ICMR BULLETIN VOL. 26-No.-3 & 4-MARCH-APRIL-1996.pdf

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ISSN 0377-4910

March-April, 1996

Vol. 26, No. 3 and 4

HIGHLIGHTS OF TRIBAL HEALTH RESEARCH UNDER
INDIAN COUNCIL OF MEDICAL RESEARCH
Tribals constitute about eight per cent of India,s
population and their largest concentration (about 87%) is
in the central belt of the country comprising Gujarat,
Maharashtra, Rajasthan, Madhya Pradesh, Andhra
Pradesh, Orissa, Bihar and West Bengal (U.P. Sinha,
Unpublished data, 1986). About one fourth of the
country's tribal population live in Madhya Pradesh
(23.7%) followed by Maharashtra (11.3%), Orissa
(10.8%), Bihar (10,2%), Gujarat (9.5%) and Rajasthan
(8.4%). Altogether there are 427 tribal communities of
which, Gonds and Bhils are the largest. From among
these, the tribes which are in an extremely under devel­
oped stage have been listed as primitive tribes and their
total number is 521.

The tribals mostly live in forests and hilly terrain
isolated from other societies, and have tlieir own way of
living and different socio-cultural settings. Illiteracy, pov­
erty, lack of proper health and education facilities, faulty
feeding habits, certain irrational belief systems and spe­
cial tribal mores are the factors which aggravate their
health and nutritional status. The growth of the tribal
communities is very uneven and in a few communities,
there is a definite decline threatening the very existence.
This decline may not be due to a low level of fertility but
to a rather high level of mortality and existing bad health
practices. For these special reasons the fertility, morbidity
and mortality profile of tribal communities is vastly dif­
ferent from the other communities in the country, and

therefore, research in tribal health is an important field in
biomedical sciences. The Indian Council of Medical Re­
search (ICN1R) encourages research in the
underprivileged population and many of its institutes
conduct health studies among the tribals. In 1984 the
Council established the Regional Medical Research Cen­
tre (RMRC) for Tribals at Jabalpur (MP) to undertake
research primarily on tribal health, in addition to other
regional health problems. Tliis write up summarises the
studies on tribal health undertaken by the RMRCs at
Jabalpur, Port Blair and Bhubaneswar and other ICMR
Institutes.
An integrated multidisciplinary approach to the tribal
health problems has been adopted by the RMRC,
Jabalpur and other Centres and Institutes. The studies
have indicated that genetic disorders (haemoglobinopathies), communicable diseases and nutritional
disorders form the bulk of their health problems.

Health and Nutrition
Studies were undertaken by the RMRC, Jabalpur, on
the health and nutritional status of seven primitive tribes
and a few nonprimitive tribes of the State of Madhya
Pradesh.

Yaws was believed to have been eradicated from
Madhya Pradesh, however, a survey by the RMRC,
Jabalpur, in Abujhmarias of Bastar district revealed a

Division of Publication & Information, ICMR, New Delhi - 1 I 0 ()29

5 H气6

resurgence of yaws and on the recommendations of the
Centre, the State Government had initiated an eradication
programme. After three penicillin campaigns, the preva­
lence of yaws reduced considerably from 7 to 1.7 per cent
within a span oftwo years (RMRC, Jabalpur unpublished
data). A very high prevalence of rickets induced
genuvalgum (65%) was also reported in the same tribe.
The population was found to be anaemic (40% had severe
anaemia with haemoglobin levels < 7 g/dl). In the Baigas
of Baigachak area of Mandla district, high prevalence of
goitre and intestinal parasites was observed2-4. In Birhors
of Raigarh district, nutritional deficiency disorders
showed high prevalence. Suggestions were made for im­
mediate intervention programmes fbr anaemia and
vitamins A and B Complex deficiencies (anaemia = 29%
and B Complex deficiency - 24%) and eye camps for
cataract (in age group 40+, 35.8%). Among the Bharias
of Patalkot valley in Chhindwara district, based on the
RMRC, Jabalpur, finding of 11.6 per cent goitre among
children below 5 years, the State Government launched an
intervention prograitime which resulted in a sharp de­
crease in goitre prevalence. Among the other primitive
tribes, scabies was a major health problem, besides uri­
nary tract infection and malnutrition. Pulmonary
tuberculosis was very high (12.7 per thousand) in Saharia
tribe ofMorena district. The Hill Korwas and Kamars of
district Raigarh and Raipur did not have any special
health problem.

The National Institute of Nutrition (NIN),
Hyderabad, carried out detailed studies on the health and
nutritional status of tribals in Sarguja, Bastar and Jhabua
districts ofMadhya Pradesh. The study suggested a pack­
age of activities to be implemented in the tribal areas.
Broadly they are (i) treatment of minor ailments like
cough, fever, skin and eye infections, dysentery and diar­
rhoea; (ii) motivation and mobilization of tribals towards
acceptance of ongoing programmes of health and nutri­
tion; and (iii) encouragement ofpositive health behaviour
with gradual weaning away from irrational beliefs and
habits. A neutral, non committal attitude should be main­
tained towards the habits which are not harmful (NIN,
unpublished data).
Surveys on health and nutrition conducted by the
RMRC at Port Blair, among the Andamanese in 1976 and
1989 suggest that they suffer from tuberculosis, syphilis
and anaemia. This study also revealed deficiencies of
caloric intake, vitamins and iron in their food.

The nutritional study conducted among the Onges
showed that their dietary intake was adequate. Except fbr
22

vitamin A deficiency, no evidences of any other malnutri­
tion was detected among them. A health survey carried out
by the RMRC, Port Blair in 1993 in the tribe in Dugong
Creek showed high prevalence of intestinal parasitoses,
Trichuris trichura being the commonest. About 40 per
cent of the Onges had skin infections, mainly ring worm
and scabies. The RMRC has also carried out health
surveys among the Nicobarese settled in Little Andaman.
Intestinal parasitoses was found to be common, Ascaris
lumbricoides being the commonest parasite. Clinically
osteoaid iritis of hip and knee were found to be common
among Nicobarese adults.

