A strategic assessment of cervical cancer prevention and treatment services in 3 districts of Uttar Pradesh, India.

BACKGROUND: Despite being a preventable disease, cervical cancer claims the lives of almost half a million women worldwide each year. India bears one-fifth of the global burden of the disease, with approximately 130,000 new cases a year. In an effort to assess the need and potential for improving the quality of cervical cancer prevention and treatment services in Uttar Pradesh, a strategic assessment was conducted in three of the state's districts: Agra, Lucknow, and Saharanpur. METHODS: Using an adaptation of stage one of the World Health Organization's Strategic Approach to Improving Reproductive Health Policies and Programmes, an assessment of the quality of cervical cancer services was carried out by a multidisciplinary team of stakeholders. The assessment included a review of the available literature, observations of services, collection of hospital statistics and the conduct of qualitative research (in-depth interviews and focus group discussions) to assess the perspectives of women, providers, policy makers and community members. RESULTS: There were gaps in provider knowledge and practices, potentially attributable to limited provider training and professional development opportunities. In the absence of a state policy on cervical cancer, screening of asymptomatic women was practically absent, except in the military sector. Cytology-based cancer screening tests (i.e. pap smears) were often used to help diagnose women with symptoms of reproductive tract infections but not routinely screen asymptomatic women. Access to appropriate treatment of precancerous lesions was limited and often inappropriately managed by hysterectomy in many urban centers. Cancer treatment facilities were well equipped but mostly inaccessible for women in need. Finally, policy makers, community members and clients were mostly unaware about cervical cancer and its preventable nature, although with information, expressed a strong interest in having services available to women in their communities. CONCLUSION: To address gaps in services and unmet needs, state policies and integrated interventions have the potential to improve the quality of services for prevention of cervical cancer in Uttar Pradesh.

Replication of turkey herpesvirus and Marek's disease virus in chick embryo skin organ culture.

Turkey herpesvirus (HVT) and an attenuated Marek's disease virus (MDV) replicated in organ cultures of chick embryo skin as assessed by immunofluorescence and/or electron microscopy. HVT-specific immunofluorescent antigen was detected in the feather follicle epithelium (FFE) and in the surface layer of the skin epidermis. Electron microscopy of infected explants revealed herpes-type cytopathology. Immature particles of both viruses appeared first in the nucleus. Oval or horseshoe-shaped non-enveloped particles of HVT and enveloped virions of MDV were seen in the cytoplasm of some transitional cells. The difference in the ability of HVT and MDV to form an envelope was believed to account for the difference in their transmissibility in chickens. The results indicated that HVT replicated in the FFE and in the epidermis of the skin. However, attempts to localise the site(s) of MDV replication by electron microscopy were unsuccessful.

Induction of delayed hypersensitivity to turkey herpesvirus in fowls.

Delayed hypersensitivity, as determined by the wattle skin reaction, to turkey herpesvirus developed in chickens sensitised with the infected cell antigen. A significant increase in skin thickness occurred in the sensitised wattles as compared with the controls.

Isolation and characterisation of herpes virus from turkeys.

Turkey herpesvirus (HVT) was isolated from the kidneys of 6 of 8 turkey poults from two flocks. The isolates were identified by syncytial-type of cytopathology, inhibition of plaque formation by 5-bromodeoxyuridine, formation of Cowdry type A intranuclear inclusions in cell cultures, and presence of herpes-type virions in negatively stained preparations and thin sections of infected cell cultures. One of these isolates inoculated into chickens proved apathogenic over an observation period of 10 weeks. Indirect immunofluorescence and serum neutralisation tests revealed serological relationship between these isolates and the strain NSW 1/70 of HVT. Staining of HVT-infected cell culture by Marek's disease herpesvirus (MDHV) antiserum showed intranuclear fluorescence but attempts to prepare HVT precipitating antigen or to demonstrate cross-precipiation between HVT and MDHV were unsuccessful.

Ways to make family planning popular in tribal villages.

PIP: A study was conducted in Lakhipur, India, a tribal village of Santhals and Paharias, to discover their knowledge of and attitude toward the national family planning program. Only 60% of the respondents had heard of the program; only 2 or 3 people had any usable knowledge of family planning. There was widespread opposition, based on tradition and religion. Children in this area are still viewed as a economic asset. Much personal attention will be necessary to change attitudes in Lakhipur. Village leaders must become family planning acceptors. Propaganda should be frequent and varied. Door to door workers should be employed. Family planning personnel must be easily accessible.^ieng