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B C Deb

Publications and source records attributed to B C Deb.

At least 19 recordsLinked to original sources

Injection drug use in Calcutta: a potential focus for an explosive HIV epidemic.

Our objective was to assess HIV risk perceptions, risk behaviours and factors that may facilitate an increase in injection drug use in Calcutta. Focus group discussions and in-depth interviews were conducted with a selected group of drug users to delineate drug use patterns, languages used to express addictive and related experiences and acceptance of harm minimization messages. Results from these were used to develop a semi-structured interview instrument which was used to interview 111 drug users (76 IDUs and 35 non-IDUs) recruited from jails and detoxification centres. Secondary data of narcotic seizures for the last 5 years were collected from the Calcutta police department. Data on percentage of IDUs admitted to large detox facility in the city was also collected. Findings show that HIV/AIDS knowledge and risk perceptions were low; sharing of injection equipment was reported by 66% of the injectors; and condom use was insignificant. Non-availability, rising cost and increasing tolerance to heroin were cited as factors contributing to switch to injection. Ecological association was found between intensified police activity and an increase in: the amount of smokable heroin seized; increased injection of buprenorphine; and admission to detoxification centres. In addition to HIV, IDUs were also found to be prone to hepatitis B and C. The findings suggest an urgent need for developing and implementing community-based HIV prevention interventions targeting drug users in Calcutta.

Journal Article↗

Reaching out beyond the hills: HIV prevention among injecting drug users in Manipur, India.

Outreach interventions using ex-IDUs to inform and educate their peers about HIV/AIDS prevention measures have been found to be effective in the United States and other developed countries. While HIV/AIDS prevention programmes targeting IDUs have also been implemented in a number of developing countries, very little information is available on the process of implementation of these programmes. This paper attempts to document some of this knowledge by describing the implementation process of an outreach intervention targeting IDUs in a small town--Churachandpur--with high injection drug use and high HIV infection rates, in the north-eastern state of Manipur. The paper describes the barriers encountered in implementing the outreach and how these barriers were minimized. In conclusion, the paper makes the case for targeting outreach to the larger community before targeting the IDUs.

Developing Countries↗

Epidemiology of Vibrio cholerae O139 with special reference to intrafamilial transmission in Calcutta.

A total of 27 families of hospitalised patients (index case families) suffering from acute watery diarrhoea caused by Vibrio cholerae O139, and 14 neighbourhood families were bacteriologically screened for 4 consecutive days to determine the extent of V. cholerae O139 infection amongst healthy contacts and other suspected vehicles of transmission at the intrafamilial level. V. cholerae O139 was isolated from faeces of 14.6% of healthy contacts in index case families as compared to none in neighbourhood families (P = 0.002). The organism could be recovered from 3.7% of handwashings of contacts of index cases and also from stored drinking water (8.0%), open well water (28.6%), flies (3.8%) and pond water (25.0%) used by the index case families and none from neighbourhood families. The large number of asymptomatic infected persons indicate an epidemiological similarity to that of eltor cholera. The organisms may be carried on hands and may act as a potential source of infection to other inmates through contamination of stored drinking water, open wells etc. The results will be useful in formulating strategies for intervention of transmission of V. cholerae O139 at the community level.

Cholera↗

HIV-2 strikes injecting drug users (IDUs) in India.

Manipur, a north-eastern state of India bordering Myanmar, observed introduction of HIV-1 among fairly large number of IDUs in October 1989, followed by rapid spread within the next 6 months. HIV-2 in injectors was not present until recently, though it was detected from other parts of India in 1991. This communication reports for the first time presence of HIV-2 among young injectors of Manipur. All the HIV-2 infected IDUs were also found to be infected with HIV-1. HIV-2 has affected a large number of people in Africa through heterosexual transmission. It remains to be seen whether HIV-2 spreads rapidly also among the drug-injecting population of Manipur. Observation of the disease progression among HIV-2 infected IDUs will also be of interest.

Acquired Immunodeficiency Syndrome↗

Epidemic of herpes zoster following HIV epidemic in Manipur, India.

Since 1989, injecting drug use (IDU) related HIV infection has affected thousands of young adults in Manipur, a north eastern state of India bordering Myanmar following a similar kind of epidemic in adjoining countries like Thailand and Myanmar. During a clinical surveillance of a group of HIV positive IDUs for a natural history study at Manipur, herpes zoster (HZ) emerged as the most specific early HIV related illness (positive predictive value of 100%) in patients belonging to the age group of 12-45 years. Data collected from the dermatology departments of the two main hospitals of the state revealed that there had been an epidemic of HZ since 1990 (rate of 1990 being 11.3/1000 compared to 6.5/1000 in 1989, P value < 0.0001) among males of 12-45 years. The epidemic of HZ has been attributed to the preceding epidemic of IDU related HIV in the same age and gender group occurring 1 year earlier. HZ should be recognised as a marker condition similar to tuberculosis indicating the necessity of screening for HIV in regions where the dual problem of IDU and HIV exist in young adults.

