Browsing by Author "Chawla, Anil"

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    Estimates of the years-of-life-lost due to the top nine causes of death in rural areas of major states in India in 1995.
    (2002-01-22) Indrayan, Abhaya; Wysocki, M J; Kumar, Rajeev; Chawla, Anil; Singh, Nihal
    BACKGROUND: Years-of-life-lost (YLL) contribute nearly two-thirds of the disability-adjusted life-years (DALYs) worldwide and are especially Important for India where infant and child mortality is still high. These were estimated for India under the Global Burden of Disease study for the year 1990. No estimates are available for the different states of India. We aimed to prepare state-wise estimates of YLL for different causes of death in rural areas and to determine the causes responsible for a higher burden in different states. METHOD: Percentage deaths of the top 9 causes reported in the Registrar-General's Survey of Causes of Deaths (Rural)--1995 in 13 major states of India and different age groups was applied to the expected number of total deaths. The life lost according to the standard life-table was age-weighted and discounted using the methodology of the Global Burden of Disease 1990 study. The causes of death were based on lay reporting which otherwise seem reliable. RESULTS: The all-cause YLL in rural India in 1995 were 207 per 1,000 population. The minimum was 74 in Kerala and maximum 276 in Madhya Pradesh. Pneumonia was the top cause responsible for 15 YLL. The inter-state variation was high as Tamil Nadu had only 1.6 and Uttar Pradesh 30.5 YLL from this cause. Cancers were a uniform burden across the states. Heart attack, and bronchitis and asthma cut across the more and less developed states. Suicides were a heavy burden in Andhra Pradesh and vehicular accidents in Haryana and Rajasthan. Bihar, Gujarat, Madhya Pradesh, Orissa, Rajasthan and Uttar Pradesh had communicable and nutritional conditions as predominant causes while Kerala and Punjab had non-communicable diseases as the predominant cause of YLL due to premature mortality. CONCLUSION: These results provide a new perspective about the causes of death that need more attention in rural areas of different states of India. These will also help prioritize areas which require more inputs at the state-level and hence will be useful for health policymakers.
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    Monovalent polio immunisation--a strategy for India.
    (2005-12-11) Chatterjee, Arani; Chawla, Anil
    For the global eradication of poliomyelitis to succeed it is necessary to address the problem of type 1 poliovirus infection in those last remaining regions and countries where type 1 disease remains endemic. By general consensus among experts, prevention and eradication of type 1 infection would not be achieved using the currently available trivalent oral poliovirus vaccine (tOPV). Monovalent OPV1 (mOPV1) will be necessary for the purpose. mOPV1 was developed by Panacea Biotec Ltd, a United Nations prequalified producer of tOPV of proven efficacy and safety, by removal from the formulation of the mOPV2 and mOPV3 components with no change whatever in the quality, chemistry and stability of the monovalent product, and the virus content of the mOPV1 vaccine unchanged from the original approved tOPV product. This article summarises the development and regulatory strategy for the World Health Organisation proposal for such development with scrupulous provision being made for the safety of the vaccinees, and for their seroprotective responses.