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Biomedical subjects

D K Srinivasa

Publications and source records attributed to D K Srinivasa.

At least 19 recordsLinked to original sources
PubMed1997

Poliomyelitis trends in Pondicherry, south India, 1989-91.

STUDY OBJECTIVES: To assess the poliomyelitis trend, including study of the epidemiological features, and to correlate this with the immunisation coverage of infants. DESIGN: Three annual lameness surveys in children aged 0-60 months employing cluster sampling methods and a series of five cross sectional surveys of immunisation coverage in children aged 12-23 months of age were undertaken. SETTING: Pondicherry, India, 1988-92. SUBJECTS: More than 10,000 children in the age group of 0-60 months took part in the three annual lameness surveys and samples of 210 children aged 12-23 months were covered each year in immunisation coverage surveys. MEASUREMENTS AND MAIN RESULTS: Altogether 50 of 11,461, 24 of 10,093, and 17 of 11,218 children surveyed during 1989, 1990, and 1991 respectively had become lame as a result of poliomyelitis, giving prevalences of 4.4, 2.4, and 1.5 per 1000 children for the three surveys. The corrected prevalences of poliomyelitis were 5.9, 3.2, and 2.0 per 1000 children during 1989, 1990, and 1991 respectively. The proportion of cases aged up to 36 months fell from 48% in 1989 to 12.5% in 1990 and 6% in 1991. The age at onset was less than 1 year in most. The median age at onset was 10.7 months. About 54% of the affected children had received three doses of oral poliomyelitis vaccine (OPV) before the onset of paralysis. In 1988 immunisation coverage for the third dose of OPV was 91% and in 1992 it was 97.6%. The drop out rate for the first versus the third dose of OPV fell from 6.3 in 1988 to 1.9% in 1992. CONCLUSION: Three successive annual lameness surveys showed that poliomyelitis was declining between 1989 and 1991. Five immunisation coverage surveys conducted from 1988 to 1992 showed high initial coverage followed by an improvement in the form of almost universal coverage for OPV.

Age Factors↗
PubMed1997

Impact of maternal and child health strategy on child survival in a rural community of Pondicherry.

OBJECTIVE: To determine the impact of Maternal and Child Health (MCH) services on child survival in a socio-economically backward rural community. SETTING: Twelve villages in Pondicherry with a population of 16,803. DESIGN: Prospective study. SUBJECTS: A birth cohort of 356 live births (LB) born between January 1st and December 31st 1988. METHODS: The live births were followed-up from birth to five years age (1988-1993). The health care received by this cohort and the antenatal services received by the cohort mothers was reviewed. Outcome measures related to child survival were determined and their changing trend since 1967 was examined. RESULTS: Fifty-four per cent of the cohort children were from families below the poverty line. Antenatal registration and tetanus immunization coverage of the mothers of the cohort was 100%. Immunization coverage of the cohort children was more than 98% for BCG, DPT (three doses) and OPV (three doses) and 82% for measles. The infant mortality rate had reduced from 201/1000 LB in 1967 to 64/1000 LB (95% CI 58.9-68.1) in 1989. The child death rate decreased from 29.4/1000 children 1-4 years of age (1970) to 18/1000 (95% CI 13.9-22.1) in 1992. There were no deaths due to neonatal tetanus or measles. Neonatal mortality (35/1000 LB; 95% CI 29.9-40.1) was higher than the post-neonatal mortality (29/1000 LB; 95% CI 24.1-33.9). Fifty eight per cent of the neonatal deaths were due to non-infective causes like prematurity, birth asphyxia, birth injuries and congenital anomalies. Eighty per cent of post neonatal deaths were due to infections. Overall, the child survival index was high (91.27%; 95% CI 88.14-94.26). This was inspite of the low socio-economic background of the children's families. CONCLUSIONS: Good MCH services can substantially improve child survival inspite of prevailing low socio-economic situations. Inputs for neonatal care need to be strengthened to further enhance child survival.

Cause of Death↗
PubMed1996

Natural history, trend of prevalence and spectrum of manifestations of Bancroftian filarial disease in Pondicherry (South India).

The study examines the changes in the disease parameters of lymphatic filariasis over a period of time based on three surveys during 1957, 1986 and 1992 in Pondicherry, South India. The overall prevalence of filarial disease in the three surveys was 4.7, 6.7 and 9.9% respectively. It was significantly higher in males (1957:5.3%; 1986:13.7%; 1992:18.8%) when compared to females (1957:3.8%; 1986:2.3%; 1992:2.7%) in all the three surveys (P <0.05). The overall prevalence of acute adenolymphangitis declined from 1.0 in 1957 to 0.2 in 1986 and 0.04% in 1992. While the prevalence of hydrocele showed an increasing trend from 2.7 in 1957 to 11.9 in 1986 and 17.3% in 1992, the prevalence of lymphoedema (1.9 in 1957; 1.9 in 1986 and 1.8% in 1992) was stable over the same period. The prevalence of disease was relatively higher in all age groups of both male and female population in 1992 when compared either to 1957 or 1986. Similarly a monotonic increase in the prevalence of hydrocele was observed in all age groups in 1992 when compared to previous surveys. The implications of the changes in prevalence of the chronic manifestations when compared to the changes in the acute manifestations over a period of 35 years are discussed.

Adolescent↗
PubMed1994

Research as a tool for the teaching of epidemiology.

At a medical school in India, undergraduates have been given the opportunity to volunteer to conduct research as a means of improving their knowledge and understanding of epidemiology. First-year clinical students have conducted case-control studies with emphasis on methodological detail. Second-year students have been involved in community-based epidemiological studies. At the intern level, projects related to social factors in health and disease and to health administration have been encouraged. This initiative has been largely welcomed by the students and has yielded highly encouraging results.

