DEMARU States in India : Daughter Eliination Killing
Health & Epidemiology
- As per WHO criteria a healthy individual is with physical, mental, healthy attributes and not merely the absence of disease
Social Well Being - an individual being a healthy member of society and free from addiction of narcotics drugs, tobacco, alcohol etc
Physical Well Being - Absence of Diseases and Pathogenic Conditions
Mental Well Being - A body free from defined mental or psychological illness
- Epidemiology is the scientific study of distribution (Frequency and pattern of spread of a particular disease) and determinance (causes and risk factor) of diseases and disorders and other aspects of health related status and events not merely diseases
Epidemiological Anthropology
- Epidemiology Anthropology is the social aspect of health and diseases, detailing about spread of diseases, pattern of occurrence ,more or less impact on specified populations, regions, races & ethnicities
- In simple words it deals with understanding of spread of diseases and disorders in society, tribals, Isolated Populations, Gender based occurrence etc taking into consideration, socio cultural practises ,environmental factors and other anthropological domains
Diseases in Humans
Facts on Geography Specific Diseases
- No New Case of Polion in Last 3 Years. Hence India had become Polio Free in 2014, No new cases in India since 2011
- Certain Geentic Disorders like Thalesemia is having more occurrence in middle eastern countries and mediterrenian region(Basin)
- Color Blindness is having higher incidences in south asia and south east asia region
- Parkinsons is a neuro degnerative disorders which can be genetic and can also be trigeered by environmental factors, max occurence in north america and east asia (china, korea, japan)
Occurence of Diseases
Viral Infections
Viral Infections and Viruses (Summary)
Name of Infection | Name of Virus |
Poliomyelitis | Poliovirus |
Rabies | Rabies virus |
Hepatitis | Various hepatitis viruses (e.g., Hepatitis A virus, Hepatitis B virus, etc.) |
Herpes | Herpes simplex virus |
Chicken Pox | Varicella-zoster virus |
COVID | SARS-CoV-2 |
Common Cold | Rhinovirus, Coronavirus (some strains) |
Measles | Measles virus |
Mumps | Mumps virus |
Rubella | Rubella virus |
HPV - Human Papilloma Virus | Human papillomavirus |
HIV - Human Immunodeficiency Virus | Human immunodeficiency virus (HIV-1 and HIV-2) |
Dengue | Dengue virus |
Chikungunya | Chikungunya virus |
Ebola | Ebola virus |
Zika | Zika virus |
Japanese Encephalitis | Japanese encephalitis virus |
NIPAH (NiV) | Nipah virus |
KFDV (Kyasanur Forest Disease Virus) | Kyasanur Forest Disease virus |
Smallpox | Variola virus |
Swine Flu | Influenza A virus (H1N1 subtype) |
Lumpy Skin Disease | Lumpy skin disease virus |
Viral - Infections & Viruses
- Poliomyelitis
- Ch Rabies
- Hepaptitis
- Herpes
- Chicek Pox
- COVID
- Common Cold
- Measles
- Mumps
- Rubells
- HPV - Human Papilloma Virus
- HIV - Human Immunodeficiency Virus
- Dengue
- Chicken Guinea
- Ebola
- Zika
- Japanese Encephalitis
- NIPAH (NiV)
- KFDV (Kysner Forest Diseases Virus → Forest in Karnataka)
- Small Pox
- Swine Flu
- Lumpy Virus Disease
Summary Table
Viral Infection | Key Characteristics | Affected Regions |
Polio | - Types: - Polio wild variety 1 - 2011 | - India |
ㅤ | - Polio wild variety 2 - 1999 (eradicated in 2014) | - Pakistan |
ㅤ | - Polio wild variety 3 - 2013 | - Afghanistan |
ㅤ | - Risks: - High chances of re-entering into India due to bordering countries (Pakistan & Afghanistan) | ㅤ |
Japanese Encephalitis | - Virus: J/E Virus | - South East Asia Region |
ㅤ | - Vector: Culex Mosquito | - BIMARU states with poor health indicators (Bihar, MP, Rajasthan, UP) |
ㅤ | - Reservoir: Domestic Pigs and Wild Birds (Herons) in Coastal Area Water Bodies | ㅤ |
MER Syndrome | ㅤ | - Some East Asian countries (South Korea, Vietnam)
- Countries: Middle Eastern countries |
