Health Hazard Associated with Water and Mosquito Borne Diseases: A Case Study in the Barak Valley Along Silchar Town of Assam, Northeast India

Objective (s): The current investigation has been carried out to determine the health hazard caused by water and mosquito borne diseases in the valley of river Barak along Silchar city (Assam); which has been recognized as a vulnerable area in terms of various kinds of hazards. Materials and Methods: In this study, the data analysis for several water and mosquito borne diseases viz., Acute diarrhoea, Bacillary dysentery, Enteric fever and Malaria has been accomplished proficiently on monthly as well as annually interval for a period of 5 successive years (i.e. 2015 to 2019). Results: The data demonstrates that the concentration of patients affected by Acute diarrhoea and Malaria was found to be decreased irrespective of years. On the other hand, in the cases of Bacillary dysentery and Enteric fever, the concentration of patients has been observed to be continue increasing within due course of the five years. Conclusion: On the basis of the results, It can be argued that Bacillary Dysentery and Enteric fever illustrated the similar and increasing trend; On the contrary, Acute diarrhoea and Malaria has been showed the drastically decreasing trend throughout the study period i.e., from 2015 to 2019.


Introduction
The North-eastern region of India consists of the eight states namely, Assam, Manipur, Mizoram, Meghalaya, Arunachal Pradesh, Nagaland, Tripura and Sikkim; which expends over the area of about 262,179 square kilometres [1]. Among of the above, Assam is called as the gateway for north-eastern region of the country and also known as the "Land of red river and the blue hills" [2]. During the recent decades, population explosion and unplanned developmental activities for settlement in vulnerable areas have increased risk in connection with several natural and anthropogenic hazards. The Barak is an important river of North-eastern region of the country as well as of Assam in particular. Its basin spreads within longitudes 89°50' E to 94°0' E and latitudes 22°44' N to 25°58' N along with maximal length and width of 460 kilometres and 350 kilometres respectively. The valley of Barak has a width of 25-30 km and it expands over an area of 6,962 square kilometres accounting for around 9 percent of the total geographical area of the state of Assam [3]. The surrounding mountains bordering the valley are subject to excessive precipitation [4].
The sickness caused by waterborne diseases arises when pathogens arrive into the supply of water in lack of detection and are then ingested, either via drinking water or through contaminated food, by uncircumcised persons [5]. In the region of South Asia, It is evaluated that around 23 percent of population (about 400 millions of person) surviving in high level risk conditions in relation to waterborne diseases [6,7]. Across to the world, the mosquito borne diseases causes to the great figures in terms of worldwide mortality and morbidity, particularly influencing to the youth adults and children on assessing the regional areas of malaria [8].
Malaria is in the category of mosquito borne infectious disease due to parasitic protozoa of genus plasmodium which spread by female Anopheles mosquitoes [9]. This disease has long plagued several countries around the globe. As per the newest evaluation by World Health Organization, globally there were around 214 million new cases of malaria in the year of 2015 (range 149-303 million) [10,11].
Bacillary dysentery is the enteric infectious disease which caused by Shigella spp [12]. It is dominantly spread by the fecal oral route through contaminated water, food, or contact of person to person [12][13][14][15][16][17]. Globally, there was around 164.7 million persons annually documented as confirmed cases of Shigella incidences as well as about 1.1 million passing in developing nations [18].
The Enteric fever which is also known as Typhoid fever [19]; is a waterborne infection which can prevalence by dairy belongings and shellfish, and less commonly through coordinate contact with faeces, or other body releases [20,21]. The dominant burden of this disease is found among the low-income nations where incapable or weak services of water and sanitation. It is evaluated that globally around 27 million new infections and more than 200000 passings have been caused by enteric fever every year [22][23][24].
The acute diarrhoea can be explained as faeces with increasing water content, volume, or frequency that remain under 14 days [25,26]. Bacteria, viruses and, infrequently, parasites are the infectious causes of this disease [26]. Waterborne diarrheal disease is very grievous, particularly for developing nations, where the outburst happens periodically and are allied with poverty and use of unhealthy water and worse sanitation [27,28]. As per the joint statement of WHO/UNICEF, every year beyond 1.5 million children below five continue to die caused by acute diarrhoea [29].
By virtue of the above, present research has been accomplished with an objective to analyse the health hazard on account of water and mosquito borne diseases in the Barak valley along the city of Silchar, Assam, NE India.

Description of Study Area
Apart from being a major administrative town, Silchar has obtained the significant weightage in terms of the trade and commerce, educational and social activities in the region of Barak valley. The municipal region expend within 24°47'47'' to 24°50'52.5'' North latitudes and 92°46'16.9'' to 92°49'33.4'' East longitude [30]. The city has the noteworthy majesty in view of the doorway for three districts of Barak valley namely, Cachar, Karimganj and Hailakandi. It is situated at around 35 metre above mean sea level (msl) and mostly on the southern bank of river Barak.
Silchar is the most densely populated town of southern Assam in the valley of Barak. The graph of population of the city hiked by 1.42 lakhs and 1.72 lakhs in the year 2001 and 2011 respectively, which reflecting an average increasing rate of 2.3 percent and 2.1 percent respectively [31]. The city is also known as the nourishing centre of tea industries of the Cachar district. In the ancient time, the British emperors used the place as the river port for the purpose of exporting the raw materials and tea. It had its first municipal in the year of 1893 [32].

