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Why did children with age 8 to 12 attend anganwadi center?? Why were they enrolled (to show better attendance?)?

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  • Prof. Umesh Kapil
    Dear Dr Shah  Many thnaks for your comments. my Brief response is as follows One thing is doubtful. Why did children with age 8 to 12 attend anganwadi
    Message 1 of 1 , Oct 1, 2013
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      Dear Dr Shah 

      Many thnaks for your comments. my Brief response is as follows

      One thing is doubtful. Why did children with age 8 to 12 attend anganwadi center?? Why were they enrolled (to show better attendance?)?
      They must not be enrolled. Only adolescent girls, out of school, which might forms a small subset, can be in that group.
      THIS USUALLY HAPPENS WHEN AWWs ARE GIVEN ADDITIONAL RESPONSIBILITIES


      Moreover what they mentioned was vitamin A tablet; what I know that its liquid formulation thats being supplied, at least in our state. Can it be some other medication?

      THIS MAY BE TYPOGRAPHICAL MSIRAKE.BUT STATE GOVTS HAVE BEEEN PROVIDIBG VA CAPSULE   ALSO LIKE   UTTAR PRADESH


      Vitamin A toxicity can be caused by its accumulation only. If thats a case, these children must have been given such tablets or solution in the past at regular interval or recently in shorter interval (August month!!).
      It would be interesting to know how might they diagnose the reason of death as vitamin A without digging further like PM or serum retinol level!

      5 ML PER CHILD I.E. 5 LAKHS IU .   PLEASE SEE BELOW


      22 out of 36 developed symptoms, thats about more than 60%. Was it likely that all such children received vit A regularly in the past till recently

      YES THIS  LIKELY SCENARIO


      NFHS 3 data (its too old to cite though) shows poor vit A coverage (18% among 5-59 months of age); DLHS 3 data for bihar (49.9% for at least one dose of vitamin A given among >9 months); DLHS 3 data for Gaya District (47% coverage of at least 1 dose among 9-35 months; only 11.3% among children >21 months of age having taken 3 doses) shows poor coverage of vit A.
      Having said that, it must be emphasized that these data are old. They represent totality and not  individuality for one AWC. Such mishaps are bound to happen when icds is mismanaged and unsupervised. Still they hint us probability of occurrence of such opposite picture - overdose of supplements.

      WE DO NOT KNOW THE REAL CAUSE



      Other possible explanations include food hygiene and some epidemic among them. Detailed report should have been published.

      WE DO NOT KNOW THE REAL CAUSE


      GOVERNMENT OF INDIA
      MINISTRY OF HEALTH AND FAMILY WELFARE

      LOK SABHA
      UNSTARRED QUESTION NO 1600
      TO BE ANSWERED ON 28.11.2001

      DEATH OF CHILDREN AFTER ADMINISTERED VITAMIN A DROPS
      1600.
      SHRI AJAY SINGH CHAUTALA
       
      SADASHIVRAO DADOBA MANDLIK
       
      CHANDRA NATH SINGH
       
       
       
      Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:-


      (a) whether the Government are aware that several children have affected and several out of them died in Assam after administered vitamin-A solution drops, recently;

      (b) if so, the details therefor;

      (c) whether the Government have send any central team to Assam for the enquiry;

      (d) if so, the details thereof;

      (e) if not, the reasons therefor; and

      (f) the corrective steps taken by the Government in this direction?
      ANSWER


      THE MINISTER OF STATE IN THE MINISTRY OF HUMAN RESOURCE DEVELOPMENT (PROF. RITA VERMA)

      (a) to (f) A statement is annexed.

      STATEMENT REFERRED IN REPLY TO PART (a) TO (f) OF LOK SABHA UNSTARRED QUESTION NO. 1600 TO BE ANSWERED ON 28.11.2001


      A state-wide campaign for administration of Vitamin A to children was organised by Government of Assam on 11th Nov. 2001. The compaign was sponsored by the UNICEF. Information received from the State Government indicates that a large number of children reported symptoms of side effects within a few hours of receiving the Vitamin A dose and some died. As of 20.11.2001, 953 children are reported to have suffered adverse symptoms and 19 are reported to have died. The cause of the deaths is under investigation. The State Government has indicated that has indicated that the deaths are not likely to be related to Vitamin A administration.