Zika Virus | - Found in: Zika Forest in Uganda | - Tropical regions of Africa (Kenya, Tanzania, DRC) and Brazilian Amazon Forest Area |
KFDV (Kyasanur Forest Disease) | - Mainly occurring in monkeys, but also found in humans | - Not specified |
ㅤ | - Also called: Tick fever (spread through tick bites) | ㅤ |
Dengue | ㅤ | - Particular parts of India during and after monsoons
- Found in: Tropical regions of South Asia |
NIPAH | - Reservoirs: Bats | - More common in Indonesia & Malaysian region |
ㅤ | ㅤ | - Spread: Kerala and West Bengal (India) |
EBOLA | ㅤ | - Found in: Tropical parts of South America (Amazon Basin) and West Africa near the equator |
Note
Viral Infections Need Both a Viral Vector & a Viral Reservoir
Polio
- Types of Polio in India
- Polio wild variety 1 - 2011
- Polio wild variety 2 - 1999 (india became free from it in 2014, No case since 2014)
- Polio wild variety 3 - 2013
- Pakistan and Afghanistan still have polio thus high chances of it re-entering into India as India is bordering country. Earlier Nigeria also had polio, but it is now Polio Free
Japanese Encephalitis
- Virus : J/E Virus
- Vector : Culex Mosquito
- Reservoir : Domestic Pigs and Wild Birds (Herons) Found in Coastal Area Water Bodies
- Region :
- South East Asia Region
- BIMARU states with poor health indicators - Bihar,MP,Rajasthan ,UP
MER Syndrome
- middle eastern countries
- some east asian countries like south korea and vietnam
Zika Virus
- Zika Forest is found in Uganda
- Mainly spread in tropical region of Africa → Kenya, Tanzania, DRC (Congo) and Brazilian Amazon Forest Area
KFDV
- mainly occurring in monkeys but we found in humans also
- also called as tick fever becoz it spread through bite of ticks (ticks are ectoparasites)
Dengue
found in tropical regions of south Asia and is rampant in particular parts of India particularly during and after monsoons
NIPAH
- Nipah virus reservoirs are bats
- more common in Indonesia & Malaysian region
- Spread happened in Kerala and West Bengal
EBOLA
tropical parts of south America mainly amazon basin and west Africa near to equator
Bacterial Infection
- Factual Point on “Black”
- Black Fever - Kalaazar - Protozoan
- Black Death - Plague - Bacterial
- Black Foot - Athletes Foot - Arsenic
- Summary Table on Names of Bacteria and Allied Infections
Bacterial Disease | Bacteria Name |
Tuberculosis (TB) | Mycobacterium tuberculosis |
Typhoid | Salmonella typhi |
Cholera | Vibrio cholerae |
Leprosy | Mycobacterium leprae |
Tetanus | Clostridium tetani |
Diphtheria | Corynebacterium diphtheriae |
Pertussis (whooping cough) | Bordetella pertussis |
Pneumonia | Various bacteria, e.g., Streptococcus pneumoniae, Haemophilus influenzae |
Plague | Yersinia pestis |
Anthrax | Bacillus anthracis |
- Tuberculosis
- Region : more than 25% of the world cases in India followed by China
- Causes : unhygienic living conditions & high population density
- Also Called : It is called as “Poor Mans Disease”
- Other Place : high incidence in south Asia and some parts of Africa
- Syphilis
high occurrence in tribal populations of central India like baigas
Protozoan Infection
Fun Fact : Maximum death due to any disease: TB
- Amoebic dysentery:
- Caused by Entamoeba
- Transmission: Contaminated food and water; can be sexually transmitted as well
- African sleeping sickness / Sleeping Sickness
- Caused by Trypanosoma
- Vector: Tse-Tse fly
- Kala-azar (also called black fever/dum-dum fever):
- Caused by Leishmania
- Vector: Sandfly
- Most common in sub-Saharan African countries and BIMARU states of India
- Malaria:
- Caused by Plasmodium
- Vector: Anopheles mosquito
- Disease of tropical regions
- Maximum death-causing vector-borne disease in the world
- Severely affects Tropical Africa, Southeast Asia, and Brahmaputra plains in India
Fungal Infections
- Athlete's foot:
- Fungus: Tinea pedis
- Occurs when the skin is continuously in contact with moist soil
- Candidiasis:
- Fungus: Candida
- Affects the female genital tract and skin
- Fungal infections primarily affect the skin, nails, and hair.
