Challenges for maintaining post elimination phase of visceral leishmaniasis control programme in India: A field-based study

BACKGROUND

India is going through the maintenance phase of VL elimination programme which may be threatened by the persistence of hidden parasite pools among asymptomatic leishmanial infection (ALI) and PKDL. The present work was designed to determine the burden of VL, PKDL, and ALI and to assess the role of treatment of ALI in maintaining post-elimination phase.

METHODS AND FINDING

The study was undertaken in Malda district, West Bengal, India during October 2016 to September 2021. Study areas were divided into 'Study' and 'Control' arms. VL and PKDL cases of both the arms were diagnosed by three active mass surveys with an interval of one year and treated as per National guideline. ALI of 'Study' arm was treated like VL. ALI of 'Control' arm was followed up to determine their fate. Fed sand-fly pools were analysed for parasitic DNA. No significant difference was noted between the incidence of VL and PKDL in both the arms. Incidence of ALI declined sharply in 'Study' arm but an increasing trend was observed in 'Control' arm. Significantly higher rate of sero-conversion was noted in 'Control' arm and was found to be associated with untreated ALI burden. Parasitic DNA was detected in 22.8% ALI cases and 2.2% sand-fly pools.

CONCLUSION

Persistence of a significant number of PKDL and ALI and ongoing transmission, as evidenced by new infection and detection of leishmanial DNA in vector sand-flies, may threaten the maintenance of post-elimination phase. Emphasis should be given for elimination of pathogen to prevent resurgence of VL epidemics.

Assessment of Knowledge, Attitudes, and Practices about Visceral Leishmaniasis in Endemic Areas of Malda District, West Bengal, India

Community participation is an important aspect for the success of kala-azar (KA) elimination program implemented in five Southeast Asian countries by the WHO. The participation of community depends on the level of knowledge of, attitude toward, and practice around risk factors associated with KA transmission among the population. We assessed the knowledge, attitude, and practice toward KA elimination in endemic areas of Malda district, West Bengal, India. A total of 709 individuals from different villages of 12 sub-centers were interviewed during April-July 2019. Data were recorded in a structured questionnaire under four categories: sociodemographic parameters, knowledge, attitude, and practice. The association of dependent variables such as knowledge, attitude, and practice with independent variables such as the economy and sociodemographic parameters was analyzed by binary logistic regression model and chi-square test using SPSS software. Despite the endemicity of the disease for a long time, the adequacy of knowledge about the disease was found to be poor that can be attributed to low education level and socioeconomic status, but the attitude and practices were good. So, there is a scope of improvement in knowledge of the disease through proper health education. This will further improve the level of attitude and practices that will be helpful for the smooth implementation of different activities of the program by more active participation of the community.

Seasonal variation of sand fly populations in Kala-azar endemic areas of the Malda district, West Bengal, India

Vector control is one of the main aspects to reach the target of eliminating visceral leishmaniasis from Indian sub-continent as set by the World Health Organisation. Data on different aspects of vector like ecology, behaviour, population dynamics and their association with environmental factors are very important for formulating an effective vector control strategy. The present work was designed to study the species abundance and impact of environmental factors on population dynamics of vector P. argentipes in a visceral leishmaniasis endemic area of Malda district, West Bengal. Adult sand flies were collected using light traps and mouth aspirators from twelve kala-azar affected villages of Habibpur block of Malda district, on a monthly basis from January to December, 2018. Morphological and molecular methods were used for species identification. Population dynamics were assessed by man hour density and per night per trap collection. Data were analysed using SPSS software to determine the impact of environmental factors on vector population P. argentipes was found to the predominant species and prevalent throughout the year. A significantly higher number of sand flies were collected from cattle sheds than human dwellings and peri-domestic vegetation. A portion of the P. argentipes population was exophilic and exophagic as evidenced by their collection from peri-domestic vegetation. The highest population density was recorded during April to September. Population dynamics were mostly influenced by average temperature along humidity and rain fall. Resting behaviour of sand flies was not restricted to the lower portion of the wall but equally distributed throughout the wall and ceiling. Programme officials should consider management of outdoor populations of the sand flies and timings of indoor residual spray for chemical control purpose.

Outcomes of surgery for post-cholecystectomy bile duct injuries: An audit from a tertiary referral center

AIM OF THE STUDY

Bile duct injury (BDI) after cholecystectomy is a serious complication. It often requires surgical repair. The aim of this study was to report on the short and long-term outcomes of surgery for post-cholecystectomy BDI.

PATIENTS AND METHODS

All the patients, who underwent surgery for post-cholecystectomy BDI between August 2007 and September 2017, were retrospectively reviewed. McDonald grading system was used to assess the long-term outcome. The risk factors for unsatisfactory long-term outcome were analyzed by univariate and multivatiate logistic regression analysis.

