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Situation Analysis of Murshidabad District, West Bengal

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Situation Analysis of Murshidabad District, West Bengal FIELD PROJECT REPORTS By Tapas Kumar Ray (MAE- FETP Scholar 2007-2008) Submitted in partial fulfillment of the requirements for the degree of Master of Applied Epidemiology (M.A.E) of Sree Chitra Tirunallnstitute for Medical Sciences and Technology, Thiruvananthapuram, Kerala-695 011 This work has been done as part of the two year Field Epidemiology Training Programme (FETP) conducted at National Institute of Epidemiology, (Indian Council of Medical Research), R-127, TamilNadu Housing Board, Ayapakkam, Chennai-77, India. January 2009 FIELD PROJECT REPORTS By Tapas Kumar Ray (MAE- FETP Scholar 2007 -2008) • ~ Submitted in partial fulfillment of the requirements for the degree of Master of Applied Epidemiology (M.A.E) of Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala-695 011 This work has been done as part of the two year Field Epidemiology Training Programme (FETP) conducted at National Institute of Epidemiology, (Indian Council of Medical Research), R-127, Tamil Nadu Housing Board, Ayapakkam, Chennai-77, India. January 2009 CERTIFICATION This is to certify that all the field projects submitted in this Bound Volume are original work carried out by Dr. Tapas Kumar Ray during the two field postings of six months each under the guidance of faculty of National Institute of Epidemiology (ICMR), Chennai and the local supervisor specially nominated for this purpose. This is in partial fulfillment of the requirements for the degree of Master of Applied Epidemiology and has not been submitted earlier by him in part or whole for any other (Publication or degree) purpose 0 Date: Acknowledgement Several dignitaries and institutions have extended their valuable time, advice and assistance to me during preparation of this report. I extend with gratitude my sincere thanks to: Dr. V. Kumaraswamy, Director, National Institute of Epidemiology, Chennai for his valuable guidance amidst his busy schedule. Dr. M. V. Murhekar, Deputy Director and Course coordinator, Master of Applied Epidemiology, National Institute of Epidemiology, Chennai and my mentor for the field projects. I express my sincere thanks and honest gratitude to him for going through the details of my project reports closely and giving suggestions and advice. Dr. Y. Hutin, World Health Organisation, India country office, Dr. B. N. Murthy, Deputy Director, R. Ramakrishnan, Deputy Director, Dr. Vidhya Ramachandran, Deputy Director, Dr P.Manickam Research Officer National Institute of Epidemiology, Chennai for his kind guidance and suggestions. Dr. S. Baksi, Director of Health Services, West Bengal for allowing me to take up MAE-FETP course at National Institute of Epidemiology, Chennai. Dr. S. Mandai, CMOH, Murshidabad, Dr. T. K. Sen and Dr. A. K. Biswas, MAE graduate, Dr. S. Roy, Dy. CMOH-111, Murshidabad, Dr. J. Dinda, Dy. CMOH-11, Murshidabad, Dr. B. P. Bag, ACMOH, Jangipur and all colleagues of my department for their guidance, support and cooperation. I will really do injustice if I do not mention several scientists and staff of NIE like Dr. Sundarmurthy, Dr. Jabber, librarian S. Satish and Mrs Uma. Last but not the least I am indebted to my family for helping me in this endeavor of hard work with patience. Finally all the respondent who very graciously spared me their valuable time and extend their cooperation. Date: Tapas Kumar Ray Table of Contents Section 1: First Field Posting ............................................... 1-49 1.1 Situational analysis of Murshidabad District, West Bengal, 2-30 India, 2006 1.2 Secondary data analysis of malaria epidemiological 31-49 situation of Murshidabad District, West Bengal, India, 2007 Section 2: Second Field Posting ......................................... 50-91 2.1 Evaluation of surveillance of acute flaccid paralysis for 51-70 poliomyelitis in Murshidabad District, West Bengal, India, 2007 2.2 Evaluation of the existing anthrax control activities in 71-91 () Murshidabad district, India, 2007 Section 3: Outbreak investigations ........ ~ ... , ......................... 92-146 3.1 An·outbreak investigation of Measles at Dihigram village of 93-104 Murshidabad district, West Bengal, India, 2007 3.2 Cutaneous Anthrax outbreaks in two villages of 105-119 Murshidabad, west Bengal, India, 2007 -~ 3.3 An outbreak of Cutaneous Anthrax, at Burakuli village, 120-133 Murshidabad, West Bengal, India, 2007 3.4 An investigation on Measles outbreak at Kulgachi village of 134-146 Murshidabad, West Bengal, India, 2008 Section 4: Journal critique ................................................ 147-154 4.1 Critical evaluation of published research 148-154 Section 5: Paper presentation ........................................... 