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NCMH Background Papers·Burden of Disease in India NCMH Background Papers Burden of Disease in India Background Papers of the National Commission on Macroeconomics and Health Background Papers of the National Commission on Background Papers Macroeconomics and Health Burden of Disease in India National Commission on Macroeconomics and Health MINISTRY OF HEALTH AND FAMILY WELFARE GOVERNMENT OF INDIA, 2005 EQUITABLE DEVELOPMENT • HEALTHY FUTURE 324 Gururaj NCMH Background Papers·Burden of Disease in India NCMH Background Papers Burden of Disease in India 324 Gururaj NCMH Background Papers·Burden of Disease in India NCMH Background Papers Burden of Disease in India lR;eso t;rs National Commission on Macroeconomics and Health Ministry of Health & Family Welfare, Government of India, New Delhi September 2005 iv NCMH Background Papers—Burden of Disease in India (New Delhi, India), September 2005 Ministry of Health & Family Welfare, Nirman Bhawan, Maulana Azad Road New Delhi 110011, India Dosage schedules are being constantly revised and new side-effects recognized. The reader is thus strongly urged to consult the printed instructions of drug companies before administering any of the drugs recommended in this book. It is possible that errors might have crept in despite our best efforts to check drug dosages. © 2005 National Commission on Macroeconomics and Health, Government of India The report has been technically edited by BYWORD EDITORIAL CONSULTANTS New Delhi, India e-mail: [email protected] Printed at Shree Om Enterprises Pvt. Ltd., A-98/3 Okhla Industrial Area, Phase II, New Delhi 110020 NCMH Background Papers·Burden of Disease in India v Contents Preface ............................................................................................................................................................... ix Contributors ....................................................................................................................................................... xi INTRODUCTION Disease burden in India: Estimations and causal analysis ............................................................................. 1 SECTION I: NATIONAL HEALTH PROGRAMMES: COMMUNICABLE DISEASES, AND REPRODUCTIVE AND CHILD HEALTH National Health Programmes Programmes for the control of leprosy, tuberculosis and malaria ................................................................. 9 AVTA R SINGH DUA Burden of tuberculosis in India for the year 2000 ............................................................................................... 24 TUBERCULOSIS RESEARCH CENTRE, CHENNAI Causal analysis and treatment protocols for tuberculosis.................................................................................... 26 TUBERCULOSIS RESEARCH CENTRE, CHENNAI Causal analysis and treatment protocols for vector-borne diseases: Malaria, dengue, Japanese encephalitis, kala-azar, lymphatic filariasis ....................................................................................................... 30 VECTOR CONTROL RESEARCH CENTRE, PONDICHERRY HIV/AIDS Controlling the HIV/AIDS epidemic in India ...................................................................................................... 44 YING-RU J. LO, PADMAJA SHETTY, D.S.C. REDDY, SALIM HABAYEB HIV-1 trends, risk factors and growth in India ............................................................................................... 58 RAJESH KUMAR, PRABHAT JHA, PAUL ARORA, NEERAJ DHINGRA, INDIAN STUDIES OF HIV/AIDS WORKING GROUP Causal analysis and treatment protocols for sexually transmitted infections, HIV/AIDS and opportunistic infections .................................................................................................................................... 74 NATIONAL AIDS RESEARCH INSTITUTE, PUNE Maternal and Child Health Review of women and children’s health in India: Focus on safe motherhood............................................... 85 RAJANI R. VED, AVTAR SINGH DUA Causal analysis and treatment protocols for maternal complications........................................................... 112 SARALA GOPALAN, SHALINI GAINDER NCMH Background Papers·Burden of Disease in India vi Contents Components of under-five mortality trends, current stagnation and future forecasting levels ..................... 152 ARVIND PANDEY, B.N. BHATTACHARYA, D. SAHU, REHENA SULTANA Newborn and child health in India: Problems and interventions ......................................................................... 179 SIDDARTH RAMJI Estimation of the burden of diarrhoeal diseases in India ..................................................................................... 182 NATIONAL INSTITUTE OF CHOLERA AND ENTERIC DISEASES, KOLKATA Causal analysis and treatment protocols for childhood diseases ......................................................................... 