      The Ministry of Health and Family Welfare had deputed a team of officers to make an onsite inquiry about the incident. The team reported that during the campaign UNICEF had replaced the two ml spoons usually supplied with the Vitamin A solution with 5 ml cups for the campaign. It was suggested by the team that during the campaign some children might have received excess dose of Vitamin A resulting in symptoms of toxicity. The team had also lifted samples of three batches of Vitamin A for testing utilized during the campaign. The results of the analysis conducted by Central Drugs Laboratory, Kolkatta indicate that samples were of standard quality.

      Government of India have advised State Governments to strengthen the routine ongoing programme for Vitamin A administration, in stead of launching campaigns for Vitamin A supplementation. Minister for Health and Family Welfare has made a statement regarding the incident in the both Houses of Parliament. A high level Committee of Experts under the chairpersonship of Dr. N.K. Ganguli, Director General, Indian Council of Medical Research has been constituted to go into various programmatic and technical aspects relating to Vitamin A administration.

       
      Source: www.bbcnews.com, September 3, 2003
      Court finds Unicef and government responsible for Assam child deaths
       
      The Guwahati High Court rules that both Unicef and the Assam state government are to blame for the death of more than 30 children who were administered vitamin A vaccines in the state
       
      In a judgement delivered this week, the Assam High Court has held both Unicef and the state government responsible for the death of more than 30 Assamese children. The children died after they were administered vitamin A vaccines in November 2001. Many became ill after taking doses of the vitamin.
      A two-judge bench of the Guwahati High Court in Assam pronounced its verdict on a public interest case filed by two Assam residents against the state government and Unicef.
      The court has asked the state government to pay compensation to the families of the children who died. It ordered compensation at the rate of Rs 20,000 over and above the paltry Rs 5,000 that each family has been already paid.
      Chief justice of the high court, P P Navlekar, and Justice AH Saikia said in their judgement that Unicef had introduced stronger doses of the vaccine by replacing the traditional two-millilitre spoon with five-millilitre cups.
      Although Unicef maintains that there was nothing wrong with the vaccines it supplied to the Assam government, the health workers involved were not properly trained and briefed, leading to the administration of greater doses that many of the sick children could not tolerate.
      According to the court verdict, there was an element of negligence in the way the Assam health department had administered the vaccines, leading to the death of so many children.
      Assam government officials have refused to comment on the court verdict. They say they will abide by its ruling.
      Source: www.bbcnews.com, September 3, 2003
      Thank you.
      Dr Malay B Shah
      MD (PSM),
      4th year Resident, 
      Government Medical College, Vadodara 
      Gujarat
      India
      Mob: 091-9429927853
      Dr. Umesh Kapil 
      Professor Public Health Nutrition 
      Room Number 118; 
      Human Nutrition Unit,
      Old OT Block,
      All India Institute of Medical Sciences 
      New Delhi,  India ,110029
      Mobile 91-9810609340

       
       


      From: Malay Shah <mmaallaayy@...>
      To: PSM residents <psmresidents@...>; iapsm_youthmembers@yahoogroups.com; baxirk@...; chavda_parag@...; dr. Saurabh Sharma <saurabh.krishnatra@...>; dramjadkhan@...; drbhavesh_psm@...; drcmpandya@...; drgeetikamadan@...; drileshkotecha@...; drsudhirchawla@...; harsh_bmc@...; harsh1012@...; jivrajdamor@...; Kotecha Sir <pvkotecha@...>; navneet_padhiyar@...; Niraj Pandit sir <drniraj74@...>; paragchavda@...; rawalvasudev@...; Sangita madam <sangita_psm@...>; shobhamisra@...; slkantharia@...; vihang.mazumdar@...
      Cc: umeshkapil@...
      Sent: Monday, September 30, 2013 10:40 PM
      Subject: FW: Re: [iapsm_youthmembers] Presentation of Two papers (One poster and one oral) at International Conference on Public Health Priorities in 21st Century