AIDS-Related Opportunistic Infections↗

Spread of Vibrio cholerae O139 Bengal in India.

Vibrio cholerae serogroup O139 Bengal, a novel strain with epidemic potential, completely displaced V. cholerae serogroup 01 in Calcutta in January 1993, which was followed by an epidemic caused by V. cholerae O139 in March-May 1993. From November 1992 to July 1993, 95.6% of 916 V. cholerae isolates submitted to the National Institute of Cholera and Enteric Diseases from 28 locations in India were confirmed as serogroup O139. As of July 1993, V. cholerae O139 had been isolated from 13 Indian states and a union territory, and large outbreaks of cholera caused by the O139 serogroup had occurred in several cities. The extent of spread of V. cholerae O139 Bengal in India and its ability to swiftly disseminate leaves little doubt that this is the beginning of the eighth pandemic of cholera.

Adolescent↗

Production and cross-reactivity patterns of a panel of high affinity monoclonal antibodies to Vibrio cholerae O139 Bengal.

A series of monoclonal antibodies of different isotypes specific for Vibrio cholerae O139, the new pandemic strain of cholera, was produced. These mAbs reacted only with the reference strain (MO45) representing serovar O139 but did not react with any of the other reference strains representing serovars O1 to O140. Significantly, the mAbs did not agglutinate the R-cultures of V. cholerae (CA385, 20-93) which demonstrated the exceptional specificity of these mAbs and indicated that the mAbs recognized antigenic determinants unique for the O139 serovar. There was heterogeneity in the intensity of reactivity of the mAbs with strains of V. cholerae O139 isolated from diverse sources. Apart from 4H6, the other mAbs agglutinated all the O139 strains examined. 2D12 and 2F8 were the best mAbs based on the intensity of agglutination with all the O139 strains. Evaluation of 3A10 in comparison with a polyclonal anti-O139 antibody raised in rabbit using the slide agglutination format revealed that 3A10 fared as well as the polyclonal antibody for the laboratory identification of the O139 serovar. The acquisition of these mAbs provide reagents which would be very useful in the development of simple immunodiagnostic assays for the diagnosis of V. cholerae O139 infections.

Agglutination Tests↗

An outbreak of acute diarrhoeal disease amongst tribal population in Tripura.

A massive outbreak of acute diarrhoeal diseases occurred during March-April, 1992 in the north district of Tripura. Investigation of the outbreak revealed Vibrio cholerae 01 biotype ElT or as the main etiologic agent in 50 per cent of patients. The outbreak which started amongst the tribal population might have spread due to prevailing illiteracy, poverty, low personal and domestic hygiene and vulnerable water sources (chhara water).

Adult↗

An operational study on implementation of oral rehydration therapy in a rural community of West Bengal, India.

An operational study of a 3-tier strategy for implementation of oral rehydration therapy (ORT) was conducted in a block of West Bengal with 216,825 population through the existing health services facilities. All the grassroot level, health workers including their supervisors at various levels were trained regarding the management of patients of diarrhoea with mild to moderate degree of dehydration, by ORT. Another block in the same district with similar demographic features where this intervention was not provided served as control. After 22 months of observation, it was evident that despite adequate training, the performance of Community Health Guides (CHGs) and Anganwadi Workers (AWWs) was not encouraging because of the low utilization of both home available fluids (32.0%) and oral rehydration solution (18.0%) in the study area. Similarly, diarrhoea associated mortality could not be reduced significantly. Lack of motivation and failure to maintain sustained level of skill by the CHGs and AWWs constitute the major bottlenecks for the successful implementation of the programme at the community level.

Child, Preschool↗

Clinical & bacteriological profiles of shigellosis in Calcutta before & after an epidemic (1984-87).

Patients below 5 yr of age, hospitalised for shigellosis over a period of four years (1984-87), were studied. During the epidemic of bacillary dysentery (1984) isolation of different Shigella spp. as well as Shigella dysenteriae type 1 was high. Decreased isolation of Sh. dysenteriae type 1 and increased isolation of Sh. flexneri was observed during post-epidemic years (1985-87). Isolation of different Shigella spp. was always above 25 per cent from patients with dysentery and greater than 7 per cent from those with watery diarrhoea during the post-epidemic years. Higher incidence of shigellosis was observed amongst older children (greater than 3 yr). Most of the shigellosis patients complained of blood and mucus in stools. Vomiting was common among shigellosis patients presenting with watery diarrhoea whereas fever was commonly seen in patients with both dysentery and watery diarrhoea. Most patients of shigellosis presenting with blood and mucus in stools had no dehydration.

Child, Preschool↗