ICMR BULLETIN VOL. 25-No.-9-SEPTEMBER-1995.pdf
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ICMR
BULtETIN
Vol. 25, No. 9
September, 1995
MALARIA IN THE THAR DESERT : A CRITICAL REVIEW
Due to its xeric character, the Thar desert in Rajasthan
has always been regarded as an area hypoendemic for
malaria, though variable, endemicities and potential for
sporadic outbreaks of the disease in epidemic form exist1'3.
However, the scenario of both disease morbidity and mor
tality seems to have altered a great deal during the past
decade which is attributable to ecological and physiographical changes in the Thar region due mainly to the
construction of three major canal systems in the desert, the
Gang canal, Bhakra-Sirhind Feeder canal and Indira Gandhi
canal. These canal systems, running over 8000 km, have not
only changed the soil composition, landscape, potential for
water retention and climate but have also increased the water
table. As a consequence, some areas especially those in the
vicinity of canalised irrigation have become marshy with the
seepage of water from these canals and turned into a veri
table paradise for perennial breeding of certain vector spe
cies, including Anopheles atlicifacies, which has apparently
invaded the desert rather recently4-5. An. stephensi, which is
chronologically the oldest vector in the Thar desert is best
adapted to survive and transmit malaria in the interior areas
where there is a great scarcity of water. 6 Since 1983, the
Thar has experienced several outbreaks of malaria, mainly
due to Plasmodium falciparum, claiming several hundreds
of lives. Under the constantly changing Thar physiography
and ecology, if concrete vector as well as disease control
measures arc not taken, it is feared tliat epidemics may
continue to recur unabated in the ftiture too. The dynamics
of both vector biology and disease prevalence in the wake
of ecological oscillations in the Thar desert region require
a thorough analysis. Therefore, it was considered opportune
to review the malaria situation to help comprehend that the
vicissitudinous Thar desert is a region with potential for
severe epidemics, particularly if the newly formed breeding
conditions conducive to vector preponderance are not taken
care of urgently.
The Thar: Topography and Climate
The Great Indian Thar desert lies approximately be
tween 24-30° latitude North and 68-78° longitude East. In
the Rajasthan State, it spans over 75,000 sq.km. (62% of
the State area) and harbours 12.8 million people (39% of
the State population). It is organized into eleven notified
desert districts (recently a twelfth district, Hanumangarh,
was carved out from Sri Ganganagar district, but due to
nonavailability of authentic geographic, demographic and
malarionictric details, it is, for convenience of description,
included in its original district). The eastern flank of the
desert is bordered by the Aravalli range of mountains, while
the seasonal Luni river intersects the landscape into two
parts; in the north a vast stretch of sand dunes or levees and
in the south an expansive bowl rimmed by flat topped hills
of sandstones and limestones.
)i visio n of Publication & Information, ICMR, New Delhi - 1 1 0 029
々L
The Thar desert has extremes of ambient temperature,
often below -0° C during the brief winter season and close
to 50° C during the hot and sultry summer months. The
annual average precipitation, which until recently was about
250 mm., has since 1990 been about 350-400mm.
Canal Systems in the Thar Desert Region
As shown in the Figure three major canal systems exist
in the Thar desert region7. The Gang canal (114 km) was
the first to be built and become fully operative in 1928, with
its 1251 km long distribution system in Sri Ganganagar
district. Along with the Bikaner feeder, it provides water to
the extent of culturable commond area (CCA) of 3,07,692
ha with 65 per cent intensity. The Bhakra-Sirhind canal
project, with its 1219 km long distribution system, was
started in 1955 to utilize the CCA of 3,72,469 ha of land.
However, the most important of all these systems is the
Indira Gandhi Nahar Pariyqjana (IGNP). The project started
in 1958 but irrigation in part of the area was initiated only
in 1961. The project when completed will include a 649 km
long main canal (of which 445 km is in the Thar region) and
over 9000 km of distributaries. Although only two of the
three stages envisaged in the IGNP project are completed,
the main canal including the feeder and 5500 km of distribu
taries is already irrigating 0.7 million ha of land. While
several irrigation-intensive crops, such as sugarcane, mus
tard, groundnut, etc., have been established in some of the
canalized desert districts, the production of paddy in Sri
Ganganagar; the most irrigated among all the desert districts,
has topped the list in the whole State. Extensive paddy
cultivation is often associated with the breeding of certain
malaria vectors, including An. citlicifacies.
