CONTENTS

1.   Introduction           Organisation Chart           NICD Faculty/Administration/Staff           Budget at a Glance (1997)

2.   Objectives and Functions of the Institute

3.   National Health Programmes           National Surveillance Programme for Communicable Diseases (NSPCD)           Guinea Worm Eradication Programme (GWEP)           Yaws Eradication Programme (YEP)

4.   Scientific and Research Activities        Headquarters           Division of AIDS & HIV           Division fo Biochemistry/Biotechnology           Division of Epidemiology           Division of Helminthology           Division of Microbiology           Division of Medical Entomology/Vector Control           Division of Training & Malariology           Division of Zoonosis        Branches           Alwar           Bangalore           Calicut           Coonoor           Jagdalpur           Patna           Rajamundry           Varanasi

5.   Manpower Development/Training Courses, Workshops, Seminars

6.   Outbreak Investigations

7.   Participation in Conferences, Workshops, Seminars and Symposia

8.   WHO/Other International Fellowships

9.   Membership of Expert Committes/Advisory Panel/Honours

10. Important Visitors during the Year

11. Publications/Presentations

Annexures           Central Library           Central Animal Facility

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NICD Branch, Calicut

The Regional Filaria Training & Research Centre, Calicut established in 1955 is now functioning as Branch of the Helminthology Division of the National Institute of Communicable Diseases, Delhi. A field station of the Centre, B.Malayi Research Unit is functioning at Cherthala, Alleppey District. Research studies on biochemical, clinical, epidemiological, entomological, immunological, socio-economic and therapeutic aspects of Lymphatic Filariasis, both Wuchereria bancrofti and Brujia malayi are undertaken in the Centre and its field station at Cherthala. Diagnostic and referral services on filariasis are provided to Public and Medical Institutions. Teaching and training on filariasis and its control are imparted to Medical Officers/Biologists, Inspectors/Technicians and other field staff employed under National Filaria Control Programme in the country. Short duration lecture cum demonstration classes on filariology are also given to students of Medical Colleges. School of Nursing and Trainees of Health and Family Welfare Training Centre.

Routine services/activities and maintenance of stock cultures of various animals pathogens and parasites

Supply of preserved material

Supply of other material – like normal and infected blood, media, strains etc.

Mahatma Gandhi Institute of              –          Microfilaraemic blood samples

Medical Sciences, Wardha

Diagnostic services

Biochemical, Microbiological and Immunological diagnosis of blood and urine

Night blood examination for microfilariae

Public health and other bacteriological, biochemical services

Routine Biochemistry, Microbiology and immunodiagnosis of filarial cases Immuno diagnosis for filarial antibodies in serum of patients for early detection of filarial infection.

Filaria survey in Lakshadweep Islands

Clinico parasitological and entomological surveys were conducted at Kavaratti, Androth and Minicoy islands of Lakshadweep to find out the long term effect of DEC medicated salt during April’May 1997.

The studies indicate that the mf rate and disease rates remain very low even after 17 years of DEC medicated salt distribution to the entire population of Lakshadweep islands. Aedes aegypti, As. Albopictus, anopheles subpictus, An. Vagus and Armigeres subalbatus were also encountered during this survey. Minicoy island is still free from filariasis.

Aedes larval survey in Calicut Corporation

Aedes larval surveys were carried out in Calicut Corporation area during Sep. 1997. The house index and container index of Ae.aegypti were 43.16 and 31.03 respectively. The house and container index of Ae.albopictus were 6.55 and 4.59 respectively. Cross checking of blood smears received from various NFCP Units in Kerala State revealed 886 negatives and 71 positives. 3710 filarial patients who attended the day clinic at this Centre were given treatment.

Research Projects

1.     Review of B. malayi filariasis in Kerala State

The objective of the project is to assess the present status of Brugia malayi filariasis in Kerala state. The project initiated during 1994 was continued during the reporting year also. Clinico-parasitological and entomological surveys were carried out from erstwhile endemic pockets of Brugia malayi in Kerala State.

          Clinico-parasitological data 1994  - 1997

Both B.malayi and W.bancrofti infections were encountered from Cherthala and Alleppey Municipal areas, however B.malayi is still the predominant species in these pockets.

Mansonia anmulifera is the predominant species than that of M.uniformis. Culex quinquefasciatus was also encountered in fairly good numbers from all the places surveyed. Infective larvae were found from M. annlifera and M.uniformis.