Education, Medical, Undergraduate↗
PubMed1993

Paralytic poliomyelitis in children under 6 years in Pondicherry: a community survey.

STUDY OBJECTIVES: To assess the amount of poliomyelitis and its epidemiological features including risk factors. DESIGN: This was a retrospective study of cases of paralytic poliomyelitis among children 0-6 years of age. SETTING: Pondicherry, India, 1983-89. SUBJECTS: A total of 47,960 children aged less than 6 years. MEASUREMENTS AND MAIN RESULTS: In 1989, 469 field workers undertook a door to door survey of children 0-6 years old to identify those with limb paralysis. This was followed by clinical examination to establish the cause, supplemented by case notes held by the Child Development Services. Altogether 203 cases of limb paralysis were identified, 188 of which were judged a result of paralytic poliomyelitis. The prevalence of poliomyelitis in 1989 was 3.9/1000 among children below 6 years of age. There was a male preponderance with a male:female ratio of 1.4:1. The prevalence was least in infants (1/1000) and highest in children aged 2 to 3 years (6.4/1000). The age at onset was less than 12 months in 42% of cases and less than 3 years in 98%. The median age at onset was 13.4 months. Time series analysis showed a high occurrence of cases from May to September between 1983 and 1989. The legs were affected in 97%. About 41% of children had received three doses of oral polio vaccine. There was a history of intramuscular injection, possibly provoking a paralytic attack, in 54% of cases. CONCLUSION: This retrospective community study involving the staff of the Integrated Child Development Services provided valid data about poliomyelitis with little additional cost and minimum training. Because the study covered a whole population of children under 6 years, rather than a sample, the data will help in monitoring and surveillance of poliomyelitis and also in planning strategies for effective control.

Age Factors↗
PubMed1993

Community experience for medical students.

This article outlines the features of community postings for medical students in their second clinical year at the Jawaharlal Institute of Postgraduate Medical Education and Research, in Pondicherry, India. Their exposure to the realities of preventive and social medicine in the field clearly helps them to cope with what would otherwise be only theoretical knowledge.

Clinical Clerkship↗
PubMed1992

A new approach in training pre-clinical medical undergraduates in community medicine in Pondicherry, South India.

Pre-clinical medical undergraduates are taught Community Medicine using a variety of teaching methods keeping the didactic lectures to the minimum in conformity with the latest recommendations of Medical Council of India. Five of the total twelve topics were taught using group discussion during 1988-89. The present paper gives the details of lesson plans for two topics. Evaluation was done based on the results of the written test, opinions expressed by the students and on the spot observation by the faculty members. Suggestions given by the students to improve the sessions have also been highlighted.

Clinical Clerkship↗
PubMed1992

Infant mortality in Pondicherry--an analysis of a cohort of 8185 births.

Infant mortality rate is one of the 12 global indicators for monitoring Health for All. Reliable data on infant mortality are not available for the majority of developing countries including India. To plan strategies for bringing down the rate and, later, to evaluate them, 'Cause Specific Rates' would be necessary. Pondicherry has achieved low rates of infant mortality. A study was conducted in the Anganwadis of Pondicherry to determine the causes of infant deaths. The 8185 children born between 1-4-1987 and 31-3-1988 in Pondicherry formed the study group. The Anganwadi workers collected information on the cause of death for the 222 children dying within the first year. The infant mortality rate was 27.1 per 1000 live births. Acute respiratory infections and diarrheal diseases accounted for 45% of the deaths.

Cause of Death↗
PubMed1991

Perceptions & practices of diabetics in Pondicherry.

The knowledge, attitude and self care regarding diabetes was assessed in 150 diabetics, residing in Pondicherry, using a pre-tested schedule addressing six areas of diabetic self-care. Observations made included the ability of the patients to test, interpret and record the result of urine examination; diet practices; and insulin use. The knowledge, attitude and practices of diabetics were less than satisfactory in all the areas of self-care. Up to 80 per cent had a complication or associated disease. Most of the patients appreciated the need for dietary care or medication, but only 50 per cent regulated their diet. Of the 97 per cent using anti-diabetic agents, some were using them harmfully. Only 10.6 per cent of the patients tested their urine, though 71 per cent were aware of the need for this. Only 34 per cent saw a physician regularly. None of the patients had any formal education regarding diabetes.

Adult↗
PubMed1987

Economic aspects of an epidemic of haemorrhagic conjunctivitis in a rural community.

The estimated economic loss due to an epidemic of acute haemorrhagic conjunctivitis in 1981 in a rural community of Goa studied by house-to-house survey of 7230 families is reported. Thirty-five per cent of families were affected and in 62% of these families more than three persons developed conjunctivitis. The affected were forced to be absent from work resulting in a reduction of the work force (loss of 7735 man days) and loss of income (Rs 1,33,300). The type of treatment followed and estimates of treatment cost are described. The economic consequences to the country of this widespread epidemic are described.

Absenteeism↗
PubMed1980

A study of out-of-wedlock pregnancies: outcome and utilization of maternal/child health services.

The characteristics of unwed pregnant women, their utilization of maternal and child health services and the infant mortality among these out-of-wedlock births were investigated. During the study period, 5% of all pregnancies (48 of 855) were of this nature. Utilization of antenatal services was poor among unwed pregnant women, compared to those who were married. However, they used the child care services satisfactorily, as observed by the well-baby-clinic visits and acceptance of immunization. The infant mortality was 125 per 1000 live births, more than double the rate among infants born to married women. Either immediately after child birth or within one year after delivery, 50% of the unwed mothers started living with the putative fathers.

Adolescent↗