       
      Respected sir,
      One thing is doubtful. Why did children with age 8 to 12 attend anganwadi center?? Why were they enrolled (to show better attendance?)?
      They must not be enrolled. Only adolescent girls, out of school, which might forms a small subset, can be in that group.
      Moreover what they mentioned was vitamin A tablet; what I know that its liquid formulation thats being supplied, at least in our state. Can it be some other medication?
      Vitamin A toxicity can be caused by its accumulation only. If thats a case, these children must have been given such tablets or solution in the past at regular interval or recently in shorter interval (August month!!).
      It would be interesting to know how might they diagnose the reason of death as vitamin A without digging further like PM or serum retinol level!
      22 out of 36 developed symptoms, thats about more than 60%. Was it likely that all such children received vit A regularly in the past till recently? NFHS 3 data (its too old to cite though) shows poor vit A coverage (18% among 5-59 months of age); DLHS 3 data for bihar (49.9% for at least one dose of vitamin A given among >9 months); DLHS 3 data for Gaya District (47% coverage of at least 1 dose among 9-35 months; only 11.3% among children >21 months of age having taken 3 doses) shows poor coverage of vit A.
      Having said that, it must be emphasized that these data are old. They represent totality and not  individuality for one AWC. Such mishaps are bound to happen when icds is mismanaged and unsupervised. Still they hint us probability of occurrence of such opposite picture - overdose of supplements.
      Other possible explanations include food hygiene and some epidemic among them. Detailed report should have been published.
      Thank you.
      Dr Malay B Shah
      MD (PSM),
      4th year Resident,
      Government Medical College, Vadodara
      Gujarat
      India
      Mob: 091-9429927853
      Sent from Yahoo! Mail on Android
       

      From: Prof. Umesh Kapil <umeshkapil@...>;
      To: iapsm_youthmembers@yahoogroups.com <iapsm_youthmembers@yahoogroups.com>; Dr KB Sood Director Health <kbsood@...>;
      Cc: Director Health Services Shimla <health-hp@...>; PrincipalRHFWTCKGR <epidrhfwtckgr@...>; Principal RHFWTC KGR <rhfwtc@...>; Dr. Gopal Chauhan <drgopal7475@...>; dr ns neki <drneki123@...>; Dr OP sharma GSI New Delhi <opsharma.gsi@...>; QualityMedical <Quality_of_Medical_Education@yahoogroups.com>; ifanet india <ifanet-india@...>; Director TEPHINETDr Dionsio Jose <dherrera@...>; IMA Panjab <ima-punjab@yahoogroups.com>; Lal RedFlowerPublication <redflowerppl@...>; Rajib Dasgupta <dasgupta.jnu@...>; Hospital management <hosp_admn_india@yahoogroups.com>; AllIndia_PublicCauses <AIMDDA-PUBLICCAUSES@yahoogroups.com>; SONAM NEGI <drsonamnegi@...>; Ravinder Kumar InUnion <RKumar@...>; Dr Vikas Bajpai JNU_PhD <drvikasbajpai@...>; Dr Digvijai Yadav SIHFW Lucknow <drdigvijaidv@...>; Abhinav Bassi <abhinavbassi@...>; Ishtiaq Ahmad <surgerynmc@...>;
      Subject: Re: [iapsm_youthmembers] Presentation of Two papers (One poster and one oral) at International Conference on Public Health Priorities in 21st Century
      Sent: Mon, Sep 16, 2013 3:09:34 AM
       
       

      Dear All

      GOI program is for 6-59 months , who is pushing Aganwadi workers to give Vitamin A ? 

      Regards, Umesh Kapil

       
       

       

      ABP News 

      Child dies, 21 taken ill after taking Vitamin A tablet
      SharePrintE-mail
      Press Trust of India
      File pic
       
       
       
       
       
       
       
       
       
       
       
       
       
       
      Gaya (Bihar): After midday meal tragedies in Chhapra and Madhubani, one child died and 21 other children fell ill after taking vitamin A tablets given to them at an anganwadi centre in Gaya district on Wednesday.
      The tablets were given to children, aged between 8 -12, by the anganwadi centre at Kumbharan Bigha village under Atri police station, District Magistrate Bala Murugan D said.
       
      Altogether 22 children out of 36 who were given the tablet fell ill and were taken to Anugrah Narayan Magadh Medical College and Hospital (ANMMCH) here.
       
