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PubMedDate not supplied

P.C. Sen Best Paper Award (2002). Profile of care providers in five blocks of Nasik Maharashtra. A window on rural health services in Maharashtra.

Five blocks of Nasik district in Maharashtra were surveyed in 1999-2000 for distribution and academic degrees of doctors of all kinds. The five blocks have 84 % villages without any health care provider (read doctor) no matter qualified or quack. All the 555 doctors including Govt. doctors are concentrated in 16 % of villages, mainly in small townships and market centers. Physical access to any doctor is thus tedious. Often it requires travelling and hidden costs like loss of wages for the accompanying person. It also involves a hidden cost of deferred treatment. To ensure access to rational medical care at affordable cost a major overhaul of the existing health services is necessary.

Educational Status↗

PubMed1993

Virological investigations of specimens from buffaloes affected by buffalopox in Maharashtra State, India between 1985 and 1987.

Isolates of poxviruses were made from thirteen of eighteen specimens of scabs taken from pox lesions on buffaloes in five different districts of Maharashtra State, India, between December, 1985 and February, 1987. The biological characters of twelve of the isolates resembled those of the Hissar strain of buffalopox virus; the thirteenth isolate appeared to be vaccinia. The Hin dIII restriction profiles of DNA from all 13 isolates and from the Hissar strain were typical of those given by vaccinia strains. DNA from all twelve Maharashtra buffalopox (BPV) isolates gave identical profiles with each of three additional endonucleases; these viruses appear to be repeated isolations of a single strain of BPV. The DNA profile of this strain was not the same as that of the Hissar strain of BPV and both could readily be distinguished from each of the three strains of vaccinia virus which had been used in India. The thirteenth Maharashtra isolate was indistinguishable from vaccinia in its biological properties, but the restriction profile of its DNA differed from those of three vaccinia strains and the BPV isolates. These observations, made 6-8 years after cessation of smallpox vaccination indicate that BPV is an emerging enzootic virus and is a subspecies of vaccinia virus.

Animals↗

PubMed2004

Mitochondrial DNA diversity in tribal and caste groups of Maharashtra (India) and its implication on their genetic origins.

Genetic relationships among caste-groups are not uniform across the geographical regions of India. Many anthropologists have speculated on the tribal origin of some caste groups in Maharashtra and other states of India. To test this hypothesis, we used neutral mtDNA markers to study genetic relatedness among tribal and caste groups from Maharashtra. Descriptive statistics such as nucleotide diversity, gene diversity and average mismatches were found to be of the same magnitude. Phylogenetic network analysis exhibited a star-like expansion that may date back to the peopling of Eurasia, approximately 50,000 year ago. The reconstruction of mtDNA haplogroups showed that both the caste and tribal populations share similar branches of the tree. Also, the coalescence age estimation of caste and tribal populations suggests the persistence of maternal lineages with their root in early late Pleistocene. Our mtDNA analyses show some preliminary and significant evidence for the origin of prehistoric tribal and hierarchical caste societies of Maharashtra.

Adult↗

PubMed2001

Reproductive health-seeking by married adolescent girls in Maharashtra, India.

In India, most adolescent girls 15-19 years old are married. A study was conducted in 1995-97 in Ahmednagar district of Maharashtra, India to gain insight into whether and how their reproductive health needs are met, especially for gynaecological problems, family planning and perceived fertility problems. It included a survey among 302 married girls of this age, and in-depth interviews with 74 girls, 37 husbands and 53 mothers-in-law. Girls were treated quickly for illnesses interfering with domestic work and were expected to conceive in the first year of marriage. Menstrual disorders and symptoms of reproductive tract infection often went untreated. There was an emerging need for delaying and spacing pregnancies; limiting the number of children was well established. Household work, protection of fertility and silence arising from embarrassment related to sexual health problems were the strongest factors influencing care-seeking. Husbands made the decision whether their wives could seek care and mothers-in-law sometimes influenced these decisions; girls had neither decision-making power nor influence. This study provides valuable input for the new reproductive and child health programme in Maharashtra.