Physiographic Changes Brought About by Extensive
Canalization
Encircled numbers represent districts with malaria epidemics
District
No.
District
tears of Epidemic
API for 1994
1
Sri Ganganagar
1983, 1984
* 1.9
2
Bikaner
1990, 1992, 1994
10.4
6
Jodhpur
1990, 1992, 1994
5.7
7
Jaisalmer
1990, 1992, 1994
55.2
8
Banner
1990, 1994
26.7
Source :Reference 11
86
Extensive canalization and the resultant new irrigational
avenues in the desert have clearly reorganized the whole
desert region into three physiographically distinct zones: The
IGNP command area (fe, irrigated areas including Sri
Ganganagar, Bikaner, Jodhpur and Jaisalmer districts), the
IGNP non-command area (iu, areas which are not covered
by the project including Churu, Jhunjunu, Nagaur, Pali,
Jalore and Sirohi districts) and the monsoon flood-prone
areas (ie. Banner district) which are to be covered in the
IGNP III Stage. The IGNP command area is characterized
by development of vast areas perennially inundated with
seepage water from the canals. In addition, surplus flood
water from the seasonal Ghaggar river, whose flow is more
or less parallel to that of the Indira Gandhi Canal, has been
let into low-hing "escape" lands where it stagnates over
large areas. According to an estimate a total of 8600 ha of
land is permanently inundated under the IGNP Stage I by
the Ghaggar flood water while 1000 ha area is converted into
marshy land due to water logging and excessive seepage
from the canal in Stage II8.
Several decades' supply of canal water in the desert
region has resulted in a rise of water table, water-holding
potential of the soil and plentiful growth of vegetation par
ticularly hydrophytic weeds. Such extensive breeding
grounds are the preferred sites fbU，. adicifacies, the most
serious vector of malaria in the whole Indian subcontinent9.
Changing Pattern of Malaria Prevalence
The situation of endemic malaria in the desert has
changed a great deal over the past nearly one decade. P
falciparum has invaded almost the whole of the region and
caused immense misery including loss of human lives. This
can be substantiated by comparing the malariomctric data
of Rajasthan State (1961-1994) with respect to that of desert
districts alone1,10"11. Between 1961 and 1994 the overall
number of positive cases in the State has increase 27 times
from 8494 cases in 1961 to 229772 cases in 1994, whereas
the targetted population increased only 2.5 times during the
same period. Various indices also point towards this drift.
While the slide positive rate (SPR) had significantly incrc^sed from 1.43 in 1961 to 5.7 (3.5 fold increase) in 1994,
the slide falciparum rate has also augmented as much from
0.55 to 2.2. The annual parasite incidence (API), too,
showed a steady increase from 0.48 to 5.2 (Table 1).
Table I. MaJariometric indices for 1961-1991, with five yearly
intervals, and for 1994
Year
Population
BSE
SPR
SFR
API
(in thousands)
1961
17562
669202
1.43
0.55
0.48
1966
22454
1863401
0.52
0.03
0.48
1971
25850
2184134
5.05
0.37
4.25
1976
28031
3578216
11.55
0.68
14.73
1981
32492
3992445
2.52
0.37
3.10
1986
34670
2941659
1.80
0.40
1.50
1991
43880
3139925
2.43
0.51
1.76
1994
43880
4525430
5.70
2.20
5.20
BSE = Blood Slides Examined; SPR = Slide Positivity Rate;
SFR = Slide Falciparum Rate; API = Annual Parasite Incidence
Source : Reference 1, 10 and 11
Before epidemics began to occur regularly in the desert
region from the mid-eighties, most of the positive cases in
the State were reported from the hyperendemic hilly and
forested terrain of Udaipur zone in the southern part oi
Rajasthan State10. Therefore, it is of interest to note that in
Rajasthan while in 1986 the Udaipur zone had contributed
44.15 per cent positive cases and 67.74 per cent P.
falciparum cases against 24.37 per cent positives and 11.65
percent/? falciparum cases reported from the desert region,
in 1994 the situation was reversed so that only 14.15 pc
positives (P falcipanim 26.61%) were from the Udaipur
zone as against 53.27 per cent positives (RJdlcipamm 62.5
per cent) from the desert districts. Presently, amongst all the
desert districts, Barmer is the most malarious, contributing
31.29 per cent positive cases and 35.78 per cent
P.falciparum cases.