2.     Studies on the epidemiology of filariasis in the ethnic hill tribal community of Kerala State

The objectives are (1) to undertake clinico-parasitological and entomological surveys in hill tribal settlements of Trivendrum, Quilon and Pathanamthitta districts to find out the type of infection and its vectors and (2) to undertake in-depth epidemiological and entomological studies in filariasis in some selected settlements. This project was initiated during 1995. Clinico-parasitological and entomological studies were conducted in 8 hill trial settlements of Trivandrum and Quilon districts from 1995-1997. The details are given in table below.

B.malayi is the only type of filarial infection prevalent among the hill tribal settlements. Mansonia uniforms is the vector of filariasis in these settlements and infected M. uniformis were encountered from one settlement.

Clinico-parasitological details of tribal settlements

Mansonia uniformis egg clusters and larvae were found form the leaves and roots respectively of some aquatic grasses. In addition to M.uniformis six specifies of culicine and six species of anopheles were encountered from these settlements. This project is continuing.

3.     Effect of continuous DEC administration on chronic lymphatic filariasis

The objectives of the study is to find out the effect of continuous DEC administration on the occurrence, frequency, duration and intensity of acute attacks and in reducing lymphodema and elephantiasis in chronic lymphatic filariasis.

Chronic filaria cases (W.bancrofti) attending the clinics conducted in the RFT & RC were selected for the study. The patients were divided into three groups A, B, C and given DEC at a dose of 100 mg. 200 mg and 300 mg. Daily continuously for a period of one month. They were asked to report again after one month and those who reported at monthly intervals were reviewed, observations recorded and given further treatment on monthly basis.

In addition to the patients given treatment in the previous years, new cases were selected and given treatment with different dosages of DEC during the year. The details are shown below in table.

The observations of the study shows that all the dosage of DEC are helpful in reducing the frequency and intensity of acute episodic attacks of the disease, 300 mg dosage of DEC appears to be better among the three dosages tried.

Detailed analysis of the data has been taken up and definite conclusion can be given only after data analysis.

4.     Effect of Diethylcarbamazine (DEC) chemotherapeutic treatment on renal, liver and pancreatic functions of filarial cases – A local population survey

The project has started in May 1997 with the following objectives (i) to investigate the level of blood urea, serum creatinine, uric acid, calcium and inorganic phosphorus (renal function tests) in filarial cases before and after DEC treatment (ii) to investigate the levels of blood glucose in filarial cases before and after DEC treatment (iii) to investigate the levels of serum aspartate transaminase (SGOT) Alanine transminase (ALT), Alkaline phospharase, Bilirubin, total serum protein and albumin (liver function tests) in filarial cases before and after DEC treatment (iv) to study the effect of long term DEC treatment on renal, pancreatic and liver functions in filarial cases.

For this study 20 new cases (both mf positive and / or symptomatic) as well as 20 chronic cases were selected. The blood samples were collected and analysed for various biochemical, and haematological parameters. The results obtained so far revealed that (1) in 20 chronic patients taking DEC continuously for the last > 5 years, 3 were found diabetic (blood fasting glucose level > 130 mg %) 6 with hyper cholestrolemia (serum cholesterol ? 250 mg %) and 1 with uremia (blood urea > 45 mg %) other biochemical parameters e.g. Serum, uric acid, A/G ratio, serum calcium and phosphorous levels were found to be normal.

Alkaline phosphatase was elevated in 2 patients wheras SGPT in 1 patient only. Only one patient demonstrated albuminuria. Haematological investigation revealed 2 chronic patients with anaemia (Hb < 12.0 g%), surprisingly 18 patients with raised ESR ( 5 – 35 mm/Hr.) (>7 mm/Hr. westergen method) and 10 with mild eosinophilia (>7%) other haematological parameters including TLC, P, L, M and B were not found to be significantly altered. Out of the these 20 patients, 18 had sufferd acute attack of filarial fever at the onset of infection with lymphagitis and lymphadenitis. Presently 19 patients had lyphoedema of extremeities and 1 with elephantiasis of right leg.

In 20 newly diagnosed cases 11 cases were found mf positive, 4 cases filarial antibodies positive and 5 cases clinically symptomatic. Biochemical investigation revealed 2 patients diabetic (Fasting blood sugar > 130 mg %), 3 patients with hyper uricemia (>7 mg %) with most other parameters not significantly altered. Haematological investigation revealed 3 patients with anaemia (Hb < 12.0g %) 14 with initially raised ESR (> 7 mm/hr, Westergren method) and 10 with mild eosinophilia. Other haematological parameters were found not to be significantly altered.

The studies on the same new cases after 12 days standard 6 mg/kg body weight DEC treatment is under progress.

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