188 SIDDARTH RAMJI SECTION II: NON-COMMUNICABLE DISEASES Vascular Diseases Forecasting vascular disease cases and associated mortality in India .................................................................. 197 A. INDRAYAN Suggested treatment for selected cardiac disorders at secondary-level health care facilities in low-resource countries ............................................................................................................................................................ 216 CENTRE FOR CHRONIC DISEASE CONTROL, NEW DELHI Cancers Cancer: Current scenario, intervention strategies and projections for 2015 ......................................................... 219 M. KRISHNAN NAIR, CHERIAN VARGHESE, R. SWAMINATHAN Mental Health Mental, neurological and substance abuse disorders: Strategies towards a systems approach ............................. 226 GURURAJ G., GIRISH N., ISAAC M.K. Asthma and COPD Economic burden of asthma ............................................................................................................................... 251 K.J.R. MURTHY, J.G. SASTRY Economic burden of chronic obstructive pulmonary disease ............................................................................... 264 K.J.R. MURTHY, J.G. SASTRY Oral and Dental Diseases Oral and dental diseases: Causes, prevention and treatment strategies ............................................................... 275 NASEEM SHAH Blindness National Programme for Control of Blindness .................................................................................................... 299 AVTA R SINGH DUA Blindness estimations, projections and service delivery ...................................................................................... 305 MURALIKRISHNAN R., PRAVEEN KRISHNA R., THULASIRAJ R.D., DAMODAR BACHANI, SANJEEV GUPTA, G.V.S. MURTHY NCMH Background Papers·Burden of Disease in India Contents vii Appendix to Section II Services, equipment, personnel and drugs required at different levels of health care for non-communicable diseases .............................................................................................................................................................. 318 BARIDALYNE NONGKYNRIH, CHERIAN VARGHESE SECTION III: INJURY Injuries in India: A national perspective ............................................................................................................. 325 GURURAJ G. ANNEXURE Annexure A: Causes of various diseases/health conditions .................................................................................. 351 NATIONAL COMMISSION ON MACROECONOMICS AND HEALTH, NEW DELHI Annexure B: Interventions for the management of diseases/health conditions at different levels of care .............. 362 NATIONAL COMMISSION ON MACROECONOMICS AND HEALTH, NEW DELHI NCMH Background Papers·Burden of Disease in India viii NCMH Background Papers·Burden of Disease in India ix Preface In pursuance of the recommendations made by the direct and indirect factors that contributed to the persistence Commission on Macroeconomics and Health, India of these diseases. Surprisingly, we found it difficult to provide established the National Commission on Macroeconomics even current-level estimates for diseases/conditions that are and Health (NCMH) in March 2004. The main objective being implemented with substantial donor funding under of the NCMH was to establish the centrality of health to the National Health Programmes. We, therefore, could not development and make an evidence-based argument to come up with any estimates for malaria or other vector- increase investment in health. The Terms of Reference of borne diseases, reproductive health, several childhood diseases the NMCH were mainly centred on identifying a package such as respiratory infections, etc. Even for tuberculosis of essential health interventions that ought to be made (TB), arriving at any projections for 2015 under the emerging available to all citizens and also list systemic constraints scenario of the rising HIV/AIDS epidemic was impossible. that need to be addressed for ensuring universal access to For these reasons it was difficult to come up with any specific this package of services. The NCMH was also to indicate targets to be achieved within a limited time-frame. the resources required and targets that ought to be achieved Likewise, we were unable to find any studies or research by 2015. which provided evidence demonstrating the efficacy of specific One of the Terms of Reference of the NCMH was to come interventions under a programme in Indian conditions and up with a baseline of the estimated prevalence of diseases among different population
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