INTRODUCTION Rabies, an invariably fatal viral disease, is transmitted to humans through animal bites, most commonly dogs. Dog bites are the primary source of human infection in all rabies endemic countries and account for 96 % of rabies cases in South East Asia region. According to WHO, Each year, 23 000-25 000 people die in the SEA Region due to rabies. These accounts for approximately 45% human deaths due to rabies worldwide. 1 Of the estimated 25,000 deaths due to rabies in SEAR, a majority are in India (around 19,000) and Bangladesh (2000). More than 2.5 million people undergo post-exposure prophylaxis after being bitten by rabid or suspected rabid animals causing considerable morbidity and economic loss. 2 In spite of economic loss and sufferings, there is little information about the incidence of animal bites and rabies because of a lack of systematic reporting In India. As rabies is not a notifiable disease in India it is widely believed that this figure may be an underestimate. 3 Sporadic studies have been conducted indifferent parts of India but profile of bites not only varies from country to country but region to ABSTRACT Background: Rabies, an invariably fatal viral disease, is transmitted to humans through animal bites, mostly dogs. Of the estimated 25,000 deaths due to rabies in SEAR, a majority are in India and Bangladesh. Objective of the study was to study the epidemiological trend of animal bite by in central India. Methods: A cross sectional institutional study was conducted in 406 animal bite victims presenting to the tertiary care hospital and district hospital Rewa, Madhya Pradesh, India. Information collected with the pre tested structured questionnaire after obtaining informed verbal consent. Data pertaining to the socio demographic profile of victim, category of bite, provoked/ unprovoked time and place of bite, characteristic of animal was collected. Data was analysed using graph pad software. Results: Among 406 victims 76.3% were males, 56.7% belongs to 15-45 yrs, 61.6% were living in urban area, 31.3% and 21.7% of the victims were agriculture worker and laborers respectively. 95.8% victims bitten by dog of them 89% were stray, 89.4% had Category III bite, lower extremity was affected in 60.8%, 75.9% bites were unprovoked, fate of the animal was not known in 78.6% and 46% of the victims were affected during evening hours. Conclusions: Animal bites, especially dog bites still poses public health problem. Majority of the bites are attributed to stray dogs, unprovoked and category III bites. This indicates need of large amount of antirabies serum or HRIG thereby increasing the cost of management of animal bite cases. There is a need to control stray dog population and immunize pet dogs.

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BackgroundDiarrhea remains a leading cause of death among children under five in India. Public health sector is an important source for diarrhea treatment with oral rehydration salts (ORS) and zinc. In 2010, Micronutrient Initiative started a project to improve service delivery for childhood diarrhea management through public health sector in Gujarat, Uttar Pradesh (UP) and Bihar. This paper aims to highlight feasible strategies, experiences and lessons learned from scaling–up zinc and ORS for childhood diarrhea management in the public sector in three Indian states.MethodsThe project was implemented in six districts of Gujarat, 12 districts of UP and 15 districts of Bihar, which includes 10.5 million children. Program strategies included capacity building of health care providers, expanding service delivery through community health workers (CHWs), providing supportive supervision to CHWs, ensuring supplies and conducting monitoring and evaluation. The lessons described in this paper are based on program data, government documents and studies that were used to generate evidence and inform program scale–up.Results140 000 health personnel, including CHWs, were trained in childhood diarrhea management. During three years, CHWs had sustained knowledge and have treated and reported more than three million children aged 2–59 months having diarrhea, of which 84% were treated with both zinc and ORS. The successful strategies were scaled–up.ConclusionIt is feasible and viable to introduce and scale–up zinc and ORS for childhood diarrhea treatment through public sector. Community–based service delivery, timely and adequate supplies, trained staff and pro–active engagement with government were essential for program success.

