could be confirmed by the SOS induction assay in JH139 cells even in the absence of T7 polymerase and cognate Bam HI methylase because of leaky expression in E. coli. This provides an alternate way to screen the active endonuclease and its variants.

A clinico-epidemiological perspective of lymphatic filariasis in Satyabadi block of Puri district, Orissa.

BACKGROUND & OBJECTIVES: Lymphatic filariasis is a major public health problem in the coastal district of Orissa. However, no systematic studies have been done to document the prevalence of microfilaraemia/disease in different regions of the State. Therefore, the present cross sectional study was undertaken during 1996-97 to obtain information on the clinical and epidemiological status of the disease in Satyabadi block area of Puri district, known to be endemic for filariasis. METHODS: Night blood smear survey and clinical examinations were performed on 4646 individuals aged 0-> or = 60 yr from systematically selected households of 17 randomly selected villages of the Block. Microfilaraemia was detected by thick drop technique using 20 microliters of peripheral blood and microfilariae (mf) density by nucleopore filtration technique collected during 1900-2300 h. RESULTS: The prevalence of microfilaraemia was observed to be 14.8 per cent; 13.3 per cent Wuchereria bancrofti, 1.4 per cent Brugia malayi and 0.09 per cent had mixed infections. Geometric mean microfilaraemia density (infected persons only) was found to be 1288 per ml in case of W. bancrofti and 204 per ml in case of B. malayi. The disease rate was observed to be 19.8 per cent; 12.85 per cent had acute manifestations and 6.97 per cent had chronic manifestations. INTERPRETATION & CONCLUSION: The rate of acute disease manifestations was observed to be significantly higher (P < 0.001) than chronic manifestations. There was a male preponderence among the affected individuals (P < 0.001). The interesting observations of the study were the occurrence of occult filarial manifestations viz., tropical pulmonary eosinophilia (TPE) in 0.47 per cent cases and other associated manifestations like asymptomatic microscopic haematuria, monoarticular arthritis and filarial associated respiratory diseases in 0.50, 0.24 and 0.19 per cent of cases respectively. The present study indicates that the area is highly endemic for lymphatic filariasis with active transmission.

Lymphatic filariasis in Khurda district of Orissa, India: an epidemiological study.

A cross-sectional survey was undertaken to determine the prevalence of disease due to lymphatic filariasis in Khurda district of Orissa, India. The total disease attributable to filariasis was significantly higher in males (14.79%) than females (10.04%). However, elephantiasis is more prevalent in females, and adenolymphangitis is more prevalent in males than their counterparts. The prevalences of various forms of the disease are age dependent in both sexes. About one-seventh of men and women of higher age groups suffered from chronic debilitation forms of the disease. The study suggests that overt clinical forms of lymphatic filariasis constitute a major public health problem in the study area.

Nutritional status of preschool children in the drought affected Kalahandi district of Orissa.

A community-based cross-sectional study was undertaken to determine the magnitude of undernutrition and protein-energy malnutrition among young children during 1996-97 in drought affected Kalahandi district of Orissa. A total of 751 children aged 0-5 yr were studied for anthropometry and clinical signs of nutritional deficiencies from 15 Gram Panchayats selected using probability proportionate to size sampling. There was no significant difference between boys and girls for nutritional status. According to weight-for-age, 57.1 per cent of the children were suffering from underweight (< median -2SD) and 21.3 per cent of children had very low body weights which were < -3SD of standard. Height-for-age and weight-for-height data showed that 41.8 per cent of children suffered from stunting and 27.9 per cent recorded wasting. The children below one year of age had relatively lower prevalence of malnutrition than the other age groups. The prevalence of clinical PEM in the form of marasmus was found in 0.7 per cent of children, while kwashiorkor was absent. This study showed that malnutrition is still a leading problem among preschool children of Kalahandi district and this has not improved in spite of nutrition intervention programmes which are currently in operation.

Seroprevalence of HIV infection among jail inmates in Orissa.

Seroprevalence of human immunodeficiency virus (HIV) infection was carried out in three prisons in Orissa from March 1994 to December 1995. All the prisoners of Indian origin (300), housed in these jails tested negative for HIV infection. On the other hand, 33.8 per cent (26/77) of jail inmates from foreign countries (Thailand and Myanmar), serving short terms in Orissa jails were found positive for HIV infection. While all the 26 HIV positive prisoners had HIV-1 infection, five of them had antibodies for HIV-1 and HIV-2 viruses. Such a high prevalence of HIV infection and detection of HIV-2 virus is being reported for the first time from Orissa.

Transmission dynamics of filariasis in Khurdha district of Orissa, India.

A three year longitudinal study was carried out to quantify the different parameters of filarial transmission in an endemic area of Orissa State, India. Parasitological surveys revealed mean microfilaria rate, microfilaria density and median microfilaria density (MFD-50) to be 9.41, 19.23 and 7.33, respectively. The per man hour density of the vector, Culex quinquefasciatus varied from 24.2 to 66.0 with a peak in January. Infection rate varied from 0.9 to 27.5%, while infectivity rate ranged between 0.0 and 15.2%. Infectivity rate showed high correlation with microfilaria rate and per man hour density of adult mosquito. The highest numbers of first stage larvae (L1), second stage larvae (L2) and third stage larvae (L3) per mosquito were found to be 25, 22 and 11, respectively. Average L3 load per infective mosquito ranged from 1.0 to 7.2. L3 load showed high correlation with microfilaria rate (r = 0.845, p < 0.01) while no correlation was seen with microfilaria density.