Monday, May 19, 2014

STRATGEY TO CONTROL PARASITIC INFECTIONS IN CHHATTISGARH STATE


 This is the write up discussed in the  BRAIN STORMING WORKSHOP held on 12th May 2014 at Chhattisgarh Kamdhenu Vishwa Vidyalaya,Durg and appeared in the Souvenir on page 49-51. These are the practical suggestions that may certainly reduce parasitic burden of a locality hence any one may try in other places too but of course giving due credit for the idea as honesty desires . It will be my pleasure to help any one in this endeavor.


MC AGRAWAL
Board Member, Chhattisgarh Kamdhenu Vishwa Vidyalaya, Durg  

It is my great privilege and honor  that I have witnessed great eagerness in our Honorable Governor Shri Shekhar Dutt jee as  how he can take  Chhattisgarh to new heights- how economy and health of its people can be enhanced tremendously . Actually, this brain storming workshop is his brain child, whose deliberations will pave the way to map out new strategies for development of the state. I consider myself privileged and lucky to  be a part of this whole program . Looking to my experiences and also importance of the subject to the state , I have selected above topic. Here, I will not discuss academic matter but only those issues which have direct bearing in controlling parasitic  infections in the state.
1.       ANY  GOVERNMENT PROGRAM ON CONTROL OF  ANIMAL PARASITES; The central government is running various disease control programs in humans like control of malaria, tuberculosis, polio , lymphatic filariasis. Even in animal’s health, there is control program on Rinder-pest, foot and mouth disease etc where a lot of funds, technical help, men power are allotted .
Is there any comparative program of central government to control any parasitic disease of any animal species ? As per my knowledge there is none.  Why it is so ?
2.        LITTLE OR NO HARM FROM PARASITES ? Possibly, the parasitic infections in animals have been neglected being considered causing little or no harm to the animals. This notion came ,perhaps, by comparing the mortality rate caused by bacterial ,viral infections and those by parasitic infections. No doubt,  there is difference in mortality rate between these infections but many times  our diagnosis has  been faulty and  failed to identify parasitic etiology of death as has happened in two outbreaks  in sheep in Karnataka and Andhra Pradesh states (Chandra et al 2003 Indian J Vet Pathol 27:93-94);  In one outbreak, 80 sheep out of 400 died while 50 others showed  symptoms including swollen temporal region ,eye walls and diarrhea with mucus and blood. In one outbreak the disease was suspected  PPR ( Peste de petits ruminants) while in other Johne’s disease- but  parasitic disease in none . However, diagnosis ,carried out by IVRI centre for animal disease  research and diagnosis, revealed the death ,in both outbreaks,  due to  ovine schistosomiasis (Schistosoma indicum). How frequently this faulty diagnosis is occurring under field conditions ? we do not know ? Does it not reflect our pre-conceived notions regarding parasitic infections and also how faulty is our diagnosis at field level ?