In 1989-90, a sample survey of the tribal population
of Janadu hills located in Ambedkar and Sambuvarayar
districts of Tamil Nadu was undertaken by the Tubercu­
losis Research Centre (TRC), Madras, to obtain the
prevalence of tuberculosis infection and disease rates,
The study observed that the burden of illness is the same
as that of the plains.

Studies have been undertaken by the Desert Medicine
Research Centre (DMRC), Jodhpur, in Banswara,
Dungarpurand Serohi districts of Rajasthan during 198990. Malaria, conjunctivitis and chronic respiratory
diseases were common ailments observed among the
tribals.
A study undertaken by the RMRC, Bhubaneswar in
the tribal dominated districts of Orissa viz. Sundargarh,
Koraput, Mayurbhanjh and Keonjhar indicated that the
child mortality at age 2 was highest in Koraput and
Keonjhar and lowest in Mayurbhanjh. However, the
mortality rate rose from age 2 to 5 years, it was 27 per
cent in Sundargarh, 25 per cent in Mayurbhanjh, 16 per
cent in Koraput and 11 per cent in Keonjhar. The major.
diseases were dysentery, A-vitaminosis, upper respira­
tory tract infection, scabies, malaria and anaemia. These
diseases accounted fbr almost 40 per cent of illnesses.
The RMRC, Jabalpur, investigated the high infertility
in Khairwar tribe ofKusmi block ofSidhi district. A high
percentage of married males and females (57 and 70%
respectively) in the reproductive age group were found to
have syphilis. The Centre had suggested suitable mea­
sures to the State Government to improve the situation.

A study of fluoride osteopathy with genuvalgum syn­
drome in some villages of Mandla.district was carried out
by the RMRC, Jabalpur in 1995-96. The most affected
village was Tilaipani where 52 per cent children less than
15 years of age had severe genuvalgum of grade IV and

73 per cent had marked dental fluorosis. This disease has
been detected for the first time in central India. On the
recommendations ofthe Centre, the State Government has
planned a detailed intervention programme including
alternative source of water supply in several hundred
villages of the district.
Diarrhoeal Diseases

The RMRC, Jabalpur, studied post measles dysentery
epidemics in 1986-87 in the tribal districts of Bilaspur,
Bastar and Seoni. A rapid epidemiological investigation
was undertaken to investigate the cause of the epidemic
and to provide guidelines for action. The stool culture
yielded multidrug resistant Shigella dysenteriae type-1 as
the cause of the epidemic. It was resistant to commonly
used antimicrobials except furazolidone.
A study on the effect of oral rehydration solution
(ORS) supplemented with lactobacilli on diarrhoeal mor­
bidity was carried out in Mandla (predominantly tribal)
district* The findings suggested that lactobacilli supple­
mented ORS rather than nonsupplemented ORS is
effective in 'reducing the duration of diarrhoea in pre­
school children.

The National Institute for Cholera and Enteric Dis­
eases (NICED), Calcutta, studied the prevalence of
diarrhoeal diseases amongst the tribals of Car Nicobar
island in 1988. The incidence of diarrhoea was found to
be as low as 0.2 episode per child per year in children
below 5 years. The ORS utilization rate was 47 per cent.
It was also observed that the amount of fluid (ORS/home
available fluids-mostly green coconut water) adminis­
tered was inadequate in 59 per cent of the cases of
diarrhoea. Enquiries on the nutritional management of
diarrhoea revealed that all the mothers (100%) preferred
to continue breast feeding during diarrhoeal episodes iiV
children5.
During 1993, the NICED, Calcutta and RMRC,
Bhubaneswar, studied an outbreak of acute diarrhoea
resulting in deaths primarily in adults in Nawrangpur and
Koraput districts of Orissa. The outbreak was mostly
confined to the tribal population. Epidemiological and
microbiological investigations revealed that this outbreak
was caused by Vibrio cholerae 01 serotype ElTor. V,
cholerae 01 strains were uniformly resistant to
furazolidone6.

Virus Diseases
The National Institute of Virology (NTV), Pune, car­
ried out a serosurveillance for HIV infection among tribal
populations in three districts ofPune, Thane and Dhule in
Maharashtra. Out of total 3048 samples screened, 10
samples (0.3%) were found ELISA positive, and only two
samples (0.06%) were found WB positive7.

Serosurveillance of HIV infection was done by the
RMRC, Bhubaneswar, among the tribals of Phulbani
district. All samples were found ELISA negative.

In 1992, an outbreak of measles in the tribal popula­
tion ofVavar village of Thane district, Maharashtra, was
investigated by the NIV The investigation suggested the
need to immunize the children of remote isolated popula­
tion on a priority basis8.
Malaria and Filariasis
The RMRC, Jabalpur, investigated an outbreak of
malaria in a tribal block of Jabalpur in 1987. It was
noticed that there was a complete breakdown of surveil­
lance and an acute shortage of anti-malarials, the fever
rate was very high in the community. Out of the samples
collected, 73.7 per cent slides were positive for malaria
parasite and of these 75.8 per cent were Plasmodium
falciparum. As a result, a small fbcus resulted in an
outbreak and intense transmission in a short period. To
prevent further morbidity and mortality due to malaria,
suitable measures were suggested to the health authori­
ties9.

Studies on malaria were carried out by the Malaria
Research Centre, Delhi's field station at Mandla in a
•forested district consisting of 60 per cent tribals viz.
Gonds, Korkus, Kols and Baigas. The area is a reservoir
of intense perennial malaria transmission. Both Plasmo­
dium vivax and Plasmodium falciparum were prevalent.
The housing and outdoor habits were conducive for trans­
mission. There were innumerable breeding sites, high
transmission of malaria particuarly P. falciparum and P.
falciparum resistance to anti-malarials. A new malaria
parasite was identified morphologically as well as by
amplification ofthe circumsporozoite protein (CSP) gene
using polymerase chain reaction (PCR) and has opened up
new opportunities and challenges in the field of malaria
research and control. The average Annual Parasite Index
(API) of Mandla has increased from 8 in 1987 to 16 in five
years.
23

Though the tribals form only about 8 per cent of the
population, it is estimated that they contribute to about 25
per cent of the total number of malaria cases, and about
50 per cent of P. falciparum cases that are reported in
India. It is a major health problem and merits special
attention.

