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PubMed2002

The elimination of contraceptive acceptor targets and the evolution of population policy in India.

In 1966 the government of India announced a new national population policy that eliminated numerical targets for new contraceptive acceptors. This paper examines the history of target setting in India and factors that led to the elimination of targets. The analysis is based on published and unpublished reports on India's population policy and the family planning programme and interviews with senior Indian and foreign officials and population specialists. Five factors are identified as playing a role in the evolution from target setting to a target-free policy:(1) the research of India's academics; (2) the work of women's health advocates; (3) the support of officials in the state bureaucracy who approved the target-free approach; (4) the influence of the donors to India's family planning programme, especially the World Bank; and (5) the International Conference on Population and Development.

Contraception↗
PubMedDate not supplied

Genetics of apolipoprotein H (beta2-glycoprotein I) polymorphism in India.

BACKGROUND: Human apolipoprotein H (beta(2)-glycoprotein I, apoH, protein; APOH, gene) is a single-chain glycoprotein that has been implicated in several metabolic pathways, including lipid metabolism, coagulation and production of antiphospholipid antibodies and many disease phenotypes. The structural, molecular and genetic bases of APOH have been studied in detail but population studies, especially from the Indian subcontinent, are limited. OBJECTIVE: This study seeks to enlarge our understanding of APOH genetic diversity in human populations from different regions and social groups of India. Also, we examine the level and extent of genetic variation at this locus in world populations and its utility as a population genetic marker. SUBJECTS AND METHODS: Blood samples from 1381 unrelated and randomly selected individuals were screened for APOH genetic polymorphism. Eleven populations from North India (Brahmins, Banias, Jat Sikhs, Khatris, Scheduled Castes, Lobanas and Rajputs), West India (Brahmin and Patels) and Central India (Brahmins and Baiga tribe) were studied for APOH polymorphism using isoelectric focusing. Allele frequencies were calculated by the gene counting method. The results were statistically evaluated using chi-square statistics for regional and ethnic variation. Genetic distances were computed on Indian populations to determine the population affinities. Correspondence analysis was used to assess ethnic variation in world populations. RESULTS: An interesting and wide genetic variation at this locus was observed in Indian populations. The frequency distribution of three observed alleles ranged from 0.034 to 0.091 for APOH*1, 0.852 to 0.917 for APOH*2 and 0.027 to 0.075 for APOH*3. The world's highest APOH*2 allele frequency was observed in the Patel (0.917) caste group from West India. CONCLUSIONS: Overall, the observed variation at this locus in Indian populations is comparable to many Caucasian populations. An analysis of world populations showed that APOH is a useful genetic marker for population and anthropological studies.

Alleles↗
PubMed2005

Epidemiological profile of rotaviral infection in India: challenges for the 21st century.

BACKGROUND: Rotaviruses cause acute viral gastroenteritis worldwide. It has been estimated that, each year, 440,000 deaths that occur among children are attributed to rotavirus infection, mainly in developing countries. In India, the diversity of rotaviruses reported during the 1980s and 1990s emphasizes the need for surveillance of cocirculating strains, to follow the rapid changes in circulation and to detect novel strains. METHODS: We analyzed data from published epidemiological studies, to collate available information on serotyping and genotyping of rotaviruses before the initiation of a national rotavirus surveillance program. The studies included 18 Indian cities and were performed during 1996-2001. RESULTS: Rotaviruses were detected in 23.4% of patients with diarrhea who presented to the hospital. There were marked geographic differences in virus circulation, with G1 being the single most common G type identified in all parts of India, except for western India. Group B rotaviruses were reported from Kolkata and Pune. Human infections with strains G6, G8, G10, and G9P[19], which may occur as a result of zoonotic transmission of bovine and porcine rotaviruses, were reported from western, southern, and eastern India. CONCLUSIONS: The remarkable diversity of rotaviruses circulating in India highlights the need for uniform, widespread surveillance for rotaviruses before the initiation and during the implementation of immunization programs.

