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Effect of El Nino Southern Oscillations on the incidence of enteric fever in Ahmedabad,India from 1985 to 2017

Asian Pacific Journal of Tropical Medicine 2019年第12期12卷 552-558页

作者： Veena Iyer Susanna Abraham Cottagiri Ayushi Sharma Divya Nair Mehul S.Raval Bhavin Solanki dileep mavalankar Indian Institute of Public Health Gandhinagar Opposite Air Force HQNear Lekavada Bus StopCRPF P.O.Gandhinagar 382042GujaratIndia ICT Department School of TechnologyPandit Deendayal Petroleum UniversityGandhinagarIndia Medical Officer of Health Ahmedabad Municipal CorporationAhmedabadGujaratIndia

Objective:To explore the relationship between climate variables and enteric fever in the city of Ahmedabad and report preliminary findings regarding the influence of El Nino Southern Oscillations and Indian Ocean Dipole over enteric fever ***:A total of 29808 Widal positive enteric fever cases reported by the Ahmedabad Municipal Corporation and local climate data in 1985-2017 from Ahmedabad Meteorology Department were *** Nino,La Nina,neutral and Indian Ocean Dipole years as reported by the National Oceanic and Atmospheric Administration for the same period were compared for the incidence of enteric ***:Population-normalized average monthly enteric fever case rates were the highest for El Nino years(25.5),lower for La Nina years(20.5)and lowest for neutral years(17.6).A repeated measures ANOVA analysis showed no significant difference in case rates during the three yearly El Nino Southern Oscillations ***,visual profile plot of estimated marginal monthly means showed two distinct characteristics:an early rise and peaking of cases in the El Nino and La Nina years,and a much more restrained rise without conspicuous peaks in neutral *** analysis based on monthly El Nino Southern Oscillations categories was conducted to detect differences in median monthly case *** case rates in strong and moderate El Nino months and strong La Nina months were significantly dissimilar from that during neutral months(P<0.001).Conclusions:El Nino Southern Oscillations events influence the incidence of enteric fever cases in Ahmedabad,and further investigation from more cities and towns is required.

关键词： Enteric fever and climate El Nino,La Nina and Enteric fever El Nino Southern Oscillations Typhoid Indian Ocean Dipole Salmonella and climate

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Geovisualization: A Newer GIS Technology for Implementation Research in Health

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Journal of Geographic Information System 2015年第1期7卷 20-28页

作者： Sandul Yasobant Kranti Suresh Vora Carl Hughes Ashish Upadhyay dileep V. mavalankar Indian Institute of Public Health-Gandhinagar Ahmedabad India McGill University Montreal Canada

Use of GIS in public health is currently limited to tracking immunizations, disease surveillance, and establishing new service areas. The potential of GIS to improve planning, implementation and monitoring of programs and to inform policymaking processes for universal access to healthcare is grossly underutilized. Major reasons for restricted use are paid access to GIS software and difficult interpretation for non-GIS professionals. WebGIS technologies present an opportunity for non-GIS public health professionals to present complex data and findings in simpler manner. Conventional GIS methods and Geovisualization are compared and contrasted in this paper using data from the MATIND project in the Gujarat state of India. In-depth literature review on GIS techniques used in health implementation research was conducted. In this paper, MATIND data have been used for comparing conventional GIS methods with a newer web based GIS tool-Geovisualization. GIS software is more useful for analytical purposes;whereas web based geovisualization techniques are much better for visualization and easy interpretation of results by non GIS public health researchers. As the images are easy to interpret, interactive/dynamic and not much technical expertise is required to perform basic analysis, the tool is useful for policy makers and planners. Geovisualization provides a user-friendly tool for presenting large scale community based survey data. Increased use of this tool will help to present implementation research in a creative way to the program planners and policy makers. For program managers, it is a useful tool to monitor implementation and impact of a program to improve health of population.