The role of permethrin impregnated bednets at the
application rate of 0.5 g(ai)/m2 in reducing Anopheles
culicifacies population in a tribal village (highly endemic
fdrP falciparum) was studied. The man-hour density was
significantly reduced in the village fbr about three months
where impregnated bednets were supplied11.

Epidemiological analysis of data from the endemic
belts of the country has revealed high P. falciparum
transmission in the forest of India, and these areas are
dominated by the tribal population. Malaria control in
these settlements has always been unattainable due to
technical and operational problems. These areas are
hardcore areas with pronounced problem of vector refrac­
toriness, in An. culi cifacies and An. fluviatilis in
peninsular India and An. dims. An. minimus and An.
fluviatilis in the eastern states. The other problems are
high proportion of P. falciparum, high level of herd
immunity resulting in asymptomatic carriers, and now a
pronounced problem of drug resistance, and an unending
source of malaria to the rest of the country. Because of the
peculiarities in the transmission dynamics in the forests
and difficulties in control operations compounded by
technical obstacles, this type of malaria has come to be
known as forest malaria or tribal malaria, requiring spe­
cialized'malaria control efforts.

A study on lanibdacyhalothrin treated bednets as an
alternative method of malaria control was carried out in
tribal villages of Orissa and their efficacy was reported.
Parasite rate and vector density was reduced considerably
in the villages where-impregnated bednets were in use12.

The Vector Control Research Centre (VCRC),
Pondicherry, has established a field station for malaria
research in Jeypore, Koraput district of Orissa. The vast
majority of the population in the area are tribals consti­
tuting more than 60 per cent of the total population. The
VCRC has undertaken studies to understand the reasons
for persistence of malaria in the area and to develop
alternative control strategies. A malaria clinic is also
functioning at the field station.

A number of studies on malaria prevalence and con­
trol have been carried out by the VCRC among the tribals/
tribal areas of Orissa.
Studies on malaria in Koraput district of Orissa
showed 13 per cent individuals (of the persons examined)
positive for malaria. In infants, the parasite rate was 23
per cent and children 2-4 years old were the worst affected
(parasite rate 27.2%). P. falciparum, P. vivax and P.
malariae accounted for 80, 10 and 3 per cent infections
respectively; the remaining 7 per cent being due to mixed
infection. Prevalence of infection and splenomegaly was
higher among children of Bonda, Kondh and Poroja
tribes10.

24

A malariometric survey was carried out among the
upper Bonda tribals ofKoraput district. The observations
showed that malaria is the major cause of morbidity
followed by worm infestation and malnutrition13.

A study on the impact of mud plastering on the
efficacy of DDT residual spraying in tribal villages of
Koraput district showed that even though mud plastering
reduces the effectiveness of the residual spraying to a
certain extent, timely spraying and better coverage with
correct dosage can still effectively reduce the malaria
incidence14.
Entomological investigations on the prevalence of
filariasis were undertaken in Panna ,district of MP. The
mean microfilaria rate among the tribals was found to be
lower (3.8%) than in nontribals (7.04%) of the same area.
The vector density in tribal areas was observed to be very
low as compared to the nontribal areas. Among the
tribals, all the symptomatic cases had acute filariasis
while in the nontribals only 56.4 per cent had acute and
44.11 per cent chronic filariasis. The reasons for absence
of chronicity in the tribals need to be investigated further.
Diurnally sub peiiodic filariasis due to W. bancrofti
had been reported to occur in the Nancowry group of
islands, but not in the Andaman Islands where nocturnal
periodic filaria is known to occur. A survey was conduct­
ed by the Centre fbr Research in Medical Entomology,
Madurai, in the islands of Chowra, Nancowry, Kamorta
and Trinket during September-October, J993. The mi­
crofilariae (mf) rate was highest in Kamorta (18.35%)
and Chowra (14.62%). It was 5.33 per cent in Nancowry
and 1.23 per cent in Trinket. Overall disease rate was
relatively low (1.9%). Incidence of mf was low in children
below 10 years (3.61%) and 11-20 years (7.38%) but
increased with increasing age. In 15 mf carriers
parasitaemia was detected throughout a period of
24 hours, with a peak around 18 hours.

Health Care Delivery

The RMRC, Jabalpur, has conducted studies on
(i) The availability, efficiency and utilization of health
care services in tribal areas of Madhya Pradesh; (ii)
Health care services in nontribal areas of Madhya Prdesh;
(iii) Evaluation of quality ofmaternal and child health and
family planning services at the PHC level and; (iv) Salt
consumption pattern in tribal areas of MP. Based on the
findings of the surveys suitable recomendations have been
made.

■

A study to investigate the feasibility of (i) involving
a literate tribal youth volunteer fbr detecting cases' of
pulmonary tuberculosis in their respective hamlets, and
(ii) anti tuberculosis drug delivery to sputum positive
patients at their homes by village health nurses was

carried out by the TRC, Madras, in 1992-93. The study
concluded that it was feasible to train literate young
volunteers within a short time and also to utilise them in
case finding, case holding and drug delivery fbr the tribal
community. They can serve as an excellent model fbr
community participation.

G-6-PD in various tribal populations of the States of
Madhya Pradesh, Maharashtra, Gujarat and Union Ter­
ritory of Dadra and Nagar Haveli. It was found that
prevalence of sickle haemoglobin was very high among
Bhilalas of Jhabua, MP (30.5%) and Pradhans of
Chandrapur and Yavatmal districts of Maharashtra
(31%). There was high prevalence of G-6-PD deficiency
among the Kawars of Raipur, MP (21.5%), Warlis in
Dadra and Nagar Haweli (14.5%) and Kokans of X^lsad
district, Gujarat (14.3%).
The RMRC, Bhubaneswar, conducted a random sur­
vey of G-6-PD deficiency and haemoglobinopathies in a
tribal dominated block (Banspal block) of Keonjhar dis­
trict. G-6-PD deficiency was very high (11.96%) in the
tribals. Abnormal haemoglobin was completely absent.

