Prevalence of ascariasis and ancylostomiasis in families: a collaborative inquiry.

A collaborative survey was carried out to estimate the prevalence of ascariasis and ancylostomiasis in random samples of 200 families in each of 3 different communities: a city slum (CS), an industrial township (IT), a farming village community (FVC). Stool examination was done by Kato's qualitative thick smear method. Ascariasis was prevalent in all the three communities; the percentage of families with multiple members infected varied from 50 to 91 per cent; the percentage of members infected within such a family varied from 48 to 74 per cent; the infection was highly prevalent (41-78%) in all age groups excepts adults in the IT. From 8 to 11 per cent of persons with ascariasis were negative on stool examination but passed worms after medication. Ancylostomiasis was arevelent mainly in the FVC and to a less extent in the IT; the percentage of families with multiple members infected was 83 per cent in the FVC and 17 per cent in the IT; the percentage of members infected within such a family was 54 per cent in the FVC and 58 per cent in the IT. All the persons surveyed received a single 10 mg/kg dose of pyrantel pamoate (Combantrin*, Pfizer) which was well tolerated.

An action research in the delivery of primary health care through community based distribution.

PIP: In adhering to the spirit of primary health care (PHC), the Varanasi District in India began its community based distribution (CBD) project of oral rehydration solution (ORS) packets in Chiraigaon block in 1979. The CBD later included Cholapur, Kashi Vidyapith, Sewapuri, Araijiline, Haurah, Pindra, and Niyamatabad during 1980-1981. In 1989, an honorary project director headed the project and its cadre of regular paid staff. At the main office, staff included a project coordinator, technical consultant medical officer, field supervisors, and field assistants. 754 depot holders or kendra kalyan sanjojak (KKS) worked at the community level. They came from all segments of the society, e.g., farmers, teachers, individuals in business, etc. The KKS implemented the CBD and its policies. Individuals at the headquarters prepared ORS packets using the standard WHO formula. They included health information brochures about ORS written in the local language in each packet. Field assistants delivered these packets to the KKS each month at a no profit no loss cost. The depot holders then sold the packets at a marginal profit. From 1980-1983, the number of packets increased from 1725-9660. From 1980-1985, CBD workers distributed a total of 29.862 packets to all 8 blocks. Rigid social marketing criteria adopted in 1984 brought about a downturn in distribution, however. The number of families trained in ORS preparation varied from 80 in 1980 to 1688 in 1985. The number of families totaled 6919. Health education activities, such as group discussion and individual contracts, flourished at the community level which stimulated demand for ORS packets.^ieng

Study of infant and childhood mortality in an ICDS block of eastern U.P.

Information on births and deaths was collected in 11 randomly selected AWW areas of Barhaj Mahen ICDS project area in Eastern U.P. by an independent survey team in 1988-89. The findings revealed that the births and deaths were under-reported to the tune of 36.6 and 13.9 percent respectively, by AWWs. The different demographic indicators generated from the data were as follows, CBR and CDR were 30.3 and 7.1 per 1000 population. Neonatal mortality rate, IMR, and MMR were 58.3, 74.7 and 6.5 per 1000 live births. 0-6 yr mortality was 16.3 per 1000 children and constituted 37.5% of the total deaths. ARI, diarrhoea and fever were the major causes of mortality in 0-6 yr old children accounting for 25.9, 22.3 and 14.8% respectively. The findings indicated that there was underreporting in adult mortalities despite the independent investigation, and a reduction in infant and childhood mortality possibly due to the beneficial effect of ICDS services.

PIP: This analysis aims to determine the extent of underreporting of births and deaths by anganwadi workers (AWW) in Barhaj Mahen project area in Eastern Uttar Pradesh state, India, in 1988, and to identify the birth rate and childhood mortality rate. Causes of mortality are identified. The project area is known to have a high infant mortality rate. Data were obtained from 11 AWW areas serving a population of 10,206. Sampling followed the random cluster technique. Initial household data collection missed 309 births (36.6%) but only 10/72 deaths (13.9%). 35.5% of male and 37.8% of female births were unreported. 14.6% of male and 12.9% of female deaths were unreported. 18 neonatal and 5 postneonatal infants died. Early neonatal mortality was 45.3/1000 live births, and neonatal mortality was 58.3. Infant mortality was 74.7, and maternal mortality was 6.5/1000 live births. Respiratory infections accounted for the highest mortality (25.9%). Other cause of death were diarrhea (22.3%), fever (14.8%), prematurity (8.1%), tetanus (7.4%), and accident (3.7%). The total death rate (7.2/1000) was lower than the national average. The birth rate in project areas of Uttar Pradesh was almost the same as the national average. Postneonatal mortality showed the lowest rates compared to Uttar Pradesh and the nation. Since this study area had been included in the Integrated Child Development Services (ICDS) since 1981, it is likely that the lower child mortality reflects the emphasis on ICDS services. Underreporting of deaths is considered to be marginal.

Epidemiology of gastro-intestinal and respiratory tract diseases in rural areas of Varanasi (India).

The pattern of gastro-intestinal (GIT) and Respiratory tract (RTI) diseases in rural areas of the Varanasi district, U.P. (India) was studied from the outpatient (OPD) attendance between July 1985 to June 1986. Out of a total of new patients, 19.71% had respiratory diseases in contrast to 27.9% with GIT disease. A decreasing trend was observed in attendance rates as age advanced. The difference in age distribution of males and females was statistically significant. The attendance rates for GIT diseases were higher in female (29.16%) than in males (25.16%) whereas in RTI, the rates were higher in males (19.39%) than in females (18.77%). The attendance rate was found to be higher in rainy season (23.59%) followed by summer (14.50%). Diarrhoea (15.44%) and upper (URTI) respiratory tract infection (19.93%) occupied the major recorded episodes.

Epidemiological correlates between consumption of Indian chewing tobacco and oral cancer.

The problem of cancer is universal; the only variation occurs in the type, site or other clinicoepidemiological parameters. Peculiarly enough, oral cancers caused by chewing tobacco are common in India and some parts of the Indian sub-continent. Oral cancers caused by other carcinogens are not common in these areas. The present study shows a significant association (P less than 0.001) between the use of Indian chewing tobacco and oral cancer. Number of quids, mean quantity of tobacco and mean duration of keeping the quids in the mouth had direct dose and effect relationships in causation of oral cancer. A dose of 10 gms of chewing tobacco for about 26 years was observed to have produced cancerous lesions in the buccal cavity.