1
|
Rana A, Misra AK. Convergent synthesis of the pentasaccharide repeating unit corresponding to the cell wall O-polysaccharide of Salmonella milwaukee (group U) O:43 strain. Carbohydr Res 2024; 542:109176. [PMID: 38851144 DOI: 10.1016/j.carres.2024.109176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/25/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024]
Abstract
Synthesis of the pentasaccharide repeating unit of the cell O-polysaccharide produced by Salmonella milwaukee O:43 strain (group U) has been achieved in very good yield adopting a convergent stereoselective [3 + 2] block glycosylation strategy. Thioglycosides and glycosyl trichloroacetimidate derivative were used as glycosyl donors in the presence of a combination of N-iodosuccinimide (NIS) and trimethylsilyl trifluoromethanesulfonate (TMSOTf) as thiophilic activator and TMSOTf as trichloroacetimidate activator respectively. The stereochemical outcome of all glycosylation reactions was excellent.
Collapse
Affiliation(s)
- Abhijit Rana
- Bose Institute, Department of Chemical Sciences, Block EN-80, Sector-V, Salt Lake, Kolkata, 700091, India
| | - Anup Kumar Misra
- Bose Institute, Department of Chemical Sciences, Block EN-80, Sector-V, Salt Lake, Kolkata, 700091, India.
| |
Collapse
|
2
|
Sharma AD, Grewal RK, Gorle S, Cuspoca AF, Kaushik V, Rajjak Shaikh A, Cavallo L, Chawla M. T cell epitope based vaccine design while targeting outer capsid proteins of rotavirus strains infecting neonates: an immunoinformatics approach. J Biomol Struct Dyn 2024; 42:4937-4955. [PMID: 37382214 DOI: 10.1080/07391102.2023.2226721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/05/2023] [Indexed: 06/30/2023]
Abstract
Gastrointestinal diarrhea is majorly caused by the rotavirus (RV) in the children who generally are under the age group of 5 years. WHO estimates that ∼95% of the children contract RV infection, by this age. The disease is highly contagious; notably in many cases, it is proven fatal with high mortality rates especially in the developing countries. In India alone, an estimated 145,000 yearly deaths occurs due to RV related gastrointestinal diarrhea. WHO pre-qualified vaccines that are available for RV are all live attenuated vaccines with modest efficacy range between 40 and 60%. Further, the risk of intussusceptions has been reported in some children on RV vaccination. Thus, in a quest to develop alternative candidate to overcome challenges associated with these oral vaccines, we chose immunoinformatics approach to design a multi-epitope vaccine (MEV) while targeting the outer capsid viral proteinsVP4 and VP7 of the neonatal strains of rotavirus. Interestingly, ten epitopes, that is, six CD8+T-cells and four CD4+T-cell epitopes were identified which were predicted to be antigenic, non-allergic, non-toxic and stable. These epitopes were then linked to adjuvants, linkers, and PADRE sequences to create a multi-epitope vaccine for RV. The in silico designed RV-MEV and human TLR5 complex displayed stable interactions during molecular dynamics simulations. Further, the immune simulation studies of RV-MEV corroborated that the vaccine candidate emerges as a promising immunogen. Future investigations while performing in vitro and in vivo analyses with designed RV-MEV construct are highly desirable to warrant the potential of this vaccine candidate in protective immunity against different strains of RVs infecting neonates.Communicated by Ramaswamy H. Sarma.
Collapse
Affiliation(s)
- Arijit Das Sharma
- School of Bio-Engineering and Bio-Sciences, Lovely Professional University, Punjab, India
| | - Ravneet Kaur Grewal
- Department of Research and Innovation, STEMskills Research and Education Lab Private Limited, Faridabad, Haryana, India
| | - Suresh Gorle
- Department of Research and Innovation, STEMskills Research and Education Lab Private Limited, Faridabad, Haryana, India
| | - Andrés Felipe Cuspoca
- Grupo de Investigación Epidemiología Clínica de Colombia (GRECO), Universidad Pedagógica y Tecnológica de Colombia, Tunja, Colombia
- Centro de Atención e Investigación Médica - CAIMED, Chía, Colombia
| | - Vikas Kaushik
- School of Bio-Engineering and Bio-Sciences, Lovely Professional University, Punjab, India
| | - Abdul Rajjak Shaikh
- Department of Research and Innovation, STEMskills Research and Education Lab Private Limited, Faridabad, Haryana, India
| | - Luigi Cavallo
- Physical Sciences and Engineering Division, Kaust Catalysis Center, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Mohit Chawla
- Physical Sciences and Engineering Division, Kaust Catalysis Center, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| |
Collapse
|
3
|
Kapse G, Agnihotri S, Sekhsaria P, Sastry M. Analysing the interlinkage between diarrhoea and drinking water faecal contamination in India. JOURNAL OF WATER AND HEALTH 2024; 22:1111-1124. [PMID: 38935461 DOI: 10.2166/wh.2024.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/08/2024] [Indexed: 06/29/2024]
Abstract
Diarrhoea is one of the major waterborne diseases spread through the faecal-oral route causing over 10 million cases and over 1,000 deaths per year in India. This study critically evaluates the interlinkage between bacteriological water quality, i.e. faecal coliforms and diarrhoea cases for the three pre-pandemic years 2017, 2018 and 2019 based on multiple sources. With around 17% of households tap water connectivity as of August 2019, the majority of the Indian population depends on raw groundwater (GW) and surface water sources. For this, faecal coliform (FC) levels in surface and GW have been mapped at district levels using data from India's National Water Quality Monitoring Programme. Health Management Information System's data on diarrhoea have been used to understand the monthly and district-wise variation of diarrhoea. The trends of FC, diarrhoea inpatient cases, and diarrhoea inpatient rates have been discussed. The analysis showed issues associated with the reliability and usefulness of these datasets with 43% of total India districts with no reported FC values for the study period. This study reveals a clear gap in the interlinkage between diarrhoea and bacteriological water quality with the unavailability of granular water quality data as a major challenge.
Collapse
Affiliation(s)
- Gaurav Kapse
- IITB-Monash Research Academy, Powai, Mumbai 400076, MH, India; Centre for Technology Alternatives for Rural Areas (CTARA), Indian Institute of Technology Bombay, Mumbai, MH, India; Department of Materials Science and Engineering, Monash University, Clayton, VIC, Australia
| | - Satish Agnihotri
- Centre for Technology Alternatives for Rural Areas (CTARA), Indian Institute of Technology Bombay, Mumbai, MH, India
| | - Pankaj Sekhsaria
- Centre for Technology Alternatives for Rural Areas (CTARA), Indian Institute of Technology Bombay, Mumbai, MH, India
| | - Murali Sastry
- Department of Materials Science and Engineering, Monash University, Clayton, VIC, Australia; Department of Chemical and Biological Engineering, Monash University, Clayton, VIC, Australia E-mail:
| |
Collapse
|
4
|
Sharma A, Wibawa BSS, Andhikaputra G, Solanki B, Sapkota A, Chiang Hsieh LH, Iyer V, Wang YC. Spatial analysis of food and water-borne diseases in Ahmedabad, India: Implications for urban public health planning. Acta Trop 2024; 253:107170. [PMID: 38467234 DOI: 10.1016/j.actatropica.2024.107170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/05/2024] [Accepted: 03/03/2024] [Indexed: 03/13/2024]
Abstract
Spatial analysis of infectious diseases can play an important role in mapping the spread of diseases and can support policy making at local level. Moreover, identification of disease clusters based on local geography and landscape forms the basis for disease control and prevention. Therefore, this study aimed to examine the spatial-temporal variations, hotspot areas, and potential risk factors of infectious diseases (including Viral Hepatitis, Typhoid and Diarrhea) in Ahmedabad city of India. We used Moran's I and Local Indicators of Spatial Association (LISA) mapping to detect spatial clustering of diseases. Spatial and temporal regression analysis was used to identify the association between disease incidence and spatial risk factors. The Moran's I statistics identified presence of positive spatial autocorrelation within the considered diseases, with Moran's I from 0.09 for typhoid to 0.21 for diarrhea (p < 0.001). This indicates a clustering of affected wards for each disease, suggesting that cases were not randomly distributed across the city. LISA mapping demonstrated the clustering of hotspots in central regions of the city, especially towards the east of the river Sabarmati, highlighting key geographical areas with elevated disease risk. The spatial clusters of infectious diseases were consistently associated with slum population density and illiteracy. Furthermore, temporal analysis suggested illiteracy rates could increase risk of viral hepatitis by 13 % (95 % Confidence Interval (CI): 1.01-1.26) and of diarrhea by 18 % (95 % CI: 1.07-1.31). Significant inverse association was also seen between viral hepatitis incidence and the distance of wards from rivers. Conclusively, the study highlight the impact of socio-economic gradients, such as slum population density (indicative of poverty) and illiteracy, on the localized transmission of water and foodborne infections. The evident social stratification between impoverished and affluent households emerges as a notable contributing factor and a potential source of differences in the dynamics of infectious diseases in Ahmedabad.
Collapse
Affiliation(s)
- Ayushi Sharma
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan; Department of Civil Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Bima Sakti Satria Wibawa
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Gerry Andhikaputra
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Bhavin Solanki
- Medical Officer of Health, Ahmedabad Municipal Corporation, Ahmedabad, Gujarat, India
| | - Amir Sapkota
- Department of Epidemiology and Biostatistics, University of Maryland, School of Public Health, College Park, MD 20742, United States
| | - Lin-Han Chiang Hsieh
- Institute of Environmental Engineering and Management, National Taipei University of Technology, Taiwan.
| | - Veena Iyer
- Indian Institute of Public Health Gandhinagar (IIPHG), Public Health Foundation of India (PHFI), Near Lekwada Bus Stop, Near Lekwada Bus Stop, Opp. New Air Force Station HQ, Palaj. Gandhinagar, 382042, Gujarat, India.
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan; Research Center for Environmental Changes, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei 11529, Taiwan.
| |
Collapse
|
5
|
Gorain C, Gupta S, Alam SSM, Hoque M, Karlyshev AV, Mallick AI. Identification and functional characterization of putative ligand binding domain(s) of JlpA protein of Campylobacter jejuni. Int J Biol Macromol 2024; 264:130388. [PMID: 38417756 DOI: 10.1016/j.ijbiomac.2024.130388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/01/2024]
Abstract
Among the major Surface Exposed Colonization Proteins (SECPs) of Campylobacter jejuni (C. jejuni), Jejuni lipoprotein A (JlpA) plays a crucial role in host cell adhesion specifically by binding to the N-terminal domain of the human heat shock protein 90α (Hsp90α-NTD). Although the JlpA binding to Hsp90α activates NF-κB and p38 MAP kinase pathways, the underlying mechanism of JlpA association with the cellular receptor remains unclear. To this end, we predicted two potential receptor binding sites within the C-terminal domain of JlpA: one spanning from amino acid residues Q332-A354 and the other from S258-T295; however, the latter exhibited weaker binding. To assess the functional attributes of these predicted sequences, we generated two JlpA mutants (JlpAΔ1: S258-T295; JlpAΔ2: Q332-A354) and assessed the Hsp90α-binding affinity-kinetics by in vitro and ex vivo experiments. Our findings confirmed that the residues Q332-A354 are of greater importance in host cell adhesion with a measurable impact on cellular responses. Further, thermal denaturation by circular dichroism (CD) confirmed that the reduced binding affinity of the JlpAΔ2 to Hsp90α is not associated with protein folding or stability. Together, this study provides a possible framework for determining the molecular function of designing rational inhibitors efficiently targeting JlpA.