A study conducted in Ashram school children in
Sudargarh district of Orissa in 1995 revealed that prev­
alence of sickle cell trait was 7.4 per cent in Khaira and
3 per cent in Munda tribes. The frequency of G-6-PD
deficiency was considerably high among Bhuyan
(16.7%), Khaira (13.9%), Munda (13.8%), Oraon
(8.4%) and Kissak, (4.1%) tribes.

Haemoglobinopathies and G-6-PD Deficiency

.
■

In studies undertaken by the RMRC, Jabalpur, in
collaboration with the Department of Biochemistry and
Molecular Biology, Medical College of Georgia, Augus­
ta, USA, a new mutation of a-1 Thai IV S-I-117 (G-»A)
has been detected fbr the first time in the world15, and two
mutations of fi thal, IVS 1-1 (G->A) and CD 30 (G->A)
were detected fbr the first time in India while studying the
tribal population of Madhya Pradesh. B thal intermedia
with the Hb HofU [B 26 (H4) Val->Glu]-B°-thaIassaemia
[Codons 8/9 (+G)] combination has been found for the
first time in central India in a Gond woman16.

Sickle haemoglobin, thalassaemia and G-6-PD defi­
ciency are most common genetic diseases in Madhya
Pradesh. These disorders found throughout Madhya
Pradesh are more common in the tribal population. The
RMRC, Jabalpur, has carried out studies in
haemoglobinopathies among various tribals and
nontribals, specifically among the primitive tribes of
Madhya Pradesh and it has been observed that the prevalence of sickle haemoglobin among the primitive tribes
ranges from zero (Birhors, Saharia, Kamar and Hill
Korwas) to 13 to 22 per cent (Bharia, Abujhmaria and
Baigas). The prevalence of G-6-PD deficiency was as
high as 11.9 per cent among the Bharia males.
B thalassaemia was found in those tribes where sickle
haemoglobin was absent and vice versa. Prevalence of
fi thalassaemia ranged from 6.5 to 10.4 per cent in
Kamarst Saharia and Hill Korwas respectively, while, it
was absent in Bharias, Abujhmarias and Baigas. Both
the genetic disorders are hypothesised to have evolved as
advantageous selection of genes to protect them from
falciparum malaria.

In studies on haemoglobinopathies among the Gond
tribal groups of central India, interaction of a and Bthalassaemia with B chain variants was carried out by the
RMRC, Jabalpur, and it has been found that the simulta­
neous presence of a Thai type U with sickle or sickle B
Thai improves the haematological and clinical profile of
the patients. The prevalence of a thalassaemia has been
found to be 85 per cent in the tribals, which appears to be
the main determinant of clinical expression of sickle
haemoglobin in addition to high foetal haemoglobin17.

The Institute of Immunohaematology, Bombay, has
conducted studies on genetic markers like blood groups,
haemoglobinopathies and red cell enzyme deficiency like

The RMRCt Dibnigarh, in 1988, carried out studies
in haemoglobinopathies among the tribals of Arunachal
Pradesh. Abnormal haemoglobin E was detected among

25

12.0, 11.4 and 10.3 per cent Nishis, Adis and Apatanis
tribes respectively, in heterozygous form. A case of
haemoglobin EE was detected in Mishing tribe. The
incidence of G-6-PD deficiency was found to be 19.4,
16.7 and 16.0 per cent among the Adis, Apatanis and
Nishis tribes respectively.
Marital patterns of the tribals have been studied and
found that most of them practice endogamy and consan­
guinity. Alliance with the first maternal cross cousin is
considered as a right. The frequency of consanguinity
ranged up to 82 per cent among the Baigasu. Since, the
marital patterns have definite influence on genetic diseas­
es, the tribes do need marriage counselling. Taking this
fact into consideration a project on effect of health edu­
cation and genetic counselling is being conducted by the
RMRC, Jabalpur, in Gond tribe of Kundam block of
district Jabalpur〉with promissing results on a mid term
evaluation.

Social Science

A study on health seeking behaviour among the var­
ious tribes revealed that tribals have a strong belief in
supernatural powers, evil spirits and evil eyes. They
attribute illness to these and thp first level of treatment
was,, therefore, the traditional medico-religious system.
However, if affordable the tribals approach private prac­
titioners and subcentre/primary health centre, but they
prefer private practitioners, because of their easy avail­
ability, effective remedies provided and polite behaviour.
Studies have shown that lack of approachability to the
PHC, nonavailability of medicines at the PHC and fees
chained by the PHC staff were also reasons for preferring
private practitioners. The visits of the PHC staff to the
areas were minimal19. The economic studies have high­
lighted that it was not true that the tribals do not have faith
in modern systems of medicine, but it was their
subsistance economic level which affected largely their
decisions20-22. Their superstitions, misbeliefs also played
an important role in their decision on health problems. For
example, Kamars of Raipur believe that child diseases
like small-pox, measles, leprosy and TB cannot be cured
by an allopathic doctor and that these can only be cured
by a traditional healer. Certain practices were observed
which affect tribal health like the use of salt after washing
with water (Bharia tribe ofPatalkot valley, Chhindwara),
non exposure of children to sunlight by keeping them
wrapped in cloth in cradles (Abujhmaria tribe ofBastar),
non use of milk, as this was considered taboo
(Abujhmarias), etc.
26

The RMRC, Jabalpur, carried out studies in birth
related practices to understand their relationship to mater­
nal and child health (MCH). It was observed in general,
that the delivery was conducted in the squatting position
as it is considered to be a less troublesome position.
Arrow head, bamboo strip, new or old blade, knife, etc.
were used for cutting the umbilical cord and soil or oil was
applied at the stump. In most of the tribes, colostrum was
not discarded. These tribals did not utilize MCH services
since they considered pregnancy and delivery to be
natural phenomenon (RMRC, Jabalpur, unpublished
data).
The demographic studies conducted in the various
tribes indicate that fertility, in general, is low as compared
to the nontribals of the same area, and, the primitive tribes
have lower fertility than the non primitive tribes of the
same area. Due to wide variations in socio-demographic
indices observed in the various tribes and between the
tribal and nontribal areas, district level planning for
health and family welfare for the tribals has been advo­
cated2334.

