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Diseases Explanation
Diseases Explanation
Rotavirus is the most common cause of severe diarrhoea among infants and young
children and is one of several viruses that cause infections often called stomach flu,
despite having no relation to influenza. It is a genus of double-stranded RNA virus in
the family Reoviridae. By the age of five, nearly every child in the world has been
infected with rotavirus at least once. However, with each infection, immunity
develops, and subsequent infections are less severe; adults are rarely affected.
There are five species of this virus, referred to as A, B, C, D, and E. Rotavirus A, the
most common, causes more than 90% of infections in humans. The virus is
transmitted by the faecal-oral route. It infects and damages the cells that line the
small intestine and causes gastroenteritis. Although rotavirus was discovered in
1973and accounts for up to 50% of hospitalisations for severe diarrhoea in infants
and children, its importance is still not widely known within the public health
community, particularly in developing countries. In addition to its impact on human
health, rotavirus also infects animals, and is a pathogen of livestock.
Close to one lakh children below the age of five years died of diarrhea attributable
to rotavirus infection in 2008, accounting for 22 per cent of the total deaths reported globally. Efficacy trials were still on in India on the rota viral vaccines and till
these trials are over there is little data to prove the efficacy or otherwise of these
new vaccines. Secondly and critically, these patented vaccines are so far being
produced by a handful of private pharmaceutical companies and are hugely
expensive. Introducing these vaccines in the public health system will involve huge
resources.
Update: the Department of Biotechnology (DBT), Program for Appropriate
Technology in Health (PATH), Bharat Biotech (BBIL) and National Institute of Health
(NIH) have jointly developed Rotavirus Vaccine in India. ROTAVAC which is
developed under this endeavour will be produced on an affordable cost of $1 per
dose against the currently available vaccines developed by pharma MNCs which
cost $45 per dose. This this a true model of successful global partnership between
India and USA; involvement of international funding agencies like PATH; scientific
experts and appropriate industrial partner; and inter-ministerial involvement with
active participation of ICMR, M/o Health & Family welfare. The vaccine has already
shown very positive results in Phase III trial.
This will indeed be the first-ever truly Indian vaccine: an Indian strain, an Indian
manufacturer, clinical trial data in the Indian context and funding by the Indian
government. Two foreign vaccines have already been licensed for marketing in
India: Rotarix of GlaxoSmithKline and RotaTeq of Merck. They have already been
introduced in more than 40 countries.
Non-communicable diseases
Big killers
Non-communicable diseases such as diabetes and high blood pressure lead to
cardio-vascular diseases and cancer. There is a shift away from risks for
communicable diseases in children to-wards those for non-communicable diseases
in adults. The three leading risk factors for global disease burden in 2010 were high
blood pressure, tobacco smoking, including second-hand smoking, and alcohol
use. Outdoor air pollution in the form of fine particles is a much more significant
public health risk than previously known. Other NCDs are hypertension, chronic
respiratory diseases, cholesterol, abdominal obesity, and tobacco and
alcohol use.
The non-communicable diseases are the leading causes of preventable morbidity
and disability, and currently cause over 60 per cent of global deaths, 80 per cent of
which occur in developing countries. By 2030, the NCDs are estimated to contribute
to 75 per cent of global deaths.
Much of the burden of non-communicable diseases is linked to the consumption of
tobacco. While tobacco and alcohol are receiving close scrutiny as key factors
influencing disease burdens, including cancer, the role of ultra-processed packaged
food is not getting the attention it deserves. Alcohol, and ultra-processed food and
drink (which are energy dense but nutrient poor).
poverty that occur in overcrowded, remote and poor areas. They received less than
$10 million each.
. Serum Institute of India was the first institution globally to create a meningococcal
A-vaccine. Similarly, the Hyderabad-based Shantha Bio-technics Ltd. had launched
an oral vaccine for preventing cholera. While mass drug-administration programmes
for lymphatic filariasis, worms and leprosy could help completely eliminate these
NTDs. A good example of international coordination in this regard was a partner-ship
between India, Bangladesh and Nepal in a drive to control leishmaniasis, which
occurred heavily in the border areas between these nations.
Pneumonia
Pneumonia continues to be the number one killer of children around the world
causing 18 per cent of all child mortality, an estimated 1.3 million child
deaths in 2011 alone, according to UNICEF figures. Nearly all pneumonia
deaths occur in developing countries. India leads the global mortality rate of
pneumonia deaths in children under-five years of age. In 2010, 3.96 lakh
children died of pneumonia in the country, of which 7 per cent die of flurelated pneumonia.
The Global Action Plan for Prevention and Control of Pneumonia
(GAPP) target was announced by the WHO and UNICEF in 2009 for
interventions in three areas: vaccination, breastfeeding and access to care
and antibiotic treatment. If 90 per cent of coverage is reached, these
interventions could prevent two-thirds of all childhood pneumonia deaths.
15 developing countries account for three-quarters of the worlds total
pneumonia deaths. According to the IVAC report, none of the 15 countries
have reached the 90 per cent GAPP target.
