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Study links uneven urbanisation with high risk of cholera outbreaks

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Study links uneven urbanisation with high risk of cholera outbreaks

By Sunderarajan Padmanabhan

Families living in rural areas of districts at higher risk of cholera as funds for water and sanitation infrastructure are diverted to urban areas, say experts

New Delhi: Higher levels of urbanisation are no guarantee for preventing the outbreak of cholera. In fact, a new study by Indian and international experts seems to indicate that higher urbanisation also leads to an increased risk of a cholera epidemic since funds for water and sanitation infrastructure are often allocated disproportionately within an ‘urban’ district, with its rural areas receiving only a pittance.

In other words, the study blames the uneven allocation of funds for water and sanitation infrastructure within districts – urban centres getting more funds than rural areas within a district that is otherwise categorised as ‘urban’. The use of improved sanitation facilities in urban areas in India has increased to 63 per cent as of 2015 while it has gone up to only 28 per cent in rural areas.

“It appears that families living in rural areas of districts with more cities are at higher risk, perhaps because the resources in these districts are allocated to the urban areas, neglecting the rural areas of the district,” the researchers have observed in their study in journal PLOS One.

The study has also found that there seemed to be large scale underreporting of cholera cases. There is significant variation between actual number of cases being reported and ground reality based on the various risk factors. For instance, the study says, Uttar Pradesh did not report any case despite having areas that qualified as ‘high risk’ zones. The reasons for underreporting are limited disease surveillance, inadequate laboratory capacity especially at the peripheral health care centres, and reluctance on part of authorities to acknowledge the problem for fear of societal repercussions.

The findings are based on district level data of cases reported between 2010 to 2015 from the Integrated Disease Surveillance Programme, and socioeconomic characteristics and coverage of water and sanitation obtained from the 2011 census report. Researchers used this data to perform spatial analysis to identify cholera hotspots, and employed a modeling method called ‘zero-inflated Poisson regression’ to identify the factors associated with cholera and predicted case counts at district level.

A total of 27,615 cholera cases were reported during the six-year period. As many as 24 out of the 36 states in the country had reported cholera during these years. Of them, 13 States were classified as endemic. In terms of districts, out of the 641 districts in the country, 78 districts in 15 states were identified as “hotspots” based on the reported cases. However, 111 districts in nine states were identified as “hotspots” from model-based predicted number of cases.

Overall, one-fourth of the districts in India reported cholera and 90 districts of them have been identified as hotspots, making cholera is a widespread major public health problem in the country. It is major problem in West Bengal, Karnataka, Chhattisgarh, Punjab, and areas of Himachal Pradesh adjoining Punjab. In addition, most districts in Karnataka have been identified as cholera hotspots. The risk for cholera in a district is linked with poor sanitation and drainage conditions and urbanization level in the district.

The research team included Mohammad Ali and David A.Sack of Department of International Health, Johns Hopkins Bloomberg School of Public Health; Nirmal K. Ganguly, Sanjukta Sen Gupta, and Nisha Arora of Policy Center for Biomedical Research, Translational Health Science and Technology Institute; Pradeep Khasnobis and Srinivas Venkatesh of National Center for Disease Control; Dipika Sur of Indian Public Health Association; and Gopinath B. Nair of World Health Organization.

(This article is from a syndicated feed provided by the India Science Wire)

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MK Stalin predicts frequent PM Modi visits to Tamil Nadu before assembly election

MK Stalin has said Prime Minister Narendra Modi will visit Tamil Nadu more often ahead of the Assembly election, calling the tours politically motivated and questioning the Centre’s support to the state.

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MK Stalin

Tamil Nadu Chief Minister M. K. Stalin has predicted that Prime Minister Narendra Modi will increase his visits to the state as the Assembly election, expected in April or May, draws closer.

Speaking ahead of the polls, the DMK president said the Prime Minister has already begun touring Tamil Nadu and is likely to visit frequently in the coming months. He claimed that such visits could create discomfort within the BJP-led National Democratic Alliance (NDA), as alliance partners may fear the political impact of repeated appearances.

Stalin calls visit politically motivated

The Chief Minister described the Prime Minister’s scheduled programmes in the state as “politically motivated”. PM Modi is set to attend various events in Madurai in southern Tamil Nadu, including the inauguration of the first phase of the AIIMS hospital project. He is also expected to visit the Thiruparankundram Temple amid the Karthigai Deepam-related controversy and participate in a public meeting organised by the NDA.

Stalin said he has been working for all sections of the population, including those who did not vote for his party. In contrast, he remarked that some leaders are visible in the state only during election time and increase their visits as polls approach.

Criticism over Union Budget allocations

The DMK leader also criticised the BJP-led central government, accusing it of neglecting Tamil Nadu. He pointed out that while approval was recently granted for the Gujarat Metro project, there were no major announcements or allocations for Tamil Nadu in the Union Budget.