RESULTS

In total, 228 patients had a Roux-en-Y hepaticojejunostomy. Open cholecystectomy was the major cause of BDI (61%). The median time from injury to definitive repair was 6 months. The types of BDI were as follows: E1 in 13 (5.7%), E2 in 68 (29.82%), E3 in 108 (47.36%), E4 in 28 (12.28%), and E5 in 11 (4.82%) patients respectively. Postoperative morbidity and mortality were 25% and 1.31% respectively. After a median follow-up of 58 months, 90% patients had excellent to good outcome. Recurrent stricture developed in 6 (3%) patients. On multivariate analysis, long injury-repair interval and previous attempt at repair were independent predictors for unsatisfactory long-term outcome.

CONCLUSION

Surgical reconstruction affords excellent to good results for majority of the patients with post-cholecystectomy BDI. As longer delay in definitive repair and previous attempt at repair were associated with unsatisfactory long-term outcome, early referral to a specialized hepatobiliary surgery unit is recommended.

Growth, yield, water use efficiency and competitive functions of intercropping system of maize (Zea mays L.) and mungbean (Vigna radiata L.) as influenced by irrigation

Field experiment was conducted at Instructional Farm, Jaguli (Mohanpur), Bidhan Chandra Krishi Viswavidyalaya, West Bengal, India during two consecutive summer seasons of 2010-11, and 2011-12. The experiment was laid out in split-plot design having 4 levels of irrigation– rainfed without mulch, rainfed with mulch, irrigation at IW (depth of irrigation water) / CPE (Cumulative pan evaporation) ratios of 0.5 and 0.75 in main-plot and 4 inter cropping systems, sole maize, sole mungbean, maize + mungbean (1:1 row ratio) and maize + mungbean (3:2 row ratio) considered as sub-plot treatments replicated thrice. Results revealed that application of irrigation and intercropping systems markedly influenced the growth, yield and yield components (number of cobs/plant, number of grains/cob in case of maize and number of pods/plant and number of seeds/pod in case of mungbean) where the maximum value of these components were recorded with the application of irrigation at IW/CPE ratio 0.75 in sole crop. Maize-mungbean in 3:2 row ratio yielded higher than that of 1:1 intercropping system which might be due to less light interception and more competition for water and nutrition between both the crops. CU of water increased with the increasing levels of irrigation and the maximum value (17.75 kg ha-1 mm- 1) of WUE (water use efficiency) was observed with irrigation at IW: CPE ratio 0.75 under intercropping system of maize : mungbean in 3:2 row ratio followed by IW: CPE ratio 0.50. Among the sole crop, maximum WUE was with IW/CPE ratio 0.75 might be due to more consumption of water corresponding to production potential of maize, while, it was more under rainfed with mulch in mungbean. The relative crowding coefficient (RCC) also revealed both the intercropping systems were advantageous and the land equivalent ratio (LER) increased with the level of irrigation.Thus, maize grown in association with mungbean (3:2 row ratio) were found to be more profitable (B:C ratio of 2.58) with higher monetary advantage as compared to sole crop of maize (B:C ratio of 1.98) with the application of irrigation at IW: CPE ratio of 0.75 in new alluvial zone of West Bengal.SAARC J. Agri., 13(2): 94-107 (2015)

Corrective role of Eugenia jambolana on testicular impairment in streptozotocin-induced diabetic male albino rat: an approach through genomic and proteomic study

The present study was conducted to explore the effect of ethyl acetate fraction of hydro-methanolic (40 : 60) extract of seed of Eugenia jambolana on testicular impairment in diabetic rats. In this respect, biomarkers of oxidative stress, genomics and proteomics in testicular tissue were assessed. Side by side, glycated haemoglobin, serum testosterone, activities of glutamate oxaloacetate transaminase and glutamate pyruvate transaminase in serum, epididymal sperm count including reproductive organosomatic indices were evaluated. Results indicate that a significant recovery (P < 0.05) in the levels of these parameters in fraction-treated diabetic group in comparison with diabetic control. A significant recovery was noted (P < 0.05) in the expression of Bax and Bcl-2 gene towards the control after the treatment of said fraction. Histological study also focused a significant recovery (P < 0.05) in the number of different generation of germ cells at stage VII of spermatogenesis in fraction-treated diabetic group. The said fraction treatment to diabetic rat can recover the activities of serum glutamate oxaloacetate transaminase and glutamate pyruvate transaminase significantly towards the control (P < 0.05). Finally, it may be concluded that ethyl acetate fraction of seed of E. jambolana has a promiseable remedial effect on diabetes-induced testicular dysfunctions in male rat without inducing any metabolic toxicity.

