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Soman B, Lathika AR, Unnikrishnan B, Shetty RS. Tracing the Disparity Between Healthcare Policy-Based Infrastructure and Health Belief-Lead Practices: a Narrative Review on Indigenous Populations of India. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01810-3. [PMID: 37787946 DOI: 10.1007/s40615-023-01810-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
Most Indian tribes have limited access to healthcare facilities and rely heavily on traditional healing practices. This narrative review aimed to identify the disparities in the implementation of healthcare services and in accessing and availing these services by the indigenous population in India. We also have tried to throw light on the plausibility in strengthening the efficiency and efficacy of the public health system, by utilizing the available resources to its maximum potential, so that there will be a measurable outcome in the health status of these populations in India, coherently with the relevant sustainable development goals (SDG). The evidence from published literatures supports the fact that the disparity exists in the health status of indigenous populations in India as compared to the general populations. It emphasizes the need to address the key determinants such as the lack of knowledge, traditional healing practices and poor utilization of healthcare services provided to them. Various factors such as accessibility to healthcare resources, traditional healing practices, lack of awareness regarding healthcare services and schemes provided by the government, insufficient data regarding their issues and challenges and cultural and language barriers worsen the health status of indigenous people. However, our review reiterates that a well-structured and sustainable policy with reframed infrastructure and administration of healthcare system might bring a positive change in the health status of indigenous population in India.
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Affiliation(s)
- Biju Soman
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ashwathi Raj Lathika
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - B Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Ranjitha S Shetty
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
- Centre for Indigenous Population, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
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Garg T, Chaisson LH, Naufal F, Shapiro AE, Golub JE. A systematic review and meta-analysis of active case finding for tuberculosis in India. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 7:100076. [PMID: 37383930 PMCID: PMC10305973 DOI: 10.1016/j.lansea.2022.100076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Background Active case finding (ACF) for tuberculosis (TB) is the cornerstone case-finding strategy in India's national TB policy. However, ACF strategies are highly diverse and pose implementation challenges in routine programming. We reviewed the literature to characterise ACF in India; assess the yield of ACF for different risk groups, screening locations, and screening criteria; and estimate losses to follow-up (LTFU) in screening and diagnosis. Methods We searched PubMed, EMBASE, Scopus, and the Cochrane library to identify studies with ACF for TB in India from November 2010 to December 2020. We calculated 1) weighted mean number needed to screen (NNS) stratified by risk group, screening location, and screening strategy; and 2) the proportion of screening and pre-diagnostic LTFU. We assessed risk of bias using the AXIS tool for cross-sectional studies. Findings Of 27,416 abstracts screened, we included 45 studies conducted in India. Most studies were from southern and western India and aimed to diagnose pulmonary TB at the primary health level in the public sector after screening. There was considerable heterogeneity in risk groups screened and ACF methodology across studies. Of the 17 risk groups identified, the lowest weighted mean NNS was seen in people with HIV (21, range 3-89, n=5), tribal populations (50, range 40-286, n=3), household contacts of people with TB (50, range 3-undefined, n=12), people with diabetes (65, range 21-undefined, n=3), and rural populations (131, range 23-737, n=5). ACF at facility-based screening (60, range 3-undefined, n=19) had lower weighted mean NNS than at other screening locations. Using the WHO symptom screen (135, 3-undefined, n=20) had lower weighted mean NNS than using criteria of abnormal chest x-ray or any symptom. Median screening and pre-diagnosis loss-to-follow-up was 6% (IQR 4.1%, 11.3%, range 0-32.5%, n=12) and 9.5% (IQR 2.4%, 34.4%, range 0-86.9%, n=27), respectively. Interpretation For ACF to be impactful in India, its design must be based on contextual understanding. The narrow evidence base available currently is insufficient for effectively targeting ACF programming in a large and diverse country. Achieving case-finding targets in India requires evidence-based ACF implementation. Funding WHO Global TB Programme.
