RCZI Publications

Identifying sources, pathways and risk drivers in ecosystems of Japanese Encephalitis in an epidemic-prone north Indian district
Despite growing concerns over the emergence of JE in India, it remains poorly understood, mainly because the problem has been approached in a compartmentalised manner, with human health, animal health, environment, socio-economic factors, policy design and implementation being examined in isolated silos. A PHFI/RCZI study in 2015 was undertaken in a high endemic district of Uttar Pradesh to understand the human-animal-ecosystem interactions, as well as the social and environmental factors that influence disease transmission in this region. The first biotope-based study of the sources, pathways, and drivers of JE in a highly endemic district of India revealed the predominant drivers of JE infection in children as well as amplifier hosts (pigs). Results from the findings provide valuable insights for programme managers to design transdisciplinary interventions to combat JE infections in the community. Further, this study provides a template to study JE and other vector borne diseases through the agent-host-vector-environment interactions in the context of different biotope. A May, 2017 issue of Plos One has published a paper.
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A short note was developed to introduce the 10-minute documentary film
“Lifting the Veil of Silence that Shrouds Japanese Encephalitis [A1] ”. The film which was part of the Ecohealth study on “Identifying Sources, Pathways and Risk Drivers in Ecosystems of Japanese Encephalitis in an Epidemic-Prone North Indian District” that was conducted between 2011-14 was brought out by PHFI/RCZI and supported by IDRC. It will be shared at various national and international forums and also sent to health institutions and agriculture/veterinary colleges to be used as resource material. The PHFI/RCZI team hopes that the powerful medium of audio-visual communication can capture the magnitude of the problem and help mobilise and intensify a collective response that can bring hope to a devastated community.

Wishful thinking blurs interpretation of AES data in a high endemic region of India
It had been reported that in the period 2008-12, there appeared a declining trend of JE/AES even though non-JE AES had stabilised. This decline was attributed to JE vaccination campaigns in the high-endemic Gorakhpur region of Uttar Pradesh. In this response to the communication by Ranjan et al, the EcoHealth Resource Core Group highlighted gaps in understanding of the epidemiology of AES/JE in Gorakhpur and important factors, especially systemic issues which influence it in the region and how these could be contributing towards a misinterpretation of the observed trends in JE incidence.

Kakkar M, Rogawski ET, Abbas SS, Chaturvedi S, Dhole TN, Hossain SS, et al. Wishful thinking blurs interpretation of AES data in a high endemic region of India. Infect. 2014 Nov;69(5):520-1. doi: 10.1016/j.jinf.2014.08.002. Epub 2014 Aug 2014;

Available: http://www.ncbi.nlm.nih.gov/pubmed/25135228

Quality of Surveillance Data for AES and JE in Kushinagar district, Uttar Pradesh, 2011-2012
This paper high lighted the need for quality surveillance for AES, including laboratory testing for understanding epidemiology and etiology of AES, planning interventions, and developing policy. The study reviewed AES surveillance data for January 2011–June 2012 from Kushinagar District, Uttar Pradesh, India to determine incidence and analyse demographic characteristics of cases and data quality. The low-quality AES/JE surveillance data in this area, provided little evidence to support development of prevention and control measures, estimate the effect of interventions, and efficient use of public health resources.

Kakkar M, Rogawski ET, Abbas SS, Chaturvedi SC, Dhole TN, Hossain SS, Krishnan SK. Quality of Surveillance Data for Acute Encephalitis Syndrome and Japanese Encephalitis in Kushinagar district, Uttar Pradesh, 2011-2012. Emerg. Infect. Dis. 2013;19(9):1361–9;

Available: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3810909&tool=pmcentrez&rendertype=abstract

Disease Outbreak News

JE outbreaks are being reported from previously unknown foci. Further, encephalitis outbreaks of other aetiologies in endemic areas have only added to their complexity. For programme managers, researchers and community health professionals, access to accurate and updated information is key to planning interventions and other relief measures.

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