In the Thar region, Jodhpur and Bikaner zones together
have nine of the eleven desert districts. It is noted that during
1981-1991 both SPR and percentage P falcipanim had
appreciably increased in both these zones. In the Sri
Ganganagar district (1976-1986) the data show that the SPR
initially declined from 13.48 in 1976 to 0.84 in 1982 during
the non-cpidcmic period, but thereafter following an epi
demic it peaked to 4.91 in 1984. Similarly, the percentage
of A falcipanim infections also increased from 2.49 in 1976
to 6.83 in 1986. The Jodhpur zone comprising six districts,
v/z., Jodhpui; Sirohi, Pali, Jaisalmer, Barmer and Jalore,
truely represents the desert region. When the data on SPR
and percentage E falciparum infections in the Jodhpur zone
districts were pooled at five yearly intervals for the period
1981-1991 and compared with those of Sri Ganganagar
district and the State, it becomes evident that P falcipanim
has emerged significantly in the desert districts, in particular
(Table II).
Outbreaks of Malaria Epidemics in the Thar Desert
Out of the three physiographic zones described, the
IGNP command area zone was responsible for the flare up
in A falcipanim infection in the desert. Four major out
breaks with markedly high representation of P. falcipanim
being seen, Sri Ganganagar district, the first of the desert
districts to receive canalized water for irrigation, experi
enced malaria epidemic in 1983 during which period 4925
positive cases (〃 fiilcipamnt 43.4%) were seen, which was
much higher than in the preceding years. Two primary, health
centres (PHCs), v/z. Sangaria and Pilibanga, which were
most severely affected, had jointly contributed 72.2 per cent
of the total number of positive cases in the district during
the epidemic.
District Barmer bore the brunt of the 1990 epidemic
which soke out following unprccidented heavy monsoon
rains (>960 mm). A total of 19322 positive cases (P
falcipanim 66%), which was 2.5 times higher than the
positive cases in the preceding year, were recorded with
several death12.
87
Table II.
Malariomcteric data in Jodhpur zone during 1981, 1986 and 1991 as compared with that of Sri Ganganagar district
and the State of Rajasthan
Jodhpur zone
districts
Population
Jodhpur
1654
BSE
Positive
(SPR)
Pf
(%)
BSE
Positive
(SPR)
Pf
(%)
BSE
Positive
(SPR)
Pf
(%)
160280
271
95
102314
1034
112
110099
6374
1042
(in thousand:0
909
112881
362
35
77317
56
566
166
18545
101
14300
7
1
152
559
60157
748
58
•
35152
268
1379
180805
2376
163
23940
31
•
(H.5)
1979
265
(7.7)
Pali
(6.8)
Jalorc
905
79373
255
13
11033
21579
301
314
(5.0)
37
79
(26.2)
4S768
3540
600
(16.9)
134850
9746
(13.8)
38043
1221
(HO)
(0.6)
(6.9)'
Sirohi
103042
(9.8)
(9.6)
Jaisalmer
(16.3)
(10.8)
(9.7)
Barmer
1991
1986
1981
1316
(13.5)
74632
2409
316
(13.1)
(11.5)、
Pooled
for Jodhpur
zonal districts
5572
612041
4813
(0.8)
371
(Z7)
291066
4313
(11.5)
502
(1L6)
492970
33403
(6.7)
4573
(13.6)
Sri Ganganagar
district
2618
247920
2088
(0.8)
55
(2.6)
191014
4240
(2.2)
290
(6.8)
158710
218
(0.1)
(5.5)
Rajasthan
State
45880
100645
(2.5)
14752
(14.6)
2941659
54618
14006
(25.6)
3179925
77573
(24)
16305
(21.0)
3992445
(18)
Pf = Plasmodium falciparum
Source: References 1, 10 and 11 and personal communication from office of the Joint Director (Malaria), Jodhpur.
