Investigation report of an epidemic of typhoid fever.

An explosive common-source epidemic of typhoid fever, probably the world's biggest, occurred in Sangli Town (Maharashtra State), India, between December 1975 and February 1976 when, with the incidence rate of 6.59% over this 12-week period, probably more than 9000 cases occurred in a population of about 135 000. Faecal contamination of municipal water supply, which was receiving unsatisfactory and inadequate chlorine treatment, was responsible for the epidemic. Contamination at suitable intervals resulted in a heavy build-up of S. typhi in the population. Massive central contamination of the ill-maintained municipal water-supply system with faecally-contaminated waste-water from a population of about 37 000, in which there were thought to be over 250 typhoid cases, ultimately resulted in the explosive epidemic. The episode underlines the importance of proper maintenance of water supply and excreta disposal systems.

Social classification and maternity practices in Aurangabad, India.

A population of 3870 individuals constituting 823 families residing in five different localities of Aurangabad city was surveyed by house to house visits. The objectives of the study were to assess the validity of social classification by residence in certain localities. The variable used in the study was maternity practices. Family members and children under five years of age were recorded. Mothers of children were asked occupation of the head of the family and delivery details pertaining to these children. Social class was decided by residence in particular localities of the city, classified according to easily ascertainable characteristics of housing. Validity of such classification was judged by comparing it with classification by well known variable like occupation. The findings indicate that the system provides an inexpensive and rapid method of social classification. A total of 661 deliveries were recorded. A total of 67.62% deliveries were conducted in Government or Private Institutions. The remaining deliveries were home deliveries conducted by untrained personnel. Indigenous dais (traditional birth attendants) conducted 20.27% and senior female relatives 10.89% of the total deliveries. The findings, thus, stress the need of identifying and training dais in urban areas.

Attitude to family planning in an Aurangabad slum.

PIP: The impact of efforts by the Medical College Hospital and the Regional Family Planning Training Centre in Aurangabad, India, to popularize family planning in the city's slum areas was assessed through a KAP survey conducted by medical interns, social workers, and other hospital staff. In all, 237 couples were surveyed. Of these, 156 were Nav Buddhas, 53 were Hindus, 17 were Christians and 11 were Muslims. When asked if they were aware of birth control, 108 replied in the affirmative (the "Aware" group) and 129 were ignorant (the "Unaware" group). Only 21 from the "Aware" group were practicing a family planning method. Of the 21 acceptors, there were 15 vasectomies, 3 tubectomies, and in 3 cases, use of the condom by the husband. The most common reason for failure to practice contraception was the desire for more children, although many felt that contraception was unnecessary or they had neglected to think about family limitation. It is important that only 33 out of 237 (14%) recognized the widely publicized symbol for family planning (inverted red triangle); and the proportion of contraception acceptors in this group was significantly more than among those who failed to recognize the symbol. Survey findings indicated that efforts to reach the population in the ever-increasing slums in urban areas must be intensified.^ieng