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The Journal of Community Health Management


An epidemiological study on incidence and determinants of Lathyrism


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Author Details: S.P. Singh, Dhiraj Bhawnani, Ajit Parihar, Nirmal Verma

Volume : 3

Issue : 3

Online ISSN : 2394-2738

Print ISSN : 2394-272X

Article First Page : 113

Article End Page : 122


Abstract

Introduction: Human lathyrism continues to be a public health problem in central India. While osteolathyrism, as such, is not a public health problem, neurolathyrism is of particular importance especially in central parts of India. In particularly Rewa, Satna, Sidhi, Sagar, Seoni, Hoshangabad and Chhattisgarh area of Madhya Pradesh bear the brunt of lathyrism. Ganapathy and Dwivedi (1961) carried out epidemiological study in estate of Vindhya Pradesh (now part of Madhya Pradesh). The sale of L. sativus has been banned in many states in India, but there has not been an effective ban on its cultivation. Lathyrus sativus is hardy crop and survives adverse agricultural conditions. For this reason it has become a main stay of some Indian diets, especially under famine conditions. India farmers continue to grow this pulse despite their awareness of its poisonous nature. It is difficult to provide an alternate crop that would grow under the semi-arid condition of these areas. In recent times, the problem has acquired new dimensions, which hold out possibilities of wider dissemination of the disease. It was probably true that the consumption of Lathyrus seeds had dropped during recent times, but this was probably because other crops like wheat, barley, lentils and Bengal gram had flourished.
Material & Method: In order to study the recent trends of lathyrism, the same area and technique have been adopted as were follow by Ganapathy & Dwivedi (1961) and Dwivedi and Prasad (1964). Revisit to study the same area where detail epidemiological work was carried out and reported by Dwivedi & Prasad (1964). They were the following 18 village of Rewa and 10 village of Satna districts.  The other part of study included the collection of information of occurrence of cases occurred during the last 10 years period i.e. case occurring from 1975 to 1982. The area of survey restricted to Rewa division to determine those factor responsible for secular variations in the prevalence of disease from the previous I.C.M.R. study spread over a period of 1956 – 1961 (Ganapathy and Dwivedi. 1961). The standard survey protocol was adopted. Only the established form of disease was investigated. The latent form of disease was not investigated. The established form directly affects the man power and in major public health problem.
Observations: The prevalence   of disease is higher amongst the male in previous studies (1964) as well as in year 1982. The maximum duration of disease was 10 to 14 years (32.72%) in previous study (1964) where as it is only 4.30 percent in year 1982. Cases of lathyrism occur round the year, both studies reveal that maximum cases occurred from June to October. The maximum cases being 58 (32.76%) were among Kole (S.T.) followed by Chamar being 16.38 percent. The cases amongst Kurmi and Brahmins are equally high being 14.12 and 13.55 percent respectively. The disease was mainly present in low socio-economic group of people being 67.79 percent and 26.5 percent had from class IV socio-economic group. Maximum patients i.e. 115 were landless and 47 had land only up to two acres. Out of them 72.34 percent were growing ‘Birri’ i.e., mixture of L. Sativus 25-50 percent. Disease was mainly restricted amongst the illiterate but as the literacy status increases the disease was is decreasing.
Conclusion: Though the frequency and the magnitude of lathyrism had been reduced, but sporadic cases do occur in some part of the country. Therefore, it is necessary that prevention of lathyrism shall be integrated in general health care programme on regional basis. Surprisingly researches are going on to develop high yielding and less toxic  variety of Khesari dal and certainly one cannot ignore the health of the people which is jeopardized by the use of the poisonous pulse resulting in permanent paralysis simply because they belong to the under- privileged sections of the society.

Keywords
: Lathyrism, L. sativus, Khesari dal, Rewa