Even as Bihar and Uttar Pradesh struggle to combat Japanese Encephalitis, which has claimed hundreds of children in the two States, a study has raised doubts on the credibility of the Government’s surveillance data which, it said, is hampering the development of prevention and control measures to check the deadly disease.
Conducted by the Public Health Foundation of India (PHFI), the study has noted that due to the gaps, the number of Acute Encephalitis Syndrome (AES) cases reported, have only gone up inspite of the introduction of a JE vaccine. As a result, the disease has spread to new districts, urban areas, and villages without pigs, which have not been associated with JE transmission, said Manish Kakkar of PHFI, lead author of the study.
The outcome sounds alarm bells as it indicates that such a poor strategy not only threatens the health of vulnerable population, but is also a waste of resources and funds being spent to fight the disease. Just last year, the Union Cabinet had cleared a Rs 4,000-crore package in view of rising number of cases in the two States.
“After reviewing the AES surveillance data for January 2011 to June 2012, in Khushinagar in eastern Uttar Pradesh, a hot spot for the disease, we found that the vaccination history of 84 per cent of AES cases in 2011 and 100 per cent in 2012 were unknown,” said Kakkar. “At the crux of the debate lies quality surveillance for AES, including laboratory testing, which is necessary for understanding AES and developing appropriate policy measures,” he added.
The research paper which has been published in the journal, Emerging Infectious Diseases, maintained that despite the high profile of AES, importance of surveillance data for guiding these initiatives has not been sufficiently realised and translated to action. “There has to be a serious and concerted effort to address this by having a systematic evaluation of the AES/JE surveillance system first, followed by providing adequate laboratory support,” Kakkar added
A total of 812 AES case records were identified, of which 23 per cent had illogical entries. In some instances, the dates were illogical (e.g., dates of symptom onset and sample collection following and preceding the dates of hospital admission, respectively), said the study.