Opportunities for One Health policies to reduce poverty

Infectious diseases are known to disproportionately affect the poorer sectors of society, particularly those living in low- and middle-income countries. These vulnerable populations battle disease, debt, loss of livelihood and reduced economic well-being with consequences that extend to their families, communities, livestock and the environment. A strong One Health approach is acknowledged as a successful way of enhancing current capacity for the prevention and control of emerging infectious diseases. Furthermore, it is also an effective way to address the multifaceted nuances of poverty. In recognising the interconnectedness of human and animal health with the health of our shared environment, One Health offers a valuable framework to prevent and control emerging infectious diseases through collaboration, coordination and communication across the various sectors involved. In recent years, as examples of One Health implementation have been documented and assessed, the linkages between One Health interventions and poverty alleviation have become more obvious. One Health interventions have the potential to reduce the economic burden of disease and create more efficient systems and approaches that generate higher savings, both direct and indirect, at the human-animal-environment interface. This paper describes aspects of this potential in detail. Although, at present, examples of the relationship between One Health and poverty alleviation are few, they are compelling. The authors believe that they provide persuasive evidence to encourage governments and policy-makers to employ the One Health approach in their efforts to alleviate poverty. Measuring the impact of this link between One Health and poverty alleviation has its constraints since appropriate metrics are still evolving. However, this paper hopes to establish the wisdom of recognising the role that One Health can play in reducing poverty, as well as its capacity to enhance existing policy frameworks.

Gallbladder cancer incidence in Gwalior district of India: Five-year trend based on the registry of a regional cancer center

BACKGROUND

We have reported here the 5-year incidence (2004-2008) of gallbladder cancer (GBC) in North Central India along with its descriptive epidemiology. This provides potential clues for better prevention. The present study has also evaluated the association of ABO blood groups with GBC.

PATIENTS AND METHODS

The study comprised 742 GBC cases referred to the regional cancer hospital, Gwalior, during 2004-2008. The demographic statistics of Gwalior district was considered to calculate the relative risk and incidence rates. ABO blood group distribution amongst 90,000 healthy subjects registered in the local blood bank during 2002-2007 was taken as controls to study the association of blood groups with GBC.

RESULTS

The age-standardized total incidence rate of GBC was calculated to be 7.16/1,00,000. The relative risk of females getting GBC was 2.693 at 95% confidence interval of 2.304-3.151 (P < 0.0001). The females formed 69.5% of total cancer cases, with age-standardized incidence rate of 10/1,00,000. The mean age of male and female GBC cases was found to be 55.4 years (SD = 13, SE = 0.77) and 51.5 years (SD = 12.3, SE = 0.50), respectively. The blood groups A (P = 0.0022) and AB (P < 0.0001) had a positive association with GBC with significant level of differences in comparison to controls.

CONCLUSION

Our study provided an estimate of a 5-year incidence of GBC in North Central India for the first time. With regard to the association of risk factors like obesity, age, and urban living with GBC, the findings of the present study are contradictory to the general opinion. Blood groups A and AB were found to be associated with GBC, which would be provisional for further investigations.

One Health: a perspective from the human health sector

Despite emerging consensus that the One Health concept involves multiple stakeholders, the human health sector has continued to view it from a predominantly human health security perspective. It has often ignored the concerns of other sectors, e.g. concerns that relate to trade, commerce, livelihoods and sustainable development, all of which are important contributors to societal well-being. In the absence of a culture of collaboration, clear One Health goals, conceptual clarity and operating frameworks, this disconnect between human health and One Health efforts has often impeded the translation of One Health from concept to reality, other than during emergency situations. If there are to be effective and sustainable One Health partnerships we must identify clear operating principles that allow flexible approaches to intersectoral collaborations. To convince technical experts and political leaders in the human health sector of the importance of intersectoral cooperation, and to make the necessary structural adjustments, we need examples of best practice models and trans-sectoral methods for measuring the risks, burden and costs across sectors. Informal collaborations between researchers and technical experts will play a decisive role in developing these methods and models and instilling societal well-being into the human health sector's view of One Health.

Scrub typhus in Darjeeling, India: opportunities for simple, practical prevention measures

To identify risk factors for scrub typhus in Darjeeling, India, we compared 62 scrub typhus cases (acute fever with eschar and specific IgM) with 62 neighbourhood controls. Cases were more likely to live close to bushes [matched odds ratio (MOR) 10; 95% CI 2.3-63] and wood piles (MOR 3.5; 95% CI 1.5-9.5), to work on farms (MOR 10; 95% CI 2.7-63), to observe rodents at home (MOR 3.6; 95% CI 1.4-11) and at work (MOR 9; 95% CI 2.4-57), and to rear domestic animals (MOR 2.4; 95% CI 1.1-5.7). Cases were less likely to wash after work (MOR 0.4; 95% CI 0.1-0.9) and change clothes to sleep (MOR 0.2; 95% CI 0.1-0.5). A cleaner, rodent-controlled environment may prevent exposure to scrub typhus. Personal protection measures and better hygiene could further reduce individual risk.

Otomycosis: a clinicomycologic study

Otomycosis is a common fungal infection of the ear that is seen in the tropical and subtropical regions of the world. We performed mycologic analyses on debris and scraping samples from the external ear canals of 95 patients who had been clinically diagnosed with otomycosis. Seventy-one samples (74.7%) were positive for fungal growth; two of these samples contained two fungi, bringing the total number of isolates to 73. The most common pathogens were Aspergillus fumigatus (41.1% of all isolates), A niger (36.9%), and Candida albicans (8.2%).

Screening for TORCH infections in pregnant women: a report from Delhi

Primary TORCH infections (toxoplasmosis, rubella, cytomegalovirus and herpes simplex virus type 1 and 2) in the mother can lead to severe fetal anomalies or even fetal loss. A prospective study was designed to detect the seroprevalence of IgM antibodies to Toxoplasma gondii, rubella virus and cytomegalovirus and IgG antibodies to herpes simplex virus type 1 and 2. One hundred and twenty pregnant women presenting to the antenatal clinic of a tertiary health center were included in this study. Out of these 120 women 112 (93.4%) had evidence of one or more infections. Prevalence of IgG antibodies to HSV was 70%. Seropositivities for toxoplasmosis, rubella and CMV respectively were 11.6, 8.3 and 20.8%. Our data demonstrating high frequency of primary infections during pregnancy support the conclusion that routine prenatal TORCH screening is justified.

Prevalence of Campylobacter infections in animals and children in Haryana, India

To study the prevalence of infections with Campylobacter spp in Haryana, India, a stool sample was collected using a rectal swab from 30 buffaloes, 62 cattle, 95 pigs and 94 children and was bacteriologically cultured. The subjects were either apparently healthy or had diarrhoea. The organisms were isolated in a medium containing reducing agents and antibiotics, and culture plates were incubated in a candle jar at 42 degrees C. 63% of all thermophilic Campylobacter were cultured from rectal swabs taken from young livestock and children with diarrhoea. Of 32 isolates fully identified, 23 were C. jejuni, 8 were C. coli and 1 was C. laridis. The C. jejuni isolates belonged to the Lior's biotype II.