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Kasabi G.S.,National Institute of Epidemiology ICMR | Murhekar M.V.,National Institute of Epidemiology ICMR | Sandhya V.K.,Virus Diagnostic Laboratory | Mehendale S.M.,National Institute of Epidemiology ICMR
PLoS Neglected Tropical Diseases | Year: 2013

Background: Kyasanur forest disease (KFD), a tick-borne viral disease with hemorrhagic manifestations, is localised in five districts of Karnataka state, India. Annual rounds of vaccination using formalin inactivated tissue-culture vaccine have been conducted in the region since 1990. Two doses of vaccine are administered to individuals aged 7-65 years at an interval of one month followed by periodic boosters after 6-9 months. In spite of high effectiveness of the vaccine reported in earlier studies, KFD cases among vaccinated individuals have been recently reported. We analysed KFD vaccination and case surveillance data from 2005 to 2010. Methodology/Principal Findings: We calculated KFD incidence among vaccinated and unvaccinated populations and computed the relative risk and vaccine effectiveness. During 2005-2010, a total of 343,256 individuals were eligible for KFD vaccination (details of vaccination for 2008 were not available). Of these, 52% did not receive any vaccine while 36% had received two doses and a booster. Of the 168 laboratory-confirmed KFD cases reported during this 5-year period, 134 (80%) were unvaccinated, nine each had received one and two doses respectively while 16 had received a booster during the pre-transmission season. The relative risks of disease following one, two and booster doses of vaccine were 1.06 (95% CI = 0.54-2.1), 0.38 (95% CI = 0.19-0.74) and 0.17 (95% CI = 0.10-0.29) respectively. The effectiveness of the vaccine was 62.4% (95% CI = 26.1-80.8) among those who received two doses and 82.9% (95% CI = 71.3-89.8) for those who received two doses followed by a booster dose as compared to the unvaccinated individuals. Conclusions: Coverage of KFD vaccine in the study area was low. Observed effectiveness of the KFD vaccine was lower as compared to the earlier reports, especially after a single dose administration. Systematic efforts are needed to increase the vaccine coverage and identify the reasons for lower effectiveness of the vaccine in the region. © 2013 Kasabi et al.

Ramaiah K.D.,Vector Control Research Center | Vanamail P.,Vector Control Research Center | Yuvaraj J.,National Institute of Epidemiology ICMR | Das P.K.,Vector Control Research Center
Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2011

Annual mass drug administration (MDA) is the recommended strategy for lymphatic filariasis (LF) elimination. We assessed the effect of six rounds of mass administration of diethylcarbamazine (DEC) and albendazole (ALB) on microfilaria (Mf) prevalence and intensity and vector infection and infectivity rates and circulating filarial antigenaemia (CFA) in a group of five villages in south India, endemic for Culex-transmitted bancroftian filariasis. During different rounds of MDA, 60-70% of the eligible population (>15 kg body weight) was treated. The MDA reduced the Mf prevalence from 8.10% (CI 6.18-10.01) to 1.01% (CI 0.31-1.71) (P<0.05) and geometric mean intensity of Mf from 0.31 (CI 0.22-0.40) to 0.02 (CI 0.00-0.04) (P<0.05), equivalent to a fall of 86% and 94% respectively. The vector infection and infectivity rates declined from 13.11% (CI 11.52-14.70) to 0.78% (CI 0.16-1.40) (P<0.05) and 1.04% (CI 0.56-1.52) to 0.13% (CI 0.00-0.39) (P<0.05), respectively. Four out of the five villages recorded <0.5% Mf prevalence and 0% vector infection rate. Circulating filarial antigenaemia (CFA) fell by 86% in the total population and 100% in 1-10 year old children. One of the five villages, which showed the highest baseline vector infection rate, showed >1.0% Mf rate. The results suggest that six rounds of mass administration of DEC and ALB, with 60-70% treatment coverage, is likely to achieve total interruption of transmission and elimination of LF in the majority of villages. © 2011 Royal Society of Tropical Medicine and Hygiene.