      One of them, identified as Roshan Kumar (10), died during treatment in ANMMCH, the DM said adding others were discharged from the hospital late this evening.
       
      The family of the deceased would be paid a compensation of Rs 1.50 lakh.
      Civil Surgeon of Gaya has gone to the village to look into the incident. 
       
      Dr. Umesh Kapil 
      Professor Public Health Nutrition 
      Room Number 118; 
      Human Nutrition Unit,
      Old OT Block,
      All India Institute of Medical Sciences 
      New Delhi,  India ,110029
      Mobile 91-9810609340
       
       
       
       

      From: surendernikhil gupta <drsurendernikhil@...>
      To: Dr KB Sood Director Health <kbsood@...>; IAPSM <iapsm_youthmembers@yahoogroups.com>
      Cc: Director Health Services Shimla <health-hp@...>; PrincipalRHFWTCKGR <epidrhfwtckgr@...>; Principal RHFWTC KGR <rhfwtc@...>; Dr. Gopal Chauhan <drgopal7475@...>; dr ns neki <drneki123@...>; Dr OP sharma GSI New Delhi <opsharma.gsi@...>; QualityMedical <Quality_of_Medical_Education@yahoogroups.com>; ifanet india <ifanet-india@...>; Director TEPHINETDr Dionsio Jose <dherrera@...>; IMA Panjab <ima-punjab@yahoogroups.com>; Lal RedFlowerPublication <redflowerppl@...>; Rajib Dasgupta <dasgupta.jnu@...>; Hospital management <hosp_admn_india@yahoogroups.com>; AllIndia_PublicCauses <AIMDDA-PUBLICCAUSES@yahoogroups.com>; SONAM NEGI <drsonamnegi@...>; Ravinder Kumar InUnion <RKumar@...>; Dr Vikas Bajpai JNU_PhD <drvikasbajpai@...>; Dr Digvijai Yadav SIHFW Lucknow <drdigvijaidv@...>; Abhinav Bassi <abhinavbassi@...>; Ishtiaq Ahmad <surgerynmc@...>
      Sent: Saturday, September 14, 2013 8:28 PM
      Subject: [iapsm_youthmembers] Presentation of Two papers (One poster and one oral) at International Conference on Public Health Priorities in 21st Century [2 Attachments]
       
       
      Respected and Dear Friends,
       
      I have the privilege to share the good news:
      -Two papers (One poster and one oral_Building Tobacco free and Creating eco-friendly environment in hills of Himachal Pradesh) were presented in the International Conference on Public Health Priorities in 21st Century_Endgame Tobacco Conference at New Delhi.
      Two photoes attached:

      *In the first photo, attending the queries of the internatonal participants following finishing the oral presentation and
      *Second photo has been with Dr. Shrinath Reddy, President, Public Health Foundation of India at New Delhi.
       
      Thank you very much.
      With warm personal regards,
       
      Nikhil
      Dr. Surender N. Gupta,
      MBBS; PGDHHM;PGDMCH;
      PGDCHFWM;FAIMS;MA (Phil);
      FIMS;MAE (Epidemiology); OCCRTI
      HFA_PHC_Johns Hopkins University, Baltimore, USA;
      Com_Ch_Public health, Johns Hopkins University, USA;
      MSData, University of Toronto, Canada;
      ITHS_University of Michigan, US;
      VaccineTr_Bloomberg School of Public Health,Johns Hopkins University;

      Epidemiologist-in-Charge, District Chamba-cum
      Faculty, Regional Health and Family Welfare Training Centre,
      Chheb, Kangra-Himachal Pradesh, India.
      Pin-176001.
      01892-265472 (Fax); 01892-263472 (Office)
      Mobile: 094181-28634.

      -Editorial Board Member_African Journal of Environmental Science and Technology;
      -Hony. Editor, American Journal of Public Health Research
      -Member_National Editorial Advisory Board_
      _Indian  Journal of Trauma and Emergency Pediatrics
      ;
      -Editorial Board Member_Wudpecker Journal of Medical Sciences;
      -Editorial Board Member_Journal of Environmental Science & Water Resources;
      -EIC-Pediatric Education and Research


      E-mail IDs: drsurendernikhil@...
                        drnikhilsurender@...
       
       
       


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