Animals↗
PubMed2001

AIDS in India: incidence, prevalence, and prevention,.

With 3.7 million human immunodeficiency virus (HIV)-positive in India, many predict that this nation of 1 billion people will soon see infection rates soar if successful prevention programs are not implemented. The majority of infections occur through sexual contact, with blood banks, intravenous drug use, and mother-to-child transmission also spreading the virus. Those in India who are HIV-positive are highly stigmatized and often have difficulty finding physicians who are willing to treat them. Nongovernment organizations provide various services, including physician referrals and legal help for those who are HIV-positive and programs to raise awareness and education. Although the Government of India has designed various programs to help prevent the further spread of HIV, lack of funding and poor regulatory systems are further barriers to their implementation. India is also at war with poverty, illiteracy, and gender inequality, all of which make the fight against acquired immune deficiency syndrome (AIDS) a more difficult battle. India's AIDS control strategy must take these issues into account in order to design successful programs to prevent infection rates from multiplying rapidly.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Lumping and splitting: the health policy agenda in India.

India's health system was designed in a different era, when expectations of the public and private sectors were quite different. India's population is also undergoing transitions in the demographic, epidemiologic and social aspects of health. Disparities in life expectancy, disease, access to health care and protection from financial risks have increased. These factors are challenging the health system to respond in new ways. The old approach to national health policies and programmes is increasingly inappropriate. By analyzing inter- and intra-state differences in contexts and processes, we argue that the content of national health policy needs to be more diverse and accommodating to specific states and districts. More 'splitting' of India's health policy at the state level would better address their health problems, and would open the way to innovation and local accountability. States further along the health transition would be able to develop policies to deal with the emerging epidemic of non-communicable diseases and more appropriate health financing systems. States early in the transition would need to focus on improving the quality and access of essential public health services, and empowering communities to take more ownership. Better 'lumping' of policy issues at the central level is also needed, but not in ways that have been done in the past. The central government needs to focus on overcoming the large inequalities in health outcomes across India, tackle growing challenges to health such as the HIV epidemic, and provide the much needed leadership on systemic issues such as the development of systems for quality assurance and regulation of the private sector. It also needs to support and facilitate states and districts to develop critical capacities rather than directly manage programmes. As India develops a more diverse set of state health policies, there will be more opportunities to learn what works in different policy environments.

Delivery of Health Care↗
PubMed2003

Fluconazole and itraconazole susceptibility of clinical isolates of Cryptococcus neoformans at a tertiary care centre in India: a need for care.

OBJECTIVES: In cryptococcosis, fluconazole is a standard prophylactic, therapeutic and maintenance option, particularly in the expanding HIV/AIDS group. However, its excessive use may lead to resistance in Cryptococcus neoformans. Variations in clinical response to fluconazole have already been noted elsewhere, and cases of post-therapy relapse are not uncommon. To assess azole antifungal susceptibility profiles of clinical cryptococcal isolates in India, the All India Institute of Medical Sciences (AIIMS) has recently initiated preliminary studies using NCCLS M27-A. MATERIALS AND METHODS: Twenty-eight randomly chosen AIIMS clinical isolates (spanning 1997-2000), 16 isolates from other institutions in North India, and six reference strains of C. neoformans were subjected to susceptibility testing to fluconazole and itraconazole. RESULTS: Among clinical isolates, susceptibilities to fluconazole and itraconazole were 84.1% and 93.2%, respectively. MICs for all clinical isolates were 0.25-32 mg/L for fluconazole and <0.03-0.25 mg/L for itraconazole. MIC50 and MIC90 values for fluconazole were 4 and 16 mg/L, respectively, and those for itraconazole were 0.032 and 0.125 mg/L, respectively. Out of 28 AIIMS clinical isolates, 22 had minimum fungicidal concentrations (MFCs) of fluconazole at 128 mg/L. Moderately high fluconazole MICs (16-32 mg/L) were observed in 16% of clinical isolates--probably the first such report from India. MIC/MFC ratios for fluconazole and itraconazole were 1:32 or more in 16 AIIMS clinical isolates, indicating possible azole tolerance. There was good agreement between MIC values obtained by the micro- and macro-broth dilution techniques of M27-A compared in this study. CONCLUSIONS: The observed MIC data warrant continued surveillance of susceptibility values of clinical cryptococcal isolates in India.