CONCLUSION
To minimize the health problems of the tribals one
should visit the field areas, identify the health problems,
scientifically analyse the data and suggest possible rem­
edies.

Despite all the efforts of the Government of India, a
lot more needs to be done to improve the health status of
the tribal communities. The situation calls fbr a close look
and an in-depth analysis of the inter-play of socio-cultural
and economic condition on the health behaviours of this
group. The analysis would also provide an in-sight to the
kind of health services needed by the different tribal
communities. A fresh look is needed at the primary health
care approach in these areas. Prioritization of health
problems is essential to chalk out control programme fbr
them. Unless location-specific and need-based health care
delivery system is evolved which is appropriate, accept­
able, accessible, and affordable, the goal of health for all
which includes the concept of * equity in health* would
remain a utopian dream.
References :
1.

Sahu, G. Birohr Tribe (Dimensions ofDevelopment), Sarup and
Sons, New Delhi, 1995.

2.

Regional Medical Research Centre for Tribals, Jabalpur. Annual
Report, 1987-88.

3.

Roy, J., Singh, R.J., Yadav, R. and Mathur, Y.N. Demographic
profile of primitive tribes ofMandla district ofMadhya Pradesh.
Man Life 17(3-4): 119, 1991.

4.

Yadav, R.» Roy, J.» Sarkar, S.K. and Mathur, Y.N. Health status
of primitive Baiga children of Mandla district, M.P. Indian J.
Prevent Soc Med 23(4) : 145, 1992.

5.

6.

7.

8.

9.

Sarkar. S., Mandal, S.K., Gupta, D.N., Sircar, B.K., Ghosh, S.»
Motiram, G., Rashid, M.A., Nagra, J.S., Pal, S.C. and Deb.
B.C.: Prevalence of diarrhoeal diseases amongst tribals of Car
Nicobar Island, Indian J Public Health 36(4) : 133, 1992.
Niyogi, S.K., Mondal, S.» Sarkar, B.K., Garg, S, Baneijee, D.
and Dey, G.N. Outbreak of cholera due to Vibrio cholerae 01
in Orissa State. Indian J Med Res 100: 217, 1994.

National Institute of Virology, Pune. Serosurveillance for HIV
infection among tribal populations of Maharashtra. Annual
Report, 1992.

Risbud, A.R., Prasad, S.R., Mehandale, S.M., Mawar, N.»
Shaikh, N., Urmani, U.B., Bedekar, S.S. and Baneijee, K.
Measles outbreak in a tribal population of Thane district,
Maharashtra. Indian Paediatr 31: 543, 1994.
Singh, N.» Sharma, V.P., Shukla, M.M. and Chand, G. Malaria
outbreak in Kundam PHC, district Jabalpur of Madhya Pradesh.
Indian J Malariol 25: 41, 1988.

10. Rajagopalan, P.K., Pani, S.P., Das, P.K. and Jambulingam, P.
Malaria in Koraput district of Orissa. Indian J Paediatr 56:
355, 1989.

11. Jambulingam, P., Gunasekharan, K. Sahu, S.S., Hota, H.K.,
Tyagi, B.K. and Kalyanasundaram, M. Effect of Permethrin
impregnated bednets in reducing population of malaria vector
Anopheles culicifacies in a tribal village of Orissa State (India).
Indian J Med Res 89: 48, 1989.
12. Das,P.K., Das,L.K., Panda, S.K., Patra, P.K. and Jambulingam,
P. Lambdacyhalothrin treated bednets as an alternative method
of malaria control in tribal villages of Koraput district, Orissa
State, India. Southeast Asian J Trop Med Public Health, 24:
513, 1993.

13. Das, L.K., Mohapatra, S.S.S., Jambulingam, P.» Gunasekaran,
K., Pani, S.K. and Das, P.K. Malaria and other common ailments
among Upper Bollda Tribals in Koraput district, Orissa. Indian
J Med Res 89: 334, 1989.
14. Sahu, S.S., Gunasekaran, K. and Sadanandane, C. A note on
the impact of mud plastering on the efficacy of DDT residual
spraying in tribal villages of Koraput district, Orissa State. J
Commun Dis 25: 47, 1993.

15. Curak, M.A., Baysal, E., Gupta, R.B., Sharma, S and Huisman,
T.H.J. An IVS-I-117 (G—>A) acceptor splice site mutation in
the al globin gene is a nondeletional a-thalassaemia-2
determinant in an Indian population, Br J Haematol 85: 148,
1993.
16. Pande, P.L., Prakash, S., Tiwary, R.S., Kazanetz,E.G., Leonova,
J.Ye. and Huisman, T.H.J. fi thalassaemia intermedia in on
Indian female with the Hb Hofii [B 126 (H4) Val-Glu] B°thalassaemia [Codons 8/9 (+G) combination. Hemoglobin, 19:
301, 1995.

17. Gupta, R.B., Tiwaiy, R.S., Pande, P.L., Kutkar, F., Onner, C.,
Oner, R. and Huisman, T.H.J. Hemoglobinopathies among the
Gond tribal groups of central India: Interaction of the alpha and
B thalassaemia with B chain variants. Hemoglobin 15: 441,
1991.
18. Gupta, R.B., Pande, P.L., Pandey, G.D. and Tiwary, R.S.
Marriage patterns in Bharia tribe of Patalkot area, M.P., J
Prevent Soc Med 20(4) : 96, 1991.

19. Pandey, G.D. and Tiwary, R.S. Some aspects of socio-cultural
charateristics and health seeking behaviour among the Hill
Konvas-Si primitive tribe of Madhya Pradesh. J Fam Welfare,
39: 44, 1993.

20. Mishra, D.K., Pandey, G.D. and Sinha, P.K. Economic
constraints and health care in a tribal population of Madhya
Pradesh. Indian J Prevent Soc Med 19 (3) : 93, 1988.
21. Mishra, D.K., Pandey, G.D. and Sinha, P.K. Some aspects of
curative health care among the aged-A study in a tribal block
of Madhya pradesh. In : Tribal Demography, Eds R.N. Fdli
and L. Jagatbed, Ashish Publishing House, New Delhi, 1991.