88
懑.
During late 1992 and early 1993 an epidemic broke out
simultaneously in several districts, ie Bikaner (Bajju,
Kolayat PHCs), Jodhpur (Baap, Phalodi PHCs) and
Jaisalmer (Pokaran, Nachna PHCs). In a study carried out
in two desert villages in vicinity of the Indira Gandhi canal,
vfz,Madassar and Awai during and after the epidemic in
early 1993, the SPR was recorded as high as 85 per cent and
E falciparum incidence was recorded as 88 per cent13. In
Jaisalmer district alone a total of 2128 positive cases (P
falciparum 73.6%) were reported in the period of the epidemic during 1992 as against a combind total of 1809 cases
(E falciparum 27.6%) during the two preceding years of
1990 and 1991. Occasionally some instances of
P.falciparum related hepatitis were also reported in the
desert region14.
In mid 1994, once again malaria in epidemic form broke
out in Barmer, Jaisalmer and Jodhpur districts. This was by
far the worst in the history of malaria in the Thar desert, and
took a toll of 361 (79.86%) humans out of a total of 452
deaths recorded in the State. E falciparum contributed to
about 60 per cent cases in the desert and was considered as
the main cause of death during the epidemic (Table III)15.
Table IIL
Malaria incidence and deaths in the six zones of
Rajasthan State during 1994
Development of Chloroquine Resistance in P. falciparum
There is very little information available on the devel
opment of resistance in P falciparum against chloroquine in
the desert region. Earlier investigations carried out between
1981-1984 indicated 100 per cent parasite susceptibility to
chloroquine (600 mg base). Recently, in 1994 in a small
sample of 12 patients studied at both Barmer and Jaisalmer,
100 per cent susceptibility was observed in the latter while
66.6 per cent susceptibility and 33.3 per cent
level of
resistance were obtained in the former desert district11.
Concentration of Labour Force from Neighbouring
Endemic States at the Site of Construction of the
Indira Gandhi Canal
The migration labour from some of the malaria
hyperendemic neighbouring States in the country to the site
of the Indira Gandhi Canal could perhaps be one possible
means of transportation of the P falciparum to the desert
region. Many of these labourers have permanently settled
near the site of work and provided a source of the parasite
which did not occur prodigiously in the local population
earlier.
Vectors in the Thar Desert
Zone
BSE
Total
positives
Pf
Deaths
Ajmer
725847
46851
12980
54
Jaipur
1046728
20256
5025
16
Bikaner
416668
23179
5299
98
Jodhpur
1110355
91611
47610
256
Kota
548803
15343
5636
27
Udaipur
677029
32532
11751
1
Pf = Plasmodium falciparum; BSE = Blood Slide Examined
Taking cognizance of the chronological development of
various epidonics since 1983 as well as their foci in the
desert region, it can be surmised that P falciparum domi
nated malaria epidemics have advanced from the northern
most Sri Ganganagar district to the west-southwardly dis
tricts in the interior of the Thar desert, more or less along
the course of the Indira Gandhi canal. The epidemic out
break in Barmer, however, seems to be correlated with heavy
monsoon rains when An. culicifacies begins to breed 8piousl乂 increasing the possibility of transmitting the malarial
parasite.
The first systematic entomological investigation was
carried out in the Sri Ganganagar district by the Desert
Medicine Research Centre (DMRC) Jodhpur16. It was found
that An. stephensi has adapted to the desert climate and bred
characteristically in the household tanka or beri whereas 4几
culicifacies^ which bred in a variety of habitats, increased
its distribution more or less parallel to the extent of canalized
irrigation. Between the two major vector species, An.
culicifacies was more preponderant in the areas under im
pact of irrigation. The dominancy
stephensi in highly
xeric situation was subsequently confirmed in a study car
ried out in ten desert villages of north-western Jodhpur
district17. In such villages where no canal water was avail
able, the occurrence of An. culicifacies was insignificant.