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Affiliation(s)
- Tushar Garg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Lelia H. Chaisson
- Division of Infectious Diseases, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Fahd Naufal
- Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Adrienne E. Shapiro
- Department of Global Health and Department of Medicine, University of Washington, Seattle, WA, United States
| | - Jonathan E. Golub
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Ibrahim MN, Nik Husain NR, Daud A, Chinnayah T. Epidemiology and Risk Factors of Delayed Sputum Smear Conversion in Malaysian Aborigines with Smear-Positive Pulmonary Tuberculosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042365. [PMID: 35206552 PMCID: PMC8872111 DOI: 10.3390/ijerph19042365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
Background: Tuberculosis (TB) remains a serious public health challenge despite enormous eradication efforts. Indigenous groups worldwide have a higher TB incidence and associated delayed sputum–smear conversion. The aim of this case–control study was to determine the epidemiology and factors associated with delayed sputum–smear conversion among Malaysian aborigines. Methods: We used secondary data from 2016 to 2020 in the MyTB surveillance system. Malaysian aborigines with smear-positive pulmonary TB were enrolled and followed until the end of the intensive phase. Descriptive statistics and multiple logistic regression were used for data analysis. Results: Of 725 Malaysian aborigines with pulmonary TB, 572 (78.9%) were smear-positive and 487 (78.9%) fulfilled the study criteria. The mean (SD) age of smear-positive pulmonary TB was 39.20 (16.33) years. Majority of participants were male (63%), Senoi tribe (54.9%), living in rural areas (88.1%), formally educated (60.4%) and living below the poverty line (97.1%). Overall, 93 (19.1%) of 487 patients showed delayed sputum-smear conversion and significantly associated factors, such as smoking (AdjOR: 3.25; 95% CI: 1.88, 5.59), diabetes mellitus (AdjOR: 12.84; 95% CI: 6.33, 26.06), and HIV infection (AdjOR: 9.76; 95% CI: 3.01, 31.65). Conclusions: Stakeholders should adopt targeted approaches to tackle the problem of aboriginal groups with pulmonary TB and these associated risk factors to realise the End TB target.
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Affiliation(s)
- Muhammad Naim Ibrahim
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia; (M.N.I.); (A.D.)
| | - Nik Rosmawati Nik Husain
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia; (M.N.I.); (A.D.)
- Correspondence: ; Tel.: +60-9767-6621
| | - Aziah Daud
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia; (M.N.I.); (A.D.)
| | - Thilaka Chinnayah
- TB and Leprosy Control Sector, Disease Control Division, Ministry of Health Malaysia, Putrajaya 62590, Malaysia;
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Mishra P, Sharma RK, Yadav R, Rao VG, Nigam S, Lingala MA, Bhat J. Reasons for loss to follow-up (LTFU) of pulmonary TB (PTB) patients: A qualitative study among Saharia, a particularly vulnerable tribal group of Madhya Pradesh, India. PLoS One 2021; 16:e0261152. [PMID: 34941885 PMCID: PMC8699669 DOI: 10.1371/journal.pone.0261152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/27/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Loss to follow-up (LTFU) among pulmonary tuberculosis (PTB) patients is a significant challenge for TB control. However, there is a dearth of information about the factors leading to LTFU among marginalized communities. This study highlights the factors associated with LTFU in Saharia, a tribe of Madhya Pradesh having high tuberculosis (TB) prevalence. METHODS A qualitative study was carried out during January-April 2020 among twenty-two pulmonary TB patients, recorded as LTFU in NIKSHAY, with ten treatment supporters and ten patient's family members. Semi-structured personal interview tools were used to collect the information on the history of anti-tuberculosis treatment, adverse drug events (ADE), social cognitive, behaviors, myths, and misbeliefs. The interviews were transcribed and thematically analysed to examine underlying themes. RESULTS The study explored various social, behavioral factors leading to loss to follow-up among PTB patients. Drug side effects, alcoholism, social stigma, lack of awareness of the seriousness of the diseases and poor counseling are the main barriers to treatment adherence in this community. CONCLUSIONS The study highlights the need to address the issues related to LTFU during TB treatment. The enhanced efforts of treatment supporters, health staff, and family & community persons must motivate and support the patients.