PurposeThis paper aims to encapsulate the gendered support and hindering factors along with the role of the state experienced by Delhi-based women entrepreneurs in setting up/operating their enterprises amidst the challenges posed by the coronavirus disease 2019 (COVID-19) pandemic.Design/methodology/approachThe study used mixed methods to explore the challenges faced and recovery mechanisms adopted by women entrepreneurs with special reference to the COVID-19 pandemic. A total of 50 Delhi-based young women entrepreneurs (42 actual entrepreneurs + 8 prospective/struggling entrepreneurs) selected using snowball/purposive sampling were studied through both a semi-structured questionnaire and personal interviews. National Small Industries Corporation (NSIC) and micro, small and medium enterprises (MSME) were consulted for the government’s policy documents and data. The SPSS package was used for quantitative data analysis.FindingsLow-budget/very small-scale women entrepreneurs face common as well as gender-based challenges in the context of the market, finance, social capital, family support and awareness in addition to accessing the state’s resources/policies in both their startups and crisis situations, such as the COVID-19 pandemic. Although gender sensitization, entrepreneurial family background, and equal access to technology and the Internet has enabled women entrepreneurs to initiate, adapt, and scale their enterprises, male domination within the family, society, market, and state apparatuses is omnipresent and has served as a bottleneck for women-owned startups while hindering the recovery of their enterprises amidst the COVID-19 pandemic.Research limitations/implicationsThe study was limited to exploring the challenges and prospects of Delhi-based women entrepreneurs at the beginning of their enterprises and amidst the COVID-19 pandemic. On the other hand, the study had access to data and facts announced by the Indian government. No data were available on the implementation of policies and programs, and therefore specific policy analysis was not attempted. However, the reachability and accessibility of government resources and policies were employed.Practical implicationsThe study highlights the complexity of patriarchy, which hampers women entrepreneurs in all family, society, market and state domains. Therefore, policy enactment and implementation and further research on women entrepreneurship are suggested to focus more deeply on the gender dimension.Originality/valueThe data used in this work comprised inputs from government sources as well as insights from fieldwork that have not been used by any other publication.

BACKGROUND Dog bites account for tens of millions of injuries annually with children being at the highest risk. Dog bite fatality rates are higher in low-and middle-income countries due to prevalent rabies virus, lack of post-exposure treatment and appropriate access to health care. Between 30% and 60% of the victims of dog bites are children under the age of 15 in countries where rabies is endemic. The objectives of this study were-1. to assess the sociodemographic profile of animal bite victims who are < 15 years old, 2. To evaluate parents' knowledge and practices for prevention and control of rabies. MATERIALS AND METHODS This is institutional based cross-sectional observational study carried out among animal bite victims attending OPD of GMH, SGMH and District Hospital of Rewa city from February 2014 to February 2015. Out of 406 victims interviewed, 72 were <15 years of age (17.7%). Data was analysed using Graph Pad software. Percentage and proportion were used for data analysis. RESULTS 17.7% (n=72) of cases were aged < 15 years. 73.6% were males and 59.7% were urban residents. 61.1% victims belonged to below poverty line families. 94.4% victims sustained dog bites. Most common site of bite was lower extremity (38.9%), followed by head and neck (30.6%). Majority of the victims 84.7% had Category III bites. Almost half were bitten by pet animal/ or animal in vicinity of their home. 100% parents knew that animal bite would lead to rabies. Three fourths of them knew about washing the wound with soap and water. Availability of ARV Injection free of cost was known to almost 60 % of them. Almost 60% of the victims after animal bite consulted to health personal. Wound washing was done in 62.5% of cases. Many (45.8%) victims had taken advice from pharmacist. 55.6% victims washed the wound within 1 hour and 51.4% victims were administered ARV within 24 hours. CONCLUSION The adoption of PEP was below par in spite of having adequate knowledge of PEP. A delay in accessing PEP was noted. Present study revealed most victims approached health care personnel or pharmacist for advice. They can be utilized for sensitization of community emphasizing early initiation of post exposure prophylaxis measures. Time interval between animal bite and early initiation of PEP is crucial for prevention of rabies. Health educational program for community and pet owners focusing on vaccination of pets, supervision of children while playing with pets can be developed and implemented through grass root leve l workers and community leaders.