Lameness survey was conducted in a rural community development block of Haryana in 1985. Enumerators contacted school teachers, anganwadi workers and several key informants in the community to identify lame children in 1-11 years age-group. Physician verified 219 lame cases to be due to poliomyelitis. Prevalence of poliomyelitis lameness was 7.3/1000 children born in 1974-76, 7.7/1000 children born in 1977-1980 and 2.3/1000 children born in 1981-1984 (expected to increase to 3.1/1000 when all children born in 1981-84 cross 5th year of life). Immunisation coverage with 3 doses of oral polio vaccine (OPV) was less than 10% during 1974-80 when immunisation was a clinic based activity. Coverage increased from 50 to 80% during 1981-85 when OPV was given in annual immunisation campaign. The results indicate that prevalence of paralytic poliomyelitis dropped at least by 60% after giving OPV in annual immunisation campaigns.

Child↗

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Determinants of infant and child mortality in rural Haryana.

To identify the individual and household level variables associated with increased risk of mortality, 159 infant and 50 child deaths (cases) and equal number of age matched live infants and children (controls) and their families were studied in a rural area of Haryana. The social, economic, educational and environmental characteristics of the case and control families were similar. Increased risk of infant and child mortality was associated with maternal age less than 20 and more than 30 years, birth order 4th or higher, unclean cord care at the time of child birth, failure of breast feeding during the first 3 months of age, lack of immunizations, and previous infant or child death(s) in the family (Odds ratio greater than 2; P less than 0.05-0.01 by X2 test). An emphasis on the interventions directed at control of the above mentioned variables may prove most helpful in reducing infant and child mortality in a rural area.

Child, Preschool↗

PubMedDate not supplied

Impact of oral rehydration therapy on maternal beliefs and practices related to acute diarrhea.

Maternal beliefs and practices related to acute diarrhea were evaluated in 69 villages of a district in Haryana. Oral rehydration therapy (ORT) programme was introduced in 47 villages; in 25 by health workers and in 22 by health volunteers. Twenty two villages served as control. Impact was assessed by interviewing 200 mothers initially and 210 each, one and two year after initiating the programme. Dehydration as a complication of diarrhea was perceived by 67.2% mothers in health worker and 71.4% in volunteer villages of Intervention area as compared to only 32.8% in control area (P less than 0.01). In Intervention area, 88.6% mothers had tried ORT as compared to 22.8% in control area and 85% of the mothers found it to be useful. The restriction of breast feeding during acute diarrheal episode was favoured by only 15.7% mothers in intervention area and by 47.1% in control area (P less than 0.01). The knowledge regarding use of home available fluids in increased amounts did not show an impressive change. There was no change as regards understanding of cause of diarrhea. Favourable change in beliefs and practices is possible by instituting ORT with culturally relevant health education.

Acute Disease↗

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Interstitial lung disease.

Interstitial lung disease in children is a complex group of disorders whose etiology and pathogenesis is not entirely clear. Although the basic pathogenesis has been extrapolated from adult studies, its relevance in the pediatric population can be questioned. Several classifications of this condition have been put forward but Liebow's histologic classification is well accepted. Clinical manifestations are non-specific and can vary from no symptoms and a positive chest X-ray to more characteristic signs and symptoms. The triad of tachypnea, intercostal retractions and dry crackles is characteristic. Chest roentgenograms are a useful diagnostic tool and CT scans help to stage disease severity. Spirometry classically shows a restrictive pattern. Lung biopsy is the gold standard for establishing a diagnosis. Corticosteroids are the cornerstone of treatment in this condition. Thus, in view of the multifactorial nature of this disease, more extensive multi-centre prospective studies are required in order to better understand this rather complex group of disorders.

Adult↗

PubMedDate not supplied