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Affiliation(s)
- Prashant Mishra
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, India
| | | | - Rajiv Yadav
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, India
| | - V. G. Rao
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, India
| | - Samridhi Nigam
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, India
| | | | - Jyothi Bhat
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, India
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Sharma R, Rao VG, Yadav R, Mishra P, Lingla MA, Nigam S, Bhat J. Comparative Yield of Pulmonary Tuberculosis by Different Symptoms among Saharia Tribe of Madhya Pradesh, India. Indian J Community Med 2021; 46:546-549. [PMID: 34759507 PMCID: PMC8575206 DOI: 10.4103/ijcm.ijcm_42_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/05/2021] [Indexed: 11/04/2022] Open
Abstract
Background Symptom elicitation is a simple and inexpensive screening tool used for population screening in tuberculosis (TB) prevalence surveys. However, the information on the yield of TB cases by symptoms is sparsely available. Methods A cross-sectional pulmonary TB (PTB) prevalence survey was conducted. All available eligible individuals were interviewed for symptoms of PTB. Sputum samples were collected and tested for PTB by smear microscopy and culture. Results Among 2890 individuals tested for PTB, 77% had cough for 2 weeks or more and one-third reported chest pain for 1 month or more. About 31% were having a history of anti-TB treatment. Cough contributed to 82% PTB cases and the history of anti-TB treatment contributed to another 8.4% confirmed cases. Fever recorded lowest yield among the symptoms of PTB. Conclusion The study suggests that fever alone may be ignored from symptomatic elicitation, and history of previous anti-TB treatment should be treated as an important indication for PTB symptomatic elicitation.
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Affiliation(s)
- Ravendra Sharma
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - V G Rao
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Rajiv Yadav
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Prashant Mishra
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Mercy Aparna Lingla
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Samridhi Nigam
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Jyothi Bhat
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, India
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Nigam S, Sharma RK, Yadav R, Rao VG, Mishra P, Lingala MA, Bhat J. Experiences and needs of patients with MDR/XDR-TB: a qualitative study among Saharia tribe in Madhya Pradesh, Central India. BMJ Open 2021; 11:e044698. [PMID: 34385228 PMCID: PMC8362723 DOI: 10.1136/bmjopen-2020-044698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 07/27/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Drug-resistant tuberculosis (DR-TB) continues to be a major public health threat posing a critical challenge to TB treatment and control worldwide. The present study was conducted among patients with DR-TB of the Saharia tribe residing in Madhya Pradesh state of Central India to document their experiences and needs, and to identify gaps for treatment adherence as this population is known to be poor because of migration and other factors. METHODS We conducted 16 in-depth interviews on purposively selected patients with DR-TB among the Saharia tribe using a predesigned open-ended in-depth interview guide, which included questions on domains like general physical health, diagnosis, treatment adherence, side-effects of drugs and experience related to the health facility. Out of these interviews, various subthemes were extracted. The obtained qualitative data were subjected to thematic analysis. RESULTS The study helped to understand the experiences and needs of the patients with DR-TB in various stages from diagnosis to treatment. Also, there was the impact of factors like lack of education and awareness, poor living conditions and lack of healthcare facilities on predominance of the disease in the community. Poor access to a healthcare facility, high pill burden and related side-effects, longer duration of treatment, financial burden, misbeliefs and misconceptions were prominent issues posing a challenge to treatment adherence. The narratives pointed out their struggle at every stage be it with diagnosis, treatment initiation or treatment adherence. CONCLUSION It is paramount to address the needs and experiences of patients with DR-TB to develop a patient-centric and context-specific approach conducive to the sociocultural set-up of tribal people. This will scale down the attrition rate of tribal patients while adhering to the complete treatment process and reducing the high burden of TB among the Saharia community. In addition, tribal patients should be counselled at regular intervals to increase their confidence in the treatment.
