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Takarinda K.C.,AIDS and TB Unit | Harries A.D.,International Union Against Tuberculosis and Lung Disease | Harries A.D.,London School of Hygiene and Tropical Medicine | Srinath S.,Qutub Institutional Area | And 3 more authors.
BMC Public Health | Year: 2012

Background. Zimbabwe is a Southern African country with a high HIV-TB burden and is ranked 19 th among the 22 Tuberculosis high burden countries worldwide. Recurrent TB is an important problem for TB control, yet there is limited information about treatment outcomes in relation to HIV status. This study was therefore conducted in Chitungwiza, a high density dormitory town outside the capital city, to determine in adults registered with recurrent TB how treatment outcomes were affected by type of recurrence and HIV status. Methods. Data were abstracted from the Chitungwiza district TB register for all 225 adult TB patients who had previously been on anti-TB treatment and who were registered as recurrent TB from January to December 2009. The Chi-square and Fischer's exact tests were used to establish associations between categorical variables. Multivariate relative risks for associations between the various TB treatment outcomes and HIV status, type of recurrent TB, sex and age were calculated using Poisson regression with robust error variance. Results. Of 225 registered TB patients with recurrent TB, 159 (71%) were HIV tested, 135 (85%) were HIV-positive and 20 (15%) were known to be on antiretroviral treatment (ART). More females were HIV-tested (75/90, 83%) compared with males (84/135, 62%). There were 103 (46%) with relapse TB, 32 (14%) with treatment after default, and 90 (40%) with "retreatment other" TB. There was one failure patient. HIV-testing and HIV-positivity were similar between patients with different types of TB. Overall, treatment success was 73% with transfer-outs at 14% being the most common adverse outcome. TB treatment outcomes did not differ by HIV status. However those with relapse TB had better treatment success compared to "retreatment other" TB patients, (adjusted RR 0.81; 95% CI 0.68 - 0.97, p = 0.02). Conclusions. No differences in treatment outcomes by HIV status were established in patients with recurrent TB. Important lessons from this study include increasing HIV testing uptake, a better understanding of what constitutes "retreatment other" TB, improved follow-up of true outcomes in patients who transfer-out and better recording practices related to HIV care and treatment especially for ART. © 2012 Takarinda et al; licensee BioMed Central Ltd.


PubMed | WHO Country Office for India, Qutub Institutional Area, Mantena Satyanarayana Raju Arogyalayam and Médecins Sans Frontières
Type: Journal Article | Journal: BMC complementary and alternative medicine | Year: 2016

With an estimated 65 million Diabetes Mellitus(DM) patients, India ranks second in the world in terms of DM burden. The emphasis of current medical practice has been on pharmacotherapy but, despite the best combination therapies, acheiving glycaemic control(reduction of blood sugar to desirable levels) is a challenge. Integrated Naturopathy and Yoga(INY) is an alternative system of medicine that lays emphasis on the role of diet and physical exercise. We assessed the short term effect of INY as an adjunct to pharmacotherapy on glycaemic control among type 2 DM patients.In this prospective cohort study with a 3 month follow-up, DM patients consecutively admitted to a hospital in India from May-October 2014 for either 15 or30 days were offered INY - a package of vegetarian diet with no added oil, sugar and salt, yoga-based exercise, patient counselling and rest. A favourable outcome was defined as glycaemic control (glycosylated hemoglobin (HbA1c)<7% or absolute reduction by 1%) along with at least 50% reduction in antidiabetes medication at 3 months relative to baseline. Compliance to diet was scored by self-report on a scale of 0-10 and categorized into poor (0-5), moderate (6-8) and excellent (9-10).Of 101 patients with 3-month follow-up data, 65(65 %) achieved a favourable outcome - with 19(19%) stopping medication while sustaining glycemic control. Factors associated with favourable outcome were baseline HbA1c and compliance to diet, which showed a significant linear relationship with mean HbA1c reductions of 0.4%, 1.1% and 1.7% in relation to poor, moderate and excellent dietary compliance respectively.INY, adjunctive to pharmacotherapy, was associated with a significant beneficial effect on glycaemic control and reduced the overall need for antidiabetes medications. These early results are promising. Further studies with long-term follow-up and using more rigorous randomized controlled trial designs are needed.


Desjeux P.,Qutub Institutional Area | Ghosh R.S.,Qutub Institutional Area | Dhalaria P.,Qutub Institutional Area | Strub-Wourgaft N.,DNDi | Zijlstra E.E.,DNDi
Parasites and Vectors | Year: 2013

Post kala-azar dermal leishmaniasis (PKDL) is a neglected complication of visceral leishmaniasis (VL)a deadly, infectious disease that claims approximately 20,000 to 40,000 lives every year. PKDL is thought to be a reservoir for transmission of VL, thus, adequate control of PKDL plays a key role in the ongoing effort to eliminate VL. Over the past few years, several expert meetings have recommended that a greater focus on PKDL was needed, especially in South Asia. This report summarizes the Post Kala-Azar Dermal Leishmaniasis Consortium Meeting held in New Delhi, India, 27-29 June 2012. The PKDL Consortium is committed to promote and facilitate activities that lead to better understanding of all aspects of PKDL that are needed for improved clinical management and to achieve control of PKDL and VL. Fifty clinicians, scientists, policy makers, and advocates came together to discuss issues relating to PKDL epidemiology, diagnosis, pathogenesis, clinical presentation, treatment, and control. Colleagues who were unable to attend participated during drafting of the consortium meeting report. © 2013 Desjeux et al.; licensee BioMed Central Ltd.