Only 46 per cent of children receive exclusive breastfeeding for the first six
months in India. Though 69 per cent children suspected with pneumonia are
taken to an appropriate health care provider, only 13 per cent receive
antibiotics.
Preventing pneumonia is essential to achieving Millennium Development
Goals of reducing under-five mortality goal.
One notable area of progress is on the coverage of two vaccines that can
help prevent pneumonia, the Hib vaccine and the measles vaccine.
While the Hib vaccine uptake has been slow in Indias public sector, the
momentum is now shifting. This has been possible following efforts to add
Hib to the Universal Immunisation Programme (UIP). Two States, Tamil
Nadu and Kerala have already introduced the Hib vaccine (in the form of
pentavalent vaccine) last year, and six more States will do it shortly.
As another positive signal, India has joined other WHO member states in
introducing a second dose of measles vaccines into the UIP to ensure
that its children are protected from the virus, which contributes to the burden
of pneumonia.
Measles was once one of the leading causes of death among children, but
global measles deaths have declined dramatically because of the widespread
coverage of two doses of measles vaccine. India began a phased introduction
of the second dose in 2010. By the end of the first year, the second dose of
measles vaccine had been added to routine immunisation in 21 states and
catch-up campaigns were completed in 197 districts in 14 states, according
to the report.
While India has made considerable stride in introducing the Hib vaccine, it
still has much to do to strengthen its comprehensive approach in fighting
pneumonia infection, including introduction of a pneumococcal conjugate
vaccine.
Cancer
NCRP
The NCRP was started in 1982 with three population-based cancer registries
and three hospital-based cancer registries which has now expanded to 27
population-based and nine hospital-based registries, and 17 collaborating
centres under Patterns of Care and Survival Studies in addition to scores of
other institutions connected with the Centre.
The National Cancer Registry Programme has developed a cancer atlas
forIndia as well as Punjab where the burden of cancer is very high,
particularly in the Malwa region. The incidence of cancer is also high in the
North Eastern states.
Over the years the network of NCRP has widened and it now receives primary
data on cancer from various sources. As of now, the estimates of cancer are
based on incidence rates of six older urban registries. But now with the
NCDIR in place and expected to be connected with all 154 medical colleges in
the country in the 12th Plan, more accurate data would be made available.
The main objective of Bangalore-based National Centre for Disease
Informatics and Research (NCDIR)is to develop a national research data-
Encephalitis
The enteroviruses are second only to the "common cold" viruses, the rhinoviruses,
as the most common viral infectious agents in humans. Enteroviruses can be found
in the respiratory secretions (e.g., saliva, sputum, or nasal mucus) and stool of an
infected person. Other persons may become infected by direct contact with
secretions from an infected person or by contact with contaminated surfaces or
objects, such as a drinking glass or telephone. Parents, teachers, and child care
center workers may also become infected by contamination of the hands with stool
from an infected infant or toddler during diaper changes. It enters the body through
the gastrointestinal tract and thrives there, often moving on to attack the nervous
system. The polioviruses are enteroviruses. In addition to the three different
polioviruses, there are 61 non-polio enteroviruses that can cause disease in
humans.
The JE disease affects mostly children below the age of 15 years, of which 25
per cent die, and among the survivors about 30-40 per cent suffer from
physical and mental impairment. Between 70 and 75 per cent of the cases
are from Uttar Pradesh.
The disease burden is high in 171 districts, spread across 19 States-Tarai
region of Poorvanchal, esp. Gorakhpur district as its nucleus,
The disease is also endemic in areas where paddy is cultivated, as this crop
needs large amounts of water. Flooding of low-lying areas following
unseasonal rains and cyclonic storms also leads to mosquitogenic conditions.
The epidemic is amplified by the presence of large numbers of pigs, which act
as hosts.
One can expect JE-type epidemics year after year in States where prolonged
drought-like conditions are followed by heavy monsoons. In scrub forests
conducive to the nesting and breeding of Ardeid birds, heavy rains result in
large water pools with algal growth. In peninsular India, one canfind such
waterbodies in large numbers; egrets and herons are seen nesting and
feeding in them. These waterbodies simulate the conditions existing in paddy
fields. They are ideal for the breeding of the JE vector. The mosquitoes, the
avian hosts and the human victims in the adjacent villages with their cattle,
poultry and pigs provide the deadly setting for an outbreak of JE.
Experts estimate that up to 30,000 people may have been left disabled by
the diseases since they were first detected in 1978
Issues
Solution
Prevention through vector control, behavior modification etc is likely to be the more
effective approach to curb the spread of encephalitis in India.
Draw up a tailor-made curriculum for children with special needs and also set
up special schools and training centres in 60 districts based on the needs of
affected children.
special measures to train and sensitise anganwadi workers and their
supervisors regarding JE/AES,
additional take-home rations to moderately undernourished children enrolled
under the Integrated Child Development Schemes in these districts.
install deep bore hand pumps, mini water supply schemes in habitations
where JE/AES cases are reported, ensure solid and liquid waste management
and provide water-quality testing of all public sources in all the affected 60
districts along with sample testing for virological examination.