3.       DIAGNOSIS OF PARASITIC INFECTIONS IN FIELD LABORATORIES :  The above example showed that field laboratory could not identify schistosome eggs in the fecal material .This is since our field veterinarians are  posted not as per their specialization but casually and this is also happening in our veterinary diagnostic laboratories. It is a fact that our veterinarians are more conversant about diagnosis of bacterial and viral infections but have little expertise in diagnosing parasitic diseases. I had an occasion to check registers of some diagnostic laboratories and surprised to note their results ; it was  like – positive for helminth eggs, positive for nematode/fluke eggs ,for coccidia ;they may identify trypanosomes in a blood slide but difficult for many to differentiate Babesia or Theileria organism from stain granules ; they can identify coccidian oocysts but could not its merozoites –the stage where damage is being carried out. We are not sure how many are trained about new techniques related to diagnosis of pathogens. And then, the expert diagnostician is transferred to some other place -to be replaced by a poultry  or alike expert.
Obviously, this diagnosis  pattern has to be changed ,if we plan to know the harm caused by the parasites . This needs  recognition of specializations while posting veterinarians in diagnostic laboratories, their training and overall monitoring of the results proclaimed by the diagnosticians .
4.       LACK OF HOSPITAL DATA: If we want to assess correctly damage caused by any ailment , our veterinary hospitals should record each animal case in such a way that the same may be assessed and analyzed  by any researcher  . Presently, the veterinary hospitals are recording the cases in a register which is difficult to analyze.
5.       ECONOMIC ASSESSMENT OF DISEASE LOSSES : This leads us to a pertinent question how we assess economic losses due to animal diseases. This loss should not be confined only to mortality but also due to other losses like milk production, body weight loss, wool quality ,reproduction etc  and then only we will be able to know the losses made by each disease in each host species. I am glad to inform this gathering that Chhattisgarh Kamdhenu University has resolved to start a separate department of veterinary economics and statistics .This department  will assess economic losses occurring in animal industry in the state and will be able to generate data  related to animal industries.
6.       HOW WE MAY PLAN CONTROL PROGRAM : Keeping above facts in mind and also that we do not have any commercial vaccine for any parasite or a large number of drugs against any parasite , we have to plan both short and long terms for controlling  parasitic infections  in Chhattisgarh state.
7.       STEREOSCOPIC MICROSCOPE IN DIAGNOSTIC LABORATORIES : Those who are familiar with parasitic infections are well aware about the importance of a stereoscopic microscope in identifying free living parasitic stages like larvae, cercariae, snails, ticks, insects  and other parasitic forms which are essential in parasitic diagnosis. But our field veterinary laboratories are  lacking a stereoscopic microscope thus impeding parasitic diagnosis . The least we can do is to provide a good stereoscopic microscope in every diagnostic laboratory.
8.       EXPERT DIAGNOSTICIAN : Now time has come when we should start recognizing importance of specializations in veterinary field . The veterinarians should be posted as per their post-graduate qualifications. Thus , diagnostic laboratories should be staffed only with those holding post graduate degrees in Pathology, Parasitology or Microbiology. They should be well aware about diagnosis of important parasitic infections or may be trained for the same.
9.       MANAGEMENT IN ANIMAL HUSBANDRY : In the present scenario, management in animal husbandry is most important in controlling parasitic infections and following points may be tried with the condition of analyzing effect of each factor so that their importance may be identified :

