BackgroundEchinococcosis is a human and animal health problem in many endemic areas worldwide. There are numerous reports and hospital-based studies from Kashmir, North India, yet there has been no epidemiological study conducted in Kashmir, the apparently endemic area for human hydatidosis. This study was designed to determine the seroprevalence of hydatid infection in Kashmir Valley and to find out association of risk factors for acquisition of this infection.MethodologyFourteen hundred and twenty-nine samples were collected from different districts in the Kashmir region (North India) using systematic random sampling. The 130 control samples included were from apparently healthy blood donors (100), patients with other parasitic infections (20), surgically confirmed hydatidosis patients (5), and apparently healthy subjects excluded for hydatidosis and intestinal parasitic infections (5). Hydatid-specific IgG antibody was detected by enzyme-linked immunosorbent assay, and seropositive samples were analysed further by Western blotting.ResultsOut of 1,429 samples, 72 (5.03%) were IgG positive by ELISA. The percentage occurrence of the highly immunoreactive antigenic fractions in IgG ELISA positive samples was 57 kDa (72.2%) followed by 70 kDa (66.7%) and 39kDa (58.3%) by immunoblotting. Samples with other parasitic infections were reactive with the cluster of 54-59 kDa antigenic fractions. Age <15 years, male gender, contact with dog, and rural residence were the most significant factors associated with the seropositivity.ConclusionThe study revealed that 72 (5.03%) out of 1,429 subjects asymptomatic for hydatidosis were seropositve to E.granulosus antigen by ELISA. Western blot analysis of 72 ELISA seropositive samples showed that 66.7% and 58.3% of samples were immunoreactive with 70 and 39kDa specific antigenic fractions, respectively. The seropositivity was significantly higher (5.79%) in the younger age group (<15 years) as compared to the 16-55 years (4.07%) and > 55 years (3.05%) age groups, suggesting ongoing transmission of this infection in the younger age group. The number of seropositive males was significantly higher as compared to females. The risk factors identified were rural residence and contact with dogs. The study suggests the presence of asymptomatic infection in subjects in Kashmir, North India, and efforts need to be made for implementation of effective prevention measures to reduce the infection burden, which may otherwise lead to symptomatology and complications in the infected subjects.

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Research Question: How important is acute respiratory tract infections in children less than 5 years of age and what are the main factors that need attention. Objective: To determine the magnitude of ARI under 5 years of age in rural areas of Kashmir valley. 2) To identify various risk factors responsible for ARI. Methodology: Community based Cross sectional study using multistage sampling procedure was used to study 1644 children. A house to house survey was carried out in the defined geographical region in order to determine the prevalence and risk factors of ARI less than 5 years of age. Results: Among 1644 children under 5 years of age studied, 886 (53.89%) were males and 758 (46.11%) female. An overall prevalence of 21.41% under 5 years of age was observed in a Kashmir valley. The prevalence of ARI varied according to the age of child being 19.3% in age group of 0-1 years, 23.0% in 1-3 years and 20.4% in age group of 3-5 years. Prevalence of ARI was more (22.5%) in male children as compared to female (20.05%) children [P>0.05]. The socio demographic variables that showed a significant relationship with ARI prevalence were parental literacy status (OR = 1.806; CI = 1.333 -2.447; P < 0.05) and more so the Mother's literacy status (OR = 1.635; CI = 1.284 -2.083; P < 0.05). ARI risk being high among Malnourished children (OR = 2.38; CI = 1.804 -3.157; P<0.05), inappropriately immunized children (OR=2.41; CI = 1.853 -3.154, P<0.05), children lacking exclusive Breast feeding (OR = 4.854; CI = 3.735 -6.309; P< 0.05) or put on early or delayed weaning (OR = 1.66; CI = 1.302 -2.140; P < 0.05). Environmental / housing variables also showed significant association with ARI with risk being high in children living in poor ventilation (OR = 4.865; CI = 3.78 -6.259; P < 0.05), overcrowded houses (OR = 1.829; CI = 1.442 -2.320; P < 0.05), houses with kitchen not separate (OR = 1.829, CI = 1.442 -5.481, P < 0.05), and using cooking fuel other than LPG (OR = 2.063; CI = 1.615-2.634; P < 0.05) Conclusion: Besides sensitizing mothers on childhood nutritional (exclusive breast feeding and early / delayed weaning) and immunization the role of environmental /housing variables (Poor ventilation, over crowding, combined kitchen and use of cooking fuel other than LPG) need attention.

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