Confidence Intervals↗
PubMed2004

HLA-B and HLA-C alleles and haplotypes in the Dravidian tribal populations of southern India.

The Dravidians are believed to be the earliest inhabitants of India. Their subsequent migration and admixture with invading racial groups has been of scientific interest for population geneticists. In the present study, seven highly endogamous and extremely isolated colonies of Dravidian tribal populations (n = 105) from Kerala in South India were analysed and compared with random non-tribal Dravidian (RND) samples (n = 78) of southern India using the polymerase chain reaction with sequence-specific primer method for HLA-B and HLA-C typing. The tribal group comprises Adiya, Kanikkar, Kattunaikka, Kuruma, Kurichiya, Malapandaram and Paniya, while the RND group includes Malayalam-speaking individuals from various non-tribal castes of Kerala selected randomly. Some of the most frequent HLA-B alleles in the RND population were similar to the North Indian population and included B*07, B*61 (B*40), B*44, B*51, B*35 and B*52. Although B*61 was the most frequent allele in our total study population, the frequency fluctuated in individual populations. HLA-Cw*14 was one of the most frequent alleles while HLA-Cw*17 was totally absent in all populations studied. The haplotype B*61-Cw*14 was present in all the study groups except in Kurichiya, and the haplotype B*51-Cw*14 was only absent in Kattunaikka. Phylogenetic tree and correspondence analysis indicate that all the Dravidian tribal communities group together as a separate cluster, while the RND group of individuals from South India lie close to the North Indian population. This suggests that the RND population of South India might have a crypto-Dravidian origin, while the smaller Dravidian tribal communities have a distinct Dravidian origin.

Alleles↗
PubMed2005

Community-based epidemiology of hepatitis B virus infection in West Bengal, India: prevalence of hepatitis B e antigen-negative infection and associated viral variants.

BACKGROUND AND AIMS: There is a paucity of population-based epidemiological information regarding hepatitis B virus (HBV) infection in India. The present study was planned to outline the magnitude and pattern of HBV infection, hepatitis B e antigen (HBeAg)-negative infection and the associated viral mutants in India. METHODS: A community-based epidemiological study of HBV infection was carried out in West Bengal, India. Serological markers of infection and potential risk factors for HBV transmission were determined. Among the infected individuals, HBV-DNA, genotypes and mutations in the precore (PC) stop codon and basal core promoter (BCP) regions were determined by DNA sequencing and polymerase chain reaction (PCR) restriction fragment length polymorphism methods. RESULTS: Of the 7653 people included in the study, 227 (2.97%) tested positive for hepatitis B surface antigen (HBsAg), of whom 204 (90%) were HBeAg-negative and hepatitis B e antibody (anti-HBe)-positive, and 78% had normal alanine aminotransferase (ALT) levels. HBV-DNA could be detected by PCR in only 32% of people. G1896A PC stop codon mutants were present in 12% of people, BCP mutants in 18% and the remainder (70%) of the HBeAg-negative infections were associated with wild type sequences in these regions. CONCLUSIONS: This first general population-based epidemiological study of HBV infection from India suggests that HBV acquisition starts in early childhood and peaks in adulthood. Most infections in the community are e-negative and inactive. The point prevalence of PC stop codon and BCP mutants is low in this primarily inactive and asymptomatic HBV-infected population sample in eastern India.