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Affiliation(s)
- Samridhi Nigam
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Ravendra K Sharma
- ICMR- National Institute of Medical Statistics, New Delhi, Delhi, India
| | - Rajiv Yadav
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Vikas Gangadhar Rao
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Prashant Mishra
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Mercy Aparna Lingala
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Jyothi Bhat
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
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Sutar R, Lahiri A, Diwan S, Satpathy P, Rozatkar A. Determinants of Mental Health Care Access in a Tribal District of Central India: Findings from a Health Camp. J Neurosci Rural Pract 2021; 12:335-342. [PMID: 33935448 PMCID: PMC8079175 DOI: 10.1055/s-0041-1723071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective Mental health care needs of urban, rural, and tribal regions of India are varied and challenging, which require region-specific approaches. A significant treatment gap calls out for a state-wise introspection of existing service delivery models to cater to the specific mental health needs. In Madhya Pradesh, key findings were noted from a camp conducted in one of the tribal districts. To establish patient-centered services, it is important to understand their mental health care needs. Materials and Methods A cross-sectional study within a mental health camp was conducted in the east-central tribal district of Madhya Pradesh by using a semi-structured interview. Statistical Analysis Treatment deficit, pathways to care, and treatment barriers were assessed for correlation with demographic and clinical variables and analyzed by using the Chi-square test and logistic regression method using SPSS version 20. Results Among 113 patients who sought help, treatment deficit was 85% with patient factors contributing 76% predominantly affecting the unmarried group of patients. Common mental illnesses (CMIs) outnumbered severe mental illnesses (SMIs) of which anxiety spectrum disorder contributed the most. SMIs still appear to remain undiagnosed till late in the course of illness. Nicotine dependence was higher in males ( p < 0.001), and an increase in the dependence pattern was observed with increasing age ( p = 0.001). Conclusion Rising awareness and recognition of CMIs as a common mental health concern while under-recognition of SMIs among tribal communities needs further research. Considering attribution of symptoms to unknown factors, treatment barriers revolving around patient factors, and higher nicotine dependence in males, a timely evaluation of a multitargeted intervention to establish the balance in access to mental health care among the tribal population of Madhya Pradesh is warranted.
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Affiliation(s)
- Roshan Sutar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, India
| | - Anuja Lahiri
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Sanjeet Diwan
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, India
| | - Parmeshwar Satpathy
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Abhijit Rozatkar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, India
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Kumar MM, Pathak VK, Ruikar M. Tribal population in India: A public health challenge and road to future. J Family Med Prim Care 2020; 9:508-512. [PMID: 32318373 PMCID: PMC7113978 DOI: 10.4103/jfmpc.jfmpc_992_19] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 12/28/2019] [Accepted: 01/06/2020] [Indexed: 12/19/2022] Open
Abstract
India with 8.6% of tribal population is finding it difficult to bridge the gap that exists between tribal and non-tribal population in regards to healthcare. Tribal population suffers triple burden of disease; in fact it is quadruple, namely, communicable diseases, non-communicable diseases, malnutrition, mental health, and addictions complicated by poor health seeking behavior. With increasing needs, an Expert committee on Tribal health has given recommendations with the goal to bridge the current gap in the health status of tribal people latest by the year 2027. An entirely parallel health system has been proposed with key focus areas, governance, and financing. To summarize and report the present scenario in terms of disease burden, health-seeking behavior, healthcare delivery system, and a roadmap for the future along the importance of primary healthcare in achieving it. Mere establishment of more health facilities cannot overcome the poor health of tribal population and so the role of trained manpower to deliver quality healthcare, in which case the role of traditional healers, local Tribal boys and girls comes in handy. It is high time and states should act swiftly to assess the needs, priorities of their own tribal population and set goals, targets to achieve the same through proven public health strategies.
