Filariasis is a major public health problem in India and inspite of existence of the National Filaria Control Programme since 1955, currently there may be up to 31 million microfilaraemics, 23 million cases of symptomatic filariasis, and about 473 million individuals potentially at risk of infection. Over the last 10 years advances have led to new diagnostic/ treatment tools and control strategies for filariasis. The new control strategy aims at transmission control through mass treatment and at disease control through individual patient management. As a signatory to 50 th World Health Assembly resolution on global elimination of lymphatic filariasis in 1997, revised filariasis control program was launched in India in 13 districts in seven endemic states where mass drug administration was undertaken. Single dose mass administration annually in combination with other techniques has already eliminated lymphatic filariasis from Japan, Taiwan, South Korea and Solomon Islands and markedly reduced the transmission in China. Very high treatment coverage (probably > 85%) is required to achieve interruption of transmission and elimination in India. Hence, there is an urgent need for effective drug delivery strategies that are adapted to regional differences. This requires powerful advocacy tools and strategies as well as procedures for monitoring and evaluating the impact of elimination programme.
Emerging organisms are likely to evade routine identification or be disregarded as non-contributory. Astute efforts directed at identification of emerging isolates, decisions by clinical microbiologists and treating physicians and containment of infection are required.
HIV/AIDS can cause malnutrition directly and also indirectly through opportunistic infections (OIs). Infectious diarrhoea and tuberculosis are the commonest OIs linked to malnutrition in HIV/AIDS. Environmental enteric dysfunction has now been identified to play a significant role in HIV-malnutrition. Food insecurity is bidirectionally associated with aggravation and perpetuation of HIV infection. Increasingly, drugs used in antiretroviral therapy have been recognised to lead malnutrition in many ways. Both HIV and malnutrition are most prevalent in the poorest areas of the world, and there is a convergence of etiological factors. Malnutrition depresses every aspect of immune function. Deficiency of key micronutrients like iron, folic acid, zinc, selenium and vitamins A, C and D also adversely affects immune function. Recent research has led to a greater understanding of these mechanisms. Immune dysfunction secondary to malnutrition is referred to as nutrition-associated immunodeficiency. Hence it is easy to surmise that malnutrition and HIV/AIDs are a deadly duo.
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