Collapse
Affiliation(s)
- Chandan Gorain
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, Nadia, West Bengal, 741246, India
| | - Subhadeep Gupta
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, Nadia, West Bengal, 741246, India
| | - S S Mahafujul Alam
- Department of Biological Sciences, Aliah University, New Town Kolkata, West Bengal, 700160, India
| | - Mehboob Hoque
- Department of Biological Sciences, Aliah University, New Town Kolkata, West Bengal, 700160, India
| | - Andrey V Karlyshev
- Department of Biomolecular Sciences, School of Life Sciences, Pharmacy and Chemistry Faculty of Health, Science, Social Care & Education, Kingston University London, Penrhyn Road, Kingston upon Thames, KT12EE, UK
| | - Amirul Islam Mallick
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, Nadia, West Bengal, 741246, India.
| |
Collapse
|
6
|
Roy A, Rahaman M, Chouhan P. Decomposing rural-urban gap in unsafe disposal practice of child stool in India using nationwide sample survey data. Sci Rep 2024; 14:6632. [PMID: 38503836 PMCID: PMC10950857 DOI: 10.1038/s41598-024-56715-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/09/2024] [Indexed: 03/21/2024] Open
Abstract
A significant rural-urban disparity in unsafe child stool disposal practices exists in India, yet existing research falls short in identifying the contributing factors to this gap. This study addresses the research gap by contextualizing the rural-urban divide in unsafe child stool disposal using data from the fifth round of the National Family Health Survey (NFHS-5, 2019-21). In particular, the study examines the prevalence and predictors of unsafe disposal practices, exploring associated contributing factors to this gap. The study involves a sample of 78,074 women aged 15-49 with a living child under 2 years, without any missing data related to the study interest. Employing descriptive statistics, the Pearson chi-square test, multilevel logistic regression, and the Fairlie decomposition model, the research aims to fulfill its objectives. The rural-urban gap in unsafe child stool disposal practices among the study participants was 22.3 percentage points (pp), with a more pronounced gap among the Scheduled Tribes (ST). Notably, the gap was particularly wide in Madhya Pradesh (33.9 pp), Telangana (27.5 pp), Gujarat (26.1 pp), and Rajasthan (25.8 pp). Predictors such as mother's education, mass media exposure, household wealth quintile, and sanitation facilities proved significant irrespective of residence. However, religion, social group, and water facility on household premises emerged as significant factors in rural areas only. The study identified that 67% of the explained gap in unsafe child stool disposal practices was attributed to the rural-urban difference in household wealth. Other noteworthy contributors were 'household sanitation facility' (21.3%), 'mother's education level' (3.9%), and 'water facility on household premises' (3.9%). These findings underscore the need for population and area-specific policy interventions, especially for individuals from socio-economically disadvantaged backgrounds, those with lower education levels, and limited exposure to mass media, particularly in states with a high prevalence of unsafe disposal practices. Such interventions are crucial to mitigating the existing rural-urban gap in unsafe child stool disposal practices.
Collapse
Affiliation(s)
- Avijit Roy
- Department of Geography, State Aided College Teacher, Malda College, Malda, West Bengal, 732101, India
| | - Margubur Rahaman
- Doctoral Fellow, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, 400088, India.
| | - Pradip Chouhan
- Department of Geography, University of Gour Banga, Malda, West Bengal, 732103, India
| |
Collapse
|
7
|
Dang HT, Tran DM, Phung TTB, Bui ATP, Vu YH, Luong MT, Nguyen HM, Trinh HT, Nguyen TT, Nguyen AH, Van Nguyen AT. Promising clinical and immunological efficacy of Bacillus clausii spore probiotics for supportive treatment of persistent diarrhea in children. Sci Rep 2024; 14:6422. [PMID: 38494525 PMCID: PMC10944834 DOI: 10.1038/s41598-024-56627-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 03/08/2024] [Indexed: 03/19/2024] Open
Abstract
Persistent diarrhea is a severe gastroenteric disease with relatively high risk of pediatric mortality in developing countries. We conducted a randomized, double-blind, controlled clinical trial to evaluate the efficacy of liquid-form Bacillus clausii spore probiotics (LiveSpo CLAUSY; 2 billion CFU/5 mL ampoule) at high dosages of 4-6 ampoules a day in supporting treatment of children with persistent diarrhea. Our findings showed that B. clausii spores significantly improved treatment outcomes, resulting in a 2-day shorter recovery period (p < 0.05) and a 1.5-1.6 folds greater efficacy in reducing diarrhea symptoms, such as high frequency of bowel movement of ≥ 3 stools a day, presence of fecal mucus, and diapered infant stool scale types 4-5B. LiveSpo CLAUSY supportive treatment achieved 3 days (p < 0.0001) faster recovery from diarrhea disease, with 1.6-fold improved treatment efficacy. At day 5 of treatment, a significant decrease in blood levels of pro-inflammatory cytokines TNF-α, IL-17, and IL-23 by 3.24% (p = 0.0409), 29.76% (p = 0.0001), and 10.87% (p = 0.0036), respectively, was observed in the Clausy group. Simultaneously, there was a significant 37.97% decrease (p = 0.0326) in the excreted IgA in stool at day 5 in the Clausy group. Overall, the clinical study demonstrates the efficacy of B. clausii spores (LiveSpo CLAUSY) as an effective symptomatic treatment and immunomodulatory agent for persistent diarrhea in children.Trial registration: NCT05812820.
Collapse
Affiliation(s)
- Ha Thuy Dang
- Department of Gastroenterology, Vietnam National Children's Hospital, No. 18/879 La Thanh, Dong Da, Hanoi, Vietnam
| | - Dien Minh Tran
- Department of Surgical Intensive Care Unit, Vietnam National Children's Hospital, No. 18/879 La Thanh, Dong Da, Hanoi, Vietnam
| | - Thuy Thi Bich Phung
- Department of Molecular Biology for Infectious Diseases, Vietnam National Children's Hospital, No. 18/879 La Thanh, Dong Da, Hanoi, Vietnam
| | - Anh Thi Phuong Bui
- Spobiotic Research Center, ANABIO R&D Ltd. Company, No. 22, Lot 7,8 Van Khe Urban, La Khe, Ha Dong, Hanoi, Vietnam
| | - Yen Hai Vu
- Department of Gastroenterology, Vietnam National Children's Hospital, No. 18/879 La Thanh, Dong Da, Hanoi, Vietnam
| | - Minh Thi Luong
- Department of Gastroenterology, Vietnam National Children's Hospital, No. 18/879 La Thanh, Dong Da, Hanoi, Vietnam
| | - Hang Minh Nguyen
- Department of Molecular Biology for Infectious Diseases, Vietnam National Children's Hospital, No. 18/879 La Thanh, Dong Da, Hanoi, Vietnam
| | - Huong Thi Trinh
- Department of Molecular Biology for Infectious Diseases, Vietnam National Children's Hospital, No. 18/879 La Thanh, Dong Da, Hanoi, Vietnam
| | - Tham Thi Nguyen
- Spobiotic Research Center, ANABIO R&D Ltd. Company, No. 22, Lot 7,8 Van Khe Urban, La Khe, Ha Dong, Hanoi, Vietnam
| | - Anh Hoa Nguyen
- Spobiotic Research Center, ANABIO R&D Ltd. Company, No. 22, Lot 7,8 Van Khe Urban, La Khe, Ha Dong, Hanoi, Vietnam.
- LiveSpo Pharma Ltd. Company, N03T5, Ngoai Giao Doan Urban, Bac Tu Liem, Hanoi, Vietnam.
| | - Anh Thi Van Nguyen
- Spobiotic Research Center, ANABIO R&D Ltd. Company, No. 22, Lot 7,8 Van Khe Urban, La Khe, Ha Dong, Hanoi, Vietnam.
| |
Collapse
|
8
|
Sabde Y, Mandal UK, Yadav V, Trushna T, Tiwari RR. Effect of the Built Environment on the Cumulative Incidence of Acute Diarrheal Diseases: A Community-Based Cohort Study From Underprivileged Areas of Bhopal, India. Cureus 2024; 16:e55942. [PMID: 38601398 PMCID: PMC11005308 DOI: 10.7759/cureus.55942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Background Diarrhea is a major public health problem in under-five children worldwide. Various sociodemographic, environmental, and behavioral factors play a role in the occurrence of diarrheal disease in children under the age of five. This study aims to estimate the cumulative incidence of acute diarrheal diseases during a one-year study period and examine its association with the built environment factors among children under the age of five in selected underprivileged areas of Bhopal. Methodology We conducted this study in Bhopal, a city in central India. We surveyed the underprivileged dwellers of Vajpayee Nagar, Sanjay Nagar, and Mother India Colony of Bhopal city. This is a prospective cohort study with a one-year follow-up period to examine the cumulative incidence of acute diarrheal diseases among under-five-year-old children in the study area. Data were analyzed using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results Data were collected from February 2021 to February 2022. A total of 658 families of eligible children were contacted to participate in the study. After excluding 38 participants for various reasons (denied consent: 3; lost to follow-up: 32; moved out of the study area: 3), data were finally analyzed for 620 participants. In the study among the under-five-year-old children, the cumulative incidence of acute diarrheal diseases was 23.8% (148 out of 620). In our study, lower age (adjusted odds ratio (OR) = 0.86, 95% confidence interval (CI) = 0.75-0.99, p = 0.041) and non-availability of flush latrine in the house (adjusted OR = 4.95, 95% CI = 1.80-13.59, p = 0.002) were statistically associated with a higher incidence of acute diarrheal disease among the study population. Conclusions In our investigation, we observed a cumulative incidence of diarrhea at 23.8% (148 out of 620) among the underprivileged under-five population residing in Bhopal, India. This incidence exhibited significant associations with younger age and the absence of in-house flush latrines.
Collapse
Affiliation(s)
- Yogesh Sabde
- Environmental Health and Epidemiology, Indian Council of Medical Research-National Institute for Research in Environmental Health, Bhopal, IND
| | - Uday K Mandal
- Environmental Health and Epidemiology, Indian Council of Medical Research-National Institute for Research in Environmental Health, Bhopal, IND
| | - Vikas Yadav
- Environmental Health and Epidemiology, Indian Council of Medical Research-National Institute for Research in Environmental Health, Bhopal, IND
| | - Tanwi Trushna
- Environmental Health and Epidemiology, Indian Council of Medical Research-National Institute for Research in Environmental Health, Bhopal, IND
| | - Rajnarayan R Tiwari
- Epidemiology and Public Health, Indian Council of Medical Research-National Institute for Research in Environmental Health, Bhopal, IND
| |
Collapse
|
9
|
Das M, Albert V, Das S, Dolma KG, Majumdar T, Baruah PJ, Hazarika SC, Apum B, Ramamurthy T. An integrated FoodNet in North East India: fostering one health approach to fortify public health. BMC Public Health 2024; 24:451. [PMID: 38347565 PMCID: PMC10863088 DOI: 10.1186/s12889-024-18007-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/06/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Food safety is a critical factor in promoting public health and nutrition, especially in developing countries like India, which experience several foodborne disease outbreaks, often with multidrug-resistant pathogens. Therefore, implementing regular surveillance of enteric pathogens in the human-animal-environment interface is necessary to reduce the disease burden in the country. OBJECTIVE To establish a network of laboratories for the identification of major food and waterborne pathogens prevailing in the northeast region of India through integrated surveillance of animal, food, human, and environment and investigate the antimicrobial susceptibility pattern of the pathogens of public health significance. METHODS The Indian Council of Medical Research (ICMR) has identified FoodNet laboratories; based on their geographical location, inclination to undertake the study, preparedness, proficiency, and adherence to quality assurance procedures, through an 8-step process to systematically expand to cover the Northeastern Region (NER) with comprehensive diagnostic capacities for foodborne pathogens and diarrhea outbreak investigations. Network initiated in the NER given the unique food habits of the ethnic population. FINDINGS This surveillance network for foodborne enteric pathogens was established in Assam, Arunachal Pradesh, Tripura, and Sikkim, and expanded to other four states, i.e., Manipur, Mizoram, Meghalaya, and Nagaland, thereby covering the entire NER by including nine medical and three veterinary centers. All these centers are strengthened with periodic training, technical support, funding, capacity building, quality assurance, monitoring, centralized digital data management, and website development. RESULTS The ICMR-FoodNet will generate NER-specific data with close to real-time reporting of foodborne disease and outbreaks, and facilitate the updating of food safety management protocols, policy reforms, and public health outbreak response. During 2020-2023, 13,981 food samples were tested and the detection of enteric pathogens ranged from 3 to 4%. In clinical samples, the detection rate of the pathogens was high in the diarrheal stools (8.9%) when 3,107 samples were tested. Thirteen outbreaks were investigated during the study period. CONCLUSION Foodborne diseases and outbreaks are a neglected subject. Given the frequent outbreaks leading to the deaths of children, it is crucial to generate robust data through well-established surveillance networks so that a strong food safety policy can be developed for better public health.
