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Communicable disease problems
Communicable diseases, continue to be a major problem in India, whereas they have been largely controlled in the developed countries such as USA and UK. It has been estimated that nearly 54 per cent of deaths in India are due to communicable diseases.
Till 1950, malaria was considered to be a major health problem of India. An estimate of the disease in 1953 showed an annual incidence of 75 million cases, and 8 lakhs deaths. The National Malaria Control and Eradication Programmes launched in 1953 and 3958 respectively gave a deathblow to malaria; by 1971, the incidence of malaria declined to just over one million cases and no deaths.
The disease, which was on its way to eradication reappeared. In 1976, the incidence of malaria arore to a peak of 6.47 million cases (of which 7, 42, 247 were falciparum cases) with 59 deaths. The Govt. of India introduced a modified plan of operation from 1977 to tackle the situation effectively. Efforts are now being made to contain the disease.
By 1984 the incidence of malaria was brought down to 2.1 million cases, since then the epidemiologlcal situation has not shown any great improvement. It seems to have reached a plateau, which is causing concern. By the end of 2001, about 2.05 million cases of malaria (with about 1 million cases of falclparum malaria) and 1015 deaths were reported from different states.
Tuberculosis may be said to be leading communicable disease of India today. Four people per 1.000 populations have bacteriologically confirmed disease. It has been estimated that there are at least 14 million cases of pulmonary tuberculosis in the country, of which at least 3.5 million are sputum positive.
The number of deaths from tuberculosis is often quoted as 500,000 each year. About 2 to 2.5 million cases of pulmonary tuberculosis are added every year.
3. Diarrhoeal diseases:
Diarrhoeal diseases constitute one of the major causes of morbidity and mortality, especially in children below 5 years of age. They are responsible for about 6.27 lakh deaths each year. Outbreaks of diarrhoeal diseases (including cholera) continue to occur in India due to poor environmental conditions. The type of cholera that is now widely prevalent in India is "El Tor Cholera". It is milder infection as compared to older "classical cholera".
4. Acute Respiratory Infections:
Acute respiratory diseases are one of the major causes of mortality and morbidity in children below 5 years of age. It is estimated that about JL3.6,. per. cent hospital admissions and 13 percent in patient deaths in paediatric wards are due to ARI
Leprosy is widely prevalent in India. With 5.59 million estimated cases India accounts for about 64 per cent of the global burden (0.9 million) of the disease and 87 per cent of the Region's registered cases. At present the reported prevalence rate is about 3.73 per 10,000 population.
Out of these cases about 18.5 per cent are children below the age of 15 years. The proportion of multibacillary cases among total cases is about 33.9 percent. The deformity rate among total active cases is approximately 2.7 per cent. Presently all the districts in the country provide free Mulit dract treatment (MDT) services.
Filariasis is another communicable disease problem of India. Although widespread in the country, the disease is heavily concentrated all along the east coast parts of Madhya Pradesh and Uttar- Pradesh. Surveys indicate that 454 million people are living in filarial areas. There are 2 types of filarial Infection in the country - W. bancrofti, and B. malayi.
Filariasis due to W. bancroftiis the more widely prevalent infection that due to B. malayi is restricted to certain areas in Kerala. Assam, Orissa, Madhya Pradesh, Chhattisgarh and West Bengal.
7. STD ( Sexually Transmitted disease):
Syphilis and gonorrhoea constitute the major problem. The exact population at a risk is not known.
The problem of AIDS is increasing in magnitude every year. Since AIDS was first detected in the year 1986, the cumulative number has risen to 8220 by the end of July 1999. About 87.3 thousand cases are seropositive for HIV in the count
Enteric fever, helminthic infestations, viral hepatitis, kala-azar, meningitis and Japanese encephalitis are among the other important communicable disease problems in India. The tragedy is that most of these diseases can be either easily prevented or treated with minimum input of resources.
The 1994 resurgence of malaria compelled the Government of India to appoint an Expert Committee on Malaria to identify the problem areas and to suggest specific measures against the different paradigms of malaria. Thus the Malaria Action Programme (MAP) was evolved and is being implemented.
The objectives of this new Malaria Action Programme
Management of serious and complicated malaria cases.
Prevention of mortality with particular reference to high risk groups
Reduction of morbidity
Control of outbreaks and epidemics
Reduction of falctparum
Incidence and containment resistance malaria
Maintenance of low incidence status.
The recent resurgence of malaria in many parts of the country necessitated the need to strengthen the health promotion component of the programme.
It has been decided to observe Anti Malaria Month before the onset of monsoon ie. month of June every year.
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