Adenine↗
PubMed2005

Need for gerodontology education in India.

OBJECTIVES: To evaluate the status and need for education in Geriatric Dentistry in India. MATERIALS AND METHODS: The status of dental education in India was studied. India has 185 dental schools producing 12 000 dental graduates every year. At postgraduate level, there are nine recognised specialities in Dentistry, and approximately 58 institutions offer 1160 places for postgraduate degree courses. Dental education is shaped and administered by the Dental Council of India. RESULTS: So far, Geriatric dentistry has not developed as a separate, independent speciality at postgraduate level. The undergraduate curriculum does not have any significant component of geriatric dentistry. The lack of training results in poor understanding of special needs of older adults in young graduates. Without adequate training and personal experience of growing old, young graduates may not be able to understand the physical, socio-economic and psychological problems of the elderly and the complexities involved in treatment planning for patients with multiple chronic diseases and medication. CONCLUSIONS: It is emphasized that geriatric dentistry should be included in each of the pre-clinical, para-clinical and clinical subjects at the undergraduate level. Graduate students should be encouraged to treat elderly patients in clinics under supervision using a multi-disciplinary approach. Also, postgraduate diploma and degree courses in geriatric dentistry should be developed to address the needs of the vast elderly population in India.

Aged↗
PubMed1999

Full-length human immunodeficiency virus type 1 genomes from subtype C-infected seroconverters in India, with evidence of intersubtype recombination.

The development of an effective human immunodeficiency virus type 1 (HIV-1) vaccine is likely to depend on knowledge of circulating variants of genes other than the commonly sequenced gag and env genes. In addition, full-genome data are particularly limited for HIV-1 subtype C, currently the most commonly transmitted subtype in India and worldwide. Likewise, little is known about sequence variation of HIV-1 in India, the country facing the largest burden of HIV worldwide. Therefore, the objective of this study was to clone and characterize the complete genome of HIV-1 from seroconverters infected with subtype C variants in India. Cocultured HIV-1 isolates were obtained from six seroincident individuals from Pune, India, and virtually full-length HIV-1 genomes were amplified, cloned, and sequenced from each. Sequence analysis revealed that five of the six genomes were of subtype C, while one was a mosaic of subtypes A and C, with multiple breakpoints in env, nef, and the 3' long terminal repeat as determined by both maximal chi2 analysis and phylogenetic bootstrapping. Sequences were compared for preservation of known cytotoxic T lymphocyte (CTL) epitopes. Compared with those of the HIV-1LAI sequence, 38% of well-defined CTL epitopes were identical. The proportion of nonconservative substitutions for Env, at 61%, was higher (P < 0.001) than those for Gag (24%), Pol (18%), and Nef (32%). Therefore, characterized CTL epitopes demonstrated substantial differences from subtype B laboratory strains, which were most pronounced in Env. Because these clones were obtained from Indian seroconverters, they are likely to facilitate vaccine-related efforts in India by providing potential antigens for vaccine candidates as well as for assays of vaccine responsiveness.

Adult↗
PubMed2000

Utilisation of eyecare services in an urban population in southern India: the Andhra Pradesh eye disease study.