Collapse
Affiliation(s)
- Madhuchhanda Das
- Indian Council of Medical Research (ICMR), Ansari Nagar, New Delhi, 110029, India.
| | - Venencia Albert
- Indian Council of Medical Research (ICMR), Ansari Nagar, New Delhi, 110029, India
| | - Samaresh Das
- Center for Development of Advanced Computing, Kolkata, India
| | | | | | | | | | - Basumoti Apum
- Bankin Pertin General Hospital & Research Institute, Arunachal Pradesh, India
| | | |
Collapse
|
10
|
Nelson S, Hare C, Mpyisi A, Yew CW, LeBrun K, Harris CR, Feese BD, Celestine R, Kinjo M, Peacock JS. A simplified methodology for the activation of organic charcoal. MethodsX 2023; 11:102241. [PMID: 37383623 PMCID: PMC10293709 DOI: 10.1016/j.mex.2023.102241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/02/2023] [Indexed: 06/30/2023] Open
Abstract
One in three people globally are challenged to live on hazardous, unsanitary water, and this relates to higher risks of death and development of diseases. According to scientific research, activated charcoal can be used to clean water contaminants to help make water safer.•Carbonization: this study demonstrates an inexpensive method of producing activated charcoal that can be performed in any setting using locally available biomass materials.•Activation: thermal air oxidation between moderate temperatures of 450-550 °C. Our data indicate that this technique produces charcoal with an adsorptive capacity near to that of commercial-grade charcoal as demonstrated by spectrophotometric analysis. This simple approach to charcoal activation may benefit rural communities where sources of sanitary water are low or nonexistent.
Collapse
|
11
|
Sharma MD, Mishra P, Ali A, Kumar P, Kapil P, Grover R, Verma R, Saini A, Kulshrestha S. Microbial Waterborne Diseases in India: Status, Interventions, and Future Perspectives. Curr Microbiol 2023; 80:400. [PMID: 37930488 DOI: 10.1007/s00284-023-03462-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/30/2023] [Indexed: 11/07/2023]
Abstract
Water plays a vital role as a natural resource since life is unsustainable without it. If water is polluted or contaminated, it results in several health issues among people. Millions of people are infected with waterborne diseases globally, and India is no exception. In the present review, we have analyzed the outbreaks of waterborne diseases that occurred in several Indian states between 2014 and 2020, identified the key infections, and provided insights into the performance of sanitation improvement programs. We noted that acute diarrheal disease (ADD), typhoid, cholera, hepatitis, and shigellosis are common waterborne diseases in India. These diseases have caused about 11,728 deaths between 2014 and 2018 out of which 10,738 deaths occurred only after 2017. The outbreaks of these diseases have been rising because of a lack of adequate sanitation, poor hygiene, and the absence of proper disposal systems. Despite various efforts by the government such as awareness campaigns, guidance on diet for infected individuals, and sanitation improvement programs, the situation is still grim. Disease hotspots and risk factors must be identified, water, sanitation, and hygiene (WASH) services must be improved, and ongoing policies must be effectively implemented to improve the situation. The efforts must be customized to the local environment. In addition, the possible effects of climate change must be projected, and strategies must be accordingly optimized.
Collapse
Affiliation(s)
- Mamta D Sharma
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Puranjan Mishra
- Institute of Bioresource and Agriculture, Hong Kong Baptist University, Hong Kong, China
| | - Aaliya Ali
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Pradeep Kumar
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Prachi Kapil
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Rahul Grover
- Shoolini Institute of Life Sciences and Business Management, The Mall, Solan, Himachal Pradesh, India
| | - Rekha Verma
- Amity School of Law, Amity University, Noida, UP, India
| | - Anita Saini
- Shoolini Institute of Life Sciences and Business Management, The Mall, Solan, Himachal Pradesh, India
| | - Saurabh Kulshrestha
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India.
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India.
| |
Collapse
|
12
|
Gaikwad U, Bhargava A, Jindal A, Padhy GK, Das P, Jagzape T, Lalwani A, Dash D. Faecal calprotectin as an inflammatory biomarker to distinguish between bacterial and viral causes of childhood diarrhoea in Indian settings. Indian J Med Microbiol 2023; 46:100459. [PMID: 37945132 DOI: 10.1016/j.ijmmb.2023.100459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/19/2023] [Accepted: 08/03/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES The purpose of this study was to determine the value of faecal calprotectin (f-CP) in distinguishing between bacterial and viral aetiologies of infective diarrhoea in children attending a tertiary care hospital in Central India. METHODS Stool samples from children aged 3 months to 10 years who had acute or persistent diarrhoea were processed for microscopy, bacterial culture, and viral antigen detection (Rotavirus and Norovirus). The remaining samples, as well as stool samples from 20 healthy controls, were tested for f-CP using the enzyme linked immunosorbent assay. RESULTS Among 48 patients, 21 (43.7%) had bacterial diarrhoea, 14 (29.2%) had viral diarrhoea, and 13 (27.1%) had an unidentified aetiology. The median f-CP values were significantly (p = 0.004) higher in children with bacterial diarrhoea (75.2 μg/g; IQR-18.75-239.15) than in children with viral diarrhoea (75.2 μg/g; IQR-123.5-1987.5). Bacterial aetiology could be reliably predicted at the optimum f-CP concentrations of >541 μg/g and >238.4 μg/g in children aged 1 and 1-4 years, with an area under the curve of 0.767 and 0.867, respectively, using receiver-operator characteristic analysis. CONCLUSIONS Faecal calprotectin could reliably distinguish between bacterial and viral aetiologies of diarrhoea in children aged up to four years, but at relatively higher age-specified cut off values.
Collapse
Affiliation(s)
- Ujjwala Gaikwad
- Department of Microbiology, All India Institute of Medical Sciences Raipur, Tatibandh, G E Road, Raipur, 492099, India.
| | - Anudita Bhargava
- Department of Microbiology, All India Institute of Medical Sciences Raipur, Tatibandh, G E Road, Raipur, 492099, India.
| | - Atul Jindal
- Department of Paediatrics, All India Institute of Medical Sciences Raipur, Tatibandh, G E Road, Raipur, 492099 , India.
| | - Gouri Kumari Padhy
- Department of Community and Family Medicine, All India Institute of Medical Sciences Raipur, Tatibandh, G E Road, Raipur, 492099, India.
| | - Padma Das
- Department of Microbiology, All India Institute of Medical Sciences Raipur, Tatibandh, G E Road, Raipur, 492099, India.
| | - Tushar Jagzape
- Department of Paediatrics, All India Institute of Medical Sciences Raipur, Tatibandh, G E Road, Raipur, 492099 , India.
| | - Akash Lalwani
- Department of Pediatrics and Neonatology Pt. Jawahar Lal Nehru Memorial Medical College, Jail Road, Raipur, 492001, India.
| | - Debabrata Dash
- Department of Microbiology, All India Institute of Medical Sciences Raipur, Tatibandh, G E Road, Raipur, 492099, India.
| |
Collapse
|
13
|
Chatterjee S, Majumder D, Roy MN. Assessing water, sanitation and hygiene (WASH) practices and their association with diarrhoea in under-five children in urban Chandernagore: Community-based evidence from a small municipal corporation in Hooghly District of West Bengal, India. JOURNAL OF WATER AND HEALTH 2023; 21:1530-1549. [PMID: 37902207 PMCID: wh_2023_262 DOI: 10.2166/wh.2023.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
The study aims to understand the relationship of childhood diarrhoea (under-five children) with water, sanitation and hygiene factors in the light of other contextual factors in an urban setting in the district of Hooghly in West Bengal, India. This primary study was carried out by SIGMA Foundation, Kolkata from 4 to 24 January 2023 across 404 households having at least one under-five child. The findings suggested that the water score was 'good' in 85.1% of the households whereas the hand hygiene score was 'good' in 14.6% of households. More than 90% of the households had piped water supply. Less than half of them treated water before consumption among which 45.3% used cloths for straining water; 59.2% of the caregivers followed safe disposal of child's faeces; 66.8% of households had no handwashing arrangement, and 30.5% had taps and wash basins for handwashing; 20.3% of the under-five children had suffered from diarrhoea in the last month before the survey and its prevalence was higher in children aged 12-23 months. Multivariate results suggested diarrhoea prevalence was lower in households that were pucca and had good water and hand hygiene scores, lower in children that had received iron fortification and whose caregivers followed safe child's stool disposal.
Collapse
Affiliation(s)
| | | | - M N Roy
- SIGMA Foundation, AI 171, Road No 29, Newtown, Kolkata 156, India
| |
Collapse
|
14
|
Alemu F, Eba K, Bonger ZT, Youya A, Gerbaba MJ, Teklu AM, Medhin G. The effect of a health extension program on improving water, sanitation, and hygiene practices in rural Ethiopia. BMC Health Serv Res 2023; 23:836. [PMID: 37550670 PMCID: PMC10408105 DOI: 10.1186/s12913-023-09833-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/19/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND To make basic primary health care services accessible, especially to the rural community, the government of Ethiopia launched the Health Extension Program (HEP) in 2004. Most of components of HEP are dedicated to hygiene and sanitation. Few studies have assessed the role of the Health Extension Program in improving water, hygiene, and sanitation (WASH) practices in Ethiopia. This study explored the role of health extension workers (HEWs) in influencing household water treatment practices, latrine ownership, latrine use and ownership, and the use of hand-washing facilities on the incidence of diarrheal diseases among the children under five years of age in rural Ethiopia. METHODS Using a cross sectional design, we conducted a national assessment that covered all nine regions of Ethiopia. We conducted face-to-face interviews among a sample of 6430 rural households using a structured questionnaire and an observation checklist to collect data from March 2018 to May 2019. Multilevel logistic regressions models were used to determine the relationships between the exposure of households to HEWs and WASH practice outcomes such as the use of water from an improved water source, household water treatment practices, availability of hand-washing and hand-washing with soap and water, availability of latrines, and use of latrines as well as the incidence of diarrheal diseases among children age 5 and younger. Our models were adjusted for covariates and confounders and P-values less than 5% were set to determine statistical significance. RESULTS We found that 72.7% of rural households had some type of latrine and 27.3% reported practicing open defecation. A total of 71.5% of rural households had access to drinking water from improved water sources, but only 9.4% reported practicing household water treatment. Exposure to HEWs was positively associated with household water treatment practices (AOR: 1.46; 95% CI = 1.01-2.10) and latrine availability (AOR: 1.44; 95% CI = 1.15-1.80). Among the households who were either visited by HEWs at their home or the that visited health posts to meet with the HEWs, being exposed to WASH health education by HEWs was significantly associated with the availability of a hand-washing facility (AOR: 5.14; 95% CI = 4.11-6.42) and latrine availability (AOR: 1.48; 95% CI = 1.10-2.01). However, we did not find a relationship between the incidence of diarrhea among children age 5 and under and exposure to HEWs (AOR: 2.09; 95% CI = 0.73- 6.62). CONCLUSION Our results show a significant association between exposure to the Health Extension Program/ HEWs and improved household water treatment practices, latrine construction, and the availability of hand-washing facilities in rural Ethiopia, suggesting the need to strengthen efforts to change WASH behavior through the Heath Extension Program. On the other hand, further investigation is needed regarding the spillover effect of latrine use practices and the reduction of the incidence of diarrheal diseases.
Collapse
Affiliation(s)
| | - Kasahun Eba
- Department of Environmental Health Sciences and Technology, Jimma University, Jimma, Ethiopia
| | | | | | | | | | - Girmay Medhin
- MERQ Consultancy PLC, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
15
|
Vellingiri K, Kumar PG, Kumar PS, Jagannathan S, Kanmani S. Status of disinfection byproducts research in India. CHEMOSPHERE 2023; 330:138694. [PMID: 37062389 DOI: 10.1016/j.chemosphere.2023.138694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 05/14/2023]
Abstract
India faces high incidents of waterborne disease outbreaks owing to their limited access to safe drinking water. In many ways, the effort to improve the quality of drinking water is performed, and it has been keenly monitored. Among those, the disinfection of drinking water is considered a necessary and important step as it controls the microbial population. Chlorination is the most practiced (greater than 80%) disinfection process in India, and it is known to generate various disinfection byproducts (DBPs). Although the toxicity and trend of DBPs are regularly monitored and investigated in most countries, still in India, the research is at the toddler level. This review summarizes i) the status of drinking water disinfection in India, ii) types of disinfection processes in centralized water treatment plants, iii) concentrations and occurrence patterns of DBPs in a different region of India, iv) a literature survey on the toxicity of DBPs, and v) removal methodologies or alternative technologies to mitigate the DBPs formation. Overall, this review may act as a roadmap to understand the trend of disinfection practices in India and their impacts on securing the goal of safe drinking water for all.
