India (National institution of Health, 2013) Bacteria (Tuberculosis)


India is positioned on the Indian subcontinent in
south central Asia and is the seventh largest country by area. (National
institute of health, 2013) India is the second most populous country with over
1.2 billion people.(National institute of health, 2013) India’s climate can
be classified as a hot tropical country. In most of India; summer is very hot.
It begins in April and continues till the beginning of October; when the
monsoon rains start to fall. The heat peaks in June with temperatures in the
northern plains and the west reaches 45° C and more. The
effects of climate change on human health in India are a broad topic, covering
areas from extreme weather events to shifts in vector borne diseases. (National
institution of Health, 2013) Floods create conducive environments for numerous
health consequences resulting from disease transmission. For example, if
floodwaters become contaminated with human or animal waste, the rate of faecal oral
disease transmission might increase; this is because different pathogens are
found within the animals or human faeces which can result in diarrhoeal disease
and other bacterial and viral illnesses to flourish. (National institute of
health, 2013) Faecal-oral transmission of diseases is of particular concern in
regions such as South Asia because of limited access to clean water and
sanitation. (National institution of Health, 2013)









Bacteria (Tuberculosis)

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Bacteria are
microscopic single celled organisms that thrive
in diverse environments. They can live within soil, in the ocean and inside the
human gut. The three basic bacterial shapes are spherical, bacillus and spiral. (Aryal.S,2015)

Tuberculosis (TB) is a
bacterial infection that spreads through inhaling tiny droplets from the coughs
or sneezes of an infected person. (NHS Choices, 2010) It mainly affects the lungs, but it
can affect any part of the body, including the abdomen glands, bones and
nervous system. (NHS choices, 2010)When a
person becomes infected with tuberculosis, the bacteria in the lungs multiply
and cause pneumonia along with chest pain, coughing up blood, and a prolonged
cough. (NHS choices, 2010)  In addition,
lymph nodes near the heart and lungs become enlarged. As the TB tries to spread
to other parts of the body, it is often interrupted by the body’s immune system
is unable to fight TB or if the bacteria break through the scar tissue, the
disease returns to an active state with pneumonia and damages the kidneys,
bones and the meninges that line the spinal cord and brain. (National institution of health, 2013)

A WHO report
shows that India has the highest number of TB resistant strains in the world,
and a person infected with the bacteria is estimated to transmit it to an
estimated 15 people within a year. (World health organisation, 2009) This trend
is in line with the current state of bacterial resistance in the country which
has been criticised for its high level of corruption, lack of sanitation and generally
low adherence of patients. (World health organisation, 2009)

Symptoms: The
symptoms of tuberculosis (TB) depend on where the infection occurs and usually
develops slowly. The symptoms might not begin until months after an individual
is initially infected. (National Institution of Health, 2013)  In some cases the infection does not cause any
symptoms, which is known as latent TB. It’s called active TB if an individual
has symptoms. (NHS inform, 2015) General symptoms of TB may include lack of
appetite, weight lose and high temperature. An individual may also experience
night sweats and extreme tiredness or fatigue. (NHS Choices, 2015) Most
infections affect the lungs, which can cause persistent cough that lasts more than three weeks and usually brings
up phlegm, which may be bloodybreathlessness that gradually gets worse.
(NHS choices, 2015)

Causes: Tuberculosis
is caused by an organism called Mycobacterium tuberculosis. (NHS choices.
2015) The bacterium spreads from person to person through microscopic droplets
released into the air. This can happen when someone with the untreated, active
form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.Therefore,
it is important for healthcare providers to have their face masks and gloves on,
when nursing a person with TB, so that they do not catch the infection. Most
people with active TB who have had appropriate drug treatment for at least two
weeks are no longer contagious. (NHS choices, 2015)

Treatments: Testing
and treatment for latent TB may be recommended for people who require treatment
that will weaken their immune system, such as long term corticosteroids, chemotherapy or TNF inhibitors. This is
because there is a risk of the infection becoming active. (NHS choices, 2015)
Treatment for latent TB generally involves either taking a combination of
rifampicin and isoniazid for three months, or isoniazid on its own for six
months. (NHS inform, 2015) However, if an individual is diagnosed with active
pulmonary TB, they will be given a six month course of a combination of
antibiotics. The usual course of treatment is two antibiotics (isoniazid and
rifampicin) for six months and two additional antibiotics (pyrazinamide and
ethambutol) for the first two months. (NHS choices, 2015)























