Enhanced tuberculosis case finding through advocacy and sensitisation meetings in prisons of Central India.

Tuberculosis (TB) in prisons is a major problem. The prisons in Chhattisgarh, India, are overcrowded, and there are no formal efforts to engage them in TB control. In 2014, the International Union Against Tuberculosis and Lung Disease and the state TB programme advocated with state prison authorities to implement an enhanced case-finding strategy in the prisons. Sensitisation meetings (one/quarter/prison) to improve awareness among prisoners about TB symptoms and services were coupled with improved access to diagnosis. Patients with presumptive TB who were examined by sputum microscopy increased by 39% per 100 000 prisoners, and TB case notification rates increased by 38%, in 2014 relative to 2013.

La tuberculose (TB) en prison est un problème majeur. Les prisons de l'état de Chhattisgarh, Inde, sont surpeuplées et il n'y a jamais eu d'actions formelles d'engagement dans la lutte contre la TB. En 2014, l'Union Internationale Contre la Tuberculose et les Maladies Respiratoires et le programme d'état pour la TB ont plaidé auprès des autorités carcérales de l'état afin de mettre en œuvre une meilleure stratégie de recherche des cas dans les prisons. Des réunions de sensibilisation (une/trimestre/prison) visant à améliorer les connaissances des détenus en matière de symptômes de la TB et de services disponibles ont été couplées à un meilleur accès au diagnostic. La proportion de patients présumés tuberculeux ayant eu une microscopie de crachats par 100 000 détenus a augmenté de 39% et le taux de déclaration des cas de TB a augmenté de 38% en 2014 par rapport à 2013.

La tuberculosis (TB) en las prisiones constituye un grave problema. Los establecimientos penitenciarios de Chhattisgarh, en la India, sufren de hacinamiento y no cuentan con iniciativas formales que promuevan el control de la TB. En el 2014, la Unión Internacional Contra la Tuberculosis y las Enfermedades Respiratorias y el programa nacional contra la TB preconizaron con las autoridades penitenciarias la instauración de una estrategia de detección reforzada de casos en las prisiones. Se asociaron las reuniones de sensibilización (una reunión trimestral por centro) encaminadas a mejorar los conocimientos de los reclusos sobre los síntomas de la TB y los servicios de atención a su alcance con un mejor acceso al diagnóstico. En el 2014, el número de pacientes con presunción clínica de TB en quienes se practicó la baciloscopia del esputo por 100 000 reclusos aumentó un 39% y la tasa de notificación de casos de TB aumento un 38%, con respecto al 2013.

Data collection using open access technology in multicentre operational research involving patient interviews.

Conducting multicentre operational research is challenging due to issues related to the logistics of travel, training, supervision, monitoring and troubleshooting support. This is even more burdensome in resource-constrained settings and if the research includes patient interviews. In this article, we describe an innovative model that uses open access tools such as Dropbox, TeamViewer and CamScanner for efficient, quality-assured data collection in an ongoing multicentre operational research study involving record review and patient interviews. The tools used for data collection have been shared for adaptation and use by other researchers.

Conduire des recherches opérationnelles multicentriques est un défi, particulièrement dans les contextes de ressources limitées, en tenant compte des questions de logistique de déplacement, de formation, de supervision, de suivi et de soutien à la résolution des problèmes; encore plus si cette recherche implique des entretiens avec des patients. Dans cet article, nous décrivons un modèle innovant qui utilise des outils à accès ouvert comme Dropbox, TeamViewer et CamScanner pour un recueil de données efficace et de qualité assurée dans le cadre d'une recherche opérationnelle continue multicentrique impliquant des revues de dossiers et des entretiens avec des patients. Les outils utilisés pour le recueil de données ont été partagés pour l'adaptation et l'utilisation par d'autres chercheurs.

La realización de investigaciones operativas multicéntricas puede ser problemática, sobre todo en los entornos con restricción de los recursos, habida cuenta de las dificultades en la organización de los desplazamientos, la capacitación, la supervisión, el seguimiento y el apoyo a la resolución de problemas; más aun, cuando la investigación precisa entrevistas a los pacientes. En el presente artículo se describe un modelo innovador que utiliza herramientas de libre acceso como las plataformas Dropbox, TeamViewer y CamScanner, con el fin de lograr una obtención de datos eficiente y de calidad garantizada, en una investigación operativa multicéntrica en curso que comporta el examen de las historias clínicas y entrevistas a los pacientes. Se comunican las herramientas utilizadas en la recogida de datos, con la finalidad de que otros investigadores puedan adaptarlas y las apliquen.

Malaria outbreak in a non endemic tribal block of Balasore district, Orissa, India during summer season.