Collapse
Affiliation(s)
- Kowsalya Vellingiri
- Water Technology Centre, Water and Effluent Treatment IC, Larsen and Toubro, Kancheepuram, 631561, Tamil Nadu, India
| | - P Ganesh Kumar
- Water Technology Centre, Water and Effluent Treatment IC, Larsen and Toubro, Kancheepuram, 631561, Tamil Nadu, India; Water and Effluent Treatment IC, Larsen and Toubro, Chennai, 600089, Tamil Nadu, India
| | - P Senthil Kumar
- Department of Chemical Engineering, Sri Sivasubramaniya Nadar College of Engineering, Kalavakkam, 603110, Tamil Nadu, India; Centre of Excellence in Water Research (CEWAR), Sri Sivasubramaniya Nadar College of Engineering, Kalavakkam, 603110, Tamil Nadu, India; School of Engineering, Lebanese American University, Byblos, Lebanon.
| | - S Jagannathan
- Water and Effluent Treatment IC, Larsen and Toubro, Chennai, 600089, Tamil Nadu, India
| | - S Kanmani
- Department of Civil Engineering, Centre for Environmental Studies, Anna University 600025, Chennai, India.
| |
Collapse
|
16
|
Ghosh K, Chakraborty AS, SenGupta S. Identifying spatial clustering of diarrhoea among children under 5 years across 707 districts in India: a cross sectional study. BMC Pediatr 2023; 23:272. [PMID: 37254063 DOI: 10.1186/s12887-023-04073-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 05/16/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Diarrhoea is one of the leading reasons for under-five child mortality and morbidity across the globe and especially in low- and middle-income countries like India. The present study aims to investigate and identify the spatial clustering and the factors associated with diarrhoea across 707 districts of different states in India. METHODS This study used National Family Health Survey-4 & 5 (2015-16 & 2019-21) data in India. Spatial analysis software i.e., ArcGIS and GeoDa including Moran's statistics have been applied to detect the spatial prevalence and auto-correlation of diarrhoea among neighbourhood districts. Bivariate analysis with a chi-square test and logistic regression has been performed to identify the factors associated with the morbidity condition. RESULTS The result shows out of 2,23,785 children, 7.3 percent children suffer from diarrhoea in India. The prevalence is highest in Bihar (13.7%) and lowest in Lakshadweep (2.3%). Around 33 percent of districts have reported more than the national average level of diarrhoea prevalence. The study also found a medium to high level of autocorrelation with 0.41 Moran's Index value and detected 69 hot-spots districts mostly from Maharashtra, Bihar, Odisha, and Gujarat. The study has also found, with an increase in children's age as well as mother's age the prevalence of the disease decreases. The prevalence is more among male children than females. Underweight [OR = 1.08, 95% CI (1.03-1.13)] children have a greater risk of suffering from diarrhoeal diseases. The odds of children living in a pucca house [OR = 0.89, 95% CI (0.68-1.16)] are less likely to suffer from diarrhoea. On the other hand, rich economic status [OR = 0.91, 95% CI (0.86-0.97)], reduce the risk of such morbid conditions. CONCLUSION The study recommends targeting the hot-spot districts with high prevalence areas, and district-level interventions by improving housing type and child nutrition status, which can help to prevent diarrhoeal diseases among children in India. Thus, the identification of hotspot districts and suggested policy interventions by the current study can help to prevent childhood mortality and morbidity, as well as to achieve the target given by Sustainable development Goals 3.2.
Collapse
Affiliation(s)
- Koustav Ghosh
- Gokhale Institute of Politics and Economics, Pune, India.
- Population Research Centre Baroda, Gujarat, India.
| | | | - Shoummo SenGupta
- International Institute for Population Sciences (IIPS), Mumbai, India
| |
Collapse
|
17
|
Muindi K, Iddi S, Gitau H, Mberu B. Housing and health outcomes: evidence on child morbidities from six Sub-Saharan African countries. BMC Pediatr 2023; 23:219. [PMID: 37147616 PMCID: PMC10163804 DOI: 10.1186/s12887-023-03992-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/05/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND The connection between healthy housing status and health is well established. The quality of housing plays a significant role in infectious and non-communicable as well as vector-borne diseases. The global burden of disease attributable to housing is considerable with millions of deaths arising from diarrheal and respiratory diseases annually. In sub-Saharan Africa (SSA), the quality of housing remains poor although improvements have been documented. There is a general dearth of comparative analysis across several countries in the sub-region. We assess in this study, the association between healthy housing and child morbidity across six countries in SSA. METHODS We use the Demographic and Health Survey (DHS) data for six countries where the most recent survey collected health outcome data on child diarrhoea, acute respiratory illness, and fever. The total sample size of 91,096 is used in the analysis (representing 15, 044 for Burkina Faso, 11, 732 for Cameroon, 5, 884 for Ghana, 20, 964 for Kenya, 33, 924 for Nigeria, and 3,548 for South Africa). The key exposure variable is healthy housing status. We control for various factors associated with the three childhood health outcomes. These include quality housing status, residency (rural/urban), age of the head of the household, mother's education, mother's BMI status, marital status, mother's age, and religious status. Others include the child's gender, age, whether the child is from multiple or single births, and breastfeeding status. Inferential analysis using survey-weighted logistic regression is employed. RESULTS Our findings indicate that housing is an important determinant of the three outcomes investigated. Compared to unhealthier housing, healthy housing status was found to be associated with reduced odds of diarrhoea in Cameroon [Healthiest: aOR = 0.48, 95% CI, (0.32,0.71), healthier: aOR = 0.50, 95% CI,(0.35,0.70), Healthy: aOR = 0.60, 95% CI, (0.44,0.83), Unhealthy: aOR = 0.60, 95% CI, (0.44,0.81)], Kenya [Healthiest: aOR = 0.68, 95% CI, (0.52,0.87), Healtheir: aOR = 0.79, 95% CI, (0.63,0.98), Healthy: aOR = 0.76, 95% CI, (0.62,0.91)], South Africa[Healthy: aOR = 0.41, 95% CI, (0.18, 0.97)], and Nigeria [Healthiest: aOR = 0.48, 95% CI,(0.37,0.62), Healthier: aOR = 0.61, 95% CI,(0.50,0.74), Healthy: aOR = 0.71, 95%CI, (0.59,0.86), Unhealthy: aOR = 0.78, 95% CI, (0.67,0.91)], and reduced odds of Acute Respiratory Infection in Cameroon [Healthy: aOR = 0.72, 95% CI,(0.54,0.96)], Kenya [Healthiest: aOR = 0.66, 95% CI, (0.54,0.81), Healthier: aOR = 0.81, 95% CI, (0.69,0.95)], and Nigeria [Healthiest: aOR = 0.69, 95% CI, (0.56,0.85), Healthier: aOR = 0.72, 95% CI, (0.60,0.87), Healthy: aOR = 0.78, 95% CI, (0.66,0.92), Unhealthy: aOR = 0.80, 95% CI, (0.69,0.93)] while it was associated with increased odds in Burkina Faso [Healthiest: aOR = 2.45, 95% CI, (1.39,4.34), Healthy: aOR = 1.55, 95% CI, (1.09,2.20)] and South Africa [Healthy: aOR = 2.36 95% CI, (1.31, 4.25)]. In addition, healthy housing was significantly associated with reduced odds of fever among children in all countries except South Africa [Healthiest: aOR = 2.09, 95% CI, (1.02, 4.29)] where children living in the healthiest homes had more than double the odds of having fever. In addition, household-level factors such as the age of the household head, and place of residence were associated with the outcomes. Child-level factors such as breastfeeding status, age, and sex, and maternal-level factors such as education, age, marital status, body mass index (BMI), and religion were also associated with the outcomes. CONCLUSIONS The dissimilarity of findings across similar covariates and the multiple relations between healthy housing and under 5 morbidity patterns show unequivocally the heterogeneity that exists across African countries and the need to account for different contexts in efforts to seek an understanding of the role of healthy housing in child morbidity and general health outcomes.
Collapse
Affiliation(s)
- Kanyiva Muindi
- Population Dynamics and Urbanization, African Population and Health Research Center, Nairobi, Kenya.
| | - Samuel Iddi
- Population Dynamics and Urbanization, African Population and Health Research Center, Nairobi, Kenya.
- Department of Statistics and Actuarial Science, University of Ghana, Legon, Accra, Ghana.
| | - Hellen Gitau
- Population Dynamics and Urbanization, African Population and Health Research Center, Nairobi, Kenya
| | - Blessing Mberu
- Population Dynamics and Urbanization, African Population and Health Research Center, Nairobi, Kenya
- Demography and Population Studies, University of Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
18
|
Khaliq A, Holmes-Stahlman R, Ali D, Karatela S, Lassi ZS. Assessment of Determinants of Paediatric Diarrhoea Case Management Adherence in Pakistan. Life (Basel) 2023; 13:life13030677. [PMID: 36983833 PMCID: PMC10053143 DOI: 10.3390/life13030677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Worldwide, diarrhoea in children under five years of age is the second leading cause of death. Despite having high morbidity and mortality, diarrhoeal diseases can be averted by simple and cost-effective interventions. The Integrated Management of Childhood Illness (IMCI) has proposed the use of Oral Rehydration Salt (ORS) and zinc together with adequate food and fluid intake for the management of acute non-dysenteric watery diarrhoea in children. In the past, few studies examined the determinants of adherence to diarrhoea case management. Therefore, this study measured the determinants of therapeutic and dietary adherence to diarrhoea case management using the third and fourth wave of Pakistan Demographics and Health Surveys (PDHS) datasets. Data from 4068 children between 0 to 59.9 months with positive history of diarrhoea were included, while data on children with dysentery, severe dehydration, and co-morbid condition was excluded. This study reported therapeutic adherence in less than 10% of children in Pakistan, while dietary adherence was reported in 39.2% of children (37.7% in 2012–2013 and 40.7% in 2017–2018). A significant improvement in therapeutic (0.8% in 2012–2013 and 8.1% in 2017–2018) and dietary adherence (37.7% in 2012–2013 and 40.7% in 2017–2018) was reported in the 2017–2018 survey compared to the 2012–2013 survey. In general, children over the age of one year (compared to children <1 year) and of the richer/richest socioeconomic class (compared to poorest/poorer socioeconomic class) showed higher therapeutic and dietary adherence. Therapeutic and dietary adherence among diarrhoeal children can be improved by increasing the awareness and accessibility of ORS, zinc, and essential foods.
Collapse
Affiliation(s)
- Asif Khaliq
- School of Public Health & Social Work, Queensland University of Technology, Brisbane 4059, Australia
- Correspondence: ; Tel.: +61-0497404389
| | - River Holmes-Stahlman
- School of Biomedical Sciences, Queensland University of Technology, Brisbane 4059, Australia
| | - Danish Ali
- Department of Orthodontics, Jinnah Sindh Medical University, Karachi 75510, Pakistan
| | - Shamshad Karatela
- School of Pharmacy, University of Queensland, Brisbane 4072, Australia
- Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville 4811, Australia
| | - Zohra S. Lassi
- Robinson Research Institute, The University of Adelaide, Adelaide 5005, Australia
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide 5005, Australia
| |
Collapse
|
19
|
Kulkarni A, Manohar K, Hippargi G, Maddigapu PR, Dhodapkar R, Rayalu SS. Nanophotonics triggered thermally enhanced solar water disinfection bottles for slum dwellers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:35269-35280. [PMID: 36527551 DOI: 10.1007/s11356-022-24245-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 11/12/2022] [Indexed: 06/17/2023]
Abstract
Among several existing technologies, solar pasteurization is widely accepted as a reliable and cost-effective method for the removal of microbial pathogens from water. This work reports nanophotonics-triggered thermally enhanced solar water disinfection bottles (nano-SODIS) designed rationally by coating plasmonic carbon nanoparticles (CNP) on the outer surface for the targeted pathogen inactivation from water. The cost-effective CNP nanophotonic material used in this work has high efficiency in harvesting solar radiation and dissipating the heat locally. It has broad absorption efficiency to cover the entire solar spectrum; hence, it is capable to generate multiple scattering. It has also properties of boosting of photon absorption and focusing the light within a constrained spatial region, resulting in powerful and targeted heating that inactivates microorganisms in near proximity. These CNPs were used to coat the nano-SODIS water bottles that achieved the highest temperature of 65-70 °C within 90 min of exposure to solar radiation with a consequent six-log reduction. The disinfection period was reduced by a factor of 3 compared to the conventional solar disinfection system. The treated water was further assessed for 7 days, which confirmed the complete absence of bacteria and no sign of regeneration after storing for a longer period. The SODIS bottles coated with CNP thus overcome the problem of limited solar absorption by acquiring higher broadband absorption potential and thus achieving comparatively high disinfection efficiency. The broad band absorption of CNP was confirmed through UV-DRS absorption spectra. The nano-SODIS bottles designed and constructed in this work are simple, durable, and user friendly in nature and have been deployed in the rural and slums areas of Nagpur, Delhi, and Mumbai, India to provide pathogen-free potable water and to improve the health of local poor communities.
