Chemoprophylaxis studies in cholera: a review of selective works.
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Biomedical subjects
Publications and source records attributed to D N Gupta.
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Over a 2-year period, 25 families comprising of 181 individuals of all ages were longitudinally observed for the excretion of Campylobacter species. Faecal samples were taken from all persons with diarrhoea. Specimens were also taken from apparently healthy individuals and from domestic animals living within the confines of the study families at monthly intervals. The overall diarrhoea attack rate was 19 episodes per 100 person-years with peak incidence in the 1- to 4-year-old age group (76/100 person-years). Eight (11.5%) of the total episodes were campylobacter-associated and the overall rate of campylobacter positive diarrhoeal episodes were 2.2 per 100 person-years. Of the 1002 stool samples from healthy individuals 32 (3.2/100 samples) were positive for campylobacter. The organism was most frequently isolated from children under 1 year of age both during diarrhoeal episodes (11.5 per 100 person-years) and non-diarrhoeal (11.1 per 100 samples). Multiple infections in a family were rare. In 19.4% of the occasions one or more animals were campylobacter positive. However, only in 7.7% of these occasions was a human infection recorded within 1 month after the animal was found to be positive. The study showed that the epidemiology of campylobacteriosis in this community was distinct compared to that observed in developed countries.
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.
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Transmission of eltor cholera infection in endemic communities continues without diminishing because of the absence of effective intervention measures. Two methods-chlorination of stored water and the use of a narrow-necked earthenware vessel (called a 'sorai') for storing the water-were found to be effective in reducing the transmission of infection among the family contacts of cholera patients. The cholera carrier rates in the chlorination and 'sorai' intervention groups were 7.3% and 4.4%, respectively, compared with 17.3% in the control group. The 'sorai' is cheap and was well accepted by the local communities; its narrow neck prevented the introduction of the hand and contamination of the stored water.
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The capability of the ampullary and isthmic parts of the rabbit Fallopian tube to contribute lactic acid (LA) to the tubal lumen was examined using an in vitro method of study. In addition concomitant study was also made using the uterus. It was found that in the oestrous rabbit, the isthmus contributed LA at a higher rate than that of the ampulla; the uterine contribution was minimal. Ovariectomy reduced while exogenous oestrogen enhanced this ability in all the three tissues. In mated post-ovulatory rabbits the contributory efficiency of either tubal part changed and appeared to exhibit a peak value in the presence of the ovum; the uterus showed no such changes. This is discussed in relation to the ability of the egg to secure its energy source until it attained morula/the pre-blastocyst stage.
The in vitro incorporation of E1U-C14]-glucose by ampullary and isthmic segments of the Fallopian tube and the uterus was determined in the intact (estrous), ovariectomized, ovariectomized plus estrogen and ovarietcomized plus estrogen + progesterone treated rabbit. In the intact animal the ampulla incorporated glucose at a faster rate than the isthmus; uterine uptake is minimal. Ovariectomy reduced the rate of incorporation below normal values in all the tissues. EDP (estradiol dipropionate) administered to ovariectomized rabbit increased the incorporation rate. Progesterone antagonized the EDP-induced uptake. The relative rate and pattern of incorporation by the three tissues were, however, determined by the dosage of estrogen and the estrogen/progesterone ratio.
Ultrastructural response of the ciliated and secretory cells from the ampullary and isthmic parts of the oviduct was studied in ovariectomized and ovariectomized plus estradiol dipropionate (EDP) treated rabbits. Ovariectomy did not significantly affect the cilia in the ampullary epithelium; degenerative signs, however, appeared overtly in the isthmic cilia. EDP at either 1 microng/kg or 5 microng/kg doses raised the number of cilia/cell in either tubal segments. For comparable change isthmic cilia seemed to require a higher dosage of the estrogen. Ovariectomy led to the depletion of the secretory granules (SGs) from the secretory cells of either tubal segments. EDP at both the doses induced formation of the SGs; this is more remarkable in the isthmic cells. Merocrine type of secretions were observed from the secretory cells of either segments but only at the high dose of estrogen. The findings are discussed in the backdrop of current knowledge.
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