AIM: To assess utilisation of eyecare services by people with visual impairment <6/18 or equivalent visual field loss in the better eye in the urban population of Hyderabad in southern India. METHODS: 2522 subjects of all ages, representative of the population of Hyderabad city, underwent a detailed interview and dilated examination as part of the population based Andhra Pradesh eye disease study. Subjects more than 15 years of age were interviewed regarding the use of eyecare services. RESULTS: Of 250 subjects with presenting distance visual acuity <6/18 or equivalent visual field loss in the better eye, information on utilisation of eyecare services was available for 229 (91.6%). Of these 229 subjects, 44 (19%) had visual acuity <6/60 or equivalent visual field loss in the better eye, and 202 (88.2%) had noticed decrease in vision over the past 5 years. Multivariate analysis showed that this decrease in vision was noticed significantly less by subjects with refractive error as the cause of visual impairment (odds ratio 0.34, 95% confidence interval 0.12-0.93). Of the 229 subjects who were visually impaired, 108 (59%) did not seek treatment. Multivariate analysis revealed that the odds for seeking treatment were significantly lower for Hindus than Muslims (odds ratio 0.53, 95% confidence interval 0.28-0.98). The reasons for not seeking treatment could be classified as personal (49.5%), economic (30.8%), and social (19.6%). CONCLUSION: A large proportion of subjects with visual impairment in this urban population in India did not seek treatment even after noticing decrease in vision. Projecting these data to the 155 million urban population >15 years of age in India, there may be 4.9 million (95% confidence interval 4.3-5.5 million) people in urban India who are not seeking treatment for their visual impairment even after noticing decrease in vision. These data suggest that efforts have to be made to better understand the reasons for this phenomenon so that optimal utilisation of the available eyecare services in urban India can be planned.

Adolescent↗
PubMed1996

Epidemiology of hepatitis B virus infection in India.

The average estimated carrier rate of hepatitis B virus (HBV) in India is 4%, with a total pool of approximately 36 million carriers. Wide variations in social, economic, and health factors in different regions may explain variations in carrier rates from one part of the country to another. Professional blood donors constitute the major high risk group for HBV infection in India, with a hepatitis B surface antigen positivity rate of 14%. Blood transfusions represent the most important route of HBV transmission among adults. However, most of India's carrier pool is established in early childhood, predominantly by horizontal spread due to crowded living conditions and poor hygiene. Acute and subacute liver failure are common complications of viral hepatitis in India and HBV is reckoned to be the aetiological agent in 42% and 45% of adult cases, respectively. HBV is reported to be responsible for 70% of cases of chronic hepatitis and 80% of cases of cirrhosis of the liver. About 60% of patients with hepatocellular carcinoma are HBV marker positive. Small numbers of patients have been reported to be infected with the pre-core mutant virus but none with the S mutant. Coinfection with hepatitis C virus or hepatitis delta virus is comparatively uncommon. In conclusion, hepatitis B is a major public health problem in India and will continue to be until appropriate nationwide vaccination programmes and other control measures are established.

Hepatitis B↗
PubMed2004

Autosomal dominant cerebellar ataxia: SCA2 is the most frequent mutation in eastern India.

OBJECTIVE: Spinocerebellar ataxia type 2 (SCA2) has been reported as the commonest dominant hereditary ataxia in India. However, India is an ethnically and religiously diverse population. Previous studies have not clearly indicated exact ethnic and religious origins, and must therefore be interpreted with caution. The purpose of this study was to determine the prevalence of different SCA mutations in a relatively homogeneous population from eastern India. METHODS: We identified 28 families with autosomal dominant cerebellar ataxia from eastern India. Each underwent full clinical evaluation and were analysed for the presence of SCA1, SCA2, SCA3, SCA6, SCA7, SCA8, SCA12, and SCA17 mutations. In addition, haplotype analysis was carried out in seven of the 16 families with SCA2. RESULTS: Seven patients from four (14%) families were positive for an expansion in SCA1 and 26 patients from 16 (57%) families were positive for an expansion in SCA2. No mutations were detected in the remaining eight families (29%). Most of the SCA1 and SCA2 families were Hindu from the state of Bihar. Five out of 26 SCA2 patients in this study did not have slow saccades. In addition, four of seven SCA1 patients had slow saccades. We found an association between the SCA2 CAG repeat expansion and the 285 base pair (bp) allele of microsatellite marker D12S1672, and also data supportive of the association between the expansion and the 225 bp allele of D12S1333, which has been previously described. CONCLUSIONS: We conclude that (1) although slow ocular saccades are highly suggestive of SCA2, that they are not universal, nor are they exclusive to this disorder and (2) SCA2 is likely to be the commonest dominant ataxia in eastern India, with further evidence for a founder effect.