While 4〃. stephensi was incriminated in the desert villages
of Jodhpur district,
culicifacies was confirmed as a
vector in Sri Ganganagar district. In yet another study
carried out in the villages in the vicinity of the Indira Gandhi
canal in Jaisalmer district, it was observed that%", culifacies
thrived with An. stephensi18. The canalized irrigation
intensive crops and stagnant seepage water collections
have led to the breeding of many other species along
with
culicifacies (eg, An. nigerrimus An. splendidus
89
and An. annularis). The physiographic changes in the Thar
desert must have been enormous since even An. d'thali,
earlier known only from a single record from western Kash
mir, has now been recorded from the IGNP command area
in Jaisalmer district.
Distribution of Vectors in the Thar Desert
Until the mid-sixties a total of 16 species of mosquitors
were reported from Rajasthan State19. Most of these taxa
were restricted to Udaipur zone in southern Rajasthan, and
only seven species (43.7%) were inventorized from five of
the eleven desert districts20. Three more taxa have since
been added to the list, viz. An. nigerrimus from Sri
Ganganagar district, and An. d'thali and An. splendidus
from Jaisalmer district, raising the total to ten (59%)17. In
as far as the desert is concerned both An. ciilicifacies and
stephensi have been incriminated as vectors of ma
laria18. An. culicifacies, a species widely recognised as a
major malaria vector in India, is rampant in the plains as well
as desert areas currently under extensive irrigation-based
developmental activities. An. stephensi has been recently
introduced in the desert region with canalized irrigation.
An. stephensi is chronologicaly identified as a desert spe
cies21, which breeds in well-like earthen pits called tanka and
beri22. Two different forms have been suggested for An.
stephensi in the desert23.
Insecticide Susceptibility Status of the. Vectors
Both An. stephensi and An. culicifacies have exhibited
an increasing trend of tolerance against DDT, the most
commonly used insecticide in the malaria control
programme. Initial reports of DDT and dieldrin resistance
against An. culicifacies were from Pali (1962), followed by
Sirohi (1963), Jodhpur (1964), Sri Ganganagar (1967) and
Bikaner (1976). As for An, stephensi, the first instance of
resistance development against DDT was reported from the
non-desert Alwar and Kota districts in the eastern Rajasthan.
All vector species have been found absolutely susceptible
against malathion since inception of its use in 1980.
A number of significant short-comings have been ob
served in the spraying of insecticide. In the desert region,
barring a few border areas where HCH is sprayed, DDT has
bsn in use since the past several years. Technical and
operational inadequacies in spraying the insecticide were
enhanced by the non-availability oftrained spray squads and
the use instead of unskilled labourers on daily wages who
did not have proper knowledge of spraying methodology
resulting in wastage of money, material and manpower. The
90
insufficient dosage of the insecticide helps the vector species
evolve tolerance against it rather early.
Warning Systems lor Epidemics
The Thar desert is a highly complex ecosystem which
is under the constant stress of change. The history of malaria
in the Thar region indicates that until the early eighties,
malaria prevalence in any desert district had seldom taken
the form of an epidemic, irrespective of the excessive rains
during many a year since 190124,25. However, it was recently
argued that the epidemics in the Thar desert region have been
influenced by the excessive rains triggered by the El Nino
Southern Oscillation (ENSO)26. This hypothesis does not
seem to hold good at least as far as the Thar desert in north
western India is concerned due primarily to the facts that
(i) a large area in the desert, which is extensively irrigated
and covered with seepage water, has perennially become
conducive to copious vector breeding, particularly An.