A virus is a microscopic organism that can replicate only inside the
cells of a host organism. (NHS choices, 2016)Once the virus enters the body, it finds a host cell
to infect; for example, cold and flu
viruses attack cells that line the respiratory or digestive tracts and the human immunodeficiency virus (HIV), which causes
AIDS, attacks the T-cells of the immune system. (Toni.t,
2016) The basic structure of a virus is made up of a genetic information
molecule and a protein layer that protects that information molecule.(Morgridge
institute for research, 2016)Shapes of viruses
are predominantly of two kinds: rods, or filaments, so called because of the
linear array of the nucleic acid and the protein subunits; and spheres, which
are actually 20-sided (icosahedral) polygons. (Encyclopaedia
Britannica, 2017)

HIV is a virus that damages
the cells in the immune system and weakens the ability to fight everyday
infections and disease. AIDS (acquired immune deficiency syndrome) is the name used
to describe a number of potentially life threatening infections and illnesses
that happen when the immune system has been severely damaged by the HIV virus. While
AIDS cannot be transmitted from one person to another, the HIV virus can. (NHS
choices, 2016)The HIV virus attacks a type of white blood cell called
T-helper cells (also called CD4 cells). These cells are important when it comes
to having a healthy immune system as they help to fight off diseases and
infections. (NHS choices, 2016) HIV cannot grow or reproduce on its own
Instead; it makes new copies of itself inside T-helper cells. This damages the
immune system and gradually weakens the natural defences. (NHS choices, 2016)

epidemic in India is driven by heterosexual sex, which accounted for 87% of new
infections in 2015. (National institute of health, 2006) However, the epidemic
is concentrated among key affected populations such as sex workers. The
vulnerabilities that drive the epidemic are different in different parts of the
country.If a person is living with HIV, taking effective HIV
treatment and being undetectable significantly reduces the risk of passing
HIV on to others. (National institute of health, 2006)

Symptoms: Most people infected with
HIV experience a short, flu like illness that occurs 2-6 weeks after
infection. (NHS choices, 2015) The most common symptoms of HIV
include; raised temperature, sore throat and body rash. However, there are
other symptoms that an individual may feel which include;tiredness, joint pain,
muscle pain and swollen glands. (NHS choices, 2015) These symptoms of HIV usually
last 1-2 weeks, but can be longer. They are a sign that the immune system is
putting up a fight against the virus.After the initial symptoms disappear, HIV
may not cause any further symptoms for many years. Once the immune system
becomes severely damaged, symptoms can include:

weight loss

chronic diarrhoea

night sweats

skin problems



Causes: HIV infection is
caused by the human immunodeficiency virus. An individual might get HIV from
contact with infected blood, semen, or vaginal fluids. (natiional institute of
health, 2015)Most people get the virus by having unprotected sex with someone who has HIV.Another common way of
getting HIV is by sharing drug needles with someone who is infected with
HIV.The virus can also be passed from a mother to her baby during pregnancy,
birth, or breastfeeding. (WebMD, 2005), (NHS Choices, 2015)


Treatments: Although
there is no cure for AIDS/ HIV, medications can retard the virus growth. (NHS
choices, 2015) The standard treatment for HIV is a combination of medicines
called antiretroviral therapy, or ART. Antiretroviral medicines slow the rate
at which the virus multiplies.Taking these medicines can reduce the amount of
virus in the body and helps to stay healthy. It is recommended that people
begin treatment for HIV as soon as they know that they are infected. (NHs
choices, 2015)
























Fungus (Tinea

A fungus is
any member of the group of eukaryotic organisms that includes microorganisms
such as yeast and molds, as well as the new familiarmushrooms. (NHS choices,
2013) The fungus grows best in warm moist environment such as shoes, socks,
swimming pools, locker rooms and the floor of public shower. (Healthline, 2010)
The main body of most fungi is made up of fine, branching, and usually
colourless threads called hyphae. (healthline, 2010)

Tinea pedis,
also called Athlete’s foot is a contagious fungal infection that affects the
skin on the feet and can spread to the toenails and sometimes the hands.
Athlete’s foot occurs when the tinea fungus grows on the feet. (Omics
international, 2015) Tinea pedis is most common in the summer and in warm,
humid climates.It occurs more often in people who wear tight shoes and who us
community baths and pools.