Kochhar S.,Qutub Institutional Area | Rath B.,Charité - Medical University of Berlin | Seeber L.D.,Charité - Medical University of Berlin | Rundblad G.,King's College London | And 2 more authors.
Expert Review of Vaccines | Year: 2013

Vaccines offer the most cost-effective approach to controlling infectious diseases. Access to vaccines remains unequal and suboptimal, particularly in poorer developing countries. Introduction of new vaccines and long-term sustainability of immunization programs will require proactive planning from conception to implementation. International and national coordination efforts as well as local and cultural factors need to be known and accounted for. Adequate infrastructure should be in place for the monitoring of disease burden, vaccine effectiveness and vaccine safety, based on the common terminology and international consensus. This overview paper aims to raise awareness of the importance of introduction efforts for vaccines of special relevance to resource-poor countries. The target audiences are those involved in immunization programs, from planning or oversight roles to frontline providers, as well as health care professionals. © Informa UK, Ltd.


PubMed | ESIC Medical College and PGIMSR and Qutub institutional area
Type: Journal Article | Journal: BMC health services research | Year: 2017

The Government of India, made TB notification by private healthcare providers mandatory from May 2012 onwards. The National TB Programme developed a case based web based online reporting mechanism called NIKSHAY. However, the notification by private providers has been very low. We conducted the present study to determine the awareness, practice and anticipated enablers related to TB notification among private practitioners in Mysore city during 2014.A cross-sectional study was conducted among private practitioners of Mysore city in south India. The private practitioners in the city were identified and 258 representative practitioners using probability proportional to size were interviewed using semi-structured questionnaire.Among the 258 study participants, only 155 (60%) respondents agreed to a detailed interview. Among those interviewed, 141 (91%) were aware that TB is a notifiable disease; however 127 (82%) of them were not aware of process of notification and NIKSHAY. Only one in six practitioners was registered in NIKSHAY, while one in three practitioners are notifying without registration. The practitioners expected certain enablers from the programme like free drugs, training to notify in NIKSHAY and timely feedback. 74 (47%) opined that notification should be backed by legal punitive measures.The programme should develop innovative strategies that provide enablers, address concerns of practitioners while having simple mechanisms for TB notification. The programme should strengthen its inherent capacity to monitor TB notification.


Shewade H.D.,Indira Gandhi Medical College and Research Institute | Shewade H.D.,Qutub Institutional Area | Palanivel C.,Indira Gandhi Medical College and Research Institute | Palanivel C.,Jawaharlal Institute of Postgraduate Medical Education & Research | Jeyashree K.,Velammal Medical College Hospital and Research Institute
Family Medicine and Community Health | Year: 2016

Objective: Family medicine, epidemiology, health management and health promotion are the core disciplines of community medicine. In this paper, we discuss the development of a community posting program within the framework of community medicine core disciplines at a primary health centre attached to a teaching hospital in Puducherry, India. Methods: This is a process documentation of our experience. Results: There were some shortcomings which revolved around the central theme that postings were conducted with department in the teaching hospital as the focal point, not the primary health centre (PHC). To address the shortcomings, we made some changes in the existing community posting program in 2013. Student feedback aimed at Kirkpatrick level 1 (satisfaction) evaluation revealed that they appreciated the benefits of having the posting with PHC as the focal point. Feedback recommended some further changes in the community posting which could be addressed through complete administrative control of the primary health centre as urban health and training center of the teaching hospital; and also through practice of core disciplines of community medicine by faculty of community medicine. Conclusion: It is important to introduce the medical undergraduates to the core disciplines of community medicine early through community postings. Community postings should be conducted with primary health centre or urban health and training centre as the focal point. © 2016 Family Medicine and Community Health.


Lal P.,Qutub Institutional Area
Global Health Promotion | Year: 2012

Globally, tobacco kills more people than HIV-related conditions or AIDS, tuberculosis and malaria combined. In 1991, The World Bank, the world's largest lender, pledged that it would no longer support tobacco-related projects. It was expected that other financial investors would follow, but most did not respond to this call. As a result, several financial institutions continue to invest in tobacco and fuel an epidemic to an unprecedented scale. Using tobacco as a case in point, this review highlights the continuing investments among financial institutions which do not conform to 'socially responsible investments' and calls for monitoring and reporting such unethical practices. The paper also underscores the need to harmonise the numerous criteria, principles and voluntary codes that govern socially responsible investing and ensure that financial institutions comply with them. © The Author(s) 2012.