culicifacies, beyound established critical densities, causing
more number of bites on human host and increasing thereby
the possibility of transmitting the malaria parasite amongst
the less immune population, and (ii) of the four major
epidemics, Barmer district, which is highly monsoon-flood
prone and is yet to be covered by the IGNP, experienced
outbreaks of malaria only twice (1990 and 1994), whereas
the IGNP command area in the Thar desert had all epidemics
behveen 1983 and 1994. Sri Ganganagar district, however,
had epidemics of malanaxOnly in 1983 and 1984
It appears that malaria epidemics in the desert region
had started occuring only after canalized irrigation was well
established. Inadvertently, seepage from these irrigation
canals perennially converted vast areas into breeding sites
fbr even those vector species which were so far unkown in
the interior of the Thar desert (eg. An. culicifacies}. There
is substantial evidence that while >1^. stephensi, traditionally
prevalent in the Thar desert, was able to transmit malaria
at a low pace, the introduction
culicifacies with a very
high density following the monsoon seems to have been the
cause behind the high-level transmission and epidemics. The
susceptibility of both these-vector species to P falciparum
is also well documented. It is for this reason that while in
the IGNP command areas malaria epidemics are a combind
effect of<，. culicifacies and 彳〃.stephensi^ in the non-IGNP
or truely desertic areas characaterized by the presence
of tanka and beri it is effected more or less completely
by An. stephensi. In the monsoon flood prone Barnier
district yet to be covered under the IGNP command
area, An. culicifacies is the main vector of malaria.
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India and the El Nino Southern Oscillation. Lancet 344:
1638, 1994.
This write-up has been contributed by Dr. B.K. Tyagi, Assistant
Director, Desert Medicine Research Centre, Jodhpur.
ABSTRACTS
Some Research Projects Completed Recently
Evaluation ofsome serological procedures for detection
cytoplasmic antigens as also antibodies for diagnosis of
of antigens and antibodies in invasive candidiasis.
invasive candidiasis.
a 9
The study was carried out for evaluation of various
serological procedures
for detection of mannan and
Mannan'ahd cytoplasmic antigens were prepared from
the blastospores and mycelial phases of Candida albicans
91
serotype A strain ATCC-1065 maintained on Sabourauds
dextrose agar. Cytoplasmic antigens were purified from
mannan fraction by affinity chromatography. Antisera were
raised in rabbits against these antigens for antigen detection
by latex agglutination test (by coating latex particles with
hyperimmune IgG fraction) and countercurrent immunoelectrophoresis (CBEP). Cytoplasmic antigen fractions were
also screened for immunodominant antigens by immunoblot
procedure using sera from five patients with histopathologically proven invasive candidiasis. A 47 kDa protein was
found to be the most immunodominant fraction. One hun
dred patients (confirmed invasive candidiasis-29, suspected
invasive candidiasis-30, superficial candidal colonication
and without any deep seated candida infection-41) were
screened for antigen and antibody.
Amongst different candida antibody detection proce
dures (like immunodifiUsion test, CIEP, whole cell aggluti
nation, and immunoblotting assay), immunoblot test for
detection of antibody against 47 kDa protein fraction was
found to be the most ideal procedure with a sensitivity of
79.3 per cent, specificity of85.4 per cent, positive predictive
value of 79.3 per cent, negative predictive value of 85.4 per
cent, and efficacy 82.9 per cent. This procedure could detect
antibody in patients with immunodeficiency. Amongst anti
gen detection procedures, latex agglutination test for detec
tion of manhan or cytoplasmic antigen was found to be
better than CIEP. However, this procedure requires to be
evaluated in patients with other fungal infections.
Candida specific precipitating antibody detection by gel
difiusion or CIEP was of high specificity but lacked sensi
tivity. Candida whole cell agglutination for detection of
antibody was found to be a good sensitive (75.9%) proce
dure but the specificity was very low (31.7%). There was
no significant difference observed in results using either of
the phases of Candida — blastospores and mycelial.
It may be concluded that detection of specific 47 kDa
fraction antigen in serum seems to be a better procedure
compared to the antigen detection tests in use currently.
Dr. A. Chakraborti
Department of Medical Microbiology
Postgraduate Institute of Medical
Education and Research
Chandigarh.
92
Screening for early detection of asymptomatic renal
disease in school children.
Urine samples of 17391 asymptomatic school children
(9580 boys and 7811 girls) aged 5-14 years were analysed
for detection of proteinuria, haematuria, pyuria and
aminoaciduria. Attempts were also made to detect
asymptomatic renal disease through ultrasonography, urine
culture, etc. Children who had proteinuria, haematuria,
pyuria, etc. in the first urine analysis were evaluated at
monthly interval for 2 successive months.
The general incidence of asymptomatic proteinuria was
4.2 per cent on first test, 1.77 per cent on the second and
1.61 per cent on the third examination; the incidence in boys
and girls being 3.57, 1.45, 1.39 and 4.97,2.16 and 1.88 per
cent respectively on first, second and third examination.