Collapse
Affiliation(s)
- Aditi Kulkarni
- Environmental Materials Division, CSIR-National Environmental Engineering Research Institute (NEERI), Nagpur, 440020, India
| | - Kiran Manohar
- Environmental Materials Division, CSIR-National Environmental Engineering Research Institute (NEERI), Nagpur, 440020, India
| | - Girivyankatesh Hippargi
- Environmental Materials Division, CSIR-National Environmental Engineering Research Institute (NEERI), Nagpur, 440020, India
| | - Pratap Reddy Maddigapu
- Environmental Materials Division, CSIR-National Environmental Engineering Research Institute (NEERI), Nagpur, 440020, India
- Environmental Science Department, Amity University Punjab (AUP), Mohali, India
| | - Rita Dhodapkar
- Director Research Cell, CSIR-CSIR-National Environmental Engineering Research Institute (NEERI), Nagpur, 440020, India
| | - Sadhana Suresh Rayalu
- Environmental Materials Division, CSIR-National Environmental Engineering Research Institute (NEERI), Nagpur, 440020, India.
| |
Collapse
|
20
|
Bagali S, Kakhandaki L, Karigoudar R, Wavare S, Shahapur PR, Patil MM. Comparative Analysis of Enzyme-Linked Immunosorbent Assay and Immunochromatography for Rotavirus and Adenovirus Detection in Children below Five Years with Acute Gastroenteritis. J Lab Physicians 2022; 15:110-116. [PMID: 37064981 PMCID: PMC10104705 DOI: 10.1055/s-0042-1757234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
Introduction The most frequent etiologies of viral gastroenteritis among young children are rotavirus and enteric adenovirus. The clinical signs and symptoms of viral gastroenteritis are not distinct enough to allow for diagnosis. For the diagnosis and treatment of acute gastroenteritis, it is preferable to use quick, simple, and low-cost procedures. This study was undertaken to determine efficacy of immune-chromatography test (ICT) in comparison with enzyme-linked immunosorbent assay (ELISA) to detect rotavirus and adenovirus antigen in fecal specimen among children less than 5 years of age with acute gastroenteritis.
Materials and Methods In a cross-sectional observational study, 314 fecal samples were collected from children aged less than 5 years with acute gastroenteritis attending or admitted to a tertiary care hospital during the 1 year study period. Samples were tested for rotavirus and adenovirus antigen using ICT and ELISA.
Results Among the 314 children evaluated, 112 (35.66%) had rotavirus infection, nine (2.86%) had adenovirus infection, and three (0.95%) had both rotavirus and adenovirus infection. This study found that ICT is 98.20% sensitive and 100% specific for the diagnosis of rotaviral diarrhea and 100% sensitive and 99.7% specific for adenovirus diarrhea, compared to ELISA.
Conclusion Immunochromatography tests used for the detection of rotavirus and adenovirus in the fecal sample showed a high degree of sensitivity and specificity. The ICT is easy to perform and rapid, and it does not require any special equipment. Hence, the ICT could be used as an alternative method for detecting viral pathogens in clinical practice.
Collapse
Affiliation(s)
- Smitha Bagali
- Department of Microbiology, BLDE(DU)'s Shri B. M. Patil Medical College, Hospital & Research Centre, Vijayapura, Karnataka, India
| | - Laxmi Kakhandaki
- Department of Microbiology, BLDE(DU)'s Shri B. M. Patil Medical College, Hospital & Research Centre, Vijayapura, Karnataka, India
| | - Rashmi Karigoudar
- Department of Microbiology, BLDE(DU)'s Shri B. M. Patil Medical College, Hospital & Research Centre, Vijayapura, Karnataka, India
| | - Sanjay Wavare
- Department of Microbiology, BLDE(DU)'s Shri B. M. Patil Medical College, Hospital & Research Centre, Vijayapura, Karnataka, India
| | - Praveen R. Shahapur
- Department of Microbiology, BLDE(DU)'s Shri B. M. Patil Medical College, Hospital & Research Centre, Vijayapura, Karnataka, India
| | - Mallanagouda M. Patil
- Department of Pediatrics, BLDE(DU)'s Shri B. M. Patil Medical College, Hospital & Research Centre, Vijayapura, Karnataka, India
| |
Collapse
|
21
|
Takia L, Baranwal AK, Gupta PK, Angurana SK, Jayashree M. Acute Diarrhea and Severe Dehydration in Children: Does Non-anion-gap Component of Severe Metabolic Acidemia Need More Attention? Indian J Crit Care Med 2022; 26:1300-1307. [PMID: 36755633 PMCID: PMC9886013 DOI: 10.5005/jp-journals-10071-24367] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 12/02/2022] Open
Abstract
Background Despite significant loss of bicarbonate during acute diarrhea, pediatric data are scarce with acute diarrhea/severe dehydration (ADSD) and severe non-anion-gap metabolic acidemia (sNAGMA). We planned to study their clinical profile, critical care needs, and outcome. Patients Children (1 month-12 years) with ADSD and sNAGMA (pH <7.2 and/or bicarbonate <15 mEq/L, and normal/mixed anion gap) admitted in Pediatric Emergency Department from January 2016 to December 2018 were enrolled. Children with pure high-anion-gap metabolic acidemia were excluded. Methods Medical records were reviewed retrospectively. The primary outcome was time taken to resolve acidemia. Secondary outcomes were acute care area free days in 5 days (ACAFD5), and adverse outcome as composite of Pediatric Intensive Care Unit (PICU) admission and/or death. Results Out of 929 diarrhea patients admitted for intravenous therapy, 121 (13%; median age, 4 months) had ADSD and sNAGMA. Median (IQR) pH was 7.11 (7.01-7.22); 21% patients had pH <7.00. Hyperchloremia (96%) and hypernatremia (45%) were common. About 12% patients each required inotropes and ventilation, while 58% had acute kidney injury (AKI). Median (IQR) time for resolution of acidemia among survivors was 24 (12, 24) hours. Thirty-two patients had adverse outcome. Higher grades of sNAGMA were associated with shock, AKI, coma, hypernatremia, hyperkalemia, adverse outcome, and lesser ACAFD5. Shock, ventilation, renal replacement therapy (RRT), and higher grades of sNAGMA were predictors of adverse outcome, with former two being independent predictors. Conclusion Severe non-anion-gap metabolic acidemia in children with ADSD is associated with organ dysfunctions, dyselectrolytemias, and lesser ACAFD5. Resolution of acidemia took unacceptably longer time. Higher grades of sNAGMA were a predictor of adverse outcomes. Trials are suggested to assess the role of additional bicarbonate therapy. How to cite this article Takia L, Baranwal AK, Gupta PK, Angurana SK, Jayashree M. Acute Diarrhea and Severe Dehydration in Children: Does Non-anion-gap Component of Severe Metabolic Acidemia Need More Attention? Indian J Crit Care Med 2022;26(12):1300-1307.
Collapse
Affiliation(s)
- Lalit Takia
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arun Kumar Baranwal
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India,Arun Kumar Baranwal, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India, Phone: +91 7766908325, e-mail:
| | - Pramod Kumar Gupta
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Suresh Kumar Angurana
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muralidharan Jayashree
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
22
|
Lahiri KR, Singh R, Apte M, Patil M, Taksande A, Varona R, Chatterjee G, Verma M, Brette S, Perez MIII. Efficacy and safety of Bacillus clausii (O/C, N/R, SIN, T) probiotic combined with oral rehydration therapy (ORT) and zinc in acute diarrhea in children: a randomized, double-blind, placebo-controlled study in India. Trop Dis Travel Med Vaccines 2022; 8:9. [PMID: 35397572 PMCID: PMC8994895 DOI: 10.1186/s40794-022-00166-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background Childhood diarrhea remains a major disease burden, particularly in developing countries, and is a leading cause of death in children aged < 5 years, worldwide. Treatment of acute diarrhea now includes probiotics to potentially reduce the duration and severity of the illness. This phase 3, randomized, placebo-controlled, double-blind study assessed the efficacy and safety of four strains (O/C, N/R, SIN, T) of Bacillus clausii probiotic (Enterogermina®) plus oral rehydration therapy (ORT) and zinc, versus placebo plus ORT and zinc, in infants and children in India with acute moderate diarrhea. Methods Patients aged 6 months to 5 years with acute moderate diarrhea (WHO 2005 definition) of < 48 h’ duration were randomly assigned to receive one mini bottle of either polyantibiotic-resistant B. clausii (oral suspension of 2 billion spores per 5 mL bottle) or matching placebo twice daily (morning and evening) for 5 days. Exclusion criteria included known hypersensitivity to B. clausii or excipients in the study treatment, or to other probiotics. Patients were admitted to hospital from Day 1 and discharged ≥6 h after diarrhea resolution, or a maximum of 5 days. The primary endpoint was duration of acute diarrhea from randomization to recovery. Secondary endpoints included frequency of stools, diapers with stools, or dehydration status. Results In total, 457 patients were randomized; 454 were treated. Similar proportions of patients showed recovery from diarrhea over the 120 h after randomization (97.0% in the B. clausii group [n = 227]; 98.0% on placebo [n = 227]). Median time to recovery was also similar: 42.83 (95% CI: 40.90–44.90) hours for B. clausii and 42.13 (95% CI: 39.80–43.87) hours for placebo. However, no statistically significant difference was observed between groups (hazard ratio = 0.93 [95% CI: 0.77–1.13]; p = 0.6968); nor were there statistically significant differences between groups for the secondary endpoints. Treatment with B. clausii was well tolerated with incidence of adverse events (9.7%) similar to that for placebo (12.3%). Conclusions No significant difference in efficacy between B. clausii and placebo was demonstrated. Sample size may have been inadequate to allow detection of a between-group difference in efficacy, given the mild/moderate severity (only ~ 20% of patients had nausea/vomiting or abdominal pains) and short duration of disease among subjects, the relatively late start of treatment (most were already on Day 2 of their disease episode when study treatment started) and the effectiveness of the standard of care with ORT and zinc in both treatment groups. Trial registration CTRI number CTRI/2018/10/016053. Registered on 17 October 2018. EudraCT number 2016-005165-31. Registered 14 May 2020 (retrospectively registered). Supplementary Information The online version contains supplementary material available at 10.1186/s40794-022-00166-6.
Collapse
|
23
|
Giri M, Behera MR, Behera D, Mishra B, Jena D. Water, Sanitation, and Hygiene Practices and Their Association With Childhood Diarrhoea in Rural Households of Mayurbhanj District, Odisha, India. Cureus 2022; 14:e29888. [PMID: 36348870 PMCID: PMC9630485 DOI: 10.7759/cureus.29888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Diarrhoeal disease is one of the major causes of childhood morbidity and mortality in India. It affects all ages, yet very few studies have been found regarding the young and older children affected by diarrhoea and its etiology. About 2.2 million deaths are attributed to diarrhoea alone in India every year. However, a large number of diarrhoeal cases may be avoided with proper sanitation and hygiene practices. The primary aim of this study was to assess the current water, sanitation, and hygiene (WASH) practises among mothers and diarrhoea among their children (6 months to 11 years) in rural households of the Mayurbhanj district, Odisha. Further, the association between WASH practises and childhood diarrhoeal disease was assessed. METHODS A community-based cross-sectional survey was conducted among 430 mothers by using a pre-tested structured questionnaire adapted from previous studies. Data collection was done using the software Epicollect5 by the trained data collector. The data were further transformed to Statistical Package for Social Sciences (SPSS, IBM Corp., Armonk, NY) version 23 for analysis to find out potential risk factors. A multistage sampling technique was used to find subjects. RESULTS Out of 430 households, 21.6% of respondents reported that their children were suffering from diarrhoea in the last two weeks from the day of the survey. Nearly 63.8% of respondents mentioned that they used to supply water as a principal source for household purposes. This study found that children of households near waste piles are more at risk of having diarrhoea than those households living far from the waste pile [AOR: 4.996; 95% CI: (2.173, 11.487)]. In the management of household wastes, households who are throwing waste here and there are 3.276 times more at risk of having diarrhoea than households who are managing the wastes by themselves by burning them outside the home [AOR: 3.276; 95%CI: (1.463, 7.042)]. In the disposal of child faeces, it was found that the household children's faeces disposed of in the garbage or dumping site are 2.438 times more at risk of having diarrhoea than those who are flushing the faeces in the latrine [AOR: 2.438; 95%CI: (1.284, 4.631)]. Also, using footwear less often was found to be highly associated with an increase in the incidence of diarrhoea (AOR: 1.634; 95% CI (.815, 3.276). CONCLUSION Findings indicate that creating awareness about the benefits of proper management of household waste and using footwear on a regular basis is the priority to avoid childhood diarrhoea. Further, area-specific planning and programme allocation of resources is necessary to prevent childhood diarrhoea.