Bhardwaj R.K.,Qutub Institutional Area
Scientometrics | Year: 2016

The paper discusses the trend of world literature on “International Business” in terms of the output of research publications as indexed in the Social Sciences Citation Index during the period from 2004 to 2013. A total of 3131 journals and 1623 papers were indexed on international business in the database during the 10 year study period. The average number of papers published per year was 162.30. The highest numbers of papers, i.e., 268 (16.513 %) were published in the year 2010. The author Eden L and Causgil ST have shared the top position who wrote the highest publications, i.e., 13 (0.801 %) each. The source title Journal of International Business Studies contained the highest number with 359 (22.12 %) publications. The most popular research area is Business Economics in which the highest number of publications, i.e., 1442 (88.848 %) counted. The United States contributed highest number of publications, i.e., 616 (37.954 %) among the total of 62 counties who contributed on the subject. Most productive institution was University of Leeds, which contributed a total of 28 (1.1164 %) publications among the total of 513 organizations. Articles amounted to 1329 (81.885 %) of the literature on international business. The study will help researchers and authors who can identify the most appropriate, influential journals in which to publish, as well as confirm the status of journals in which they have published (Hasan et al. in Proceedings of the fourth international conference of the digital libraries, 27–29 November 2013 New Delhi, India. TERI, New Delhi, pp 319–329, 2013). It will help professors, academicians and students who can discover where to find the current reading list in their respective fields (Krishna and Kumar in SRELS J Inf Manag 41(2):229–234, 2004). The publishers and editors can determine journals’ influence in the marketplace and review editorial functions (Chuang et al. in Scientometrics 87(3):551–562, 2011). The educational institutions, business groups, to look into the trends and make appropriate policies related to international business on the basis of inferences depicted from the analysis. The administrators, policy and planning makers can track bibliometric and citation patterns to make strategic and funding decisions (Arora et al. in Curr Sci 104(3):307–315, 2013). The librarians and information analysts can support selection or removal of journals from their collections, and determine how long to keep each journal in the collection before archiving it (Trivedi in Libr Philos Pract, 1–6, 2010). © 2015, Akadémiai Kiadó, Budapest, Hungary.


Lal P.,Qutub Institutional Area | Wilson N.C.,Qutub Institutional Area | Singh R.J.,Qutub Institutional Area
International Journal of Tuberculosis and Lung Disease | Year: 2011

Smoke-free initiatives have gained significant momentum since India enacted comprehensive smoke-free legislation in October 2008. The International Union Against Tuberculosis and Lung Disease has actively supported various levels of government, legislators, civil society, and communities across the country to implement smoke-free public places and comply with the law. On World No Tobacco Day 2010, four jurisdictions demonstrated that public places within their jurisdictions were smoke-free. These jurisdictions cover a wide spectrum of demographic and geographic variation and include an entire state. The demonstration of being 'smoke-free' in these jurisdictions was supported by a simple survey that documented compliance with the smoke-free law in the country. © 2011 The Union.


PubMed | Qutub Institutional Area
Type: Journal Article | Journal: BMC public health | Year: 2016

Correct knowledge about Tuberculosis (TB) is essential for appropriate healthcare seeking behaviour and to accessing diagnosis and treatment services timely. There are several factors influencing knowledge about TB. The present study was conducted to assess the change in community knowledge of Tuberculosis (TB) and its association with respondents socio-demographic characteristics in two serial knowledge-attitude-practice surveys.Community level interventions including community meetings with youth groups, village health committees and self-help groups and through mass media activities were undertaken to create awareness and knowledge about TB and service availability. Increase in knowledge on TB and its association with respondents socio-demographic characteristics was assessed by two serial KAP surveys in 2010-2011 (baseline) and 2012-2013 (midline) in 30 districts of India. Correct knowledge of TB was assessed by using lead questions and scores were assigned. The composite score was dichotomized into two groups (score 0-6, poor TB knowledge and score 7-13, good TB knowledge).In baseline and midline survey, 4562 and 4808 individuals were interviewed. The correct knowledge about TB; cough 2weeks, transmission through air, 6-8 months treatment duration, and free treatment increased by 7% (p-value <0.05), 11% (p-value <0.05), 2% (p-value <0.05), and 8% (p-value <0.05) in midline compared to baseline, respectively. The knowledge on sputum smear test for diagnosis of TB was 66% in both surveys while knowledge on availability of free treatment and that TB is curable disease decreased by 5% and 2% in midline (p-0.001), compared to baseline, respectively. The mean score for correct knowledge about TB increased from 60% in baseline to 71% in midline which is a 11% increase (p-value <0.001). The misconception regarding on transmission of TB by- sharing of food and clothes and handshake persisted in midline. Respondents residing in northern (OR, 2.2, 95% CI, 1.7-2.6) and western districts (OR, 3.4, 95% CI, 2.7-4.1) of India and age groups- 25-34 years (OR, 1.3; 95% CI, 1.1-1.6) and 45-44 years (OR, 1.4; 95% CI, 1.1-1.7)- were independently associated with good TB knowledge.The knowledge about TB has increased over a period of 2years and this may be attributable to the community intervention in 30 districts of India. The study offers valuable lesson for designing TB related awareness programmes in India and in other high burden countries.

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