Proteinuria was more than traces in 0.99, 0.46 and 0.58 per
cent ofboys and 1.81,0.93 and 0.70 per cent ofgirls in each
test respectively. The degree ofproteinuria was more in older
age group children. The urinary protein/creatinine ratio
showed significant proteinuria in 150 (53.57%) and massive
proteinuria in 5 (1.79%) of proteinuric children. Seventeen
children showed significant pyuria on the first and 3 each
on the second and third examinations. Urine culture was
found positive in 4 of the 17391 children; ofthese three were
positive for Escherichia coli and one for Klebsiella.
Five children had microscopic haematuria on the first,
one oathe second and* two on the third examinations. Two
children were found positive for alkaptonuria.
Renal ultrasonography showed abnormality in 11.41
per cent of asmyptomatic proteinuric children. The abnor
malities were renal parenchymal changes in 3,
hydronephrosis in 4, calycial dilation in 10, renal calculi
in 2, renal cyst in 1, duplex kidney in 1, m电a pelvis in 2
and foetal lobulation was seen in 5 children. Two children
had a contracted kidney with posterior urethral valve and
multiple renal calculi and bilateral parenchymal changes in
one each.
It is concluded that screening for asymptomatic renal
disorders is easy and cost-benefit ratio is very high. It can
thus be included as a routine test for all school children
during their annual medical test.
/
B. Sanjeev Rai
Kasturba Medical College
Manipal.
ICMR NEWS
The following meetings of various technical groups/
committees of the Council were held:
Meetings of the Scientific Advisory Groups (SAGs)/
Scientific Advisory Committees (SACs)ZProject
Advisory Committees (PACs)ZProject Review
Committees (PRCs) held:
SAG of the Division of
Reproductive Health and
Nutrition
August 16-17, 1995
(at NewDelhi)
PAC of the International
Chlamydia Reference Laboratory
August 21, 1995
(at New Delhi)
PRC on Biochemistry and
Moleculor Biology
August 21, 1995
(at New Delhi)
PRC for Projects on
Non-Communicable Diseases
September 6, 1995
(at New Delhi)
SAC of the Centre for
Advanced Research on Health
Consequences of Earthquake
Disaster with Special Reference to
Mental Health, Pune
September 14, 1995
(at Pune)
International Symposium on Iron Nutrition in Health and
Diseases at Stockholm (August 24-27, 1995).
Dr. B.K. Tyagi, Assistant Director, Desert Medicine
Research Centre, Jodhpur, participated in the IX European
Meeting of the Society for Vector Ecology, at Prague (Sep
tember 4-7, 1995).
Dr. Swamp Sarkar, Assistant Director, ICMR Unit for
Research on AIDS in North-Eastern States of India,
jCalcutta, participated in a WHO Meeting on Implementa
tion of a Proposed Multicentric Study on Drug Injecting
Behaviour and HIV Infection, at Bangkok (September 1115, 1995).
Dr. Kalyan Banerjee, Director, National Institute of
Virology, Pune; Dr. J.J. Rodrigues, Director-in-Charge,
Dr. S.M. Mehendale, Dr. A.R. Risbud, Asstt. Directors and
Dr. Nita Mawar and Dr. A. Divekar, Sr. Research Officers,
National AIDS Research Institute, Pune; Dr. Swamp Sarkar,
Asstt. Director from Calcutta; and Dr. M.A. Khan,
Sr. Research Officer, Central Jalma Institute for Leprosy,
Agra, participated in the III International Conference on
AIDS in Asia and Pacific at Chiang Mai (September 17-21,
1995).
Hindi Day Celebrations:
Participation of ICMR Scientists in Scientific Events:
Dr. K. Madhavan Nair, Research Officer, National
Institute of Nutrition, Hyderabad, participated in the
As part of Hindi Day Celebrations by the ICMR Head
quarters, a popular lecture (in Hindi) on 'Heart Diseases:
Causes and Treatment* was delivered on September 13,
1995 by Dr. H.S. Wasir, Professor and Head, Department
of Cardiology, All India Institute of Medical Sciences, New
Delhi.