Infection caused by Worms
- Worm infections are caused by invertebrates called Nemathelminths/nematodes
- Example 1 : Ascariasis Disease
- Caused by Roundworm Ascaris
- Transmission: Contaminated food, water, and when children eat soil
- Common in Chhattisgarh, Odisha region, and Southeast Asia
- Example 2 : Filariasis / Elephantiasis (Swollen Leg)
- Caused by Wuchereria transmitted through the bite of Culex mosquito
- Found in Places like South India, Eastern Coast of India. South East Asia has occurrnece of Filariasis
Social Concept of Diseases
Introduction
- Occuremce of Disease : Social + Cultural + Behavoural Fctors = Occurence of Disease
- Occurrence of Disease is based on a Causal Web
Causal Web = Web of Determinants of a Disease. It is the goal of epidemiological anthropology to identify and measure the relative importance of factors within this causal web of occurrence of diseases
Types of Causes for Occurence of Diseases
- Factors
- Religion
- Ethnicity
- Environmental Factors
- Demographic Factors
- Determinants
- Exogenous
- Outside Factors
- Diseases from Pathogens - Biotic (Pathogens) & Abiotic (Air, Water & Soil)
- Endogenous
- Immune Factor
- Genetic Disorder
- Hereditary Diseases
- Demographic
- Age Related
- Gender Based
- Prevelant in Dense Populations
- Behavoural
- Socio Cultural
- Psychological
- Ritual / Religious
Defintion of Social Concept of Diseases
It is the goal of Epidemiological Anthropology to identify & measure the relative importance of factors within this causal web of occurrence of diseases
Factors Affecting Good Health
- A balanced Diet - Food and Nutrition
- Personal and societal hygiene - Includes availability of potable water
- Poverty and Poor Economic Conditions
- Intoxicants + Consumption of Alcohol, Smoking, Tobacco Chewing
- Lethargic Lifestyle w/o any physcial activity
- Stress + Inadequate Sleep
- Various types of pollution and infectious weather conditions
When these are clubbed with inaccessibility, unawareness, social stigmas, leads to bigger health challenges
Example : Many tribal groups in India are facing severe health concerns and challenges by multiple factors clubbed with → no access to health care system, intoxication and unhygienic lifestyle
Epidemiological Transition (Causes & Consequences) (20M)*****
Introduction
- In 2021 global hunger index ; india’s ranking is 101/116
Niti Aayog is making a task force to study the reasons for the worst performance of India . So they are going to study the epidemiological transitions
- ET is related to changes in the occurrence of disease like spread, age related, gender related ,geography related due to changing patterns of population distribution and settlements
- This transition can be studied based on
- changing patterns of mortality
- increase or decrease of fertility
- increase or decrease of life expectancy
- leading reasons of death
- Two major components formulated by Orman for Epidemiological Transition
- changes in the population growth trajectories and composition
- changes in the patterns of mortality like increasing life expectancy, or focus on the causes of death
5 Propositional / Assumptions by OMRON
- In the beginning of ET, mortality (death) is the most fundamental factor in population dynamics
- Long term shift in mortality and disease pattern will define the transition where infectious disease will be gradually replaced with degenerative and manmade diseases as the main reason of death
- Most profound changes in health and disease patterns will be witnessed in young population and women
- Demographic, socio cultural and economic factors will closely impact the shift in health and disease pattern
- Omrans preposition outlines 3 different stages of transitions involving peculiar variations in the pattern
3 Typical Stages of ET
Age of Pestilence & Famines
- Meaning
- Pestilence - epidemic
- Famine - severe scarcity of food
- It was considered dating to be dating back to prehistoric period, bearly 10,000 Years Ago
- there will be high and fluctuating mortality rates leading to low avg life span
- leading to variation in life expectancy and hence periods of population growths were not sustained.