Collapse
Affiliation(s)
- Madhulipika Giri
- Epidemiology and Public Health, Utkal University, Bhubaneswar, IND
| | - Manas Ranjan Behera
- School of Public Health, Kalinga Institute of Industrial Technology (KIIT) University, Bhubaneswar, IND
| | - Deepanjali Behera
- School of Public Health, Kalinga Institute of Industrial Technology (KIIT) University, Bhubaneswar, IND
| | - Biswajit Mishra
- Quality Assurance, Kalinga Institute of Industrial Technology (KIIT) University, Bhubaneswar, IND
| | - Damodar Jena
- School of Rural Management, Kalinga Institute of Industrial Technology (KIIT) University, Bhubaneswar, IND
| |
Collapse
|
24
|
Kharwar A, Bazaz MR, Dandekar MP. Quantitative and qualitative characterization of commercially available oral suspension of probiotic products containing Bacillus Clausii spores. BMC Microbiol 2022; 22:217. [PMID: 36114449 PMCID: PMC9482283 DOI: 10.1186/s12866-022-02631-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 09/02/2022] [Indexed: 11/15/2022] Open
Abstract
Probiotics contain beneficial live bacteria that confer several health benefits to the host. For the past 50 years, spore-forming Bacillus species have been used in the form of probiotics. Among these, Bacillus clausii strains are used for the management of acute and antibiotic-associated diarrhoea. In the present work, we have evaluated the asserted label information on randomly chosen commercial Bacillus clausii spore suspension of probiotic products. The quality and number of viable bacteria were evaluated based on the colony count, antibiotic resistance, and hemolytic activity assays. The colony fingerprinting and 16S rRNA gene-sequencing techniques were used to confirm the presence of a univariate strain (Bacillus clausii). Our results corroborated the label count of 2 × 109 CFU/5 mL in BACIPRO®, ENTEROGERMINA®, and TUFPRO® products. However, vegetative spore count was not found to match with the given label count in BENEGUT®, PROALANA-B®, β-LOCK®, and PROCILLUS® Bacillus clausii brands. In the hemolytic activity assay, except for β-LOCK®, the other 6 products showed gamma-hemolysis activity. Bacillus clausii isolated from all 7 probiotic products demonstrated resistance to several broad-spectrum antibiotics. The 16S rRNA gene-sequencing data detected genera of Bacillus and Bacillus clausii strain in the BACIPRO®, ENTEROGERMINA®, PROALANA-B®, BENEGUT®, and TUFPRO® products; however, Ralstonia mannitolilytica and Paenibacillus dendritiformis species were identified in β-LOCK® and PROCILLUS®, respectively. As correct label information was observed only in BACIPRO®, ENTEROGERMINA®, and TUFPRO® products, it is proposed that a more stringent quality check would minimize the possibility of mismatch concerning the label information.
Collapse
|
25
|
NAG SURYADEEPTO, CHAKRABARTY SIDDHARTHAP. MODELING THE DYNAMICS OF COVID-19 TRANSMISSION IN INDIA: SOCIAL DISTANCING, REGIONAL SPREAD AND HEALTHCARE CAPACITY. J BIOL SYST 2022. [DOI: 10.1142/s0218339022500231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In the new paradigm of health-centric governance, policymakers are in constant need of appropriate metrics to determine suitable policies in a non-arbitrary fashion. To this end, in this paper, a compartmentalized model for the transmission of COVID-19 is developed, with a socially distanced compartment added to the model. The modification allows for administrators to quantify the extent to which voluntary social distancing norms are followed, and address restrictions accordingly. Modifications are also made to incorporate inter-region migration, and suitable metrics are proposed to quantify the impact of migration on the rise of cases. The healthcare capacity is modeled and a method is developed to study the consequences of the saturation of the healthcare system. The model and related measures are used to study the nature of the transmission and spread of COVID-19 in India, and appropriate insights are drawn.
Collapse
Affiliation(s)
- SURYADEEPTO NAG
- Indian Institute of Science Education and Research, Pune, Pune 411008, Maharashtra, India
| | | |
Collapse
|
26
|
D' Mello MK, Badiger S, Sudeep Kumar, Kumar N, D'Souza N, Purushothama J. Geospatial analysis and hotspots of diarrheal cases among under-five children within a rural district of Karnataka, India. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i3.1705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction and Aim: Diarrhea is a significant public health problem, resulting in nearly 16% of child deaths below the age of five, globally. This study was undertaken to find the relation between geographical variance in diarrheal prevalence and spatial dependence among under-five children of Karkala taluk of Karnataka State, India, between 2015 to 2018.
Materials and Methods: Data on registered diarrheal cases among under-five children between April 2015 and March 2018was obtained from the State Department of Health and Family Welfare. The thematic maps were prepared for the study area using data available at the village level. The GeoDa software was used to carry out spatial data analysis and spatial autocorrelation. Spatial dependence was analyzed through the Global Moran's Index and Local Indicators of Spatial Association (LISA).
Results: Three thousand eight hundred ninety-four under-five children were recorded with diarrhea in Karkala taluk with a mean annual rate of 123.6/1000 diarrheal cases. There was an increase in diarrheal incidence during the study period with peak trends being seasonal. Global and Local spatial correlation analysis detected several hot and cold spot clusters among villages in Karkala taluk.
Conclusion: Diarrheal incidence among under-five children is highly seasonal and spatially clustered. The spatial analysis helps decide preventive measures for identified clusters and determines the observed heterogeneity of diarrheal infection.
Collapse
|
27
|
Indian Academy of Pediatrics Consensus Guidelines for Probiotic Use in Childhood Diarrhea. Indian Pediatr 2022. [DOI: 10.1007/s13312-022-2557-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
28
|
Banerjee S, Dave S, Siddiqui IN. Improved Yet Unsafe: At the Light of NFHS-V. JOURNAL OF HEALTH MANAGEMENT 2022. [DOI: 10.1177/09720634221105742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Following UNICEF’s analysis of National Family Health Survey-III Data (NFHS-III), it was opined that households with access to better sanitation and better access to improved water sources have much better infant survival rates than the others. Sahu et al. (2015, The Indian journal of medical research, 141(5), 709), Arun et al. (2017, International Conference on Cognitive Computing and Information Processing (pp. 81–92), Springer) and Tripathy and Mishra (2017, Journal of Tropical Pediatrics, 63(6), 431–439) supported these findings. However, Banerjee (2020a , Journal of Health Management, 22(1), 57–66), analysing NFHS-IV data, has vehemently criticised such findings and showed using regression with robust standard errors that improved access to better water sources leads to higher infant mortality. In another article published in the same year, Banerjee (2020b , Journal of Health Management, 22(3), 466–471) explained this paradox. Now with NFHS-V data coming out, time is apt to test the robustness of Banerjee’s findings (2002a). However, owing to the incomplete NFHS-V data published so far, unlike Banerjee (2002a) that has used data of 29 states, the present analysis is based on only 17 states. The findings support that the findings of Banerjee (2002a) were robust.
Collapse
Affiliation(s)
| | - Sumita Dave
- Amity Business School, Amity University Chhattisgarh
| | | |
Collapse
|
29
|
Saha J, Mondal S, Chouhan P, Hussain M, Yang J, Bibi A. Occurrence of Diarrheal Disease among Under-Five Children and Associated Sociodemographic and Household Environmental Factors: An Investigation Based on National Family Health Survey-4 in Rural India. CHILDREN (BASEL, SWITZERLAND) 2022; 9:658. [PMID: 35626835 PMCID: PMC9139802 DOI: 10.3390/children9050658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 12/07/2022]
Abstract
Diarrheal disease is a significant public health problem leading to mortality and morbidity among children aged 0-59 months in rural India. Therefore, the rationale of this study was to identify the sociodemographic and environmental predictors associated with diarrhea among under-five children in rural India. A total of 188,521 living children (0-59 months) were studied from the National Family Health Survey-4, (NFHS-4) 2015-2016. Bivariate and binary logistic regression models were carried out from the available NFHS-4 data for selected sociodemographic and environmental predictors to identify the relationship of occurrence of diarrhea using STATA 13.1. In rural India, children aged 12-23 months, 24-35 months, 36-47 months, and 48-59 months were significantly improbable to suffer diarrheal disease. Children of the female sex, as well as children of scheduled tribes (ST) and other backward classes (OBC), were less likely to experience diarrhea. The disease was more likely to occur among children of scheduled castes (SC); Muslim or other religions; children belonging to central, eastern, and western regions; children with low birth weight; as well as children with improper stool disposal and rudimentary roof materials. In the rural parts of India, sociodemographic and household environmental factors were most influential. Effective community education; improved handwashing practices; pure water supply; and proper waste disposal, including building and utilizing latrines, would help reduce the burden of diarrheal disease in children.
Collapse
Affiliation(s)
- Jay Saha
- Department of Geography, University of Gour Banga (UGB), Malda 732103, WB, India; (S.M.); (P.C.)
| | - Sabbir Mondal
- Department of Geography, University of Gour Banga (UGB), Malda 732103, WB, India; (S.M.); (P.C.)
| | - Pradip Chouhan
- Department of Geography, University of Gour Banga (UGB), Malda 732103, WB, India; (S.M.); (P.C.)
| | - Mulazim Hussain
- The Children Hospital, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad 44000, Pakistan;
| | - Juan Yang
- Chinese Academy of Science and Technology for Development, Beijing 100038, China
| | - Asma Bibi
- Independent Researcher, Lahore 54000, Pakistan;
| |
Collapse
|
30
|
Sanklecha M, Verma L, Pai U, Mishra S, Maqsood S, Birla A. Lactobacillus rhamnosus GG Evaluation in Acute Diarrhea (LEAD): An Observational Study. Cureus 2022; 14:e24594. [PMID: 35506120 PMCID: PMC9053112 DOI: 10.7759/cureus.24594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 12/28/2022] Open
Abstract
Background and objective Probiotics with documented efficacy such as Lactobacillus rhamnosus GG(LGG) and Saccharomyces boulardii might be utilized as adjuncts to rehydration for the management of acute gastroenteritis (AGE) in children. In this study, we aimed to evaluate the potential role of LGG in acute diarrhea in the Indian pediatric population. Methods An observational, cross-sectional study [Lactobacillus rhamnosus GG Evaluation in Acute Diarrhea (LEAD)] was conducted among children aged one month to 12 years with acute watery diarrhea. In addition to standard management of diarrhea, LGG was given as an adjuvant treatment at the discretion of treating physicians based on their routine practice. Observations were documented on days one, three, and five. Outcomes such as frequency and duration of diarrhea, time to change in consistency of stools, Bristol Stool Chart (BSC) reading, and global assessment by healthcare practitioners (HCPs) and patients were also recorded. Results Of the 2,080 patients enrolled, 1,900 completed the five-day follow-up. There was marked improvement observed in the number of incidences of loose stools from day one (mean: 7.33) to day five (mean: 1.6). The mean time to improvement in stool consistency was 34 hours. The mean duration of diarrhea was 44.63 hours. A relatively shorter duration of diarrhea was reported among participants in this study. There was also a significant improvement in the number of vomiting episodes. Most patients and HCPs reported the product to be excellent/very good on the global assessment scale. No adverse effects were noted in any of the groups. Conclusion Based on our findings, LGG supplementation may be a beneficial adjuvant treatment in reducing the severity and duration of acute diarrheal episodes.