Methods
The information on water and mosquito borne diseases was procured for the timeframe of 5 consecutive years (i.e. from 2015 to 2019) on weekly basis; and monthly as well as annually values were computed. The concerned data on several water and mosquito borne diseases namely, Bacillary dysentery, Malaria, Enteric fever and Acute diarrhoea have been collected from the Office of the Chief Medical Officer, S. M. Dev Civil Hospital, Silchar, Assam. The information was acquired from aforesaid department computed to estimate the health hazard due to water and mosquito borne diseases in the valley of river Barak along Silchar town, Assam, Northeast India.

Results and Discussion
The findings of current study with the aim of investigating health hazard associated with water and mosquito borne diseases in Barak valley along Silchar city of Assam can be shown as follows.
During 2015, the number of patients affected by Acute diarrhoea, Enteric fever and Malaria ranged between 868 (in the month of October) to 1385 (in the month of July), 27 (in the month of March) to 81 (in the month of October) and 65 (in the month of January) to 133 (in the month of September), respectively. Bacillary dysentery was not reported so far (Table 1). Similarly, during 2016, the minimum and maximum number of patients affected by Acute diarrhoeal disease was 701 (in the month of December) to 1485 (in the month of March) respectively; Bacillary dysentery up to 10 (in the month of April); Enteric fever was 42 (in the month of April) to 136 (in the month of June) respectively; Malaria was observed as 55 (in the month of December) to 158 (in the month of June) respectively (Table 2). In addition, during 2017, the number of persons affected by Acute diarrhoea, Bacillary dysentery, Enteric fever and Malaria ranged between 556 (in the month of February) to 1330 (in the month of August), up to 7 (in the month of February), 54 (in the month of February) to 166 (in the month of July) and 69 (in the month of February) to 166 (in the month of July), respectively (Table 3). During 2018, the minimum and maximum number of patients affected by Acute diarrhoeal disease was 676 (in the month of December) to 1445 (in the month of August) respectively; Bacillary dysentery was 2 (in the month of January) to 8 (in the month of July) respectively; Enteric fever was 79 (in the month of January) to 247 (in the month of October) respectively; Malaria was observed by 60 (in the month of April) to 145 (in the month of October) respectively (Table 4).  January  1151  2  79  80  February  1049  8  90  90  March  940  3  110  91  April  1034  3  154  60  May  1376  5  201  95  June  1057  7  159  103  July  1168  8  232  93  August  1445  8  213  77  September  1098  5  199  76  October  946  2  247  145  November  800  2  195  81  December  676  6  147  79 Moreover, during 2019, the number of patients affected by Acute diarrhoea ranged between 589 (in the month of February) to 1306 (in the month of July), Bacillary dysentery between 1 (in the month of December) to 11 (in the month of July), Enteric fever between 26 (in the month of December) to 436 (in the month of July) and Malaria between 26 (in the month of December) to 170 (in the month of July) ( Table 5). The graphical representation of water and mosquito borne diseases i.e., Acute diarrhoea, Bacillary dysentery, Enteric fever and Malaria throughout study period  are presented in figures 1 to 4 respectively.
In case of Acute diarrhoea, the total number of patients affected was decreased from 2015 to 2019, with exception during 2016 and 2018 reflecting minor growth. A sharp decrement was noticed during the year of 2019 showing much less numbers than 2018. It was observed that the trendline (linear) shows the downward direction ( Figure 1). Therefore, the trend reflects that the concentration of patients affected by Acute diarrhoea has been decreased due course of five year time.
There is an increasing trend has been observed in case of Bacillary dysentery as the number of patients was continue increased from 2015 to 2019 with a major growth during the year of 2018. It was detected that the trend-line shows the upward direction ( Figure 2). Therefore, the trend reflects that the concentration of patients affected by Bacillary dysentery is increasing due course of time.
Similarly, the total number of patients affected by Enteric fever was continue increased from 2015 to 2019 and follows the trend as observed in case of Bacillary dysentery. The trend-line shows the upward direction ( Figure 3). Therefore, the trend reflects that the concentration of patients affected by Enteric fever is increasing due course of time.
In addition, the total number of patients affected by Malaria was decreased from 2015 to 2019, with exception during 2016 and 2017 reflecting minor growth. The large scale decrement was noticed during the year of 2018 and 2019. It was observed that the trend-line shows the downward direction ( Figure 4). Therefore, the trend reflects that the concentration of patients affected by Malaria has been decreased due course of five years.    The overall scenario reflects that the concentration of patients affected by Acute diarrhoea and Malaria is decreasing from 2015 to 2019. Whereas, a reverse trend in results has been established for Bacillary dysentery and Enteric fever as the concentration of patients were found to be continue increasing across study time frame. Mouton et al. (2017) carried out the research on typhoid enteric fever [19]; An extensive research was conducted on Acute diarrhea by Barr [37]. The findings of current investigation are in conformity with the researches of aforesaid scientists.

Conclusion
The present research was designed to determine the health hazard caused by water and mosquito borne diseases (Acute diarrhoea, Bacillary dysentery, Enteric fever and Malaria) in the Barak valley along Silchar city of Assam, Northeast India. The appropriate information and data were procured from the concerned department for the period of 5 successive years (i.e. 2015 to 2019) for computation purpose. The results depict the decreasing trend in the cases of Acute diarrhoea and Malaria as the concentration of patients was found to decreased throughout study period. On the contrary, a similar and increasing trend was observed in the cases of Bacillary dysentery and Enteric fever with continue increasing the concentration of patients within due course of five years. The findings of current research may be a base line for further studies to investigating health hazard as a consequence of water and mosquito borne diseases in the valley of Barak River along Silchar town, Assam (India).