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Epidemics, Empire, and Environments
Throughout the nineteenth century, cholera was a global scourge against human populations. Practitioners had little success in mitigating the symptoms of the disease, and its causes were bitterly disputed. What experts did agree on was that the environment played a crucial role in the sites where outbreaks occurred. In this book, Michael Zeheter offers a probing case study of the environmental changes made to fight cholera in two markedly different British colonies: Madras in India and Quebec City in Canada.The colonial state in Quebec aimed to emulate British precedent and develop similar institutions that allowed authorities to prevent cholera by imposing quarantines and controlling the disease through comprehensive change to the urban environment and sanitary improvements. In Madras, however, the provincial government sought to exploit the colony for profit and was reluctant to commit its resources to measures against cholera that would alienate the city's inhabitants. It was only in 1857, after concern rose in Britain over the health of its troops in India, that a civilizing mission of sanitary improvement was begun. As Zeheter shows, complex political and economic factors came to bear on the reshaping of each colony's environment and the urgency placed on disease control.
eBook
Epidemics, empire, and environments : cholera in Madras and Quebec City, 1818-1910
\"Throughout the nineteenth century, cholera was a global scourge against human populations. Practitioners had little success in mitigating the symptoms of the disease, and its causes were bitterly disputed. What experts did agree on was that the environment played a crucial role in the sites where outbreaks occurred. In this book, Michael Zeheter offers a probing case study of the environmental changes made to fight cholera in two markedly different British colonies: Madras in India and Quebec City in Canada. The colonial state in Quebec aimed to emulate British precedent and develop similar institutions that allowed authorities to prevent cholera by imposing quarantines and controlling the disease through comprehensive change to the urban environment and sanitary improvements. In Madras, however, the provincial government sought to exploit the colony for profit and was reluctant to commit its resources to measures against cholera that would alienate the city's inhabitants. It was only in 1857, after concern rose in Britain over the health of its troops in India, that a civilizing mission of sanitary improvement was begun. As Zeheter shows, complex political and economic factors came to bear on the reshaping of each colony's environment and the urgency placed on disease control\"-- Provided by publisher.
Book
Reassessing Reported Deaths and Estimated Infection Attack Rate during the First 6 Months of the COVID-19 Epidemic, Delhi, India
India reported >10 million coronavirus disease (COVID-19) cases and 149,000 deaths in 2020. To reassess reported deaths and estimate incidence rates during the first 6 months of the epidemic, we used a severe acute respiratory syndrome coronavirus 2 transmission model fit to data from 3 serosurveys in Delhi and time-series documentation of reported deaths. We estimated 48.7% (95% credible interval 22.1%-76.8%) cumulative infection in the population through the end of September 2020. Using an age-adjusted overall infection fatality ratio based on age-specific estimates from mostly high-income countries, we estimated that just 15.0% (95% credible interval 9.3%-34.0%) of COVID-19 deaths had been reported, indicating either substantial underreporting or lower age-specific infection-fatality ratios in India than in high-income countries. Despite the estimated high attack rate, additional epidemic waves occurred in late 2020 and April-May 2021. Future dynamics will depend on the duration of natural and vaccine-induced immunity and their effectiveness against new variants.
Journal Article
An outbreak of dengue fever in Peri Urban slums of Chandigarh, India, with special reference to entomological and climatic factors
Backgrounds: Dengue viral infection is one of the most important
public health problem in tropical countries. Aim: An outbreak of dengue
fever was investigated in a periurban slum area of Chandigarh, India,
during September to December, 2002. Materials and methods: Blood
samples from 218 patients and 30 apparently healthy contacts were
tested for dengue-specific immunoglobulin M (IgM) and IgG antibodies
including 80 acute samples collected within 5 days of illness were
subjected for virus isolation in newborn mice. The average temperature,
rainfall, and humidity of the epidemic year were compared with the
number of dengue cases. Statistical analysis: statistical significance
was found out using β2-test. Results: A total of 76 cases were
positive by either dengue IgM capture assay (n=57) or virus isolation
(n=17) or both (n=2). fifteen of nineteen viral isolates subjected for
typing by type-specific multiplex reverse transcription-polymerase
chain reaction were found to be of dengue virus. High rainfall and
humidity with the temperature range from 21°c to 33°c during
the months of August and September might have favored the breeding of
mosquitoes, thus leading to an increase in the number of dengue cases
in October and November, 2002. Conclusion: The present outbreak thus
emphasizes the need for continuous sero epidemiological and
entomological surveillance for the timely implementation of effective
dengue control programme.
Journal Article
India Responds to the HIV/AIDS Pandemic: Unintended Consequences of Global Health Initiatives
This chapter contains sections titled:
Introduction
Social Science Research on HIV/AIDS in India
Responses to HIV/AIDS in India
Tamil Nadu, the Pioneer State
The PPTCT Program and its Social Impact in Tamil Nadu
Conclusion
References
Book Chapter
Multicenter Epidemiologic Study of Coronavirus Disease–Associated Mucormycosis, India
During September-December 2020, we conducted a multicenter retrospective study across India to evaluate epidemiology and outcomes among cases of coronavirus disease (COVID-19)-associated mucormycosis (CAM). Among 287 mucormycosis patients, 187 (65.2%) had CAM; CAM prevalence was 0.27% among hospitalized COVID-19 patients. We noted a 2.1-fold rise in mucormycosis during the study period compared with September-December 2019. Uncontrolled diabetes mellitus was the most common underlying disease among CAM and non-CAM patients. COVID-19 was the only underlying disease in 32.6% of CAM patients. COVID-19-related hypoxemia and improper glucocorticoid use independently were associated with CAM. The mucormycosis case-fatality rate at 12 weeks was 45.7% but was similar for CAM and non-CAM patients. Age, rhino-orbital-cerebral involvement, and intensive care unit admission were associated with increased mortality rates; sequential antifungal drug treatment improved mucormycosis survival. The COVID-19 pandemic has led to increases in mucormycosis in India, partly from inappropriate glucocorticoid use.
Journal Article
National Early Warning Score 2
While several parameters have emerged as predictors of prognosis of COVID-19, a simple clinical score at baseline might help early risk stratification. We determined the ability of National Early Warning Score 2 (NEWS2) to predict poor outcomes among adults with COVID-19. A prospective study was conducted on 399 hospitalised adults with confirmed SARS-CoV-2 infection between August and December 2020. Baseline NEWS2 score was determined. Primary outcome was poor outcomes defined as need for mechanical ventilation or death within 28 days. The sensitivity, specificity and Area under the curve were determined for NEWS2 scores of 5 and 6. Mean age of patients was 55.5 ± 14.8 years and 275 of 399 (68.9%) were male. Overall mortality was 3.8% and 7.5% had poor outcomes. Median (interquartile range) NEWS2 score at admission was 2 (0-6). Sensitivity and specificity of NEWS 2 of 5 or more in predicting poor outcomes was 93.3% (95% CI: 76.5-98.8) and 70.7% (95% CI: 65.7-75.3) respectively [area under curve 0.88 (95% CI: 0.847-0.927)]. Age, baseline pulse rate, baseline oxygen saturation, need for supplemental oxygen and ARDS on chest X ray were independently associated with poor outcomes. NEWS2 score of 5 or more at admission predicts poor outcomes in patients with COVID-19 with good sensitivity and can easily be applied for risk stratification at baseline. Further studies are needed in the Indian setting to validate this simple score and recommend widespread use.
Journal Article