Guha M.,Tata Institute of Social Sciences | Baschieri A.,London School of Hygiene and Tropical Medicine | Bharat S.,Tata Institute of Social Sciences | Bhatnagar T.,National Institute of Epidemiology ICMR | And 6 more authors.
Journal of Epidemiology and Community Health | Year: 2012

Background: Empowering sex workers to mobilise and influence the structural context that obstructs risk reduction efforts is now seen an essential component of successful HIV prevention programmes. However, success depends on local programme environments and history. Methods: The authors analysed data from the Integrated Behavioural and Biological Assessment Round I cross-sectional survey among female sex workers in Tamil Nadu and Maharashtra. The authors used propensity score matching to estimate the impact of participation in intervention activities on reduction of risk (consistent condom use) and vulnerability (perceived collective efficacy and community support). Results: Background levels of risk and vulnerability as well as intervention impact varied widely across the different settings. The effect size ATT of attending meetings/trainings on consistent condom use was as high as 21% in Tamil Nadu (outside of Chennai) where overall use was lowest at 51%. Overall, levels of perceived collective efficacy were low at the time of the survey; perceived community support was high in Tamil Nadu and especially in Chennai (93%) contrasting with 33% in Mumbai. Consistent with previous research, the context of Mumbai seems least conducive to vulnerability reduction, yet self-help groups had a significant impact on consistent condom use (ATT=10%) and were significantly associated with higher collective efficacy (ATT=31%). Conclusions: Significant risk reduction can be achieved by large-scale female sex worker interventions, but the impact depends on the history of programming, the complexity of the context in which sex work happens and pre-existing levels of support sex workers perceive from their peers. Copyright Article author (or their employer) 2012.

PubMed | SRM University and National Institute of Epidemiology ICMR
Type: Journal Article | Journal: Journal of family medicine and primary care | Year: 2016

Globally, about 17 million people die of cardiovascular diseases (CVDs) every year and a substantial number of these deaths are attributed to four major risk factors namely unhealthy diet, physical inactivity, tobacco consumption, and alcohol consumption. Doctors and nurses often have a sedentary lifestyle.This study aimed at assessing the lifestyle-associated risk for CVDs among doctors and nurses in a medical college hospital.Cross-sectional study among 250 doctors and nurses, selected using a stratified random sampling, working at a medical college hospital in Tamil Nadu.After consenting, each participant answered a questionnaire comprising questions pertaining to the sociodemographic characteristics as well as lifestyle-related risk factors. Risk was categorized into low, moderate, and high based on general risk factors, physical activity risk factors, and dietary risk factors separately.Descriptive statistics and Chi-square analysis were used to analyze the data.It was found that 31.2% of all study subjects and 49.2% of doctors were at high general risk for CVDs; 30.4% of all study subjects and 42.1% of doctors were at high physical activity-related risk for CVDs; 14.4% of all study subjects and 19.8% of all doctors were at high dietary pattern-related risk for CVDs. Advancing age is a statistically significant risk factor across all risk groups.Doctors are at a higher risk for CVDs as compared to nurses as well as the general population.

PubMed | Narayana Medical College and Hospital, National Institute of Mental Health and Neuro Sciences and National Institute of Epidemiology ICMR
Type: Journal Article | Journal: International journal of critical illness and injury science | Year: 2016

Traumatic brain injury (TBI) is a major public health problem. Both genders are affected, but little is known about female TBI. The present study exclusively explores epidemiological, clinical, imaging, and death aspects of female TBI, and how it differs from males.It is a retrospective study. Data were documented from a tertiary institute during January 2010 to March 2010. All variables were documented on standard proforma. The data were analyzed using R statistics software. Age group was categorized into pediatric (<18 years), middle (19-60 years) and elderly (>61 years). Significance was tested using Chi-square test at the significance level of P < 0.05.Data of 1627 TBI patients were recorded. Of the total, female TBIs contributed nearly 20%. Compared to males, female patients reported higher percentages in manifesting symptoms (84.3% vs. 82.6%), injuries due to fall (32.1% vs. 24.4%), and surgical interventions (11.6% vs. 10.4%). Female patients were significantly higher in mild head injury group (76.8% vs. 69.5%, P - 0.016) and mortality (3.4% vs. 1.6%, P - 0.048). Number of patients and deaths was more among females than males in pediatric and elderly age group. Severities of injuries were more among female patients than male patients in middle and elder age groups.The study results observe that female TBI group differ significantly in the severity of injury and mortality.