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Affiliation(s)
- M Mohan Kumar
- Department of Community and Family Medicine, Medical College Building, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Vineet Kumar Pathak
- Department of Community and Family Medicine, Medical College Building, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Manisha Ruikar
- Department of Community and Family Medicine, Medical College Building, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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Narain JP. Health of tribal populations in India: How long can we afford to neglect? Indian J Med Res 2020; 149:313-316. [PMID: 31249192 PMCID: PMC6607830 DOI: 10.4103/ijmr.ijmr_2079_18] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Jai Prakash Narain
- Formerly at WHO Regional Office for South-East Asia, New Delhi 110 002, India
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Rao VG, Bhat J, Yadav R, Sharma RK, Muniyandi M. Declining tuberculosis prevalence in Saharia, a particularly vulnerable tribal community in Central India: evidences for action. BMC Infect Dis 2019; 19:180. [PMID: 30786860 PMCID: PMC6383441 DOI: 10.1186/s12879-019-3815-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 02/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background In spite of an alarmingly high tuberculosis (TB) burden amongst the Saharia tribe of central India, there is hardly any study to investigate the impact of DOTS implementation on the magnitude of tuberculosis disease and the changes over time. This article present the findings of TB prevalence surveys conducted amongst this indigenous population in two different time periods to know the change in the prevalence of TB. Methods A cross sectional survey was conducted among Saharia population in Shivpuri district, Madhya Pradesh during February 2013 to May 2013 and resurvey during March 2015 to July 2015. All individuals (≥15 years) were examined for chest symptoms suggestive of TB. Sputum samples were collected from all presumptive TB cases and were confirmed by laboratory examination by Ziehl-Neelsen smear microscopy and solid media culture methods. All detected cases were referred to health facility for anti-tuberculosis treatment as per RNTCP guidelines. Results There was significant reduction (trend Chi square 19.97; OR = 1.521; p = 0.000) in the prevalence of TB at the endline (1995 per 100,000) as compared to baseline (3003 per 100,000). The reduction was significant among males as compared to females (OR 1.55; p = 0.000) and in the age group of 25–34 years (OR 2.0; p = 0.007) and 45–54 years (OR 4.39; p = 0.003). There was significant reduction in the prevalence in both smear (OR 1.29; p = 0.02) and culture positive (OR 1.57; p = 0.000) TB at the endline survey. Conclusion The study findings highlight a reduction in the prevalence of TB among Saharia tribal population. Further studies are needed to identify the factors associated with reduction in prevalence among this population and also further surveys to monitor the prevalence trend over a period.
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Affiliation(s)
- V G Rao
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India.
| | - J Bhat
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India
| | - R Yadav
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India
| | - R K Sharma
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India
| | - M Muniyandi
- ICMR -National Institute for Research in Tuberculosis, (Indian Council of Medical Research), No. 1, Mayor Sathiyamoorthy Road, Chetpet, Chennai, 600031, India
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Mishra G, Poojary SS, Jain S, Tiwari PK. Genotype-phenotype relationship of CCL5 in pulmonary tuberculosis infection in Sahariya tribe: A pilot study. Indian J Med Res 2018; 146:768-773. [PMID: 29664036 PMCID: PMC5926349 DOI: 10.4103/ijmr.ijmr_1582_15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background & objectives: Sahariya, a primitive tribe of Central India, has shown significantly increased incidence of pulmonary tuberculosis (PTB). Our previous study on Sahariya showed a significant association of −403G>A single nucleotide polymorphism (SNP) of CCL5 with susceptibility to PTB. Hence, this study was aimed to analyze a genotype-phenotype relationship of this disease-associated SNP to develop a potential diagnostic marker for TB in this tribe. Methods: The present study was carried out on 70 plasma samples from Sahariya tribe, wherein the plasma CCL5 level was determined using a commercially available ELISA kit. Results: The level of CCL5 decreased significantly in patients who were on therapy/completed their therapy [inactive TB patient/inactive PTB (IPTB)], particularly with AA genotype of −403G>A (P=0.046). The level, with AA genotype, was also found to gradually decrease in sputum 3+ and 1+/2+ than in sputum-negative samples. Similarly, the CCL5 level was found to be higher in sputum-positive/active TB patients than in IPTB group and healthy controls. Interpretation & conclusions: Our results suggested that the CCL5 level was influenced collectively not only by the genotypes of −403G>A SNP and bacillary load but also by the treatment. Thus, CCL5 may be considered for the development of a diagnostic marker and also as an indicator of recovery.