10.   GOBAR GAS PLANT OR VERMICOMPOSE : If we start collecting cow-dung from all the places and use it either in gobar gas plants or in preparing vermicompose, this single step will not only improve economy of rural household but  curtail parasitic infections to a great extend since almost 90% parasites excrete their infective stages through feces (we have to devise alternative methods for other animal species ).
11.   NO OVER USE OF MEDICINES AGAINST PARASITIC INFECTIONS :  Presently chemotherapy is the only remedy used by our field veterinarians against parasitic infections and to a greater extend there is indiscriminate use of the medicines. We do not have large number of drugs against parasitic infections ; neither research is promoted for developing new drugs. There are reports of developing drug resistance in the parasites and if it increases further, we will not have effective drugs against dreaded parasites. Therefore, there is the need to use the drugs judiciously while dealing parasitic infections as well as monitoring drug resistance in the parasites.
12.   HOW TO USE FAMACHA SYSTEM OF FAO : The organization has developed a method of assessing anemia in small ruminants by comparing paleness of conjunctiva  and recommending treatment, against Haemonchus Contortus infection, of the animals showing anemia, without further examination . However, this system is developed for the countries where only Haemonchus contortus is a problem. Since our country has a multiple parasitic problems, each having different treatment, this system can not be followed in Toto. Instead of taking anemia as the only criterion, I suggest to check animals for anemia, diarrhea , bottle jaw  ; if any of these symptoms are present in the animal, their excreta should be examined by laboratory  methods for parasitic infections and positive cases should be treated accordingly.
13.   TRIBAL EXPERIENCES AND SEARCH OF  MEDICINAL PLANTS : There is a need to study how tribes are treating their animals against important ailments. As tribal population in the state is more than fifty percent, their rich experience should be exploited  which may lead us identifying some new plants having rich anti-parasitic activities.
14.   COLLABORATION WITH OTHERS : There are many stakeholders who are working on animal diseases either directly or indirectly but are working in isolation. The university is not an executive body hence it is important to have a close link with executive body i.e. animal husbandry department. Likewise, there is a need of collaboration with public health institutes particularly for preparing strategies for zoonotic diseases and all the stakeholders must work in collaboration for controlling communicable diseases. I have already emphasized the need for a National Institute on Parasitology (www.indianschistosomiasis.blogspot.com) .
15.   USE OF INTERNET /VIDEOS /MOBILES : We are living in twenty first century which is witnessing spread of internet and mobiles with high speed. Therefore, it will be prudent on the part of the university/AH Department to  prepare short videos of about 5-10 minutes depicting important control strategies , diagnosis methodologies with photographs of the parasitic stages and to up-load the same on different websites including you tube. These devises should also be used to redress any problem ,faced by field staff or animal owners.
16.   PRIORITIES IN OUR RESEARCH AREAS  :  We have to reschedule priorities of our research areas which should help in controlling parasitic infections. All the above fields require constant monitoring so that best results may be identified. Thus , there is the need to assess importance of each animal species (with its age and sex) in spreading one or other parasitic infection in each geographical area ; to check efficacy of laboratory diagnostic techniques , ante-mortem and post mortem, in diagnosing parasitic infections; developing new parasitic techniques for diagnosis( but  can not over-emphasize immuno-diagnosis) ; economic losses at every stage of the infection, knowing local medicinal plants for curing parasitic infections and other new research fields . Here, I will like to mention following points also ,regarding our research priorities :
(a).CLINCAL NUTRITION : This aspect has been neglected in veterinary medicine and a new course on “Clinical Nutrition” should be introduced at post-graduate level . This will have two parts. The first part is about the nutrition like protein diet ,minerals, vitamins etc which help in increasing resistance against the disease while second part, less studied , is about the deficiencies caused by the diseases at different times and the need of supplementing these constituents while treating the animal for particular disease.
(b). PARASITIC SUSCEPTIBILITIES : Generally, the animals are found infected , in nature, not with one parasitic infection but a multiple parasitic infections. Many times, it has been difficult to pin point pathogenic effect due to  a specific  parasitic species.
Again, there are reports that infection of one parasitic infection makes animal susceptible to another important parasitic species. For example, in one experimental study at IVRI sheep , infected with Schistosoma indicum, were found harboring three times more  number of Haemonchus contortus  in its abomasum  in comparison to the control sheep and the difference was attributed to schistosome infection  (Srivastava et al ,1964 Indian J Vet Sci 34:35-40). Obviously, such studies are very few but require our attention.
(c ) MENTION OF PARASITIC SPECIES NOT EXISTING IN INDIA : In the technical or semi technical writings , I have witnessed mentioning of many parasitic species, by the veterinarians , that are not existing in India and which are even difficult to establish in India due to absence of particular intermediate host (at times, it creates problems to other stakeholders ). Thus , I have seen the papers about existing of Schistosoma japonicum or Fasciola hepatica (in non- hilly region ) , Trypanosoma bruci or alike ones which are not existing in the country. A some what similar problem is  in mentioning drugs/ molluscicides /insecticides  that are absent from  Indian markets.
If we scrutinize the problem ,it appears that at undergraduate level , the teachers fail to emphasize about the parasitic species which are not existing in the country. As our VCI has reduced undergraduate courses in parasitology, will it not be a good proposition to teach , at undergraduate level, only those parasites which are existing in the country ? And in post-graduate courses details of all parasites should be taught so that scholars should understand epizootiology of each infection, very clearly.     
In my opinion, professor level scientists should be given hard research areas and we must discard the research which has continuously proved  unfruitful .