Mishra N.N.,PGIMER Dr RML Hospital | Bhatia T.,PGIMER Dr RML Hospital | Kumar N.,National Institute of Epidemiology ICMR | Nimgaonkar V.L.,University of Pittsburgh | And 2 more authors.
Indian Journal of Medical Research | Year: 2014

Background & objectives: Mental health professionals have varied attitudes and views regarding informed consent and confidentiality protections in psychiatric research and clinical care. The present study was designed to understand the knowledge and views of mental health professionals (MHPs) regarding informed consent and confidentiality protection practices. Methods: Mental health professionals (n=121) who were members of the Delhi Psychiatric Society, were invited to participate in this questionnaire-based study of their knowledge and attitudes regarding informed consent and confidentiality. Half of them expressed willingness to discuss participation and gave initial oral consent (n=62); of these, 31 gave written informed consent to participate and completed the questionnaires. The questionnaires included both forced choice (yes/no/do not know) and open-ended questions. Questionnaires content reflected prominent guidelines on informed consent and confidentiality protection. Results: Attitudes of the majority of the participants towards informed consent and confidentiality were in line with ethical principles and guidelines. All expressed the opinion that confidentiality should generally be respected and that if confidentiality was breached, there could be mistrust of the professional by the patient/participant. The mean knowledge scores regarding informed consent and confidentiality were 8.55 ± 1.46 and 8.16 ± 1.29, respectively. Interpretation & conclusions: The participating mental health professionals appeared to have adequate knowledge of basic ethical guidelines concerning informed consent and confidentiality. Most respondents were aware of ethical issues in research. Given the small sample size and low response rate, the significance of the quantitative analysis must be regarded with modesty, and qualitative analysis of open-ended questions may be more valuable for development of future research. Increased efforts to involve mental health professionals in research on ethical concerns pertinent to their work must be made, and the actual practices of these professionals with regard to ethical guidelines need to be studied.

Ramachandran V.,National Institute of Epidemiology ICMR | Kaur P.,National Institute of Epidemiology ICMR | Kanagasabai K.,National Institute of Epidemiology ICMR | Vadivoo S.,National Institute of Epidemiology ICMR | Murhekar M.,National Institute of Epidemiology ICMR
Journal of Postgraduate Medicine | Year: 2014

Context: Chikungunya (CHIK) fever is viral disease characterized by joint pain for prolonged duration in various settings. However, there are no reports of long-term follow-up of the CHIK patients from India. Aims: We conducted a cohort study to describe the clinical manifestations, incidence of persistent arthralgia, and the associated risk factors among patients with CHIK identified during an outbreak in a suburb of Chennai, India. Materials and Methods: We conducted a retrospective cum prospective cohort study in Gowripet, Avadi, Chennai. We included all adult CHIK case patients identified during the outbreak. We conducted a nested case-control study to identify the risk factors for persistent arthralgia defined as a CHIK case experiencing arthralgia for more than 15 days from the date of onset of illness. We included all 81 patients and 81 randomly selected controls. Results: All 403 case patients had joint pain. Approximately 40% suffered joint pain for up to 1 month and 7% had it beyond 1 year. The most commonly affected types of joints were knee (96%), wrist (80%), and ankle (77%) joints. Regarding the number of types of joints affected, 36% had six types of joints, 23% had five types of joints, and 14% had three types of joints affected. The overall incidence of persistent arthralgia was 80%. High-grade fever, involvement of four or more types of joints, and joint swelling were significantly associated with persistent arthralgia. Conclusions: High prevalence of persistent arthralgia indicates the need for appropriate treatment strategies to reduce the severity and duration of joint pain.