22. Mishra, D.K., Pandey, G.D. and Sinha, P.K. Use of and'
spending on curative health care in a tribal block of Madhya
Pradesh. In : Paying for India's Health Care, Eds M.E. Khan,
and P. Berman, Sage Publications, New Delhi, 1993.
23. Pandey, G.D. A study of demographic characteristics of tribals
in M.P.: Some observations for health and family welfare
planning. Indian J Prevent Soc Med 19 (4) : 119, 1988.
24. Pandey, G.D,: Fecundability of tribal women in rural Madhya
Pradesh. Southasian Anthropol 10 (2): 7, 1989.

25. Pandey, G.D. A study of couple fertility in a tribal population
of Madhya Pradesh. In : Population Transition in India. Eds
S.N. Singh, M.K. Premi, .and A. Bose, B.R. Publishing
Corporation, New Delhi, 1989.
26. Pandey, G.D. and Saxena, B.N.: District level planning for
health and family welfare fbr tribals. Demogr India, 17(2) :216,
1988.
27. Pandey, G.D. Fertility in Koi tribe of Madhya Pradesh, J Fam
Welfare, 37(4): 59, 1991.

28. Pandey, G.D. Some correlates of literacy and educational
attainments among tribal children of rural Madhya Pradesh,
Demogr India, 19(2) : 289, 1990.
29. Pandey, G.D. and Singh, R.J. Some characteristics of tribal
households in Madhya Pradesh. Social Change, 21(2): 85,
1991.
30. Pandey, G.D. A study of household characteristics of backward
communities in a rural area of Madhya Pradesh. Man India,
73(2) : 107, 1993.
31. Pandey, G.D. and Tiwary, R.S. Diflerentials in demographic
characteristics of STs, SCs and Other Castes: Some
observations in a tribal block of Madhya Pradesh. In: Emerging
Trend in Economics. Eds. A.D.N. Bajpai, S. Chaubey and N.G.
Pendsey. Atlantic Publishers and Distributors, New Delhi, 1994.

32. Pandey, G.D. and Tiwary, R.S. Demographic characteristics in
tribal block of Madhya Pradesh. Social Change, 23(2-3) : 39,
1993.

27

33. Pandey, G.D. and Tiwary, R.S. Literary and demographic
characteristic»-A study of association among the tribals of
Madhya Pradesh. In: Tribal Situation and Development in
Central India. Ed. S.K. Tiwari, M.D. Publications, New Delhi,
1995.

34. Pandey, G.D. and Tiwary, R.S. Impact of migration on KAP
ofMCH and Family Wei fere Services-A study in the Koi tribe

of Madhya Pradesh. In: Tribal Situation and Development in
Central India. Ed. S.K. Tiwari, M.D. Publications, New Delhi,
1995.

This write-up has been contributed by Dr. G.D. Pandey,
Asstt. Director; Regional Medical Research Centre for
Tribals, Jabalpur.

85th ANNVERSARY CELEBRATIONS OF ICMR
Tuberculosis and leprosy were the themes selected for
the dissemination of scientific information to scientists,
professionals, planners, policy makers as well as the general
public in January and Februaiy 1996, respectively. Many of
the Council's Institutes clubbed these activities with those
relating to the National Science Day celebrations in Febru­
aiy 1996.

The Tuberculosis Research Centre, Madras, organised
an awareness programme on tuberculosis on Januaiy 22-23,
1996 which was inaugurated by Shri N. Haribhaskaran,
Chief Secretary, Government of Tamil Nadu. The
programme included a scientific lecture by Dr. S.
Radhakrishna, former Director, Institute for Research in
Medical Statistics, Madras; a two day exhibition on tuber­
culosis for the lay public and students (including video film
shows on tuberculosis), and a quiz programme for school
children. A free health check-up was also oi^anized on the
occasion in 讪ich visitors were examined and patients were
advised and treated.
The National Institute of Cholera and Enteric Diseases
(NICED), Calcutta, organised a symposium on Januaiy 31,
1996 highlighting different aspects of tuberculosis and the
activities of the Councifs Tuberculosis Research Centre,
Madras. Representatives from various voluntary organiza­
tions and nyrsing staff from various hospitals of Calcutta
participated in the symposium. Lectures/discussions were
followed by an exhibition and screening of video films.
The NICED, Calcutta, organised an awareness
programme on lq)rosy on Februaiy 28, 1996. Students and
teachers from difierent schools, field workers from Gandhi
Memorial Lq)rosy Foundation, Calcutta and staff of the
NICED participated in the programme which included lec­
tures/discussions and exhibition on leprosy and screening of
video films.

The National Institute ofNutrition, Hyderabad brought
out a special issue of the Nutrition News (Januaiy - March,
1996) featuring an article on Tuberculosis and malnutrition.
28

The ICMR Headquarters, brought out special issues of
the ICMR Bulletin in January and Februaiy, 1996 featuring
articles on Highlights of Research at the Tuberculosis Re­
search Centre, Madras and Neuritic leprosy; respectively.
The Institute of Pathology, New Delhi, organised two
lectures on February 16, 1996 — one on Tuberculosis by
Dr. S. P. Khanna, Director, New Delhi Tuberculosis Re­
search Centre and the other on Leprosy eradication: achieve­
ments ad future prospects, by Dr. R.S. Misra, Consultant
and Head, Department of Dermatology Xfenereology and
Lqjrology, Safdaijang Hospital, New Delhi.