Adolescent↗

PubMed2004

An epidemic of rotavirus diarrhoea in Jawhar Taluk, Thane district, Maharashtra, India, December 2000-January 2001.

An epidemic of diarrhoea in Jawhar, a tribal area of Thane district, Maharashtra, India was investigated. Within a period of approximately 2 months 490 cases of acute diarrhoea were reported among children under 5 years of age, with a case fatality rate of 0.40%. Twenty-seven out of 39 (69.23%) rectal swabs/faecal specimens obtained from hospitalized paediatric patients up to 2 years of age from Jawhar were positive by ELISA for rotavirus. Of these, seven were in the age group of < or = 6 months. Seven ELISA-positive faecal specimens were positive for serotype G3 by RT PCR. Out of 15 serum samples collected from these patients, 12 showed the presence of rotavirus-specific IgM. Rotavirus appears to be the aetiological agent of this widespread outbreak in Jawhar, Thane district, Maharashtra state, India.

Adolescent↗

PubMed2000

The extent and impact of sheep pox and goat pox in the state of Maharashtra, India.

A survey of sheep and goat producers in the state of Maharashtra, India, was undertaken to ascertain the extent and economic impact of sheep pox and goat pox (SGP). One thousand one hundred and sixteen owners were interviewed. Eighty owners (7.2%) reported that they had experienced an outbreak of the disease in the previous 6 years. The results showed that, while producers ranked SGP below other infectious diseases such as foot-and-mouth disease, rinderpest and enterotoxaemia, when SGP occurred it had a major impact, with average morbidity and mortality rates of 63.5% and 49.5%, respectively. Modelling studies suggested it would take about 6 years for a flock or herd to recover from an outbreak, with average annual losses in income of 30-43%, depending on flock type and the owner's actions. Statewide, it is estimated that around 5000 flocks and herds are affected by SGP annually in Maharashtra, costing up to INR 107.5 million. The highest losses occurred in the Aurangabad region.

Animal Husbandry↗

PubMed2006

Why are rural Indian women so thin? Findings from a village in Maharashtra.

OBJECTIVE: To identify social, behavioural and cultural factors that explain the thinness of young women relative to their men in rural Maharashtra, India. DESIGN: Twelve focus group discussions were conducted to explore the villagers' understanding of why women in their area might be thinner than men. SETTING: Pabal village and surrounding hamlets, in the Pune district of Maharashtra, India. SUBJECTS: Samples of young mothers and fathers, grandmothers and grandfathers were selected from families in the village with children below 10 years of age. RESULTS: Four factors were identified that the villagers felt contributed to the disparity in thinness. First, marriage isolated girls from their own families and villages, and brought the expectation of early motherhood. Young brides were often unable to relax and eat adequately. Second, marriage increased the workload of young women. They were expected to do the heaviest household chores as well as farm work in this predominantly agricultural community. Third, women had no financial autonomy or freedom of movement, and were therefore denied access to supplementary food sources available to men. Fourth, young women felt responsible for their household's health and success. They were encouraged to fast regularly to ensure this. Despite feeling responsible, young women had no control over factors that might affect the household's well being. This made them anxious and worried a great deal of the time. CONCLUSIONS: Interventions to improve the nutritional status of young women in this region need to recognise the roles and responsibilities taken up by young brides.

Adolescent↗

PubMedDate not supplied

Genetic structure and microdifferentiation among four endogamous groups of Maharashtra, western India.

Phenotype and gene frequencies of 24 blood group, serum protein and red cell enzyme loci are examined in four endogamous groups (Brahmin, Maratha, Gujarati Hindu Patel and Parsee) of Maharashtra, Western India. Several genetic systems are investigated for the first time in this region. Genetic heterogeneity is suggested, although the overall variation shows general agreement with the populations already studied from Western India. In addition to the historical migration and possible selective effects, the present-day gene pool of Maharashtra is greatly influenced by sociocultural adaptation and breeding structure. The presence of rare alleles ESD*5, and BF*S1 suggests a Caucasoid affiliation of populations of this region.