Adolescent↗
PubMed2005

Prevalence and distribution of high-risk human papilloma virus (HPV) types in invasive squamous cell carcinoma of the cervix and in normal women in Andhra Pradesh, India.

BACKGROUND: Despite the high incidence of cervical cancer reported from India, large scale population based studies on the HPV prevalence and genotype distribution are very few from this region. In view of the clinical trials for HPV vaccine taking place in India, it is of utmost importance to understand the prevalence of HPV genotypes in various geographical regions of India. We investigated the genotype distribution of high-risk HPV types in squamous cell carcinomas and the prevalence of high-risk HPV in cervicovaginal samples in the southern state of Andhra Pradesh (AP), India. METHODS: HPV genotyping was done in cervical cancer specimens (n = 41) obtained from women attending a regional cancer hospital in Hyderabad. HPV-DNA testing was also done in cervicovaginal samples (n = 185) collected from women enrolled in the cervical cancer screening pilot study conducted in the rural community, of Medchal Mandal, twenty kilometers away from Hyderabad. RESULTS: High-risk HPV types were found in 87.8% (n = 36/41) of the squamous cell carcinomas using a PCR-based line blot assay. Among the HPV positive cancers, the overall type distribution of the major high-risk HPV types was as follows: HPV 16 (66.7%), HPV 18 (19.4%), HPV 33 (5.6%), HPV 35 (5.6%), HPV 45 (5.6%), HPV 52 (2.8%), HPV 58(2.8%), HPV 59(2.8%) and HPV 73 (2.8%). Women participating in the community screening programme provided both a self-collected vaginal swab and a clinician-collected cervical swab for HPV DNA testing. Primary screening for high risk HPV was performed using the Digene Hybrid Capture 2 (hc2) assay. All hc2 positive samples by any one method of collection were further analyzed using the Roche PCR-based line blot for genotype determination. The prevalence of high risk HPV infection in this community-based screening population was 10.3% (19/185) using the clinician-collected and 7.0% (13/185) using the self-collected samples. The overall agreement between self-collected and clinician-collected samples was 92%; however among HPV-positive specimens, the HPV agreement was only moderate (39.1%). The most frequently detected HPV types in the Medchal community are HPV 52 and 16. CONCLUSION: Our results suggest that the HPV type distribution in both cervical cancer tissues and in a general screening population from Andhra Pradesh is similar to that reported in India and other parts of the world. We also conclude that an effective vaccine targeting HPV 16 will reduce the cervical cancer burden in AP.

Adult↗
PubMed2003

Early detection of cervical cancer with visual inspection methods: a summary of completed and on-going studies in India.

India is a high-risk country for cervical cancer which accounts a quarter (126,000 new cases, 71,000 deaths around 2,000) of the world burden. The age-standardized incidence rates range from 16-55 per 100,000 women in different regions with particularly high rates in rural areas. Control of cervical cancer by early detection and treatment is a priority of the National Cancer Control Programme of India. There are no organized cytology screening programmes in the country. The technical and financial constraints to organize cytology screening have encouraged the evaluation of visual inspection approaches as potential alternatives to cervical cytology in India. Four types of visual detection approaches for cervical neoplasia are investigated in India: a) naked eye inspection without acetic acid application, widely known as 'downstaging'; b) naked eye inspection after application of 3-5% acetic acid (VIA); c) VIA using magnification devices (VIAM); d) visual inspection after the application of Lugol's iodine (VILI). Downstaging has been shown to be poorly sensitive and specific to detect cervical neoplasia and is no longer considered as a suitable screening test for cervical cancer. VIA, VIAM and VILI are currently being investigated in multicentre cross-sectional studies (without verification bias), in which cytology and HPV testing are also simultaneously evaluated, and the results of these investigations will be available in 2003. These studies will provide valuable information on the average, comparative test performances in detecting high-grade cervical cancer precursors and cancer. Results from pooled analysis of data from two completed studies indicated an approximate sensitivity of 93.4% and specificity of 85.1% for VIA to detect CIN 2 or worse lesions; the corresponding figures for cytology were 72.1% and 91.6%. The efficacy of VIA in reducing incidence of an mortality from cervical cancer and its cost-effectiveness is currently being investigated in two cluster randomized controlled intervention trials in India. One of these studies is a 4-arm trial addressing the comparative efficacy of VIA, cytology and primary screening with HPV DNA testing. This trial will provide valuable information on comparative detection rates of CIN 2-3 lesions by the middle of 2003. The expected outcomes from the Indian studies will contribute valuable information for guiding the development of public health policies on cervical cancer prevention in countries with different levels of socio-economic and health services development and open up new avenues of research. This paper is available too at: http//www.insp.mx/salud/index.html.

