BackgroundFollowing the World Health Assembly resolution on Elimination of lymphatic filariasis (ELF) as a public health problem by the year 2020, a Global Program (GPELF) was launched in 1997 to help endemic countries to initiate national programs. The current strategy to interrupt transmission of LF, is administration of once-yearly, single-dose, two-drug regimen (Albendazole with Diethylcarbamazine (DEC) to be used in endemic areas with the goal of reaching 65% epidemiological coverage for 4–6 years. We report findings of independent assessment from year 2010 to 2015 for last six rounds, after initial five rounds of Mass Drug Administration (MDA) since 2005 for ELF in endemic area of Gujarat.MethodsIndependent assessment of MDA was performed to find coverage and compliance indicators, reasons for non-coverage and non-compliance in five Implementation Units (IUs). Pre, during and post MDA evaluations were done in three phases. The impact of MDA was measured by microfilaraemia survey. A total of eight sites, four random and four fixed sentinel sites were selected to calculate microfilaria rate (MF) per IUs per year. In years 2010 to 2015, we report results from 125,936 nocturnal blood smears and 17551 population in 120 selected clusters. Four clusters were selected per year in each of the five IUs for assessment of MDA round.ResultPost MDA survey showed drug coverage between 81%-88% and epidemiological coverage 77%-89% across years. Main reasons for non-coverage were drug administrator related (the team did not visit or missed people) while non-compliance was population related (fear of side effects, sickness, people forgot or absent). During MDA findings show that the directly observed consumption is considerably improved from 58% in 2010 to 82% in 2015. The knowledge about benefits of drug provided also increased from 59% to 90% over the years. The current MF rate is less than one in all IUs with an overall 68% percent decrease from baseline year 2005 to year 2015. The average MF rate of Gujarat is 0.44 for year 2015.ConclusionsThe findings show that achieving adequate epidemiological and drug coverage is possible by actual field level operation of the program in large endemic areas. The results and feedback from independent assessment, performed regularly, could guide the policymakers and program managers for mid-term corrections and to frame strategies to enhance program. Monitoring of coverage and impact indicator together informs decisions for reaching end-point of MDA. The impact indicator- microfilaria rate in all IUs of South Gujarat Region has reached and remained less than one percent signaling end-points of MDA. Post MDA stringent monitoring in form of TAS is recommended to keep vigil on maintenance of elimination achieved.
Background: Sickle cell anaemia is widely distributed in African and American negroes. It also seen in Arabian peninsula, Indian Subcontinent and parts of Europe. A high prevalence has been demonstrated in various tribal communities of Gujarat. Aims & Objective: To assess Knowledge, Attitude and Practice about sickle cell anaemia in patients with positive Sickle Cell Status. Materials and Methods: Cross Sectional Observational Study from June 2010 to May 2011. 276 patients with purposive sampling in Bardoli Taluka having sickle cell positivity in age group of 18 to 30 years were taken.Results: Only 16% of the study participants knew correct symptoms of Sickle cell anaemia. 30 % patients were availing the treatment of some kind. It was observed that females were more active as compared to males in taking medication for Sickle Cell Anaemia and the difference between them was found to be significant. It was found that 96 % of the study participants had received Color coded cards after testing showing the high accomplishment of mass screening programs in identifying Sickle Cell Status by simple means. But approximately 90% didn't know the cause of disease and only 52 (18 %) were counselled about this disease. More than 95% of the participants were unaware regarding their haemoglobin status. Conclusion: All the strategies for the prevention of this outrageous disease will be effective only if they are utilized to its maximal extent by creating more awareness to the affected and also the other population.
Background: Iodine is an essential micronutrient required for normal human growth and development as it is needed for the synthesis of thyroid hormones produced by thyroid glands. The sicknesses occurred due to deficiencies of iodine in the nutrition are termed iodine deficiency disorders. Urinary iodine concentration is the prime indicator of a person’s nutritional iodine status. So, the aim of this study was to assess the status of iodine deficiency based on median urinary iodine excretion.Methods: Community based cross sectional study was carried out among purposively selected primary schools of the Dang district. All students between the age group of 6 to 12 years who were present on the day of visit were included in the study. A total 387 urine samples were collected during the period of August 2015 to September 2016.Results: Based on median urinary iodine excretion, among total analysed samples, about 6.5% samples confirmed severe iodine deficiency, 22% samples showed moderate iodine deficiency and about 36% samples indicated mild iodine deficiency. About one third (31.3%) samples suggested optimum iodine intake. Only few samples (4.4%) revealed more than required iodine intake.Conclusions: About one third (31.3%) of the surveyed population had adequate iodine intake while majority (64.4%) of them had inadequate iodine intake.
Purpose: Women living with human immunodeficiency virus (WLWH) have a higher risk of cervical cancer than women without HIV. In addition, women in India experience a high burden of death from cervical cancer. This qualitative study evaluated individual and interpersonal factors influencing cervical cancer screening among WLWH in Surat, India. Methods:In-depth interviews were conducted with 25 WLWH and 15 stakeholders in Surat, India. Data were analyzed using directed content analysis to identify individual and intrapersonal barriers and facilitators.Results: WLWH lacked knowledge and reported being afraid of cervical cancer and cervical cancer screening but were interested in learning more about it. Interpersonal factors influencing cervical cancer screening included receipt or lack of instrumental and emotional family support, interactions with healthcare providers, and receipt or lack of information about cervical cancer and the Pap test from healthcare providers. Conclusion:Widespread public education is necessary to increase awareness of cervical cancer and cervical cancer screening and to encourage family members to support women who wish to obtain screening. Patient-and provider-focused interventions may facilitate the process of
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