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Affiliation(s)
- Gunja Mishra
- Department of Molecular & Human Genetics, Centre for Genomics, Jiwaji University, Gwalior, India
| | - Satish S Poojary
- Department of Molecular & Human Genetics, Centre for Genomics, Jiwaji University, Gwalior, India
| | - Sanjay Jain
- Revised National Tuberculosis Control Programme Unit, District Hospital, Sheopur, India
| | - Pramod Kumar Tiwari
- Department of Molecular & Human Genetics, Centre for Genomics, Jiwaji University, Gwalior, India
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Bhat J, Rao VG, Sharma RK, Muniyandi M, Yadav R, Bhondley MK. Investigation of the risk factors for pulmonary tuberculosis: A case-control study among Saharia tribe in Gwalior district, Madhya Pradesh, India. Indian J Med Res 2017; 146:97-104. [PMID: 29168465 PMCID: PMC5719614 DOI: 10.4103/ijmr.ijmr_1029_16] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND & OBJECTIVES Prevalence of pulmonary tuberculosis (PTB) is known to be high in the indigenous tribal community Saharia in Madhya Pradesh, India. The risk factors for PTB are not well known among them. This study was done to determine various risk factors associated with PTB in the indigenous community Saharia. METHODS A prevalence survey was conducted among Saharias of Gwalior district of Madhya Pradesh. The population surveyed was 12,123 which was the source of cases and controls for the present study. All the bacillary-positive cases and controls in the ratio of 1:5 were included in the survey. Data were collected by the trained health workers from the patients and controls using a semi-structured pre-coded and pre-tested questionnaire which included data on risk factors including demographic factors, host-related factors and household factors. The individuals were also screened for diabetes mellitus and HIV. RESULTS Malnutrition and history of asthma were associated with an increased risk of PTB. More than 56 per cent cases were attributed to malnutrition and 12 per cent attributed to asthma. Low family income, alcohol consumption and smoking were the other contributors. The risk was higher in males as compared to females. INTERPRETATION & CONCLUSIONS The study emphasized that the main contributors were social factors. Nutrition supplementation, especially in tuberculosis (TB) patients and integrated approach to improve their living conditions are needed to control TB in this community.
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Affiliation(s)
- Jyothi Bhat
- Department of Microbiology, National Institute for Research in Tribal Health, Jabalpur, India
| | - V. G. Rao
- Department of Community Medicine, National Institute for Research in Tribal Health, Jabalpur, India
| | - R. K. Sharma
- Department of Social Sciences, National Institute for Research in Tribal Health, Jabalpur, India
| | - M. Muniyandi
- Department of Social and behavioural research, National Institute for Research in Tuberculosis, Chennai, India
| | - Rajiv Yadav
- Department of Genetics, National Institute for Research in Tribal Health, Jabalpur, India
| | - M K. Bhondley
- Department of Community Medicine, National Institute for Research in Tribal Health, Jabalpur, India
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Singh N. Understanding poor man's diseases in contemporary perspective. Indian J Med Res 2015; 141:501-4. [PMID: 26139764 PMCID: PMC4510745 DOI: 10.4103/0971-5916.159487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Neeru Singh
- National Institute for Research in Tribal Health (ICMR), Jabalpur 482 003, Madhya Pradesh, India & Coordinator, ICMR THRF, India
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