Acetic Acid↗
PubMed1978

Social justice and the demographic transition: lessons from India's Kerala State.

Kerala is a small, densely crowded state in South India. It is a poor state, even by Indian standards. Its per capita income of US$80 lies well below the all-India average of US$120, and it suffers from the lowest per capita caloric intake in India. Nevertheless, Kerala has managed to achieve the demographic transition from high (premodern) to low (modern) birth and death rates-something no other Indian state has been able to attain. Indeed, the magnitude of Kerala's fertility decline-the birth rate fell from 39 in 1961 to 26.5 in 1974-has never before been observed in a nation with comparable levels of income and undernutrition. Other indices of Kerala's soical development are equally surprising: levels of literacy, life expectancy, female education, and age at marriage are the highest in India, while mortality rates, including infant and child mortality, are the lowest among Indian states. But Kerala's anomalous and unexpected demographic trends and levels are not the result of the direct interventions designed to influence health and fertility levels elsewhere in India-conventional strategies of population control and health services delivery that thus far are notable for their failure to generate such positive results. Instead, Kerala's demographic levels evidently reflect a broad social response to structural reforms in its political economy.

Birth Rate↗
PubMed2001

Present leprosy situation in India and the decade long experience of this correspondent.

Leprosy, which was known to ancient India as "Kustha Roga" is thought to be its origin from India also. It is, still, a major public health problem in India affecting many people every year. India is, now, having maximum numbers of leprosy cases worldwide and accounts for 67% of total prevalence and 73% of total new case dectection. Huge numbers of new cases have been detected in recent years (Last year new cases were 782,501) because of adoption of new strategy, Modified Leprosy Elimination compaign (MLEC), and effective health education campaign. Presently, 70% of the total new caseloads of India are from five most heavily infected states. There is significant improvement in the overall situation as is evident from steady decline of prevalence rate from 38.6 cases per 10,000 population in 1985 to 5.0 per 10,000 in 1999.

Drug Therapy, Combination↗
PubMed1998

Economic burden of blindness in India.

Economic analysis is one way to determine the allocation of scarce resources for health-care programs. The initial step in this process is to estimate in economic terms the burden of diseases and the benefit from interventions for prevention and treatment of these diseases. In this paper, the direct and indirect economic loss due to blindness in India is calculated on the basis of certain assumptions. The cost of treating cataract blindness in India is estimated at current prices. The economic burden of blindness in India for the year 1997 based on our assumptions is Rs. 159 billion (US$ 4.4 billion), and the cumulative loss over lifetime of the blind is Rs. 2,787 billion (US$ 77.4 billion). Childhood blindness accounts for 28.7% of this lifetime loss. The cost of treating all cases of cataract blindness in India is Rs. 5.3 billion (US$ 0.15 billion). Similar estimates for causes of blindness other than cataract have to be made in order to develop a comprehensive approach to deal with blindness in India.

Adolescent↗