Effect of different intensities of swimming exercise on testicular oxidative stress and reproductive dysfunction in mature male albino Wistar rats

Swimming exercise for 1, 2 and 3 hr for 5 days/week for consecutive 4 weeks, results in a significant reduction in testicular, epididymal, prostetic, seminal vesicle somatic indices; epididymal sperm count, sperm motility; preleptotine spermatocytes, mid pachytene spermatocytes and stage 7 spermatids; plasma levels of testosterone, luteinizing hormone; testicular delta5, 3beta-hydroxysteroid dehydrogenase, 17beta-hydroxysteroid dehydrogenase; testicular superoxide dismutase, catalase, glutathione peroxidase, glutathione-s-transferase and glutathione along with significant elevation in malondialdehyde in male albino rats. However, no significant change was noted in final body weight, spermatogonia-A and plasma level of follicle stimulating hormone. The results that oxidative stress develops with the increasing of exercise intensity, which may interfere in male reproductive activities.

Effect of intensive exercise-induced testicular gametogenic and steroidogenic disorders in mature male Wistar strain rats: a correlative approach to oxidative stress

AIMS

In order to investigate the effects of intensive exercise on reproductive dysfunctions in relation to oxidative stress, a total of 12 male rats (age: 3 months, weight: 127 +/- 2.86 g) were randomly divided into: (1) control group (CG, n = 6) and (2) experimental group (Exp. G, n = 6).

METHODS

An exercise protocol of 3 h swimming day(-1), 5 days week(-1) was followed for 4 weeks in Exp. G, with no exercise in CG. All the animals were killed; blood, testes and the accessory sex organs were collected for estimation of different parameters.

RESULTS

A significant diminution (P < 0.001) was noted in testicular Delta5, 3beta-hydroxy-steroid dehydrogenase (Delta5, 3beta-HSD), 17beta-hydroxy steroid dehydrogenase (17beta-HSD); plasma levels of testosterone, luteinizing hormone (LH); preleptotine spermatocytes (pLSc), midpachytene spermatocytes (mPSc) and stage 7 spermatids (7Sd); with no significant alteration in follicle stimulating hormone (FSH) and spermatogoia A (Asg) after intensive exercise. A significant elevation (P < 0.001) in malondialdehyde (MDA) and conjugated dienes (CD) along with significant reduction (P < 0.001) in glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), glutathione-s-transferase (GST) and peroxidase were found in testes of Exp. G. Moreover, the somatic index of testes and accessory sex organs were also decreased significantly (P < 0.001) after exercise. High correlations have been found in 17 beta-HSD with CAT (r = 0.90, P < 0.05) and peroxidase (r = 0.83, P < 0.05), epididymal somatic index with CD (r = -0.91; P < 0.05) and GSH (r = 0.84, P < 0.05).

CONCLUSION

The present study focused an chronic intensive exercise-induced oxidative stress that may cause dysfunctions in male reproductive system including steroidogenesis and spermatogenesis.

Dose-dependent response to an intratesticular injection of calcium chloride for induction of chemosterilization in adult albino rats

This study concerned the minimum and optimum effective doses of calcium chloride needed for induction of chemosterilization in male albino rats, 30 days after a single intratesticular injection of calcium chloride (CaCl2.2H2O) solution at 2.5, 5, 10 or 20 mg per 100 g body weight per testis. There was a significant diminution in the relative wet weight of the sex organs (p<0.01), epididymal sperm count (p<0.001), plasma concentration of testosterone (p<0.01), testicular activities of delta5,3beta-hydroxy steroid dehydrogenase (delta5,3beta-HSD), 17beta-hydroxy steroid dehydrogenase (17beta-HSD) (p<0.01), glutathione S-transferase (GST) (p<0.01), superoxide dismutase (SOD) (p<0.01), and peroxidase (p<0.01), significant elevations in testicular content of malondialdehyde (MDA) and conjugated dienes (p<0.01), along with derangement of seminiferous tubular architecture and degeneration of the Leydig cells in the testis and elevations in the concentrations in the plasma of LH and FSH (p<0.01), commencing at a dose of 5 mg, with the greatest effects at a dose of 20 mg. No significant alterations in these factors occurred at the dose of 2.5 mg in comparison to the control that received only the vehicle. There was no significant alteration in the plasma concentrations of prolactin (p>0.05), corticosterone (p>0.05) or fasting blood glucose or in the rectal temperature (p>0.05) at any of the doses relative to the control group, suggesting that this chemosterilizing procedure did not exert any chronic stress on the experimental animals. From these observations, it may be suggested that 5 mg should be considered as the minimum dose, and 10 mg or 20 mg as the optimum dose, whereas 2.5 mg was ineffective for induction of chemosterilization. There would seem to be little point in using more than 20 mg of calcium chloride for this purpose. Intratesticular injection of calcium chloride at an effective dose may be considered as an alternative to surgical castration.