Badrinathan S.,Vellore Institute of Technology | Suneeva S.C.,Vellore Institute of Technology | Shiju T.M.,Vellore Institute of Technology | Girish Kumar C.P.,National Institute of Epidemiology ICMR | Pragasam V.,Vellore Institute of Technology
Journal of Medicinal Plants Research | Year: 2011

Sargassum myriocystum was selected to evaluate for reactive oxygen radical scavenging capacities and antioxidant activities using commonly accepted assays. After shade drying, marine seaweeds were powdered and extracts were prepared by cold and Soxhlet methods using various organic solvents. Crude powder materials were used for determination of bio-chemical constituents like protein, carbohydrate and phenolic contents. It was found that phenolic contents constituted 22 mg gallic acid equivalents/ gm of dry plant materials. Methanol/chloroform extracts of Soxhlet showed highest reducing power, total antioxidant and hydroxyl scavenging activity. 80 to 120% inhibition of hydroxyl radical quenching activity was observed and demonstrated by all Soxhlet derived extracts, except petroleum ether. Hence, from the results we conclude presence of novel compound(s) in the crude extract of (methanol: chloroform) S. myriocystum is responsible for its hydroxyl radical scavenging activity. © 2011 Academic Journals.

Anand P.K.,Desert Medicine Research Center | Ramakrishnan R.,National Institute of Epidemiology ICMR
Indian Journal of Medical Research | Year: 2010

Background & objectives: Outbreaks of typhoid have been reported from Maharashtra, Bangalore, West Bengal and Pondicherry in India but rarely from Rajasthan. We investigated an outbreak of typhoid in a village of Thar Desert of Rajasthan. Methods: A retrospective cohort study was carried out during May-July 2007 in Varkana village, Pali district, Rajasthan, to identify the risk factor for disease. The information on outbreak was collected and then described in time, place and person characteristics to arrive at aetiological hypotheses. Results: There were 219 cases of typhoid in village. Attack rate was 104 cases per 1000 population. Maximum attack rate of 276 cases per 1000 population was noted in persons of 10-14 yr age group. Forty three serum samples were reported positive for Widal agglutination test out of 70 tested. Drinking of water from government overhead tanks was associated with disease significantly (RR= 11.1, 95% CI= 3.7-33). Two of the three water samples from government tanks were found positive for faecal contamination. Interpretation & conclusion: The outbreak of typhoid in a village affected >200 persons of all age groups and both gender. Exposure to the drinking water from government tanks was found significantly associated with the disease. Preventive and control measures undertaken after analytical epidemiological study helped in terminating the outbreak.

PubMed | National AIDS Research Institute ICMR, National Institute of Epidemiology ICMR, Center for Sexuality and Health Research and Policy a, FHI 360 India and National Institute of Nutrition ICMR
Type: | Journal: Journal of sexually transmitted diseases | Year: 2015

We examined the prevalence and type of rectal lubricants use and factors associated with exclusive use of latex-condom compatible lubricants (water-based lubricants) among men who have sex with men (MSM) using data from a large-scale cross-sectional survey conducted in 2009/10 in three Indian states. Using time-location cluster sampling, 3880MSM were recruited from cruising sites. We used multiple logistic regression to assess the association between type of lubricants used and sociodemographic and programmatic indicators. Among those who reported using lubricants (64%) more than half (53%) exclusively used water-based lubricants, less than one-tenth used exclusively oil-based lubricants, and nearly 40% used both water-based and oil-based lubricants. Factors associated with exclusive use of water-based lubricants were exposure to HIV prevention interventions (AOR: 6.18, 95% CI 4.82 to 7.92) and kothi-identified MSM-feminine/anal-receptive (AOR: 2.56, 95% CI 2.12 to 3.10). Targeted HIV interventions among MSM need to promote and distribute latex condom-compatible lubricants for use during anal sex-irrespective of their presumed or stated sexual role in anal sex, and educate them not to use oil-based lubricants with condoms.

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