Sex differences in birth defects exist between opposite-sex twins.

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India's Total Sanitation Campaign (TSC), started in 1999, has the primary aim of 'eradicating the practice of open defecation by 2012'. This paper describes a cross-sectional health indicator study of four villages-two 'open-defecation free' (ODF) villages and two non-ODF villages) in Madhya Pradesh in 2006. The study included:(a) an epidemiological investigation based on a study population of 1,245 individuals; (b) microbiological and parasitological examinations of 10 per cent of stool samples from study population; and (c) water quality and sanitary inspection analysis. Results from the study indicate that both diarrhoeal morbidity and overall worm infestations from stool samples reduced in the ODF villages. Results however indicated high levels of microbiological contamination of the water supplies in ODF villages as well as an increased prevalence of hookworm infestation in 16 per cent of the population. These results refl ect that, as revealed by interviews, despite improved latrine coverage, many ODF villages are still practising open fi eld defecation resulting in the transmission of hookworms through the human-soil-human contamination route. The study concluded that, to maximize the health benefi t of ODF, a choice of alternative sanitation technology options combined with appropriate hygiene promotion must be undertaken.

Introduction: In August 2011, Chittoor district authorities reported a cluster of suspected human anthrax cases to the Andhra Pradesh state surveillance unit. We investigated this cluster to confirm its etiology, describe its magnitude, identify potential risk factors, and make recommendations for preventing similar outbreaks in the future. Methodology: Suspected cutaneous anthrax was defined as a painless skin lesion (papule, vesicle, or eschar) that appeared in a resident of Musalimadugu between July and August 2011. Clinical details and smears from skin lesions from suspected cases were collected to describe the outbreak by time, place and person. A retrospective cohort study among villagers aged ≥ 15 years was conducted to identify risk factors for acquiring the infection. Results: Sixteen livestock in the village died between 24 June and 7 August 2011. Smears from five animals showed Gram-positive, spore bearing characteristics of Bacillus anthracis. Villagers butchered and skinned the dead animals, sold the skin, and consumed the meat after boiling it for two hours. The outbreak in humans started on 30 July, and nine suspected cases of cutaneous anthrax (attack rate: 2%, no deaths) occurred until 7 August. The attack rate was higher among those aged ≥15 years. All the smears were negative on Gram staining. Individuals, who had handled, skinned, and slaughtered dead livestock were at higher risk of infection. Conclusions: We recommend ciprofloxacin prophylaxis to close family contacts. Vaccination of the livestock in the area and community education on the dangers of handling and slaughtering dead/ill livestock are necessary.