- This transition was due to transformation of hunting gathering society to a settled agricultural society with domestication of animals.
- These reduced migration events and dependency on the same resources can lead to scarcity of that resource, ultimately causing an ecological imbalance and spread of infections
Age of Reducing Pandemics
- Omran argued that there will be a shift in the occurrence of diseases which will lead to changes in the population distribution
- This stage will witness the reduction in the mortality rates due to less occurrence of disease and hence there will be more sustained avg life expectancy (30 to 50 years)
- all these changes will alter the population distribution, growth in the population and sharp reduction in occurrence of diseases
- Due to this kind of Occurence of Diseases, there will be a shift in pattern of diseases from Primary Infections to Chronic Degenerative & Man Made Diseases.
- This will be best expressed in third transitional stage
- Omran Gave reasoning for this transition based on
- Improved Socio Economic Conditions
- Increased Awareness
- Improved Lifestyle and Hygiene, Clubbed with
- Improvement in Health Care Facilities
Age of Degenerations & Man Made Diseases
- This stage mainly corresponded to late 19th and 20th cent in developed countries and late 20th centurty in developed countries like India
- In this transition pandemics are caused by occurrence of new and new infections like the recent pandemic of covid 19th becoz routine infections will be controlled by better healthcare facility and awareness.
- There will be significant decline in mortality and hence rise in avg life expectancy which will be above 55 yrs
- Primary Causes Are
- Lethargic Life Style
- Changed Fooding habits
- environmental pollution
- increase in the nuclear families
- isolated life style
- new diseases and life style disorders are on the rise like psychological disorders including depression, diabetes, hypertension etc
Study of Some Diseases
Diabetes Mellitus → Type 1 & Type 2
- Type 1 : IDDM : insulin dependent diabetes dependent
Special Case : Juvelline Diabetes : type one but auto immune in nature
- Type 2 : NIDM : non insulin dependant diabetes dependent
Cause : is lifestyle disorder like,obesity,lethargic lifestyle, stress
Malnutrition
- Malnutrition → Nutrition + Energy + Minerals
- When there is deficiency (undernutrition), excess or imbalance of Vitamins, proteins ,carbohydrates, essential fatty acids, minerals : fe,ca,mg is Malnutrition
- In Malnutrition more than 90% of cases are of undernutrition
- When there is imbalanced diet it can lead to 3 things
- stunting ; less height for a given age
- wasting ; low weight for an height
- underweight ; low weight than age
- This Stunting, Wasting & Underwight leads to Deficiency Disorders in Body like Rickets & Scurvy
- Deficiency & Diseases Chart
Deficiency | Disease |
Vitamin D + Calcium (Children) | Rickets |
Vitamin D + Calcium (Adults) | Osteomalacia |
Vitamin A | Xerophthalmia |
Vitamin A (Hypo Vitaminosis A), Def of Essential Fatty Acid | Phrynoderma |
Vitamin A | Night Blindness |
Vitamin C | Scurvy |
Vitamin (B1) (Thiamine) | Beriberi |
Vitamin B2 | Chilosis |
Vitamin (B3) (Niacine) | Pellagra |
Protein Energy Malnutrition (PEM) | Marasmus |
Protein Malnutrition | Kwashiorkar |
Iodine | Goiter |
Iron Def Anemia | Iron |
Maglobalstic Anemia | Vit B9/10 (Folic Acid) |
Pernicious Anemia | Vit B12 |
Please note that this table is not an exhaustive list of all vitamin and mineral deficiencies and their associated diseases but covers some common examples. Additionally, some of the diseases listed may have multiple causes, and deficiencies may not be the sole factor leading to the condition. It's essential to maintain a balanced diet to prevent nutritional deficiencies and associated health issues. If you suspect you have a deficiency or are experiencing health problems, consult a healthcare professional for proper diagnosis and treatment.