Prevalence in the india of any valve disease is 3.5%.
Of those with fungus disease
about 4.0% have Athlete’s foot. (Omics
international, 2017) The prevalence of moderate or severe aortic stenosis in
patients more than 75 years old is 3.0%. (Omic international, 2017) It is the
most common Athlete’s foot disease of the elderly and increases
with age. The prevalence is 5.5% at age 75 years and 8.1% at 85 years. (Omics
international, 2017)

There are many possible symptoms of athlete’s foot, which include; itching,
stinging, and burning between the toes and on the soles of the feet. (NHS  choices, 2013) An infected person might also
feel blisters on the feet that itch and cracking and peeling of the skin on the
feet, most commonly between the toes and on the soles. (NHS, choices, 2013) The
symptoms of athlete’s foot also include discoloured, thick, and crumbly toenailsthat pull away from
the nail bed.(NHS, choices, 2013)

Tinea pedis is caused by a microscopic fungus that lives on dead tissue of the
hair, toenails and other skin layers and it occurs when the tinea fungus grows on the feet.
(Healthline, 2010) An individual may catch the fungus through direct contact
with an infected person, or by touching surfaces contaminated with the fungus. (NHS
choices, 2013) The fungus thrives in warm, moist environments. It’s commonly
found in showers, on locker room floors, and around swimming pools (Healthline,

Treatment: Athlete’s foot is unlikely to get better
on its own. It can be treated using antifungal treatments available
from pharmacies without needing to see a GP.(NHS choices, 2012) Antifungal
treatments work by stopping the fungus causing athlete’s foot from growing.
(NHS choices, 2010) They come in creams, sprays, liquids and powders which are
similarly effective but some work faster than others. (NHS choices,2010) It is
important to practise good foot hygiene during treatment to speed up recovery
and prevent athlete’s foot returning.





are paracites that multiply within heir defentive hosts and are characterised
by small size, short generation times and a tendency to include immunity to
re-infection in those hosts that survive. (Biology science, 2016)

Malaria is a
life threatening disease and is typically transmitted through the bite of an infected Anopheles mosquito.
(Biology science, 2016) Infected mosquitoes carry
the Plasmodium parasite. When the mosquito bites the parasite is
released into the bloodstream. (Healthline, 2005) Once the parasites are inside
the body they travel to the liver where they mature.
After several days the mature parasites enter the bloodstream and begin to
infect red blood
cells. Within 48 to 72 hours the parasites inside the red blood
cells multiply causing the infected cells to burst open. (Healthline, 2005)

In South
Asia, malaria is one of the most pertinent examples of increased occurrence of
a vector borne disease. Malaria is one of the life threatening vector borne
diseases in India; changes in temperature and precipitation patterns have the
potential to expand the geographical range of malaria into temperate and arid
parts of South Asia. (National institute of health, 2013) For example, in India
malaria distribution is expected to expand to higher latitudes and altitudes.
Because the relationship between climate and disease distribution is complex,
in some areas increasing temperatures may restrict malaria transmission. (National
institute of health, 2013)

of malaria include fever, headache and vomiting, and usually appear between 10
and 15 days after the mosquito bite. (NHS choices, 2013) If not treated, malaria
can become life threatening by disrupting the blood supply to vital organs.
some people have malaria attacks that happen every two or three days and last
between  six and 10 hours therefore it is
important to get immediate treatment as the symptoms of malaria can get worse
very quickly. (NHS choices, 2013)

