chickungunya - present status in kerala.

Chickungunya- Present status in kerala. 

Kerala status of having one of the best healthcare systems in India has received a severe a blow in the recent years due to the outbreak of chickungunya viral fever in the state. Many people died and suffered during the outbreak of the mosquito borne viral fever in the coastal districts of Alappuza, kollam and Ernakulam. The present outbreak of chickungunya in many parts of kerala has raised questions about how good kerala healthcare system really is. According to sources, more than 10,000 people are down with fever in the south and central districts of the state and the disease is now spreading to the northern districts as well. The number of Chikungunya cases in kerala, India, has followed an increasing trend since 2005. From our survey, which was done in a systemic manner with respect to age, it was found that people in the age group of 20-40 years were more affected than the older age. This shows that older generation are more cautious in taking the precautions in terms of hygiene as well as preventing the entry of mosquitoes in to the place of living like closing the windows at right time, installing the wire meshes at the doorway windows which helps in aeration but prevents the entry of mosquitoes. In respect to gender wise distribution, females were found to be more prone to Chickungunya due to staying more in waterborne area, (like cleaning washing etc).and

it may be due to biological difference.

Rural area accounts for more number of cases. Most of the places, good hygienic conditions were not been maintained. Contaminated water from the household had not been disposed off properly due to which it has become a breeding center for mosquitoes. Socio economic factors also have an impact on chikungunya. Most cases, increase in temperature, muscular pain and sleep disturbances, were found to be major symptoms. Patients with the above said symptoms were not able to carryout the daily routine procedure or job which affected them economically too. In this regard, the treatment regimens followed by the physicians were found to be administration of analgesics and antipyretics followed by rest for a minimum period of 1-2 weeks. In very few cases, arthritis and myocarditis were reported. Very few patients were advised to take steroids. With respect to recovery time, few patients recovered with in one week and most of the patients took almost one month time to recover and such patients were from the rural area. This shows the severity of the conditions. The study revealed that most patients went to primary health centre and govt hospitals for the treatment of chickengunya and majority were found to be outdoor patients. The reason in avoiding private hospitals may be due to lack of interest in taking the costly medication provided by corporate sector hospital.

Chikungunya Treatment in Ayurveda

Ayurveda is the traditional Indian medicine and is a popular alternative medicine in India. Ayurveda medicines are usually natural drugs and hence side effects usually are minimal.  Our findings reveals that, since there is no new medicine for Chikungunya in allopathy, there is an increasing trend among people in kerala turning to traditional Indian medicines especially ayurveda.In comparative evaluation of different system of medicines and present scenario of chickungunya in Malabar kerala, in case of ayurvedic medicine, questionnaire were distributed to 5 doctors and collected the feed back, regarding medicines, treatment available, diagnosis etc.  The study reveals that many numbers of medicines were prescribed including… Vilvadi Gulika, Sudarsanam Gulika, Amritarishta. Vettumaran gulika, Amruthotharam kashayam, Amruthadiguggulu (1gm tds), Rasnaeranda kwatha churna(15ml tds), Vanathulasi patra, Dhanvantaram Gutika etc. The recovery of the patients normally takes place within three days if it is in early stage. most of the doctors assured that ayurvedic system of medication and treatment could cure the patient at earlier period without much side effects, since the preparation are from natural source without any added artificial preservations or artificial excepients. All the doctors participated in the survey (100%) assured that ayurvedic medicines were   more effective than other systems of medicines and they were aware about the efficacy and adverse effects of drugs used. The study revealed that the condition of chickungunya worsen in patients who have arthritis. One observation noted during the study is that there is a wide belief among people in kerala that, the application of local herb Chromolaena odorata, (Communist pacha in local language) can be used for the treatment of chickungunya especially in pain relief. Communist pacha is a local leaf available in kerala, which is effective in treating joint pain. Most of the doctors were aware of this which is an additional therapy in chickungunya. Ayurveda is a system wherein the patients were asked to follow a strict diet regimen avoiding coffee, tea, cool drinks and other similar food material which may interfere in the treatment status. Some practitioners of Ayurveda claim that a medicine called Panchathikta Kashayam can cure Chikungunya. It is a very bitter drug. Ayurveda massage is also administered for joint pain relief.      Herbs such as Sacred Basil (Tulsi), Carrot and Grapes are usually recommended as a relief for the pain and fever. Since these are natural herbs and vegetable there is no risk in trying them out. Ayurvedic treatment of chickungunya uses herbal drugs, but patients have to be very careful since there are a large number of unlicensed ayurvedic practitioners and some of them are known to add steroids in medicines for quick benefit. Ayurvedic method of living offers a solution to the problems of viral fever and almost all types of diseases. Ayurveda attributes the reasons of spread of diseases to the pollution of air, water and land and its imbalances in the body.

Homeopathic treatment of Chikungunya

In the case of homeopathy, feedback was obtained from 5 doctors. The treatment was symptomatic, provisional diagnosis was done and the patients were asked not to follow any other system of medicine during homeopathy treatment. Only 60% of the homeopathy doctors were aware about the efficacy and adverseffects of drugs used. Most of the doctors (100%) believe that homeopathic medicine can cure chickungunya completely. (Assessment is based on the feedback obtained from certain doctors in our locality, in other locality, doctors may be aware of adverse effects). Cardiac, respiratory and arthritis can worsen chickengunya according to homeopathic system. According to homeopathic experts effective drugs are available to prevent as well as to speed up recovery from Chikungunya. Eupatorium Perfoliatum Q (tincture, 3 to 5 drop dose) can prevent Chikungunya infection. Other medicines prescribed for the disease include Pyroginum, Rhus-tox, Cedron, Influenzinum, China, Arnica. Ledumpal, bryonia, Belladonna, Nuxvomica. Etc. The study reveals that these homeopathic medicines were very effective for relieving complaints during chickungunya. . The duration of illness was reduced. The study reveals that, homeopathic medicines was very effective and gives about 90-95 percent protection, and they were able to go to work in 2-3 days

CONCLUSION

Though the growing concern about chikungunya is increasing at logarithmic rate, day after day, month after month, more committtment and proper massive awareness campaign from the donors and states is needed for the successful mitigation of chikungunya. Different system of medicine has much to offer in preventing chikungunya, but the wide spreading of disease is going high in alarming rate in developing countries is because of the population and polluted environment. Keeping an unpolluted surrounding and clean environment is vital in the disease management which lacks in our locality.

Compared to other systems of medicine, people in our locality prefer Ayurveda, since it is devoid of side effects and the cure rate is also very high with this system of medicine. The local herb communist pacha which is a new finding can cure the chikungunya and (Especially pain and swelling) has good potential in the future. Ayurvedic experts should tap/ exploit the potential of this herb, since people claim that it has got curing effect and efficacy. Multispeciality hospitals tackle the chickungunya menace but the extend of participation in mitigating the chickungunya is less. From our study we found that in some places there is no proper documentation, even though there are proper guidelines framed by the relevant authorities. It can be concluded from the study that all the systems of medicine are equally important for the management of chikungunya. Additional effort in promoting the guidelines at local level and proper documentation helps to achieve the goal of curbing the chikungunya. It is high time to increase our effort and promote these messages at grass root level which benefits the society/ community as a whole.

DILIP.C

ASST PROFESSOR 

ALSHIFA COLLEGE OF PHARMACY

KERALA.