Malnutrition Profile of India
- Supported by SDG Number 2
- According to by NFHS (National Family Health Survey) 2015-16
- nearly 21 % children in India are wasted
- nearly 40% children are stunted
- nearly 36% children are undernourished
- nearly 46 % of children are anaemia (underweight), for girl chid it is 55%
- Nearly 55% of women are also anaemic
- According to State of Food Security and Nutrition in World Report 2020 → The report is jointly published by FAO and the World Health Organization (WHO)
- nearly 51.5% of reproductive age population of India are suffering from anaemia
- nearly 50% of reproductive age females face severe undernutrition in India and anaemia
- According to Global Hunger Index 2021
- india 101/116 countries highlighting severe malnutrition in India
- This malnutrition is one of the major reasons for high U5MR (below the age of 5 years death rate)
Reason Behind this Profile
IN THE WORDS OF AMARTYA SEN
Famines, food security challenges and improper nutrition are caused not by unavailability of food but are caused by inadequate access to food for poor and marginalised due to social, administrative and economic barriers
Reasons for Undernutrition Are :
- poverty, social inequality and high population leading to inequitable food distribution and hence the consumption
- Lack of sanitation, clean and hygienic food and water
- Monocultural agricultural practises focusing on staple food grains only, lack of access to core serials, pulses, fruits etc
- The vicious cycle of ill health and malnutrition related to maternal health and food in children
- Environmental factors like the rising levels of pollutants, contaminated food stuff through excessive chemicals and adulteration
- Opaque public distribution system, lacunas in mid-day meal scheme and other administrative bottlenecks due to lack of transparency and corruption
Measures Taken by Indian Government Are
- Poshan Abhiyan → National Nutritional Mission 2017
- it is based on national nutrition strategy by niti aayog
- targets kuposhan mukt bharat by 2022
- But under poshan abhiyan we added one more target – i.e reduction in the stunting by 2% per annum to be achieved by 2022
- Overall reduction in 25 % in the no. of stunted population
- Under poshan abhiyan : policy is to map various schemes that address malnutrition and setup and robust mechanism which is ICT enabled real time monitoring system along with incentivising states and UTs to meet there targets
- A Poshan atlas was formulated by ministry of women and child development for mapping of food grains grown in different parts of country so that nutritious and protein rich cropping can be promoted in local areas
- National Nutrition Strategy by Niti Aayog ; Targets Are
- Reduction in under nutrition by 2% per annum(for young children ,women and adolescent girls)
- Reduction in anaemia by 3% per annum (for young children ,women and adolescent girls)
- Reduction in low birth rate by 2% per annuum
- National Food Security Mission
- Mid Day Meal Scheme under National Food Security Mission
- ICDS - integrated child development scheme 1975
Backbone of many scheme is anganwadi centres to supply foods to mothers and children
- SABLA Scheme
its new version is project Tejaswini : to focus on adolescent from world bank for countering iron deficiency
- PM Matru vandna Yogna
- Janani Suraksha Yojana
- Indra Gandhi Matritv Sahyog Yojna
Challenges to achieve the targets of efforts of malnutrition
- There is a lack of functional aganwadi infrastructure. Like in orisa and bihar huge deficit of anganwadi workers
- Lack of transparency, iconicity and rampant corruption
- Lack of real time data monitoring & thus lack of analysis for proper decision making
- Not fulfilling the targets of 2.5 % of the budgetary allocation towards the health
- False Pos & Neg in benificiaries Identification
- Lack of awareness ,imbalanced diet and ignorance towards a healthy diet due to over emphasis on staple crops
- Lack of coordination b/w different ministries and state governments.