Blood Group Antigens↗

PubMed2003

Modification of family size in families reporting history of haemophilia from Maharashtra, India.

BACKGROUND: In India, genetic counselling services are largely unavailable. The question of whether awareness of the hereditary nature of the disorder leads to modified family size in affected families remains unanswered. The objective of this study was to determine whether family history of haemophilia resulted in modification of family size in families reporting haemophilia in the State of Maharashtra, India. METHODS: The study was a retrospective cohort analysis from pedigrees collected from an earlier survey on haemophilia in Maharashtra. Pedigree data were manually defined into families with or without experience of haemophilia. Family size was defined as the number of live births per woman as documented in the pedigree. The data were analysed using Microsoft Excel package (version 2000) and SPSS package (version 10). RESULTS: Family size of obligate carriers who were daughters of patients was significantly less than the family size of obligate carriers who reported haemophilia in a brother or maternal relative (z = 7.14, P < 0.001). As compared with parents from an older generation, a significant reduction in the number of children born to younger families with haemophilia was observed, irrespective of family history of the condition. In families with history of haemophilia, there was no significant reduction in the number of families with more than one affected son in between two generations of parents (chi(2) = 1.43). CONCLUSIONS: The results revealed a reduction in size of families with haemophilia over a generation, which possibly reflected the reducing fertility trends observed in the Indian population. Reduction in the number of children born to women with a haemophilic father suggested a comprehension of father to daughter transmission of haemophilia. This was not true when relatives other than the father were affected. The lack of significant reduction in the number of families with history of haemophilia of having more than one affected son may suggest a compensatory response to the high mortality associated with the disorder in India.

Cohort Studies↗

PubMed1990

Distribution and insecticide resistance of the plague flea Xenopsylla cheopis in Maharashtra State, India.

Distributions are reported for commensal rat fleas, predominantly Xenopsylla cheopis (Rothschild), in the State of Maharashtra, India, including the city of Bombay, during 1965-80. The X.cheopis flea index was high in most parts of Maharashtra, but low in Bombay. Rattus rattus Linnaeus is the principal host of X.cheopis, but the host range includes Bandicota bengalensis Gray, Golunda ellioti Gray, Mus musculus Linnaeus, Rattus blandfordi Thomas, R. norvegicus Berkenhout, Suncus caerulaeus Lerr, S. murinus Linnaeus and Tatera indica Hardwicke. X.cheopis was found to have high degrees of resistance to DDT, malathion and fenthion, tolerance to gamma HCH (= gamma BCH) but susceptibility to dieldrin. This insecticide resistance situation may contribute to the high flea indices prevailing in the state, with consequent risks of plague outbreaks. Two other species of rat flea, X.astia Rothschild and X.brasiliensis (Baker) were found to be less common than previously recorded. Their apparent replacement by X.cheopis is tentatively attributed, at least partly, to the selective advantage of insecticide resistance in the latter species.

Animals↗

PubMed1983

Incidence of hepatitis B (Australia) antigen among three communities in malarial Western Maharashtra, India.

The incidence of hepatitis B surface antigen (HBs Ag, Australia antigen) has been determined in three communities residing in an endemic malarial region in Western Maharashtra. A high incidence (5.92%) is found in the Marathas, a socially well-placed community, as compared to Nava-Buddhas (2.62%) and scheduled castes (1.63%) which are socially low-placed communities. A higher incidence (8.91%) among the Maratha females is a surprising observation as the males have been shown to be predominant among HBs Ag carriers in most world populations. A positive association of HBs Ag and the anthropometric traits, skinfold thickness of biceps and triceps, has been observed in the present study. The results demonstrate that other factor(s) (e.g. immunological) besides malarial infection may be involved in the maintenance of a high HBs Ag frequency in Western Maharashtra.

