Browsing by Author "D.C. Reddy"

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A community study on the aetiology of childhood diarrhoea with special reference to Campylobacter jejuni in a semiurban slum of Varanasi, India.
(1993) G. Nath; B.N. Shukla; D.C. Reddy; S.C. Sanyal
In a community study of 607 diarrhoeal and 529 non-diarrhoeal (control) patients less than 5 years old carried out between August 1988 and July 1989, the Campylobacter jejuni isolation rate was 4% in the diarrhoeal and 0.9% in the control group. It was the second most common bacterial enteropathogen isolated after Escherichia coli. Its incidence was more common among 1-2 year old children (4.8%) and during rainy season (July-October). Features of dysentery were absent in C. jejuni diarrhoea. Findings strongly suggest its aetiological role in childhood diarrhoea. Among other enteropathogens in diarrhoeal specimens, rotavirus was the commonest (16.4%) followed by enterotoxigenic E. coli (13.8%), G. lamblia (10.3%), enteropathogenic E. coli (7.0%), E. histolytica (5.0%), Cryptosporidium (3.8%), H. nana spp. (1.5%), NAG vibrios (0.5%), P. shigelloides (0.5%), V. mimicus and Salmonella spp. (0.3%). Approximately one quarter of the stool specimens (22.6%, 256/1136) tested were positive for the ova of A. lumbricoides.
Estimating true burden of disease detected by screening tests of varying validity.
(2001) R.N. Mishra; C.P. Mishra; D.C. Reddy; V.M. Gupta
Timely and accurate information on disease load is essential for planning health programs. Unfortunately, complexity, cost and need of skilled personnel limit the use of screening tools of high validity in developing countries. The disease load estimated with tools of low validity differs considerably from true disease load, particularly for diseases of extreme levels of prevalence/incidence. A tool of 70% sensitivity and specificity may yield a prevalence/incidence rate of 34% (CI: 32.23-35.67%) for a disease whose true rate is only 10.0% (CI: 8.94-11.06%). We proposed a procedure to derive the true estimate in such cases, based on the concepts of sensitivity and specificity of a diagnostic/screening test. It is applied on two sets of real data--one pertaining to incidence rate of low birth weight (LBW) and the other to prevalence rate of obesity--where multiple screening tests of varying validity were used to estimate the magnitude. Different screening tests yielded widely varying incidence/prevalence rates of LBW/obesity. The prevalence/incidence rates derived by using the proposed estimation procedure are similar and close to the true estimate obtained by screening tests considered as gold standard. Further, sample size determined on the basis of the results of a tool of low validity may be either larger or smaller than the required sample size. Estimation of true disease load enables determination of correct sample size, thus improving the precision of the estimate and, in some instances, reducing the cost of investigation.
Extents of contamination of top milk and their determinants in an urban slum of Varanasi, India.
(2000) G. Ray; G. Nath; D.C. Reddy
A community based study to examine the extent of contamination of supplementary milk feeds of 149 children aged 6-24 months was conducted in a semi urban slum of Varanasi, India. Out of 201 children, 149 top milk samples were collected directly from the feeding utensils into a sterile vial and subjected to bacteriological analysis. Overall, 53.7% of milk samples were contaminated by bacteria and among them 16.1% were potentially enteropathogenic in nature. The distribution of pathogens was E. coli (13.4%), Klebsiella spp (5.4%), Enterobacter spp. (5.4%), Pseudomonas aeruginosa (4.7%), Shigella spp. (2.7%) and others (22.1%). The rate of contamination was significantly higher (p < 0.001) in lower income group (73.4%), lower caste (69.6%) and in case of illiterate mothers (69.3%). Bivariate analysis indicated that wherever the afore mentioned parameters of hygiene were adverse, isolation rates increased multifoldely. Multiple logistic regression analysis indicated that the probability of a milk sample being positive for bacterial contamination was higher by 20 times when unclean utensils were used, by 3 times if mothers hands were dirty and by 2.8 time if the mothers were illiterate. The odds of contamination by pathogens was 25.7 times higher if the feeding utensils were dirty.
Study of infant and childhood mortality in an ICDS block of eastern U.P.
(1993) S.P. Singh; D.C. Reddy; S.C. Mohapatra; S.D. Gaur
Information on births and deaths was collected in 11 randomly selected AWW areas of Barhaj Mahen ICDS project area in Eastern U.P. by an independent survey team in 1988-89. The findings revealed that the births and deaths were under-reported to the tune of 36.6 and 13.9 percent respectively, by AWWs. The different demographic indicators generated from the data were as follows, CBR and CDR were 30.3 and 7.1 per 1000 population. Neonatal mortality rate, IMR, and MMR were 58.3, 74.7 and 6.5 per 1000 live births. 0-6 yr mortality was 16.3 per 1000 children and constituted 37.5% of the total deaths. ARI, diarrhoea and fever were the major causes of mortality in 0-6 yr old children accounting for 25.9, 22.3 and 14.8% respectively. The findings indicated that there was underreporting in adult mortalities despite the independent investigation, and a reduction in infant and childhood mortality possibly due to the beneficial effect of ICDS services.; This analysis aims to determine the extent of underreporting of births and deaths by anganwadi workers (AWW) in Barhaj Mahen project area in Eastern Uttar Pradesh state, India, in 1988, and to identify the birth rate and childhood mortality rate. Causes of mortality are identified. The project area is known to have a high infant mortality rate. Data were obtained from 11 AWW areas serving a population of 10,206. Sampling followed the random cluster technique. Initial household data collection missed 309 births (36.6%) but only 10/72 deaths (13.9%). 35.5% of male and 37.8% of female births were unreported. 14.6% of male and 12.9% of female deaths were unreported. 18 neonatal and 5 postneonatal infants died. Early neonatal mortality was 45.3/1000 live births, and neonatal mortality was 58.3. Infant mortality was 74.7, and maternal mortality was 6.5/1000 live births. Respiratory infections accounted for the highest mortality (25.9%). Other cause of death were diarrhea (22.3%), fever (14.8%), prematurity (8.1%), tetanus (7.4%), and accident (3.7%). The total death rate (7.2/1000) was lower than the national average. The birth rate in project areas of Uttar Pradesh was almost the same as the national average. Postneonatal mortality showed the lowest rates compared to Uttar Pradesh and the nation. Since this study area had been included in the Integrated Child Development Services (ICDS) since 1981, it is likely that the lower child mortality reflects the emphasis on ICDS services. Underreporting of deaths is considered to be marginal.