Collapse
Affiliation(s)
- Mukesh Sanklecha
- Department of Pediatrics, Bombay Hospital Institute of Medical Sciences, Mumbai, IND
| | - Lalit Verma
- Department of Pediatrics, SRCC Narayana Children's Hospital, Mumbai, IND
| | - Uday Pai
- Pediatrics, Sai Kutir Clinic, Mumbai, IND
| | - Suman Mishra
- Department of Pediatrics, Asian City Hospital and Sparsh Child Care, Patna, IND
| | - Sameer Maqsood
- Department of Pediatrics, Max Super Speciality Hospital, Delhi, IND
| | - Amita Birla
- Clinical Research, ACT Life Sciences Pvt Ltd., Navi Mumbai, IND
| |
Collapse
|
31
|
Tadesse A, Walelign Fentaye F, Mekonen AM, Yasine T. The impact of Ethiopian community-based health extension program on diarrheal diseases among under-five children and factors associated with diarrheal diseases in the rural community of Kalu district, Northeast Ethiopia: a cross-sectional study. BMC Health Serv Res 2022; 22:168. [PMID: 35139841 PMCID: PMC8830013 DOI: 10.1186/s12913-022-07565-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background The health extension program is a community-based health care delivery program with eighteen defined packages. The main aim of the health extension program is to help to reduce child mortality. So, the aim of this study is to assess the impact of a health extension program on diarrheal disease under-five children in the rural community of Kalu district, Northeast Ethiopia, 2021. Methods A community-based cross-sectional study design was conducted from March to April/2021. A Multi-stage sampling technique was used to get a total sample size of 556 (182 model households and 374 non-model households) with a response rate of 92.22%. Binary logistic regression analysis was done, and P-value < 0.05 was considered statistically significant. Propensity score matching analysis was used to determine the contribution of health extension program “model households” on diarrhea diseases among under-five children. The average treatment effect on the treated was calculated to compare the means of outcomes across model and non-model households. Results Health extension program (HEP) model household contributed a 17.7% (t = -5.02) decrease in children’s diarrheal diseases among under-five children compared with HEP non-model households. Mothers from non-model households were 2.19 times more likely to develop under-five children diarrheal diseases AOR (Adjusted Odds Ratio): 2.19, 95% CI: 1.34–3.57 than mothers from model households. Households who got no frequent home visits were 3.28 times more likely to develop under-five diarrheal diseases AOR (Adjusted Odds Ratio): 3.28, 95% CI: 1.40–7.68. Conclusion When the health extension program is implemented fully (model household), the prevalence of under-five diarrheal disease in the rural community could decrease. The need to develop supportive strategies for the sustainability of model households and encouraging households to be model households is very important. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07565-7.
Collapse
Affiliation(s)
- Ahmed Tadesse
- Department of Health Systems Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Amhara, Ethiopia
| | - Fasil Walelign Fentaye
- Department of Health Systems Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Amhara, Ethiopia
| | - Asnakew Molla Mekonen
- Department of Health Systems Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Amhara, Ethiopia.
| | - Toyeb Yasine
- Department of Health Systems Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Amhara, Ethiopia
| |
Collapse
|
32
|
Lakshmi Ss J, Prabaa Ms D, Murugan D, Anandan S, Veeraraghavan B. Real-time multiplex PCR assay reveals the increased prevalence of Campylobacter spp and diarrhoeagenic Escherichia coli in humans from Vellore, South India. J Med Microbiol 2022; 71. [PMID: 35037615 DOI: 10.1099/jmm.0.001478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Bacterial dysentery is one of the greatest causes of morbidity and mortality worldwide. Campylobacter spp. and diarrhoeagenic Escherichia coli (DEC) are recognised as the most common causes of bacterial enteritis in developing countries including India.Hypothesis/Gap statement. Rapid and accurate identification of dysentery causing organisms using molecular methods is essential for better disease management, epidemiology and outbreak investigations.Aim. In view of the limited information available on the dysentery causing agents like Campylobacter spp., enterohemorrhagic E. coli (EHEC)/enteropathogenic E. coli (EPEC) and enteroinvasive E. coli (EIEC)/Shigella in India, this study was undertaken to investigate the presence of these pathogens in human and poultry stool samples by molecular methods.Methodology. In total, 400 human stool samples and 128 poultry samples were studied. Microaerophilic culture along with real-time multiplex PCR with the targets specific to the genus Campylobacter, Campylobacter jejuni, Campylobacter coli, EHEC, EPEC and EIEC/Shigella was performed. Further species confirmation was done using MALDI-TOF MS.Results. On microaerophilic culture, C. coli was isolated in one human sample and two C. jejuni and one C. fetus in poultry samples. On PCR analysis, among human stool samples, typical EPEC (42%) was predominantly seen followed by Campylobacter spp. (19%) and EIEC/Shigella (10%). In contrast, Campylobacter spp. (41%) was predominant in poultry samples, followed by typical EPEC (26%) and EIEC/Shigella (9%). Poly-infections with Campylobacter spp. and DEC were also observed among both sources.Conclusion. The present study documented the increased prevalence of Campylobacter spp. in humans compared with the results of previous studies from India. Typical EPEC was found to be predominant in children less than 5 years of age in this study. The high prevalence of coinfections in the current study indicates that a multiple aetiology of diarrhoea is common in our settings.
Collapse
Affiliation(s)
- Jaya Lakshmi Ss
- Department of Clinical Microbiology, Christian Medical College, Vellore-632004, India
| | - Dhiviya Prabaa Ms
- Department of Clinical Microbiology, Christian Medical College, Vellore-632004, India
| | | | - Shalini Anandan
- Department of Clinical Microbiology, Christian Medical College, Vellore-632004, India
| | | |
Collapse
|
33
|
Behera DK, Mishra S. The burden of diarrhea, etiologies, and risk factors in India from 1990 to 2019: evidence from the global burden of disease study. BMC Public Health 2022; 22:92. [PMID: 35027031 PMCID: PMC8759196 DOI: 10.1186/s12889-022-12515-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 01/05/2022] [Indexed: 01/16/2023] Open
Abstract
Background This study aims to measure the burden of diarrhea in India and analyze the trend of mortality associated with it for the past 30 years. We also intend to find the prevailing etiology and risk factors associated with diarrheal mortality in India. Methods The study has used the latest round of Global Burden of Disease (GBD) study-2019. GBD data is available across age groups and gender-wise over the period from 1990 to 2019. The study has identified 13 etiologies for the cause of diarrhea deaths and 20 risk factors to analyze the burden of disease. Results Our study shows, childhood diarrhea has declined over the years significantly, yet contributes to a larger share of DALYs associated with the disease. Among all the death cases of Diarrhea, in 2019, the most prevalent disease-causing pathogen is found to be Campylobacter. But Adenovirus is the major contributor to childhood diarrheal deaths. Though the burden of diarrhea is declining over the period, still there is a need to progress the interventions to prevent and control diarrhea rapidly to avoid the huge number of deaths and disabilities experienced in India. Conclusions Consumption of safe and clean water, proper sanitation facility in every household, required nutrition intake by mother and child, safe breastfeeding and stool disposal practices and careful case management, rotavirus vaccination are some of the effective interventions to be implemented all over the country. Further, evidence-based policies should be made and implemented to sustain diarrhea prevention programs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12515-3.
Collapse
Affiliation(s)
- Deepak Kumar Behera
- Faculty of Health Economics, Department of Commerce, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576 104, India.
| | | |
Collapse
|
34
|
Banerjee S, SubirBiswas, Roy S, Pal M, Hossain MG, Bharati P. Nutritional and immunization status of under-five children of India and Bangladesh. BMC Nutr 2021; 7:77. [PMID: 34852848 PMCID: PMC8638544 DOI: 10.1186/s40795-021-00484-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/18/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The nutritional and immunization status of children can play an important role in determining their future health status of a particular country. The aim of the present study is to investigate the nutritional and immunization status of under-five children in India and Bangladesh, and to find the difference in the status between these two countries. METHODS We have used the National Family Health Survey data, 2015-2016 of India and Bangladesh Demographic Health Survey, 2017-2018 datasets. The sample sizes are 222,418, among them 8759 and 8759 children for India and Bangladesh respectively. The nutritional status of under-five children is measured by standard anthropometric indicators of height-for-age (HAZ) and weight-for-age (WAZ). Regarding child immunization status, only BCG, DPT, polio and measles vaccinations are considered for the present study. Multiple binary logistic model has been used for analysing the data. RESULTS This study reveals that the prevalence of stunting and underweight of under-five children in India are higher than Bangladeshi children. Secondary and higher educated mothers are more likely of having normal HAZ and WAZ children than up to primary educated mothers for both countries. Chances of having normal HAZ and WAZ are higher among non-poor category for both countries. The present study also shows that immunization status of Bangladeshi children is better than Indian children except measles. Religion of mother also shows influence on immunization status of children in India whereas Bangladesh shows no significant results regarding religion. Mother's educational attainment and wealth index show influence on immunization status among children for both countries. CONCLUSIONS The study concludes that a remarkable number of under-five children are suffering from under nutrition for both countries, however Bangladeshi children have better nutritional and immunization status compared to Indian children. Higher wealth index, better educational attainment and lower unemployment of Bangladeshi mothers may be the causes for better nutritional and immunization status of children. Mother's socio-economic factors have significant impact on determining the child's health status. Our findings can help to government of Indian and Bangladesh for taking health policy to improve under-five children nutritional and immunization status.
Collapse
Affiliation(s)
- Sreeparna Banerjee
- Department of Anthropology, West Bengal State University, Berunanpukuria, PO-Malikapur, Barasat, West Bengal 700126 India
| | - SubirBiswas
- Department of Anthropology, West Bengal State University, Berunanpukuria, PO-Malikapur, Barasat, West Bengal 700126 India
| | - Shimul Roy
- Department of Anthropology, Vidyasagar University, Midnapore, West Bengal 721102 India
| | - Manoranjan Pal
- Economic Research Unit, Indian Statistical Institute, 203 BT Road, Kolkata, West Bengal 700 108 India
| | - Md. Golam Hossain
- Department of Statistics, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Premananda Bharati
- Biological Anthropology, Indian Statistical Institute, 203 BT Road, Kolkata, West Bengal 700 108 India
| |
Collapse
|
35
|
Mahapatra T, Mahapatra S, Chakraborty ND, Raj A, Bakshi B, Banerjee B, Saha S, Guha A, Dutta S, Kanungo S. Intervention to improve diarrhea related knowledge and practices among informal healthcare providers in slums of Kolkata. J Infect Dis 2021; 224:S890-S900. [PMID: 34718638 PMCID: PMC8687078 DOI: 10.1093/infdis/jiab499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background In the densely populated slums of Kolkata, informal healthcare providers’ (IHP) diarrhea-related knowledge and rationality of practices should be improved to reduce risk of adverse outcome, expenditure, and antimicrobial resistance. Methods A multicomponent intervention was conducted among 140 representative IHPs in the slums of 8 wards in Kolkata to assess its impact on their diarrhea-related knowledge and practice. Six intervention modules in local languages were provided (1 per month) with baseline (N = 140) and postintervention (N = 124) evaluation. Results Mean overall (61.1 to 69.3; P < .0001) and domain-specific knowledge scores for etiology/spread (5.4 to 8.1; P < .0001), management (6.4 to 7.2; P < .0001), and oral rehydration solution ([ORS] 5.7 to 6.5; P < .0001) increased significantly (at α = 0.05) after intervention and were well retained. Impact on knowledge regarding etiology/spread (adjusted odds ratio [aOR] = 5.6; P < .0001), cholera (aOR = 2.0; P = .0041), management (aOR = 3.1; P < .0001), ORS (aOR = 2.3; P = .0008), and overall (aOR = 4.3; P < .0001) were significant. Intervention worked better for IHPs who practiced for ≥10 years (aOR = 3.2; P < .0001), untrained IHPs (aOR = 4.8; P < .0001), and pharmacists (aOR = 8.3; P < .0001). Irrational practices like empirical antibiotic use for every cholera case (aOR = 0.3; P < .0001) and investigation for every diarrhea case (aOR = 0.4; P = .0003) were reduced. Rationality of testing (aOR = 4.2; P < .0001) and antibiotic use (aOR = 1.8; P = .0487) improved. Conclusions Multicomponent educational intervention resulted in sustainable improvement in diarrhea-related knowledge and practices among IHPs in slums of Kolkata. Policy implications should be advocated along with implementation and scale-up.