Body Constitution↗

PubMedDate not supplied

Insignificant prevalence of antibodies to hepatitis C in a rural area of western Maharashtra.

OBJECTIVE: To determine the age-specific seroprevalence of hepatitis C virus (HCV) in a rural population in Maharashtra. METHODS: 1054 serum samples collected from apparently healthy persons were tested by recombinant immunoblot assay for antibodies against HCV (anti-HCV). Anti-HCV positive samples were tested for HCV-RNA by nested reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: One man tested positive for anti-HCV; his sample was also HCV-RNA positive. CONCLUSIONS: HCV infection is infrequent in this rural area in Maharashtra.

Adolescent↗

PubMedDate not supplied

Some factors influencing variations in the rate of natural increase of population in western Maharashtra.

This paper analyzes the impact of various factors on variations in the rate of natural increase of population in Western Maharashtra, India. By using district level data, coefficients of correlation have been calculated between the rate of natural increase, the birth rate and the death rate on the 1 hand and different factors affecting them on the other. The analysis shows that in Western Maharashtra the birth rate is high in response to the high death rate and the high infant mortality rate. It is also revealed that the rate of natural increase of the population declines with an increase in the proportion of working females as well as the proportion of educated males. All this signifies that the region under study is in the 2nd stage of the "demographic transition."

Asia↗

PubMed1992

HIV-2 antibodies in serum samples from Maharashtra state.

Two hundred serum samples were tested to detect the presence of HIV-2 infection in Maharashtra state. The serum samples were derived from various groups including those with high risk behaviour for HIV infection. All samples were tested by three combined HIV-1 and HIV-2 ELISA kits. The reactivity was confirmed by LiaTek HIV 1+2 immunoblot. The study confirmed that HIV-2 infection exists in Maharashtra, as 14 samples showed antibodies to HIV-2 and 14 showed antibodies to both HIV-1 and HIV-2. Antibodies to HIV-2 or HIV-1 and HIV-2 were detected mainly in persons with high risk behaviour.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Violence against women in India: evidence from rural Maharashtra, India.

INTRODUCTION: In recent years violence against women has emerged as an important social problem in India. It has attracted the attention of a wide spectrum of agencies, from healthcare providers to law enforcement authorities. This study attempted to determine the characteristics and the magnitude of physical and psychological violence against women in rural Maharashtra, central India. METHODS: The study initially undertook focus group activities. This was followed by the formulation of the survey instrument in English, which focused on partner violence and child disciplinary practices. After pre-testing the instrument in 25 households, the actual study was conducted by trained interviewers in five randomly selected villages of rural Maharashtra. The study included 500 households (sample size = 500 women, eligible if they had at least one child less than 18 years of age). RESULTS: The results revealed that of the women interviewed, almost one-third (30.4%) had no formal education and the women's husbands were better educated. More than half the women lived in one-room dwellings and were at or above the clinical cut-off point for depression on the Center for Epidemiologic Studies Depression Scale (CES-D). 38% of the women were verbally insulted by their husband with a median of 11 times in past 6 months. Almost half the women said they had been slapped, hit, kicked or beaten by their husbands at some time. 24% of the women reported having been kicked by their husbands at some point during their married life, and 44% were reportedly kicked during pregnancy. 12% were specifically threatened by their husbands with having kerosene oil poured on them to set them on fire. 30% of the physically assaulted victims required medical care. CONCLUSIONS: Considering the prevalence of domestic violence, health-care providers should screen for domestic violence in routine practice. In addition, protocols should be developed for referral of abused women to appropriate community resources. In the present Indian rural setting, solutions to domestic violence must be found within the social structure of the family and the community.

Journal Article↗

PubMedDate not supplied

Management of snake-bite in rural Maharashtra: a 10-year experience.