155-163 5.1 Oral presentation in National Conference on Emerging Issues in Public Health, AMCCON, Trivandrum, Kerala, 156-157 January 11-13, 2008 5.2 Oral presentation in International Night session, 57th Annual EIS Conference, April14-18, 2008, Centers for Disease 158-159 Control and Prevention, Atlanta, USA 5.3 Poster presentation in, 5th Global TEPHINET Conference, 160-161 1st-6th November 2008, Kualalumpur, Malaysia 5.4 Oral presentation in, 5th Global TEPHINET Conference, 162-163 1st-6th November 2008, Kualalumpur, Malaysia - -· -· -·---··- -----------· -- -- -- ----- --------------- Section 1: First Field Posting Pageno.1 Situation analysis of Murshidabad district, West Bengal, India, 2007 o Introduction Indian public health scenario The public sector health system of India is one of the largest systems in the world in terms of its infrastructure. India has its own declared National Health and National Population Policy. Smallpox as well as Gunea worm has been eradicated and Plague is not a problem now1. Morbidity from diarrhoeal diseases has come down to a great extent. The birth rate has come down from 33.7/1000 population to 23.8/ population, crude death rate from 12.6/1000 to 7.6/1000 population and the infant mortality rate from 114/1000 live births to 58/1000 live births2. The problems of malnutrition, poor sanitation, and Illiteracy are hindering the improvement in the burden. The major public health problems have not been changed so much in last six decades. The prevalence of tuberculosis, leprosy, filariasis, viral hepatitis, diarrhea, dysentery and disorders of malnutrition has not shown any significant change. MDR-TB is posing a potential threat to tuberculosis control in the country. Diarrhoeal diseases and acute respiratory diseases are still the major killer diseases. Malaria and Kala-Azar which showed a decline in the 1960s have come back3. Japanese encephalitis and Meningococcal encephalitis have shown. an Page no. 2 increasing trend. Some non-communicable diseases like diabetes, heart disease, cancer, mental illness, hypertension accidents and injuries etc show a growing threat. The factors which play a role in the changing pattern of the disease include demographic factors, changing lifestyles and living standards, urbanization and industrialization, medical intervention, transmission of genetic defects and the widespread effect of technology on ecosystem. The changing pattern of the disease in this country and the emergence of new problems highlight the need for an aggressive change in health planning and management. Public health scenario in West Bengal West Bengal had a population of 68,077,965 with population density of 903/sq.km making it the most densely populated state in lndia4. The birth rate is 18.8/1000 population, crude death rate 6.4/1000 population, the infant mortality rate 38/1000 live births2 and the Maternal mortality ratio is 194/100000 live births4. The diseases like Malaria, Dengue, Kala-azar, Diarrheal Diseases, HIV, Tuberculosis, and Arsenicosis are the major public health problems the state is trying to combat5. I have been worked as Assistant Chief Medical Officer of Health, Jangipur, under Murshidabad district before enrollment in the Master of Applied Epidemiology course. The job responsibility was to plan, implement, monitor and supervise all Family Welfare & Public Health programmes as well as administrative function at Sub-divisional level. Since the district faces multiple Family Welfare & Public Page no. 3 Health problems including Malaria, Kala-azar, Filarial, Leprosy and Tuberculosis, the post demands hard working for successful surveillance activities. The post carries responsibility of Sub~divisional level nodal officer for all national programmes. Moreover the Assistant Chief Medical Officer of Health, Jangipur ~ office is a Unit office for National Vector Born Disease Control Programme as per Government of India norm. As such the undersigned has to procure medicines and equipments for the above programme from state and distribution of the same for the all "blocks of Jangipur, Lalbagh sub-division and 2 blocks of Domkol sub- division. As well as fund management for the above programme was also done regt,.~larly. These includes compilation, collection, interpretation and feedback of all data generated at Sub-division level related to indicators of reproductive and child 0 health programme, all national public health programmes and health care facilities .. I had to send the report to Chief Medical officer of Health of the district and respective district programme officers. As field epidemiology training programme (FETP) scholar, I shall work as medical officer on training reserve under the Government of West Bengal and shall be placed under the Chief Medical Officer of Health, Murshidabad and Assistant Chief Medical
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