Patient navigation pathway and barriers to treatment seeking in cancer in India: A qualitative inquiry

Cancer is a leading cause of mortality worldwide. Early diagnosis and treatment of cancer may curb the growing burden of the disease. Understanding cancer patients’ navigation pathways for seeking treatment is important in order to facilitate early diagnosis and treatment. With this background we conducted a hospital-based cross-sectional study comprising 68 randomly selected cancer inpatients in a tertiary cancer specialty hospital in Odisha, India, to explore the treatment-seeking pathways of the cancer patients and the barriers and enablers in seeking treatment. Financial constraint is one of the major reasons for the delay in accessing treatment, even when patients are suspected of or diagnosed with cancer. Low awareness of the presenting signs and symptoms of cancer and limited knowledge of the availability of cancer diagnosis and treatment facilities are major factors contributing to delay. Family and friends’ support is found to be the major enabling factor toward seeking treatment. Generation of awareness of cancer among the general population and primary-care practitioners – including those in alternative systems of medicine – is important. Information on diagnostic and treatment services appears to be a felt need.     

Description of a new species of the genus Awaous Valenciennes, 1837 (Gobiiformes: Oxudercidae) from the middle stretch of the Mahanadi River,Odisha, India,with comments on the Awaous species from India

A new species of the genus Awaous (Oxudercidae), Awaous motla sp. nov., is described based on 18 specimens collected from the Mahanadi River near Sonepur, Subarnapur District, and 3 specimens from the same river near Boudh bridge, Boudh District of Odisha, India. This species is distinct from its congeners by having a combination of characteristics: relatively small eyes, diameter of 6.6–8.4 in head length (LH); robust and long snout, 2.0–2.6 in LH; eye diameter 2.7–4.1 in snout length; cephalic sensory pore system interrupted with eight pores; predorsal scales 13–15; longitudinal scale series 55–58; gill rakers 2 + 1 + (6–7) on the first gill arch; teeth small, conical, and in a single row on the upper jaw and multiserial (2–3) on the lower jaw. This species is also differentiated from some of its congeners in the nucleotide composition of the cytochrome c oxidase I gene by 8.3%–13.8% Kimura two-parameter (K2P) distance and belongs to a separate cluster in the maximum likelihood tree analysis. This finding is also supported by the species delimitation analysis based on Assemble Species by Automatic Partitioning. The new species holds high commercial value in its locality and needs special conservation attention for sustainable utilization.     

The intertidal polychaete (Annelida) fauna of the Sitakunda coast (Chittagong,Bangladesh), with notes on the Capitellidae,Glyceridae, Lumbrineridae,Nephtyidae, Nereididae and Phyllodocidae of the “Northern Bay of Bengal Ecoregion”

Of seven species of polychaetous annelids collected from the intertidal zone of Sitakunda coast, Chittagong, Bangladesh, five were new records for the country. The seven are listed, with brief notes on these, some previously recorded! species and others housed in the collections of the Natural History Museum, London. Keys are given to the recorded species of Phyllodocidae, Nereididae, Lumbrineridae, Nephtyidae and Capitellidae of the “Northern Bay of Bengal Ecoregion”, and to the recognised species of Glyceridae from the Bay of Bengal. The worms in this Ecoregion are subject to the outflows of the Irrawaddy, Ganges, Hooghly and Mahanadi Rivers, and many of them are known to be freshwater tolerant.     

Insecticide resistance status of three vectors of Japanese encephalitis in east central India

Japanese encephalitis (JE) has been reported in different districts of Odisha state (east central India) since 1992. During 2016, a major outbreak of JE and acute encephalitis syndrome (AES) occurred in the Malkangiri district of Odisha, causing 103 deaths in children, of which 37 were caused by JE and 66 by AES. Information on insecticide resistance in JE vectors is important for the selection of appropriate insecticides for use in vector control. The present study was designed to determine the resistance status of three important vectors of JE, Culex vishnui, Culex tritaeniorhynchus and Culex bitaeniorhynchus (Diptera: Culicidae), against dichlorodiphenyltrichloroethane (DDT), malathion and deltamethrin in three districts of Odisha state affected by JE. Female adult mosquitoes were collected using mouth aspirators both indoors and outdoors in JE‐affected villages and used in susceptibility bioassays following World Health Organization guidelines. Knock‐downs were recorded every 10 min up to 1 h and mortality rates were recorded at 24 h post‐exposure. Culex vishnui and Cx. tritaeniorhynchus showed resistance to DDT, malathion and deltamethrin, whereas Cx. bitaeniorhynchus was susceptible in all study districts. The information generated by this study will be highly useful in the planning and implementing of appropriate vector control operations for the prevention and control of JE in east central India.     

Biodiversity and insecticide susceptibility status of major Anopheline fauna in three malariogenically stratified districts of Odisha,India

Understanding the species composition and biodiversity of anopheles mosquito population is a vital part of any malaria control intervention. Similarly, an effective malaria control strategy relies primarily on insecticides. The Anopheline diversity, composition, distribution as well as insectide susceptibility/resistance status were surveyed in three districts of Odisha viz. Kalahandi (southern hyper –endemic district), Bargarh (western meso-endemic district) and Cuttack (sub-coastal hypo-endemic district) which significantly differ from each other according to the malariogenic stratification. Anopheline fauna showed a higher species richness and diversification in Kalahandi followed by Cuttack and Bargarh. An. culicifacies, the most abundant primary vector in Odisha, showed resistant to DDT as well as malathion in all three districts with a higher knockdown time in Kalahandi. Except Bargarh and Cuttack, the vector species also showed resistance to deltamethrin in Kalahandi district. The species found susceptible to deltamethrin in Cuttack while in Bargarh, its response was under ‘verification required’. In contrast, the secondary vector, An. annularis showed resistance to DDT in all three districts and to malathion in only Kalahandi district. In Cuttack and Bargarh district, their response against the insecticide malathion was under verification required. The deltamethrin susceptible populations were detected in Cuttack and Bargarh district where as in Kalahandi they came under verification required category. The current study constitutes an essential step for understanding the dynamics of malaria transmission in relation to vector diversification and their resistant status to various insecticides that can provide guide to intervention policies and programmes in the fight against malaria.