BACKGROUND: A high incidence of snake-bite envenomation has been reported from Marathwada, Maharashtra. This study analysed the pattern of snake-bites and their management in a rural area of India over a 10-year period. METHODS: A total of 633 patients with snake-bite admitted to the Rural Community Centre and Punde Hospital in Mukhed taluka, Nanded district (Marathwada) of Maharashtra, between 1992 and 2001, were analysed retrospectively. The local and systemic manifestations of snake-bite, response to antisnake venom, atropine and neostigmine, the treatment of complications and the outcome were analysed. RESULTS: Of the 633 patients, 427 (67.5%) had been bitten by poisonous snakes and 206 (32.5%) by non-poisonous snakes. The majority of snake-bites (68.9%) occurred between May and November. Those affected were mainly farmers (228 [36%]), students (191 [30.2%]) and housewives (175 [27.6%]). Of the 427 envenomed by poisonous snakes, 274 (64.2%) were by Echis carinatus (saw-scaled viper), 71 (16.6%) by cobra, 42 (9.8%) by krait and 40 (9.4%) by Russell viper. The requirement of antisnake venom for treating neurotoxic envenomation was 40-320 ml and for Echiscarinatus and Russell viper bites it was 20-250 ml. Among those envenomed by poisonous snakes, the mortality was 4.7% (n=20). CONCLUSION: Snake-bite is a common life-threatening emergency in the study area. We observed an occupational risk and a seasonal incidence of snake-bite. Knowledge of the varied clinical manifestations of snake-bite are important for effective management. Ready availability and appropriate use of antisnake venom, close monitoring of patients, institution of ventilatory support and early referral to a larger hospital when required help in reducing the mortality. Most patients with snake-bites can be successfully managed even in small rural hospitals with limited facilities.

Adult↗

PubMedDate not supplied

Geographic variation in cancer incidence and its patterns in urban Maharashtra, 2001.

In this paper an attempt has been made to study the geographic variations in cancer incidence and its pattern in Urban Maharashtra. Data collected by Mumbai, Poona, Nagpur, and Aurangabad, Population based Cancer Registries, for the year 2001 have been utilized. The incidence patterns by sex, age, and religion has been compared between these four agglomerations. Besides this childhood cancers and tobacco related cancers for each registry are also described. Age specific cancer incidence rates show increasing trend with increasing age in all the four populations. The curves for Mumbai, Poona, Nagpur are closed together with fluctuations, indicating similarities in the rise. In all the four registries, amongst males, cancers of the lung, larynx, oesophagus, tongue and prostate while in females breast, cervix, ovary, oesophagus, mouth and leukemias occupy places in ten leading sites. The proportion of childhood cancers varies from 1.9% in females in Poona to 4.5% in males in the Nagpur populations. The proportion of tobacco related cancers varies in males from 38.9% in Poona to 54.4% in Aurangabad, where as in females from 14.1% in Nagpur to 21.7% in Aurangabad. Considerable variations was observed in the incidence of cancer of various sites in both the sexes, professing different religious faiths within this populations. The findings of this paper can be used to estimate the incidence and prevalence of cancer for future for whole Maharashtra state and studies in cancer etiology and control can be planned.

Adolescent↗

PubMed1985

G-6-PD and haemoglobin variants among twelve endogamous Dhangar castes of Maharashtra, India.

Incidence of haemoglobin variants and G-6-PD deficiency among 1385 males belonging to 12 endogamous Dhangar castes of Maharashtra, India, have been reported. Of the 12 castes studied 11 lacked the allele for G-6-PD deficiency; 2.7% of the Thellaris were found to be deficient. Haemoglobin Hb-D trait is found in 2 of the 12 castes; the incidence among Ahirs and Hatkars being 0.82% and 1.91%, respectively. One case of Hb-J among the Ahirs, and 2 examples of thalassaemia trait, one each among Ahirs and Gadharis, have been detected. The low incidence of observed G-6-PD deficiency and the detection of Hb-D and J traits, as well as thalassaemia have been discussed in the light of the nomadic way of life of some of the Dhangar castes and prevalence of malaria in the region they occupy. The data strongly suggest that the Dhangars arrived in Maharashtra in the recent past from northwest.

Consanguinity↗