Opportunities for One Health policies to reduce poverty.

Infectious diseases are known to disproportionately affect the poorer sectors of society, particularly those living in low- and middle-income countries. These vulnerable populations battle disease, debt, loss of livelihood and reduced economic well-being with consequences that extend to their families, communities, livestock and the environment. A strong One Health approach is acknowledged as a successful way of enhancing current capacity for the prevention and control of emerging infectious diseases. Furthermore, it is also an effective way to address the multifaceted nuances of poverty. In recognising the interconnectedness of human and animal health with the health of our shared environment, One Health offers a valuable framework to prevent and control emerging infectious diseases through collaboration, coordination and communication across the various sectors involved. In recent years, as examples of One Health implementation have been documented and assessed, the linkages between One Health interventions and poverty alleviation have become more obvious. One Health interventions have the potential to reduce the economic burden of disease and create more efficient systems and approaches that generate higher savings, both direct and indirect, at the human-animal-environment interface. This paper describes aspects of this potential in detail. Although, at present, examples of the relationship between One Health and poverty alleviation are few, they are compelling. The authors believe that they provide persuasive evidence to encourage governments and policy-makers to employ the One Health approach in their efforts to alleviate poverty. Measuring the impact of this link between One Health and poverty alleviation has its constraints since appropriate metrics are still evolving. However, this paper hopes to establish the wisdom of recognising the role that One Health can play in reducing poverty, as well as its capacity to enhance existing policy frameworks.

On sait que les secteurs les plus pauvres de la société subissent de manière disproportionnée l'impact des maladies infectieuses, en particulier dans les pays à revenu faible ou intermédiaire. Ces populations vulnérables sont confrontées à la maladie, à l'endettement, à la perte de leurs moyens de subsistance et à un déficit de bien-être économique dont les effets se perçoivent au niveau des familles et des communautés mais s'étendent également au bétail et à l'environnement. L'approche Une seule santé appliquée avec rigueur est reconnue comme un moyen efficace d'améliorer les capacités actuelles de prévention et de lutte contre les maladies infectieuses émergentes. Elle constitue également un outil puissant pour traiter les différents aspects plurifactoriels de la pauvreté. En prenant en compte l'interconnexion entre la santé humaine et animale et celle de notre environnement commun, Une seule santé fournit un cadre précieux pour prévenir et contrôler les maladies infectieuses émergentes à travers la mise en place d'une collaboration, d'une coordination et d'une communication transversales entre les différents secteurs concernés. Au cours de ces dernières années, l'évaluation et la collecte d'informations sur les exemples de mise en œuvre de l'approche Une seule santé ont fait ressortir les liens entre ces interventions et l'allègement de la pauvreté. Les interventions Une seule santé peuvent réduire le fardeau économique des maladies en créant des approches et des systèmes plus efficients qui permettent de réaliser des économies accrues, tant directes qu'indirectes, à l'interface homme­animal­environnement. Les auteurs décrivent en détail les différents aspects de ce potentiel. Les exemples du lien entre Une seule santé et l'allègement de la pauvreté sont encore peu nombreux mais ils sont probants. Les auteurs estiment apporter une démonstration suffisamment convaincante pour encourager les gouvernements et les décideurs politiques à recourir à l'approche Une seule santé dans le cadre de leurs initiatives de réduction de la pauvreté. La mesure de l'impact du lien entre Une seule santé et l'allègement de la pauvreté reste problématique en raison de l'évolution actuelle des méthodes d'évaluation appropriées. Néanmoins, les auteurs espèrent avoir établi le bien-fondé du rôle que peut jouer Une seule santé dans la réduction de la pauvreté ainsi que sa capacité d'améliorer les cadres politiques existants.

