Chikungunya Fever: A Killer Epidemic in Ahmedabad City, India

Background The Chikungunya virus is an alphavirus native to tropical Africa and Asia and is transmitted to humans by the bite of infected Aedes mosquitoes. The symptoms of Chikungunya include sudden onset of fever, severe arthralgia, and maculopapular rash. Thirty percent of the population on the French R�union Island was afflicted with Chikungunya in the past year. They reported 237 deaths. India on the other hand reported 1.39 million cases of Chikungunya but no deaths. Methods Mortality data from 2002-2006 was obtained from the Ahmedabad Municipal Corporation (AMC). Actual mortality rate of 2006 was compared to the mortality rate of 2002-05 and its statistical significance tests were carried out. Findings Mortality data obtained from the Ahmedabad Municipal Corporation (AMC) suggests that 3112 excess deaths occurred in August-November (epidemic period) compared to the average deaths in the same months during the previous four years. These differences in deaths were found to be highly statistically significant. A peak in excess mortality is seen in the month of September when 1489 additional deaths were recorded. Case fatality rates for Ahmedabad also turn out to be much higher than that of the Reunion Island. Interpretation The Chikungunya epidemic was raging when the excess deaths occurred. There were no other adverse events or other epidemics that took place could explain this excess mortality. Government authorities, WHO and other international public health agencies should take these findings of excess mortality seriously and investigate into this occurrence of excess deaths to understand this reemerging disease and prevent future epidemics and mortality.

Increased Mortality Rate Associated with Chikungunya Epidemic, Ahmedabad, India

A total of 3,056 excess deaths epidemiologically linked to chikungunya occurred in 2006

A comparative study of direct health intervention and peer-led intervention on menstrual hygiene management of adolescent girls in rural India

Background: Menstrual hygiene management (MHM) among adolescents in rural India is negatively influenced by myths and taboos which predispose them to infections which can be dispelled by health education by experts or peers. The study aimed to demonstrate the relative effectiveness of direct health education over peer led health education on MHM.Methods: A longitudinal follow up intervention study recruiting 486 school going adolescent females divided in three groups I, II and III was conducted. Group I received peer led, while group II received direct health education and group III was control. Pre and post intervention scores of participants were compared.Results: Direct intervention group demonstrated highest improvement in number of participants having good MHM scores (p&lt;0.05). Mean MHM scores of direct intervention group participants were the highest among all the three groups (p&lt;0.05). Knowledge score of direct intervention group was significantly higher than group 1 (p=0.001) and group III with no difference in practice scores between group I and II (p=0.147).Conclusions: Direct health education as an intervention is more relatively effective than peer led in MHM of adolescent females.</jats:p

Socio-cultural barriers for menstrual hygiene management among adolescent school girls of southern India

Background: India is home to 20% of the world’s adolescent population, with 1 in 10 children currently experiencing puberty. Menstruation, a physiological process in females is influenced not only by race, nutrition and heredity but also by the socio-cultural milieu. In Indian society, the social and cultural restrictions influence the knowledge, attitudes and the practices of adolescent girls towards menstrual hygiene. The present study was carried out to find out the level of knowledge, attitude and practice and the restrictions they face during the process of menstruation.Methods: The study was a descriptive cross-sectional study where 489 adolescent school going females of the age group of 13-15 were recruited using simple random sampling from a cluster of schools and interviewed using a semi structured questionnaire for their knowledge, attitudes, practices and the restrictions they face during menstruation. A scoring system was adopted and categorised as poor, average and good.Results: 423 (88.6%) participants demonstrated average to poor knowledge scores, while 279 (57.1%) participants demonstrated average to poor practice scores. There was a significant difference observed between the educational status of mother (p=0.041) and the knowledge scores of study participants. There was no correlation observed between the monthly per capita income of households and the knowledge (r=0.097) and practice scores (r=0.0034). 375 (76%) study participants faced multiple restrictions during menstruation like not allowed to pray or visit temples (93.6%), total seclusion (74.6%), wash clothes separately (74.6%), sleep on floor (74.6%), restriction on leisure (70.4%), eat out of separate utensils (70.4%), and restriction on consumption of food items (49.8%).Conclusions: Knowledge and practices regarding menstrual hygiene was low among study participants and was influenced by various prevalent socio-cultural restrictions. </jats:p