Stalin asserted that voters would remember the lack of significant measures for the state. He framed the upcoming election as a contest between Tamil Nadu and the NDA, stating that the state should be governed from Fort St George in Chennai rather than from Delhi.

The ruling DMK is currently allied with several smaller parties and, at present, the Congress, as it seeks a third consecutive term in office. Its principal rival, the AIADMK, is aligned with the BJP as part of the NDA.

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Shashi Tharoor questions Centre over Kerala name change to Keralam

Shashi Tharoor has criticised the Centre’s decision to approve renaming Kerala as Keralam, questioning its impact and pointing to the lack of major projects for the state.

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shashi tharoor

Congress MP Shashi Tharoor has criticised the central government over its decision to approve the renaming of Kerala as ‘Keralam’, arguing that the move prioritises symbolism over development.

Reacting to the Union Cabinet’s approval, Tharoor said that the state’s name has always been ‘Keralam’ in Malayalam and questioned the practical impact of introducing the Malayalam term into English usage.

“It has already been ‘Keralam’ in Malayalam. So now, a Malayalam word is coming into English. I don’t know what difference it makes,” he said, adding that the state has not received major projects such as an AIIMS or new institutions from the Centre. He also pointed out that no significant allocations were made for Kerala in the Union Budget.

In a separate post on X, Tharoor raised what he described as a “small linguistic question” about what residents of the state would be called if the name change is implemented. Referring to existing terms such as “Keralite” and “Keralan”, he remarked that alternatives like “Keralamite” sounded like a microbe and “Keralamian” like a rare earth mineral.

The Union Cabinet, chaired by Prime Minister Narendra Modi, cleared the proposal on Tuesday. The move comes ahead of the upcoming state Assembly elections, in which 140 members of the legislative assembly are to be elected. The poll schedule is yet to be announced by the Election Commission of India.

The state assembly had earlier passed a resolution seeking the change in official records. Chief Minister Pinarayi Vijayan had moved the resolution in 2024, urging the Union government to adopt the name ‘Keralam’ in all languages listed in the Eighth Schedule of the Constitution.

He had stated that the demand for a united Kerala for Malayalam-speaking people dates back to the national freedom movement.

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Tamil Nadu potboiler: Now, Sasikala to launch new party ahead of election

Sasikala has announced the launch of a new political party ahead of the Tamil Nadu Assembly elections, positioning herself against AIADMK chief Edappadi K Palaniswami.

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In a significant political development ahead of the Tamil Nadu Assembly elections, expelled AIADMK leader V. K. Sasikala has announced that she will float a new political party and contest the polls by fielding her own candidates.

Speaking in Madurai before heading to Pasumpon for a public event, Sasikala said she would unveil her party’s flag later in the evening. She indicated that more details regarding the party’s structure and plans would be shared at the gathering.

The event venue carries political symbolism. Pasumpon is the birthplace of Thevar leader Muthuramalinga Thevar, and Sasikala herself belongs to the influential Thevar community in southern Tamil Nadu. The programme was held as part of birth anniversary events of former Chief Minister J. Jayalalithaa.

Direct challenge to EPS

Sasikala’s move is being viewed as a direct political challenge to AIADMK general secretary Edappadi K. Palaniswami (EPS). After Jayalalithaa’s death in 2016, Sasikala briefly took control of the party and had appointed Palaniswami as Chief Minister. However, following her conviction in the disproportionate assets case, she served a four-year prison term, and during that period, she was expelled from the party.

Palaniswami later aligned with O. Panneerselvam, whom Sasikala had earlier removed from the Chief Minister’s post. The two leaders subsequently adopted a dual leadership arrangement within the party and government.

Sasikala remains disqualified from contesting elections until 2027 due to her conviction. Nevertheless, she has stated that she intends to field candidates under her new party banner.

Fragmented Thevar vote base

Over the years, expulsions within the AIADMK — including Sasikala, her nephew TTV Dhinakaran and O Panneerselvam — have led to divisions within the Thevar support base. Political observers have linked this fragmentation to the party’s weakened electoral performance in the elections following Jayalalithaa’s passing.

While Dhinakaran has returned to the NDA fold, reports suggest Palaniswami is opposed to any arrangement that includes Sasikala or Panneerselvam. OPS, meanwhile, has exited the NDA.

Sasikala has repeatedly criticised Palaniswami, describing him as a betrayer, while he maintains that his leadership stems from the support of AIADMK legislators rather than her backing.

The AIADMK has not issued an official statement on Sasikala’s announcement. However, a senior party leader questioned her political standing, pointing out her disqualification from contesting elections and referring to legal issues linked to Jayalalithaa’s death.

With the Assembly polls approaching, Sasikala’s re-entry into active politics could further complicate the opposition space in Tamil Nadu and influence electoral calculations, particularly in the southern districts.

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