Se sabe que las enfermedades infecciosas afectan de forma desproporcionada a los sectores pobres de la sociedad, especialmente en los países de renta baja o mediana. Estas poblaciones vulnerables libran batalla a la enfermedad, las deudas, la pérdida de sus medios de vida y la merma de su bienestar económico con consecuencias que se extienden a su familia, su comunidad, su ganado y el medio ambiente. También está comprobado que una firme apuesta por la filosofía de Una sola salud es un expediente fructífero para mejorar la actual capacidad de prevención y control de enfermedades infecciosas emergentes. Se trata además de un medio eficaz para combatir la pobreza en sus múltiples facetas. Partiendo de la evidencia de la conexión recíproca existente entre salud humana, sanidad animal y el medio ambiente que todos compartimos, la noción de Una sola salud ofrece un valioso marco de referencia desde el que prevenir y combatir las enfermedades infecciosas emergentes gracias a la colaboración, coordinación y comunicación entre los distintos sectores interesados. De unos años a esta parte, a medida que se llevaban adelante y se describían experiencias de aplicación práctica de esta filosofía, ha ido quedando claro el nexo entre las intervenciones realizadas en clave de Una sola salud y la mitigación de la pobreza. Este tipo de intervenciones ofrecen la posibilidad de reducir el fardo económico que suponen las enfermedades y de propiciar sistemas y soluciones más eficaces y que generen un mayor ahorro, tanto directo como indirecto, en la interfaz del ser humano, los animales y el medio ambiente. Los autores describen en detalle una serie de aspectos del potencial que encierran esas intervenciones. Los ejemplos de la relación existente entre Una sola salud y la mitigación de la pobreza, aunque a día de hoy son contados, no dejan de resultar elocuentes. Los autores entienden que los datos expuestos son lo bastante convincentes como para alentar a gobiernos y planificadores de políticas a trabajar desde la óptica de Una sola salud para combatir la pobreza. Cuantificar los efectos de este nexo entre Una sola salud y mitigación de la pobreza no es tarea fácil, por cuanto las herramientas métricas necesarias aún están en plena gestación. Con todo, los autores esperan que el artículo avale la sabia conclusión de que los principios de Una sola salud pueden ser útiles para reducir la pobreza y también para perfeccionar los marcos de políticas existentes hoy en día.

Gallbladder cancer incidence in Gwalior district of India: Five-year trend based on the registry of a regional cancer center.

BACKGROUND: We have reported here the 5-year incidence (2004-2008) of gallbladder cancer (GBC) in North Central India along with its descriptive epidemiology. This provides potential clues for better prevention. The present study has also evaluated the association of ABO blood groups with GBC. PATIENTS AND METHODS: The study comprised 742 GBC cases referred to the regional cancer hospital, Gwalior, during 2004-2008. The demographic statistics of Gwalior district was considered to calculate the relative risk and incidence rates. ABO blood group distribution amongst 90,000 healthy subjects registered in the local blood bank during 2002-2007 was taken as controls to study the association of blood groups with GBC. RESULTS: The age-standardized total incidence rate of GBC was calculated to be 7.16/1,00,000. The relative risk of females getting GBC was 2.693 at 95% confidence interval of 2.304-3.151 (P < 0.0001). The females formed 69.5% of total cancer cases, with age-standardized incidence rate of 10/1,00,000. The mean age of male and female GBC cases was found to be 55.4 years (SD = 13, SE = 0.77) and 51.5 years (SD = 12.3, SE = 0.50), respectively. The blood groups A (P = 0.0022) and AB (P < 0.0001) had a positive association with GBC with significant level of differences in comparison to controls. CONCLUSION: Our study provided an estimate of a 5-year incidence of GBC in North Central India for the first time. With regard to the association of risk factors like obesity, age, and urban living with GBC, the findings of the present study are contradictory to the general opinion. Blood groups A and AB were found to be associated with GBC, which would be provisional for further investigations.

One Health: a perspective from the human health sector.

Despite emerging consensus that the One Health concept involves multiple stakeholders, the human health sector has continued to view it from a predominantly human health security perspective. It has often ignored the concerns of other sectors, e.g. concerns that relate to trade, commerce, livelihoods and sustainable development, all of which are important contributors to societal well-being. In the absence of a culture of collaboration, clear One Health goals, conceptual clarity and operating frameworks, this disconnect between human health and One Health efforts has often impeded the translation of One Health from concept to reality, other than during emergency situations. If there are to be effective and sustainable One Health partnerships we must identify clear operating principles that allow flexible approaches to intersectoral collaborations. To convince technical experts and political leaders in the human health sector of the importance of intersectoral cooperation, and to make the necessary structural adjustments, we need examples of best practice models and trans-sectoral methods for measuring the risks, burden and costs across sectors. Informal collaborations between researchers and technical experts will play a decisive role in developing these methods and models and instilling societal well-being into the human health sector's view of One Health.

Antenatal and perinatal care in an ICDS area: progress made in 19 years.

ICDS program has made significant improvement in availability and utilization of antenatal and natal care including IFA supplementation, TT administration and delivery by trained personnel. However, postnatal care and promotion and initiation of breastfeeding within 2 hours of birth still remain deficit areas.

Scrub typhus in Darjeeling, India: opportunities for simple, practical prevention measures.

