Socio-epidemiological determinants of 2002 plague outbreak in Himachal Pradesh, India: a qualitative study

BMC Public Health

Amarjeet Singh³  Umesh Chauhan³  Anil Kumar Gupta²  Harvinder Kaur³  Sonu Goel¹ 

[1] Health Management, School of Public Health, PGIMER, Chandigarh, India;Department of Hospital Administration, PGIMER, Chandigarh, India;School of Public Health, PGIMER, Chandigarh, India

关键词: Ethno-aetiology and social epidemiology;    Plague;    Lifestyle;    Hunting;    Himachal Pradesh;    Gujjars;   

Others  :  1131600
DOI  :  10.1186/1471-2458-14-325

 received in 2013-03-09, accepted in 2014-03-28,  发布年份 2014

【 摘 要 】

Background

This qualitative investigation was conducted to determine the socio-epidemiological factors related to the plague outbreak (2002) in Himachal Pradesh (HP), India.

Methods

The data for socio-epidemiological factors related to the plague outbreak (2002) in HP was obtained from residents through 150 in-depth Interviews (IDI) and 30 Focus Group Discussions (FGD) during six visits (from May 2011 to April 2012) by the research team. Natives, health officials and the nomadic population were interviewed. According to their opinion and viewpoints data was collected and their lifestyle and hunting practices were studied in detail. Tape recorders were used during various FGDs and IDIs. The interviews and FGDs were later transcribed and coded. In-depth analysis of the recorded data was done using an inductive thematic analysis approach.

Results

The study reports that the outbreak in 2002 in a few villages of Himachal Pradesh was that of plague and it occurred by the contact of an index case with wild animals after hunting and de-skinning. The first wave of plague transmission which took 16 lives of residents was followed by a second wave of transmission in a ward of a tertiary care hospital where one visitor acquired it from relatives of the index case and succumbed. The life-style practices of residents (hunting behavior, long stay in caves and jungles, overcrowding in houses, poor hygiene and sanitation, belief in ‘God’ and faith healers for cure of diseases) was optimal for the occurrence and rapid spread of such a communicable disease. The man-rodent contact is intensified due to the practice of hunting in such a rodent-ridden environment. The residents harbor a strong belief that plague occurs due to the wrath of gods. Various un-reported outbreaks of plague were also observed by officials, residents and old folk. The persistence of plague in HP is favoured by its hilly terrain, inaccessible areas, inclement weather (snow) in winters, unhygienic lifestyle, hunting practices of residents, and treatment practices through faith healers.

Conclusions

This study suggests that the lifestyle of the natives of HP and other socio-epidemiological factors played a role in the outbreak of plague in that area.

【 授权许可】

   
2014 Goel et al.; licensee BioMed Central Ltd.

【 图 表 】

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