关键词： Geovisualization GIS Public Health

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Laboratory Capacity for Surveillance of Infectious Diseases in Gujarat: Quantity, Quality, Effects and Way Forward

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Health 2019年第7期11卷 998-1016页

作者： Veena Iyer Nandini Choudhury Ajit Rajiva Susanna Abraham Cottagiri Ayushi Sharma dileep mavalankar Indian Institute of Public Health Gandhinagar Gujarat India Department of Biochemistry and Biotechnology St. Xavier’s College Ahmedabad Gujarat India Yale School of Forestry and Environmental Studies University Department in New Haven Connecticut USA

Background: India carries one of the largest burdens of infectious diseases in the world. To estimate this, laboratory confirmation is vital. We estimated the lab capacity and effectiveness in the state of Gujarat for Enteric Fever, Infectious Hepatitis, and Dengue. Methods: We estimated the number of labs in the state through telephonic surveys and physical screening of a representative sample of labs. We created four levels of tests, Level-0 being no test and 3 being the best confirmatory test available in the state. For the profusion of rapid diagnostic test kits (RDTKs), we constructed Effective Diagnostic Scores (EDS) calculated from their sensitivity and specificity at disease prevalences specified in the literature. Tests with EDS > 0.51 were level-2 tests, and EDS Results: Our analysis showed that there are 4293 labs in the state (1765 public and 2528 private), 7/100,000 population. However, only 2878 labs contributed to a total pooled Effective Lab Diagnostic Score (ELDS) of 6776 in the state. Strikingly, 94% of the lab effectiveness lay in RDTs (level-2 and 1 tests) which are essentially screening tests. Ninety-six percent of the overall lab effectiveness of Gujarat existed in private and only 4% in public labs. Contrarily, the level-3 confirmatory testing effectiveness, through ELISA and culture constituted only 4% of private and 36% of public lab effectiveness. More than half of the private lab effectiveness was located in eight Tier 1 cities. Level-3 confirmatory testing effectiveness was present only in Tier 1 and 2 towns. Hepatitis B testing contributed 34% of the total ELDS, followed by Dengue (30%), Enteric Fever (26%) and Hepatitis A and E (10%). Conclusion: Our study has established that the capacity and effectiveness of the lab network in Gujarat lie predominantly in RDTKs. We need to adapt our systems to capture this data in a manner that will allow us to monitor the burdens of these diseases.

关键词： Rapid Diagnostic Test Kits (RDTKs) Enteric Fever Hepatitis Dengue Lab Diagnostic Effectiveness Integrated Diseases Surveillance Program (IDSP) India Gujarat

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Community Based Survey Methodology for Maternal Healthcare Utilization: Gujarat, India

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Health 2016年第14期8卷 1542-1553页

作者： Kranti Suresh Vora Kristi Sidney Annerstedt dileep V. mavalankar Nishith B. Dholakia Sandul Yasobant Shahin Saiyed Ashish Upadhyay Ayesha De Costa Indian Institute of Public Health Gandhinagar India Public Health Sciences Karolinska Institutet Stockholm Sweden Department of Health & Family Welfare Government of Gujarat Gandhinagar India

Background: About 60% of institutional births occur in the private sector in Gujarat due to limited availability of obstetricians in the government. Chiranjeevi Yojana (CY), a voucher-like program initiated in 2007, accredits private obstetricians who are reimbursed by the state government to provide free delivery care to eligible women i.e. below poverty line and tribal. One million women have delivered under the CY program yet there are no large community based studies of the program. Methodology of a prospective community study is described here. Methods/Designs: A prospective cohort study was done in 142 villages across 3 districts in Gujarat between July, 2013 and November, 2014. A detailed survey was done by trained researchers to ascertain maternal healthcare information including antenatal, intra-partum and post-partum care, place of delivery, birth outcomes, out of pocket expenses etc. Results: 54,955 households were surveyed. 73% of all households had poverty documentation. 4274 mothers who delivered in the study period were included. Discussion: This paper is description of the methodology of a large community based survey and household and individual level characteristics. The survey was nested in a larger project to evaluate the CY program in the state of Gujarat.

关键词： India Demand Side Financing Maternal Morality Chiranjeevi Yojana Community Based Survey

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印度Ahmedabad地区增加的死亡率与基孔肯雅流行有关

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中国人兽共患病学报 2008年第5期 386-386页

作者： dileep mavalankar Priya Shastri Tathagata Bandyopadhyay 修文琼张拥军福建省疾病预防控制中心

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