Malaria happens when a bite from the female Anopheles mosquito
infects the body with Plasmodium. (NHS choices, 2013) Only the Anopheles mosquito
can transmit malaria.When an infected mosquito bites a human host, the parasite
enters the bloodstream and lays dormant within the liver.The host will have no
symptoms for an average of 10.5 days, but the
malaria parasite will begin multiplying during this time. (Medical newstoday,
2012) The new malaria parasites are then released back into the bloodstream,
where they infect red blood cells and multiply further. (Medical news today,
2012) Some malaria parasites remain in the liver and are not released until
later, resulting in recurrence.An unaffected mosquito becomes infected once it
feeds on an infected individual. This restarts the cycle. (Medical news today,

Treatment: Malaria is
treated with antimalarial drugs and measure to control symptoms includingmedication
to control fever. The drugs available to treat malaria include:






People with Falciparum
malaria have the most severe symptoms and may need to be monitored in the
intensive care unit of a hospital during the first days of treatment because
the disease can cause breathing failure, coma and kidney failure. (Medical news
today, 2012)



























Macro parasite (Schistosomiasis)

Macroparasites are
parasites that are large enough to be seen with the naked eye. (NHS choices,
2012) They grow in one host but reproduce by infective stages
outside this host. (NHS choices, 2012) These generally includeflatworms and other animals which can be either
external parasites or internal parasites.(National institute of health,

Schistosomiasis, also known
as bilharzia, is an infection caused by a parasitic worm that lives in
fresh water in subtropical and tropical regions. (World Health Organisation, 2017) Infection occurs when the skin comes in contact with
contaminated freshwater in which certain types of snails that carry
schistosomes are living. (Centers for disease control and prevention, 2012) Freshwater
becomes contaminated by Schistosoma eggs when infected people urinate or defecate
in the water. (NHS choices, 2012) The eggs hatch, and if certain types of
freshwater snails are present in the water, the parasites develop and multiply
inside the snails. The parasite leaves the snail and enters the water where it
can survive for about 48 hours. (NHS choices, 2012) Schistosoma parasites
can penetrate the skin of individuals who are wading, swimming, bathing, or
washing in contaminated water. (National institute of health, 2013) Within
several weeks, parasite mature into adult worms, residing in the blood vessels
of the body where the females produce eggs. (National institute of health,
2013) Some of the eggs travel to the bladder or intestine and are passed into
the urine or stool. (Centers for disease control and prevention, 2012)

Indian subcontinent has always been considered as a low risk
region for human schistosomiasis. Several species has been described in India
which may have association with human infection and cercarial rash. Although
sporadic cases are not uncommon, the status of human schistosomiasis in India
is not well investigated.
(Worl health organisation, 2013) The
non existence of intermediate host of anthropophilic schistosomes in India is
believed to be the principal reason which precludes the natural lifecycle of
these schistosomes in Indian subcontinent (Journal of Parasitology
Research, 2011)

Symptoms: Many people with
schistosomiasis do not have any symptoms, or do not experience any for several
months or even years. (NHSchoices, 2013)People may not notice that they have
been infected, although they might get small, itchy red bumps on their skin for
a few days where the worms’ burrowed in. (NHS choices, 2016)after a few
weeks, some people develop:

a high temperature

an itchy, red,
blotchy and raised rash

a cough


muscle and joint pain

abdominal (tummy) pain

a general sense
of feeling unwell

These symptoms, known as
acute schistosomiasis, often get better by themselves within
a few weeks. (NHS choices, 2013) But it is still important to get treated
because the parasite can remain in the body and lead to long term problems.
(NHS choices, 2016)


Causes: People become
infected when larval forms of the parasite, released by freshwater snails, penetrate
the skin during contact with infested water. (National institute of
health,2013) Transmission occurs when people suffering from schistosomiasis contaminate
freshwater sources with their excreta containing parasite eggs, which hatch in
water. (World Health Organisation, 2002)

Treatments: Schistosomiasis can usually be
treated successfully with a short course of a medication called praziquantel,
which kills the worms. (NHS, Choices, 2016) Praziquantel is most effective once
the worms have grown a little, so treatment may be delayed until eight weeks
after you were infected, or repeated again after this time.(NHS choices, 2016) Steroid medication can also be used to help relieve the symptoms of acute
schistosomiasis, or symptoms caused by damage to the brain or nervous system.
(NHS choices, 2016)