|
|
National Institute of Communicable Diseases |
|
||||||||
|
|||||||||
 | |||||||||||
|
|||||||||||
ANNUAL REPORT 1997 |
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Division of
Helminthology Division
of Helminthology came in to being as a result of re-organiation of the
erstwhile Filaria Division. The activities were expanded to include helminthic
diseases of public health importance like Dracunculiasis & Intestinal Parasitic
Infection. The division has public health specialists and entomologists as
staff and is responsible for coordinating the activities of three of NICD
Branches in filaria endemic areas namely Calicut, Rajahmundry & Varanasi as
Regional Filaria Training and Research Centres. The main responsibilities of
the division are in providing support to National Filaria Control Programme
(NFCP) in carrying out operational research for improvement in the NFCP;
control of Intestinal Parasitic Infection (IPI) and National Guinea Worm
Eradication Programme (GWEP) for which the division is the nodal point in the
country. The Central Survey Team (CST) attached to the Division under takes the
delimitation surveys for filariasis in the non-endemic States. The Division has
contributed 450 Scientific papers in the field of Epidemiology, Chemotherapy,
Entomology and control aspects of Lymphatic Filariasis, Dracunculiasis and IPI.
The Division is adequately equipped for the Parasitological studies and has
adequate computer facilities for data compilation, analysis and retrievals
services. Filariasis Diagnostic services: Patients referred from various
hospitals in Delhi were screened for microfilaraemia. Cross-checking of Blood
smears and on sample basis from State NFCP units by quality assurance. Therapeutic Services: Referred filaria patients from
various hospitals were given the treatment. Maintenance of Vector Colonies:
L.carinii, D.immitis, D.repens, B.malayi (human strain) were being maintained in the
laboratory in dogs, white rats and jirds, Vector Cx quinquefasciatus was also being maintained for sustaining the above
stated animal filarial strains. Supply of infected blood, media, strain, teaching material Prepared
blood smears positive for microfilaria of W. bancrofti & B. malayi
infection have been supplied to various research institutes. 600 blood smears
of D. immitis and D. repens were supplied to the All India Institute of Medical
Sciences, University college of Medical Sciences, Guru Teg Bahadur Hospital, Maulana
Azad Medical College, Lady Harding Medical College and other institutions in
Delhi and Medical College, Calicut for teaching purposes to undergraduate
students. Guinea worm education material and manuals provided to State Govt.
and to medical institutions on request. Intestinal Parasitic Infections Examination of Voluntter stool
samples: From Jan
97 to May 97, a total of 214 volunteer stool samples were examined for
helminthic and protozoal infection. Out of which 152 were found positive for
one or more intestinal parasitic infection. Research Projects 1. To study the Bio-ecological
aspects of Cx.quinquefasciatus in relation to transmission of lymphatic
filariasis in and around Delhi During
the year under report the aquatic as well as the adult collection of Cx.quinquefasciatus was made from
north-east, north-west, south-west and South Delhi areas. Cx-quinquefasciatus was found profusely breeding in the months of
March/April and Sept./Oct. in domestic drains, pools, Septic tanks and low
lying areas especially in slums/resettlement colonies. A maximum of 686 and a
minimum of 98 per ten man hour density was reported from Northeast and South
Delhi areas in the months of April and November,97. Altogether 1200 adult
females were dissected for the detection of developmental stage of human
filaria parasite, however, none of them was found to be positive for the
filaria parasites. Study is likely to continue from other areas during 1998
targeting resettlement colonies/adjacent industrial towns which attract cheap
labour from endemic areas. Apart from ecological studies, night blood surveys
will be extended to these areas for monitoring the transmission of lymphatic
filariasis. 2. Monitoring of filariasis
transmission in endemic/ non endemic areas Under
the National Filaria Control Programme the Central Survey Team undertakes
delimitation surveys in hitherto filaria non-endemic areas, and also in army
and railway establishments. Five such surveys were undertaken in 1997. Parasitological
and entomological observations of filaria surveys during 1997
Four Islands
Chowra, Kamotra, Non Cowry and Terrasa were targeted for survey. In all four
islands diurnally subperiodic form of W.
bancrofti mf. Was noticed. Since these islands are closed Islands and the
community is also motivated, a single annual mass therapy with DEC could be
attempted on this strain which is different from the main land strain. The
impact of mass drug administration could be assessed 3-5 years after cessation
of this regimen. 3. Intestinal Parasite Infection
(IPI) Survey The
Division undertakes Intestinal parasitic surveys in urban and rural areas of
various parts of the country to estimate the prevalence of Intestinal Parasitic
Infections. During 1997, three such survey were carried-out. The brief results
of the surveys are give given in table below :
AL-Ascaris
lumbricoides GL – Glardia lambia EH – Entamboeba histolytica EC-E coli, EN-E,
nana HN-H, nana TT - Trichuris trichria TN - Tinea
solium EV - Entamoeba vermiculasis IB-HW-Hook worm 4. Efficacy and operational
feasibility of different DEC prophylactic regimen delivered through community
in bancroftian filariasis endemic rural areas A
Multi-centric project is in operation at Rajahmundry, Varansari and Calicut
with the objedctives to evaluate the efficacy of three different mass DEC
regimens against bancroftian delivered through community in the endemic rural areas.
The purposes of the study is operational feasibility of involving head of the
family in delivery of DEC tablets to the house holds members, to study the
compliance to DEC regimens and the nature of their side reactions among the
individuals. Four
villages with similar base-line mf rate of 4% and above were selected for the
study. In three villages, A,B and B1 mass DEC treatment was given and the
fourth village ‘C’ was kept as control. In village ‘A’ a weekly dose of 25 mg
of DEC was given to every children below 10 years and 50mg to persons above 10
years. In village ‘B’ single dose mass therapy with 6mg of DEC per kg body
weight was given for six months and in village B1 a single annual dose of DEC
6mg per kg body weight was given for 2 years. In the control village a placebo
was given. The study population was educated on various aspects of filariasis
and expected side reactions to DEC administration for their better co-operation
and involvement in the project.
Base-line
clinco-epidemiological surveys were carried out in all the four villages before
drug administrator. Follow-up surveys were carried out at 6, 12 and 24 months
intervals. Further follow-up surveys at 36, 48 and 60 months interval in all
the villages will be taken up to evaluate the efficacy and operational
feasibility of the DEC regimen
delivered through community. A
comparative review of clinico-parasitological & entomological indices of
baseline & follow-up surveys indicated that there was decrease in mf. Rate
in the study villages. However there was considerable decrease in mf density in
villages B (bi-annual regimen). In 1st round of monitoring of drug
compliance revealed that in Rajahmundry 24.8% of families had defaulted and in
Varanasi 17.3% families had defaulted in taking Dec. Adverse reactions were minmal, and were noted in 22 individuals in village B (6 monthly regimen) and in 48 individuals in village B1 ( annual regimen ) and were confined to nausea and GI disturbances. 6, 12, 24, 36 & 48 monthly follow-up of the study subjects is in progress. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