The \fector Control Research Centre, Pondicherry,
oiganised a science exhibition focussing on what the com­
munity can do to prevent/control vectors and vector-bome
diseases, tuberculosis and leprosy at the VOC Higher Sec­
ondary School, Pondicherry on January 11-12, 1996. A
large number of students from different schools/colleges of
Pondicheny visited the exhibition. The VCRC Field Station
at Cherthala (in Kerala) oiganised two lectures on January
17, 1996 _ one on Tuberculosis by Dr. Rabindranatha,
District Medical Ofificei; Tuberculosis Control Programme,
Alleppey and the other on Leprosy by Sister Alicia Francis,
Coordinator, Leprosy Control Programme, Green Garden
Hospital, Cherthala.
The Centre for Research in Medical Entomology;
Madurai, organised symposia on Tuberculosis and Lq)rosy
on January 23, 1996.
The National AIDS Research Institute (NARI), Pune,
oiganised a lecture on Rehabilitation of leprosy patients by
Dr. Jal Mehta, Honorary President, Poona District Leprosy
Committee, on January 29,1996 at the BJ Medical Collie,
Pune.
The CJIL Field Unit, Avadi (Madras) organised film
shows, demonstrations and lectures on leprosy in various

schools at Avadi on January 30, 1996. An awareness
programme on tuberculosis and Iqprosy was also organised
at the Government Girls High School in Walajabad on
February 27, 1996 where video films on tuberculosis and
leprosy were screened. The CJIL Field Unit also organised
a symposium on "Leprosy epidemiology research and Na­
tional Leprosy Eradication Programme" at the Tuberculosis
Research Centre, Madras, on February 5, 1996. The sym­
posium was chaired by Dr. S.K. Noordeen, Director, Lep­
rosy Unit, WHO, Geneva. Eminent speakers at the sympo­
sium included Dr. P.S. Rao, Director-in-Charge CLTRI,
Chengalput; Dr. P.S.S. Sundar Rao, Director, SLRTC,
Karigiri; Dr. H. Srinivasan, Editor Indian Journal of Lep­
rosy Dr. S. Radhakrishna, Former Director, I RMS, Ma­
dras, etc.

The Regional Medical Research Centre (RMRC) for
Tribals, Jabalpur, organised a talk on the preventive aspect
of leprosy followed by a question-answer session on the
topic at Jabalpur on February 25, 1996.

The Desert Medicine Research Centre, Jodhpur,
oiganised a free health check Hip camp at Village Ramdeora,
near Kushtha Gram on February 28, 1996. The health
camp was followed by an exhibition covering different
aspects of leprosy and public meeting on the topic as also
a debate for school children.
The RMRC Dibrugarh conducted a KAP study and an
awareness programme among the tuberculosis patients and
their attendants visiting the District Tuberculosis Centre,
Margherita during January 23-25, 1996.

ICMR NEWS
De B.N. Saxena, Senior Dy. Director-General and
Chief Division of Reproductive Health and Nutrition, took
over as the new Additional Director-General ofICMR w.e.f.
February 29, 1996.
***

***

***

The following meetings of various technical groups/
committees of the Council were held:

Meetings of the Project Review Committees (PRCs),
Task Forces (TFs), Scientific Advisory Committees
(SACs) and Annual Review Meetings:

Special Reference to Mental
Health, Pune

PRC on Anatomy, Physiology
and Haematology

March 12, 1996
(at New Delhi)

Annual Review Meeting of
National Cancer Registry
Programme

March 13, 199
(at Bangalore)

TF to Study Normal Ranges
of the Important Lymphocyte
Subpopulation in Indian
Population

March 14, 1996
(at New Delhi)

Annual Review Meeting on
►Traditional Remedies for
Bronchial Asthma

February 23, 1996
(at New Delhi)

Participation of ICMR Scientists in ScientiGc Events

Annual Review Meeting on
Traditional Remedies for
Diabetes. Mellitus

February 23, 1996
(at New Delhi)

Dr. M.D. Gupte, Officer-in-Chaige, CJIL Field Unit,
Avadi, Madras, participated in the international workshop
on Leprosy Research at Bangkok (March 11-13, 1996).

TF on Vbnoms and Toxins

February 23, 1996
(at New Delhi)

SAC of the Centre for Advanced
Research on Standardisation and
Quality Control and Formulation
of Selected Traditional Remedies/
Natural Products, Jammu

February 27, 1996
(at Jammu)

SAC of the Centre for Advanced
Research for Health Consequences
of Earthquake Disaster with

March 11-12, 1996
(at Pune)-

Dr. Roshan B. Colah, Senior Research Officei; Institute
of Immunohaematology, Bombay, participated in the work­
shop on Molecular Techniques in Laboratory Medicine at
Kuwait (March 16-20, 1996).

Dr. N. Raghuramulu, Dy. Director, National Institute of
Nutrition, Hyderabad, participated in the XXVII Interna­
tional Vitamin A Consultative Group meeting at Guatemala
City (March 18-22, 1996).
Dr. S.K. Kashyap, Director, National Institute of Oc­
cupational Health, Ahmedabad, participated in the WHO's

29

International Programme on Chemical Safety (IPCS) Task
Group on Phosgene and Selected Chloroalkyl Ethers at
Carshalton (March 18-23, 1966).

Institute, Lucknow; delivered the Dr. YS. Narayana Rao
Award (1993) Oration of the ICMR on Search fof
Colonising Antigens of Vibrio cholerae as a Prelude to
Sccine Development, at the ICMR Headquarters, New
Delhi on March 26, 1996.

Dr. G.V Satyavati, Director-General, ICMR, delivered
the inaugural address at the symposium on Heatlh Care in
India: Present Scenerio and Future Directions, at the Central
Drug Research Institute, Lucknow (March 23； 1996).

Training Programmes/Workshops/Symposia held:

Dr. VB. Mandke, Dy. Director, Enterovirus Research
Centre, Bombay; participated in the HI Informal Consulta­
tion of Virologists from the SEAR Polio Laboratory Net­
work at Jakarta (April 1-3, 1966).

A training programme on Biostatistical Techniques in
Controlled Clinical Trials on Traditional Medicine was held
at the Institute for Research in Medical Statistics, Madras
(March 4-15, 1996).

Dr. D.A. Gadkari, Dy. Director and Dr. S.P. Tripathy,
Sr. Research Officer, National AIDS Research Institute,
Pune, participated in the meeting on HTV Vaccines for
Developing Countries: Antigen Design at Boston (April 811, 1996).

An ICMR/CONRAD workshop on Reproductive Epi­
demiology was held at the Indian Institute of Health Man­
agement Research, Jaipur (March 18-30, 1996).

