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Epidemiology of Gastroenteritis in Andhra Pradesh
 GE incidence in AP Case Fatality rate of GE High Incidence district in AP
The figure below shows gastroenteritis incidence in the state over the past decade (1991 - 2000). There is a gradual decrease in incidence except for the spurt of incidence in years 1993 and again in 1998.
Figure-1: Gastroenteritis Incidence in Andhra Pradesh, 1991-2000

Case fatality rate tells us how effective is the management of gastroenteritis once it occurs. In other words CFR teels us how sucessful is the household in recognising gastroenteritis and giving oral rehydration, how successful are our health workers in early management of gastroenteritis and how well our hospital teams are doing in management of severe gastrenteritis cases. Since we have very highly effective technology to manage gastroenteritis cases, the case fatality should be low. The sheet anchor of gastroenteritis management is giving fluids at home, oral rehydration solution, and management of fluid balance in hospitals.
There is a decline in GE incidence and related case fatality in the last two years. This decline in case fatality rate would suggest that health education efforts to promote oral rehydration and hospital management of gastroenteritis cases is having some impact. However, the absolute level of CFR, even after the recent reduction is not acceptable. As mentioned earlier gastroenteritis is a treatable condition. With appropriate management, almost every gastroentetitis patient should recover. But we are still left with a case fatality of about 1%. In other words 1 out of every 100 gastroenteritis patients is dying. Quite clearly, the health education efforts need to be further intensified, healtyh worker skills in early management of diarrhoea needs to improve and hospitals must strictly follow practice guidelines.
There was an increase in case fatality in 1998. This again suggest that we have not been able to consolidate skills for effective management of gastroeneteritis at different levels.


Figure-2: Gastroenteritis Case Fatality Rate in AP, 1991-2000

The following figures shows district wise gastroenteritis incidence for the past decade. Six districts fall under high incidence districts, seven in medium incidence and ten districts in low incidence districts
Figure-3: Gastroenteritis High Incidence Districts, 1991-2000


GE Manual by IHS gives you the complete Picture. For details contact:                                                        Updated by Ravindra Vemula 

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