ICMR AIDED SYMPOSIA/SEMINARSAVORKSHOPS/COURSES/CONFERENCES
Symposium/ScminarAVorkshop/
Course/Confcrence
Date & Place
Contact Address
International Symposium on Human Stones, Free
Radical and Trace Metals and VEH National
Conference ofUrolithiasis Society of India 1995.
September 14-16,
1995;
(at Udaipur)
Dr.
P.P.
Singh,
Organising Secretary,
Department of Biochemistry, R.N.T. Medical
College, Udaipur.
National Seminar on Public Health Aspects of Fixed
Duration Treatment (FDT) in Leprosy.
September 22, 1995;
(at Bombay)
Dr. C.R. Revankar, Organising Secretary,
Bombay Leprosy Project, Vidnyon Bhawan,
Sion- Chunabhatti, Bombay.
Symposium on Prevention and Control of Goitre
Endemism in Tribal Population through Education and
Mass Communication.
October 2-3,1995:
(at Bhopal)
Dr. D.K. Belsare, Director, Institute for Natural
Resources and Human Environment, Bhopal.
93
Symposium/ScminarAVorkshop/
Course/Confcrcnce
Date & Place
Contact Address
Cytology Update - 1995.
October 14-15, 1995;
(at Chandigarh)
Dr. A. Rajwanshi, Organising Secretary of
Update,
Department
of Cytology
and
Gynaecologic Pathology, Postgraduate Institute
of Medical Education and Research, Chandigarh.
XXVI Annual Conference of the Endocrine Society of
India.
December 1-3,1995;
(at Ahmedabad)
Dr. J.M. Bhatavdekar, Organising Secretary,
ESICON - 1995, Division of Molecular
Endocrino- logy. The Gujarat Cancer Society,
Ahmedabad.
International Symposium on Radiomodi Gers in Human
Health.
December 28-31,
1995;
(at Manipal)
Prof P. Uma Devi, Convenor, ISRHH,
Department of Radiobiology, Kasturba Medical
College, Manipal.
COUNCIL'S TRAINING PROGRAMMES
Reproductive Biology
Occupational Health
At the Institute for Research in Reproduction, Bombay:
•
Training Course on Techniques in Immunology, Cell
Biology and Molecular Biology (November 5-25,1995).
At the National Institute of Occupational Health,
Ahmedabad:
•
Training Course on Techniques in Neuroendocrine Re
search (February 6-10, 1996).
•
Orientation Course on Occupational Health for
Industrial Medical Officers (November 13-24,
1995).
、
•
Training Course on Air Pollution Monitoring and Risk
Assessment (December 13-19, 1995).
Endocrinology
At the National Institute of Nutrition, Hyderabad:
•
Annual Training Course on Endocrinological Tech
niques and their Application (August/September, 1995).
Laboratory Animal Technology
Nutrition
At the National Institute of Nutrition, Hyderabad:
•
Annual Training Course in Nutrition (December 1,
1995 - February 28, 1996).
At the Laboratory Animal Information Services Centre,
National Institute of Nutrition, Hyderabad:
•
Training Course for Laboratory Animal Supemsors
(September 4 - November 30, 1995).
Oncology
At the Institute of Cytology and Preventive Oncology,
New Delhi:
•
94
Workshop on Molecular Biology ofViruses and Cancer
alongwith Oligo DNA Synthesis and Polymerase Chain
Reaction (September 18-22, 1995).
Haematology
At the Institute of Immunohaematology, Bombay:
•
Training Course in Advanced Haematology and
Immunohaematology (September 11-29, 1995).
ICMR PUBLICATIONS
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Nutritive A^lue 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)
25.00
Growth & Physical Development of Indian Infants and Children
(1972, Reprinted 1989)
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Studies on Weaning & Supplementary Foods (1974, Reprimed 1986)
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A Manual of Nutrition (Second Edition 1974, Reprinted 1992)
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Menus for Low Cost Balanced Diets and School Lunch Programmes Suitable
for South India (Third Edition 1977, Reprinted 1991)
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Some Common Indian Recipes and their Nutritive Value (Fourth Edition 1977,
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95
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