Lectures/Orations:
Prof T. Jacob John, Emeritus Medical Scientist
(ICMR), Christian Medical College, Vfellore, delivered
the Amrut Mody Unichem Prize (1993) Oration
of the ICMR on Preventing Poliomyelitis and Measles:
From Laboratory Concepts to Community Models, at
the ICMR Headquarters, New Delhi on February 28,
1996.

Dr. Brahm S. Srivastava, Dy. Director and Head,
Division of Microbial Genetics, Central Drug Research

A young scientist symposium on Frontiers of Rep reduc­
tive Biology Research was held at the University of
Hyderabad, Hyderabad (March 20-22, 1996).
An ICMR national workshop-cum-training programme
on Quality Control and Standardization of Herbal Drugs
was held at the Regional Research Laboratory, Jammu
(March 25-29, 1996).
A workshop on Biomedical Communication was held at
the Regional Medical Research Centre, Dibrugarh (March
26-28, 1996). The participants of this workshop were from
Medical Colleges/Research Institutes and Hospitals, located
in the North-Eastern part of India.

ICMR AIDED SYMPOSIA/SEMINARSAVORKSHOPS/COURSES/CONFERENCES
Symposium/SeminarAVorkshop/
Course/Confercnce

Date & Place

Symposium on National Health Policy and People's
Health

March 11-13, 1996;
(at Allahabad)

Dr. N.P. Chaubey, General Secretary, Indian
Academy of Social Sciences, Iswar Saran Ashram
Campus, Allahabad.

I International Conference on Molecular Association.

March 18-20, 1996;
(at Aligarh)

Prof Pushkin M. Qureshi, Conference Director,
Department of Chemistry, Aligarh Muslim Uni­
versity, Aligarh.

Symposium on Schizophrenia : The Indian Scene

March 22-23; 1996;
(at Chandigarh)

Dr. P. Kulhara, Additional Professor, Department
of Psychiatry, Postgraduate Institute of Medical
Education and Research, Chandigarh.

30

Contact Address

COUNCIL'S TRAINING PROGRAMMES FOR 1996-97
Orientation Course on Occupational Health for
Industrial Medical Officers (September 17-29, 1996).

Leprosy

•

At the Central Jalma Institute for Leprosy, Agra:
• Multidrug Therapy Orientation Course in Leprosy for
Medical Officers (March 11-22, September 9-20,
1996).

Medical Entomology

At the Vector Control Research Centre, Pondicherry:

Virology

•

At the National Institute of Virology, Pune:

•

Diploma in Medical Virology (June 1996-May 1997).

Reproductive Biology

At the Institute for Research in Reproduction, Bombay:
•

Training Course on Immunoassay Techniques (June
3-15, 1996).

•

Training Course on Current Trends in Management of
Infertility and Reproductive Disorders (September
2-13, 1996).

Laboratory Animal Technology

At the National Centre far Laboratory Animal Science,
National Institute of Nutrition, Hyderabad:

•

Training Course for Laboratory Animal Technicians
(June 15-July 31, 1996).

•

Training Course for Laboratory Animal Supervisors
(September 1-November 30, 1996.

Haematology

Endocrinology

At the Institute of Immunohaematology, Bombay:

At the National Institute of Nutrition, Hyderabad:
•

M.Sc. in Medical Entomology (from August 1996; for
2 years).

Annual Training Course on Endocrinological
Techniques and their Applications (August 1September 15, 1996).

•

Training Course in Transfusion Medicine for Blood
Bank Medical Officers (August 5-October 4, 1996).
• Training Course in Blood Group Serology and Blood
Bank Methodology for Technicians (August
5-September 4, 1996).

Nutrition
At the National Institute of Nutrition, Hyderabad:

•

M.Sc. in Applied Nutrition (June 1,1996-February 28,
1997).

・ Training Course in Advanced Haematology and
Immunohaematology (September 17-October4,1996).

•

Annual Training Course in Nutrition (December
1996-February 28, 1997).

Biostatistical Techniques

1,

Occupational Health

At the Institutefor Research inMedical Statistics, Madras:

At the National Institute of Occupational Health,
Ahmedabad:

•

Training Course for Doctors in Biostatistical Techniques
in Controlled Clinical Trials (March 4-15, 1996).

愿^'library '顷
V £
AHO
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31

ICMR PUBLICATIONS
Price (Rs.)

Nutritive Value of Indian Foods (1985), by C. Gopalan, B.V. Ramasastri and
S.C. Balasubramaniam, Revised and Updated (1989), by B.S. Narasinga Rao, K.C. Pant
and Y.G. Deosthale (Reprinted 1995)

23.00

Growth & Physical Development of Indian Infants and Children (1972, Reprinted 1989)

10.00

Studies on Weaning & Supplementary Foods (1974, Reprinted 1996)

15.00

Studies on Pre-School Children (1974, Reprinted 1984)

6.00

A Manual of Nutrition (Second Edition 1974, Reprinted 1995)

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Low Cost Nutritious Supplements (Second Edition 1975, Reprinted 1994)

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Menus for Low Cost Balanced Diets and School Lunch Programmes Suitable for
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Some Common Indian Recipes and their Nutritive Value (Fourth Edition 1977,
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Japanese Encephalitis in India (Revised Edition 1980)

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Some Therapeutic Diets (Fourth Edition 1988/ Reprinted 1995) by Swaran Pasricha

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Nutrient Requirements & Recommended Dietary Allowances for Indians (1990, Reprinted 1994)

16.00

Count What You Eat (1989, Reprinted 1991) by Swaran Pasricha

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Diet & Diabetes (Second Edition 1993) by T.C. Raghuram, Swaran Pasricha & R.D. Shanna

18.00

Dietary Tips for the Elderly (1992, by Swaran Pasricha & B.V.S. Thimmayamma

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EDITORIAL BOARD
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...

Chairperson

Dr. Badri N. Saxena

...

Member

Dr. N. Medappa

...

Editor

Printed and Published by Shri J.N. Mathur for the Indian Council of Medical Research, New Delhi

at the ICMR Offset Press, New Delhi-110029

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