To identify risk factors for scrub typhus in Darjeeling, India, we compared 62 scrub typhus cases (acute fever with eschar and specific IgM) with 62 neighbourhood controls. Cases were more likely to live close to bushes [matched odds ratio (MOR) 10; 95% CI 2.3-63] and wood piles (MOR 3.5; 95% CI 1.5-9.5), to work on farms (MOR 10; 95% CI 2.7-63), to observe rodents at home (MOR 3.6; 95% CI 1.4-11) and at work (MOR 9; 95% CI 2.4-57), and to rear domestic animals (MOR 2.4; 95% CI 1.1-5.7). Cases were less likely to wash after work (MOR 0.4; 95% CI 0.1-0.9) and change clothes to sleep (MOR 0.2; 95% CI 0.1-0.5). A cleaner, rodent-controlled environment may prevent exposure to scrub typhus. Personal protection measures and better hygiene could further reduce individual risk.

Otomycosis: a clinicomycologic study.

Otomycosis is a common fungal infection of the ear that is seen in the tropical and subtropical regions of the world. We performed mycologic analyses on debris and scraping samples from the external ear canals of 95 patients who had been clinically diagnosed with otomycosis. Seventy-one samples (74.7%) were positive for fungal growth; two of these samples contained two fungi, bringing the total number of isolates to 73. The most common pathogens were Aspergillus fumigatus (41.1% of all isolates), A niger (36.9%), and Candida albicans (8.2%).

Screening for TORCH infections in pregnant women: a report from Delhi.

Primary TORCH infections (toxoplasmosis, rubella, cytomegalovirus and herpes simplex virus type 1 and 2) in the mother can lead to severe fetal anomalies or even fetal loss. A prospective study was designed to detect the seroprevalence of IgM antibodies to Toxoplasma gondii, rubella virus and cytomegalovirus and IgG antibodies to herpes simplex virus type 1 and 2. One hundred and twenty pregnant women presenting to the antenatal clinic of a tertiary health center were included in this study. Out of these 120 women 112 (93.4%) had evidence of one or more infections. Prevalence of IgG antibodies to HSV was 70%. Seropositivities for toxoplasmosis, rubella and CMV respectively were 11.6, 8.3 and 20.8%. Our data demonstrating high frequency of primary infections during pregnancy support the conclusion that routine prenatal TORCH screening is justified.

Availability of antenatal and perinatal care in an ICDS area.

PIP: During March-April 1991, in the Chaksu rural Integrated Child Development Services (ICDS) block near Jaipur, India, interviews were conducted with all lactating mothers living near the anganwadi centers of Kothoon, Shivdaspur, and Dehlala (subcenter level) and of Mahadevpura, Kareda-Khurz, and Sawai Jai Singh Pura (peripheral level) to determine availability of prenatal and perinatal care. 93.4% of the mothers were between 18 and 35 years old. 72.8% of all mothers received prenatal care with assistant nurse-midwives providing most of the prenatal care (39.7% of all mothers). 11% of mothers received their first prenatal care checkup during the first trimester. The figures for the second and third trimesters were 39.7% and 22.1%, respectively. 66.2% of all mothers received the tetanus toxoid (either 2 doses or a booster dose) during pregnancy. All mothers received labor and delivery care, mainly from untrained traditional birth attendants (54.4%) and from others (28.7%). 78.6% of deliveries occurred at home. 28.3% of mothers began breast feeding after 48 hours postpartum. Only 17.2% began breast feeding within 6 hours of birth. Only 11.7% received any postnatal care at all, with medical officers providing most of it (8.8% of all mothers). Most mothers did not receive any supplementary nutrition during pregnancy (64.7%) and during lactation (71.3%). Only 8.8% and 12.5% received supplementary nutrition regularly during pregnancy and during lactation, respectively. 50% of mothers received iron folic acid during pregnancy. Yet only 33.8% received it regularly. These findings suggest that prenatal checkups and complete tetanus toxoid immunization were adequate, but initiation of breast feeding and postnatal care were poor in this rural ICDS area.^ieng

Prevalence of Campylobacter infections in animals and children in Haryana, India.

To study the prevalence of infections with Campylobacter spp in Haryana, India, a stool sample was collected using a rectal swab from 30 buffaloes, 62 cattle, 95 pigs and 94 children and was bacteriologically cultured. The subjects were either apparently healthy or had diarrhoea. The organisms were isolated in a medium containing reducing agents and antibiotics, and culture plates were incubated in a candle jar at 42 degrees C. 63% of all thermophilic Campylobacter were cultured from rectal swabs taken from young livestock and children with diarrhoea. Of 32 isolates fully identified, 23 were C. jejuni, 8 were C. coli and 1 was C. laridis. The C. jejuni isolates belonged to the Lior's biotype II.