VHAI Information and Documentation Service collects informations on health and development from various sources and disseminates them to a large number of users

New Leprosy Vaccine Developed
The National Institute of Immunology has developed a new vaccine for leprosy treatment as announced on the Anti-Leprosy Day, on 30th January 1998. The vaccine will be launched under the brand name, Leprovac, by Cadilla Pharmaceuticals, in the next three months. The vaccine will not cure leprosy but will hasten the process of recovery in case of patients undergoing the multiple drug therapy by about 18 months from the standard period of two to four years. Research on the vaccine started in 1972. The new vaccine is priced at Rs 6 per dose and the overall expense incurred by a patient on the vaccine will be less than Rs 50 during the course of the treatment.

The Net that Zaps Mosquities
Doctors and drug companies are getting exasperated over their inability to counter drug resistant malaria. The Health Ministry has come out with a novel method to tackle the problem - use of chemically-coated nets which are safe for humans but deadly for mosquitoes. A pilot project in Assam, where one lakh mosquito nets were given to villagers in the worst hit area of Sonapur in Kamrup district, has succeeded in bringing down malignant malaria cases by over 70 per cent. From over 500 reported deaths a year between 1993-96, the mortalities declined to 150 in 1996-97. Encouraged by the results, the ministry has proposed to distribute over a million nets in the North-East, Bengal and Orissa. The washable nets will also be sold so that people in semi urban areas and cities can buy.
The chemical, deltamethrin,applies itself better to nylon nets than cotton ones, and one
application can be effective for six months. The effect lasts up to three washes, its intensity reducing with every wash. Mosquitoes and other insects die on contact after a fresh application and subsequently are kept at bay for days. The nets also help reduce vector density in villages. The procedure for impregnation is simple and can be done by communities themselves. A 10 ml dose, diluted in 200 ml of water is enough for the complete absorption by one mosquito net. Unlike other insecticides, this does not leave a foul smell, neither during application nor in use.
Drug resistant malaria wasfirst noticed in the Himalaya foothill areas of the North-East It is now rampant in all the seven states of the region. It has also been recorded in Bengal and Orissa since the last monsoon. According to health ministry statistics, there were 2500 reported deaths from malaria during 1996-97 from all over the country.
Source: Business Standard, Calcutta 24 January 1998

The Mefloquine Story
Mefloquine, a 4 - quinoline methanol compound chemically related to quinine, is now available in India. Marketed under the trade name ‘Mefleam’ by Cipla, it is available as tablets containing 250 mg of mefloquine. Mefloquine is a potent, long-acting blood schizonticide active against malaria parasites resistant to chloroquine, sulfonamide/pyrimethamine combinations and other 4 - aminoquinolines. As it is very slowly eliminated (plasma half life 10 to 40 days), a single weekly dose of 250 mg provides effective prophylaxis. In uncomplicated malaria a single dose of 15 mg/kg body weight is usually adequate.
In India mefloquine is recommended only as a second line drug in the treatment of malaria. It should ideally be used only for the treatment of chloroquine resistant malaria and not as a prophylactic or for the treatment of uncomplicated malaria. Almost one every five persons who take mefloquine prophylactically notice some dizziness, nausea, vomiting, diarrhoea, or abdominal pain. These symptoms are generally mild and resolve without specific treatment. Over a ten-year period starting in 1985 more than 1500 neuropsychiatric adverse events, associated with mefloquine were reported. The most common were affective disorders, anxiety disorders, hallucinations and sleep disturbances. WHO currently advises that mefloquine may be given safety during the second and third trimesters of pregnancy both for prophylaxis and treatment. Bradycardia and sinus arrhythmia is estimated to occur in some two-thirds of patients treated with mefloquine. There may be ECG changes, when used with related anti-malarial drugs.
Source: WHO Drug Information,Vol. No 10. No 2, 1996.

The Plague Epidemic and After
The panic generated by the plague epidemic both in India and abroad resulting in hardships to thousands is now well documented. The Institute of Public Health, based in Chandigarh, under the leadership of Dr Satnam Singh, a long time WHO expert, was involved in understanding how the State and Central government institutions have been coping with the outbreak with a view to evolving a communicable disease surveillance and control strategy in the country on a scientific basis, since 1994.
By December 1995 there were four reports on the incident available. The WHO International team report on Plague in India, 13-26 October 1994 concluded that ‘No evidence was found to suggest transmission of Y. pestis in any major urban population other than in the city of Surat’. A report by an expert committee appointed by the Gujarat Government which appeared in March 1995 concluded that the ‘majority of evidence does not support the initial suspected diagnosis of pneumonic plague’. The Government of India Technical Advisory Committee on plague provided ‘very strong evidence’ in favour of plague being the cause of deaths in Surat.
Dr. Singh’s report containing elements of quick research concluded that ‘no evidence of man-to-man transmission of the killer disease was obtained. In view of the diverging conclusions of these reports Dr. Singh had approached the India International Centre, New Delhi and the Health Ministry of the Government of India to get together about a dozen government and non-government sector health scientists from different disciplines including at least one from Surat to deliberate and arrive at a consensus on whether the 47 deaths reported in Surat between September 21 to 30 1994 were caused by pneumonic plague. As such a deliberation which required a period of about two days could not be arranged so far either by the Ministry or ICMR or IIC.
Even after writing to two Health Ministers and Prime Minister, the matter has not moved further. This leaves the job for the new government to resolve the plague issue so that it can make corrective short and long-term national plans for infectious disease surveillance and control in the country.
Extracted from Hindustan Times, New Delhi 8 March, 1998.

Insulin Information
A new genetically-engineered human insulin called Humalog, which is absorbed rapidly into the circulatory system, is now available. It enables diabetics to inject insulin immediately before meals. The new drug may help insulin-dependent diabetics whose meal times are unpredictable and those who eat late in the evening and are prone to early nocturnal hypoglycemia.
Insulin-dependent diabetics usually reply on balancing diet with a mixture of soluble (fast acting) and isophane (delayed action) or a similar type of insulin to control their ailment. If their stabilisation fails, they suffer hypoglycemia, displaying symptoms of sweating, fainting, loss of speech and sight, and finally unconsciousness. The injections are usually given 30 to 40 minutes before a meal.
Compared to human-soluble insulin, Humalog has a faster action (15 minutes, as compared to 45), a shorter time to the peak action (30-70 minutes against one-three hours) when injected subcutaneously. So far, there is no data on mixing Humalog with intermediate and long-lasting insulins, which is likely to be a central figure of therapy, subject to further trials.
Source: Indian Express,28 January, 1998.

TRAINING PROGRAMMES
Planning, Monitoring & Evaluation of Rural Development Projects May 18-23 (6 days)
Meant for Senior Executives of NGOs and Government who are directly involved in planning and execution of rural development projects. The programme attempts to enhance the knowledge and skill base of these functionaries.

Disaster Management: Flood and Drought
May 25-30 (6 days)
Meant for Executives and disaster management personnel of NGOs, block and district level Government officers.

A Comprehensive Programme on Human Rights
July 20-25 (6 days)
Meant for personnel from Government and NGOs who are concerned with legal matters and human rights issues.
The above courses have 25 seats each, with a course fee of Rs. 3000 plus registration fee of Rs. 100 . The language of the courses will be English.

For details write to:

Centre for Development Research & Training
Xavier Institute of Management
Bhubaneswar 751 013
Orissa

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