A focal outbreak of malaria at Sialimal sub-centre of Balasore district of Orissa was reported during the month of March, 2010. Three villages of the above block were affected. Regional Medical Research Centre, Bhubaneswar has conducted an entomological survey and a central clinic simultaneously, with door to door household survey to identify the fever cases. Within a span of 18 days around 172 fever cases were reported with Slide Positivity Rate (SPR) of 24.4% and Pf % of 81%. The malaria epidemiological data of the sub-centre area for last three years indicates that the area is non endemic for malaria (API was 0.81). Entomological survey revealed the presence of three known vectors of malaria i.e. Anopheles culicifacies, Anopheles annularis and Anopheles subpictus (local vector). Per Man Hour Density (PMHD) of these three species were 4.2, 2.8 and 10.8 respectively. Plasmodium falciparum sporozoites were detected in two An. culicifacies, in one An. annularis and in one An. subpictus. Larval density of Anopheline mosquitoes per dip ranged between 12 to 20. The vectors were found to be resistant to DDT but susceptible to synthetic pyrethroid. With this finding necessary remedial measures were taken by the government to curtail the transmission.

Determination of iodine nutrition and community knowledge regarding iodine deficiency disorders in selected tribal blocks of Orissa, India.

AIM: To determine the status of iodine nutrition and knowledge of iodine deficiency disorders (IDD) in selected tribal mountainous blocks of Orissa, India. DESIGN: A community-based survey was performed, adopting the 30-cluster sampling and surveillance methodology for assessment of IDD recommended by WHO/UNICEF/ICCIDD. SUBJECTS: School-age children (6-12 years) and their mothers. METHODS: Total goitre rate (n=623) and urinary iodine excretion of children (n=530), iodine content in edible salt (n=505) and water (n=21) were measured. Community knowledge regarding IDD and awareness of iodized salt (n 20) was assessed. RESULTS: Total goitre rate was 23.6%, of which visible goiter was 6.9%. Prevalence of goiter increased with age in female and tribal children. Median urinary iodine was 38 Cmicro.Tl(-1) and 51.7% of children had urinary iodine values <100 pmicrogtl(-1) The mean iodine content for drinking water ranged from 1.22-3.6 pmicro.Tl(-1) Only 9.9% of salt samples had adequate iodine content (> or =5 ppm). Over 80% of respondents did not have knowledge of IDD and were not aware of salt iodization. CONCLUSIONS: Study results show moderate iodine deficiency with poor community knowledge of iodine nutrition. There is need to strengthen the monitoring of salt iodization and intensive education activities in the tribal areas.

Iodine deficiency in urban slums of Bhubaneswar.

OBJECTIVE: The present study aimed at assessing the population prevalence of goiter and iodine deficiency in school children of 6-12 yr living in urban slums of Bhubaneswer, the capital city of Orissa. METHODS: A cross-sectional study was performed using the 30-cluster sampling methodology and surveillance methods for iodine deficiency as recommended by WHO/ICCIDD/UNICEF. The total goitre rate (n=1248), urinary iodine concentration (UIC) (n=411) and iodine content of edible salt (n=368) were measured. RESULTS: The goitre prevalence was 23.6% (grade 1=18.9%, grade 2=4.7%) with no significant gender variation. Goitre prevalence was significantly higher in children of 10-12 yr (P=0.012) and scheduled caste and tribe (P=0.003). Median urinary iodine concentration was 50.0 microg/l with 85.7% of children having values less than 100 microg/l, indicating as biochemical iodine deficiency. Median UIC was inversely in association with gradations of goitre. Children of 10-12 yr and scheduled caste/tribe communities had significantly higher median UIC (P=0.001) than their counterpart peers. About 51% of children were consuming salt having stipulated iodine content of 15 ppm. CONCLUSION: The study indicates moderate iodine deficiency in the population, despite a mandatory salt iodization programme in Orissa that has been in force since 1989. There is a need to improve the situation through enforcing monitoring of salt iodization to ensure quality and increasing the level of awareness about the iodized salt for sustainable prevention and control of iodine deficiency.

The economic loss due to treatment costs and work loss to individuals with chronic lymphatic filariasis in rural communities of Orissa, India.

This paper is based on 1 year round case control study to investigate the economic burden, in terms of treatment costs and loss of work to people affected with chronic lymphatic filariasis in rural communities of Orissa, Eastern India. Around three-fourths of the chronic patients have sought treatment for their condition and spent, on average an amount of INR 396 (approximately US$ 8.7) per year. The major component of the expenditure is the cost of medicines. The data on loss of work time due to chronic condition reveal that the total absenteeism to the work is significantly higher among chronic filariasis patients than controls. The total number of working hours spent per day by patients and controls are 4.94 and 6.06, respectively with a significant difference. The total absenteeism and the total number of working hours per day are influenced significantly by disease condition and other personal characteristics, namely age, sex and family type. The chronic patients lose a total of 68 days of work per year, which is equivalent to 19% of the total working time of the year. The present results show that the chronic conditions of lymphatic filariasis pose considerable burden on the patient, family and community.

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.

Polarization-dependent interference effects in grazing-angle Fourier transform infrared reflection-absorption spectroscopy to determine the thickness of water-ice films.

Interference fringes appeared between 6000 and 4095 cm(-1) in the infrared spectra of thin water-ice films vapor deposited on an aluminum substrate and probed with grazing-angle Fourier transform infrared reflection-absorption spectroscopy. At grazing incidence the position of the fringe under perpendicularly polarized light (E(sigma)) is 180 degrees out of phase with the position of the fringe under parallel polarized light (E(pi)). This shift in fringe position with polarization offers a convenient way to estimate the thickness (+/-5%) of water-ice films between 0.5 and 1.4 microm.