Collapse
Affiliation(s)
- Tanmay Mahapatra
- ICMR- National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Sanchita Mahapatra
- ICMR- National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - Aparna Raj
- CARE India Solutions for Sustainable Development, Patna, India
| | - Bhawani Bakshi
- CARE India Solutions for Sustainable Development, Patna, India
| | - Barnali Banerjee
- ICMR- National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Snehasish Saha
- ICMR- National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Abhijit Guha
- ICMR- National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shanta Dutta
- ICMR- National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Suman Kanungo
- ICMR- National Institute of Cholera and Enteric Diseases, Kolkata, India
| |
Collapse
|
36
|
Ghosh K, Chakraborty AS, Mog M. Prevalence of diarrhoea among under five children in India and its contextual determinants: A geo-spatial analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
37
|
Barriers to the Delivery and Uptake of Water Sanitation and Hygiene (WASH) Promotion and Infant Diarrhea Prevention Services: A Case Study in Rural Tribal Banswara, Rajasthan. Indian Pediatr 2021. [DOI: 10.1007/s13312-022-2418-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
38
|
Thuthikkadu Indhuprakash S, Karthikeyan M, Gopal G, Ambi SV, Sekaran S, Palaniappan B, Diraviyam T. Antibody therapy against antibiotic-resistant diarrheagenic Escherichia coli: a systematic review. Immunotherapy 2021; 13:1305-1320. [PMID: 34463122 DOI: 10.2217/imt-2021-0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Over four billion episodes of diarrhea occur annually in developing countries with diarrheagenic Escherichia coli (DEC) outbreaks also being reported, until now bacterial diarrhea is conventionally addressed by the antibiotic treatment regimes. In recent decades, the emergence of antimicrobial-resistant strains has become a major obstacle in diarrheal treatment; hence, novel and ideal therapeutics are needed. Notably, 80% of DEC is resistant to first-class antibiotics. Among the existing strategies, passive immunization is considered as an alternative to combat drug-resistant bacteria. Antibodies specific to an antigen can be used for prophylactic and therapeutic purposes. In this review, we have systematically discussed the effect of passive immunotherapy to combat DEC and explored the types and advancements in antibodies used against antibiotic-resistant DEC.
Collapse
Affiliation(s)
- Srichandrasekar Thuthikkadu Indhuprakash
- Department of Bioengineering, Centre for Research in Infectious Diseases (CRID), School of Chemical & Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India
| | - Mukunthan Karthikeyan
- Department of Biotechnology, Centre for Research in Infectious Diseases (CRID), School of Chemical & Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India
| | - Gayathri Gopal
- Department of Bioengineering, Centre for Research in Infectious Diseases (CRID), School of Chemical & Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India
| | - Senthil Visaga Ambi
- Department of Bioengineering, Centre for Research in Infectious Diseases (CRID), School of Chemical & Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India
| | - Saravanan Sekaran
- Department of Pharmacology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai-77, Tamil Nadu, India
| | - Balamurugan Palaniappan
- Department of Biotechnology, Centre for Research in Infectious Diseases (CRID), School of Chemical & Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India
| | - Thirumalai Diraviyam
- Department of Bioengineering, Centre for Research in Infectious Diseases (CRID), School of Chemical & Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India
| |
Collapse
|
39
|
Rose L, Mary XA, Johnson I, Srinivasan G, Priya L, Bhagavathsingh J. Polyaza functionalized graphene oxide nanomaterial based sensor for Escherichia coli detection in water matrices. Sci Rep 2021; 11:16872. [PMID: 34413450 PMCID: PMC8377045 DOI: 10.1038/s41598-021-96539-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022] Open
Abstract
Water quality is widely discussed owing to its significance in public health due to the inability to access clean water. Waterborne diseases account for the presence of pathogens like Escherichia coli (E. coli) in drinking water in the environmental community. Owing to the rapid increase of such bacterial microorganisms, a cost-effective sensor setup has been developed. Herein, we demonstrate the amine-functionalized graphene oxide (fGO) based 2D nanomaterial used to graft E. coli on its surface. The comparative analysis of the deposition of nanosheets on the glass substrate and PDMS was executed. The impedance variations of GO-based nanosensor at various concentrations of E. coli were performed and their potential difference was recorded. It was observed that the impedance changes inversely with the bacterial concentrations and was fed to the Arduino microcontroller. The experimental setup was standardized for the range of 0.01 Hz to 100 kHz. The obtained analog data was programmed with a microcontroller and the bacterial concentration in colony-forming units was displayed. The real-time analysis showsthe low-level detection of E. coli in aquatic environments. Experiments were conducted using the developed nanosensor to test the efficiency in complex water matrices and whose behavior changes with various physical, chemical, and environmental factors.
Collapse
Affiliation(s)
- Lina Rose
- Department of Biomedical Engineering, Karunya Institute of Technology and Sciences, Coimbatore, Tamil Nadu, 641 114, India
| | - X Anitha Mary
- Department of Robotics Engineering, Karunya Institute of Technology and Sciences, Coimbatore, Tamil Nadu, 641 114, India
| | - I Johnson
- Department of Millets, Tamil Nadu Agricultural University, Coimbatore, Tamil Nadu, 641003, India
| | - Ganesh Srinivasan
- Department of Applied Chemistry, Karunya Institute of Technology and Sciences, Coimbatore, Tamil Nadu, 641 114, India
| | - Lakshmi Priya
- Department of Applied Chemistry, Karunya Institute of Technology and Sciences, Coimbatore, Tamil Nadu, 641 114, India
| | - Jebasingh Bhagavathsingh
- Department of Applied Chemistry, Karunya Institute of Technology and Sciences, Coimbatore, Tamil Nadu, 641 114, India.
| |
Collapse
|
40
|
McFarland LV, Srinivasan R, Setty RP, Ganapathy S, Bavdekar A, Mitra M, Raju B, Mohan N. Specific Probiotics for the Treatment of Pediatric Acute Gastroenteritis in India: A Systematic Review and Meta-Analysis. JPGN REPORTS 2021; 2:e079. [PMID: 37205949 PMCID: PMC10191489 DOI: 10.1097/pg9.0000000000000079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/08/2021] [Indexed: 05/21/2023]
Abstract
Pediatric acute gastroenteritis (PAGE) is a significant cause of morbidity, mortality and healthcare costs in many countries, but differences in PAGE vary from country-to-country; thus, we limited our analysis to 1 country. Probiotics have been recommended as an adjunct to standard treatment, but the choice of probiotic is unclear. PubMed, Google Scholar, and reviews were searched from inception to May 2020 for randomized controlled trials (RCTs) in India using probiotics for a treatment for PAGE. Meta-analyses using subgroups of identical probiotic types (≥2 RCT/type) were conducted for primary outcomes (duration of diarrhea, cured by day 3, rapidity of response, and length of hospital stay). Twenty-two RCTs were included in the systematic review (N = 4059 participants) including 5 single-strained probiotics and 3 multi-strained mixtures. For the meta-analyses, 17 RCT (20 treatment arms) were included. Saccharomyces boulardii CNCM I-745 had the strongest effect on shortening the duration of diarrhea (standardized mean difference, -1.86 d; 95% confidence interval, -2.8 to -0.9), while both Lactobacillus rhamnosus GG and a mixture of 4 Bacillus clausii strains (O/C, SIN, N/R, T) significantly reduced the duration of diarrhea (-1.7 and -1.4 d, respectively). S. boulardii and L. rhamnosus GG significantly reduced hospital stays (-1.8 and -1.1 d, respectively), while B. clausii had no effect. The frequency of stools/day was significantly reduced by day 4 for S. boulardii and by day 5 for L. rhamnosus GG. In India, 2 types of probiotics (S. boulardii CNCM I-745 and L. rhamnosus GG) significantly shortened both the duration of diarrhea and hospitalization stays in pediatric patients with PAGE. While these 2 probiotic strains were safe and effective for children in India, further research is needed to confirm if other probiotic strains or mixtures may be effective.
Collapse
Affiliation(s)
- Lynne V. McFarland
- From the Department of Medicinal Chemistry, University of Washington, Seattle, WA
| | - Ramesh Srinivasan
- Department of Gastroenterology, Apollo Hospitals, Jubilee Hills, Hyderabad, India
| | - Rajendra P. Setty
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Pure Bliss Hospital, Panchkula, India
| | | | | | - Monjori Mitra
- Department of Pediatrics, Institute of Child Health, Kolkata, India
| | - Bhaskar Raju
- Department of Gastroenterology, Dr. Mehta’s Children’s Hospital, Chennai, India
| | - Neelam Mohan
- Department of Pediatric Gastroenterology, Medanta Medicity, Gurgaon, India
| |
Collapse
|
41
|
Jeyakumar A, Godbharle SR, Giri BR. Water, sanitation and hygiene (WaSH) practices and diarrhoea prevalence among children under five years in a tribal setting in Palghar, Maharashtra, India. J Child Health Care 2021; 25:182-193. [PMID: 32249584 DOI: 10.1177/1367493520916028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Providing safe drinking water, sanitation and hygiene (WaSH) in geographically isolated settings is a global public health priority. Prevalence of WaSH practices among mothers and diarrhoea among their children (birth to 59 months) was studied in nine randomly selected tribal villages of Mokhada in Palghar, Maharashtra, India. A community-based cross-sectional survey among 577 mother-child pairs was performed. Participants were recruited from the anganwadi list of enrolled children through household visits. WaSH index was used for assessing WaSH practices. Well was the major (47%) drinking water source. Almost 70% treated and covered the stored drinking water. Nearly 75% of the mothers used soap for washing hands before food and 35% after defecation. Open drains and open defecation were observed in 99% and 50% of households, respectively. The median score for drinking water index was 3 (interquartile range (IQR) = 2), personal hygiene index (PHI) was 2 (IQR = 2), household hygiene index (HHI) was 2 (IQR = 1) and composite index (CI) was 6 (IQR = 2). Prevalence of diarrhoea among children was found to be 33.4% and was significantly associated with poor HHI (p = .007), PHI (p < .001) and CI (p < .001). Measures to provide basic WaSH resources combined with efforts to create awareness would ensure improved WaSH practices and prevent diarrhoea.
Collapse
Affiliation(s)
- Angeline Jeyakumar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.,School of Tourism and Hospitality, University of Johannesburg, Johannesburg, South Africa
| | | | - Bibek Raj Giri
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
| |
Collapse
|
42
|
Varre JV. Vaccines are not one size fits all, just like medications: rotavirus vaccine study. Clin Exp Vaccine Res 2021; 10:148-150. [PMID: 34222127 PMCID: PMC8217582 DOI: 10.7774/cevr.2021.10.2.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 12/31/2020] [Accepted: 05/06/2021] [Indexed: 11/23/2022] Open
Abstract
The current global coronavirus disease 2019 pandemic has shown us once again how important vaccination is in controlling and preventing the spread of deadly diseases. Vaccinations are one of the most tried and tested public health measures aimed at the prevention and eventual eradication of various diseases. Many debilitating diseases like polio have been eradicated in countries like India due to effective vaccination strategies. Just like with any other public health initiative, there do exist various challenges for vaccination. Efficacy and correlate of protection studies are crucial in determining which vaccine works best. The rotavirus vaccine (ROTAVAC; Bharat Biotech International Ltd., Hyderabad, India) is one such example where efficacy seen in one geographical and ethnic population is not replicated elsewhere. This has prompted various researchers and pharmaceutical companies to think about customizing vaccines to the individual needs of a particular geographic and ethnic group. In this brief communication, we look at the rotavirus vaccination story and see how it laid down the idea for customized vaccination development and what the future of vaccine development looks like.
Collapse
Affiliation(s)
- Joseph Vinod Varre
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
43
|
Gupta V, Anand S. Why don't they do it? Handwashing barriers and influencer study in Faridabad district, India. Perspect Public Health 2021; 141:354-360. [PMID: 33998334 DOI: 10.1177/17579139211003614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Handwashing has been widely accepted as the simplest protection against communicable diseases. However, despite proven effectiveness and cost-efficiency, adoption of regular handwashing is still poor in developing countries. As children in school-going age are vulnerable and continue to suffer from preventable illnesses, this study aims to spot barriers to handwashing among children while simultaneously recognizing the influencing factors to aid the solutions narrative for effective water, sanitation and hygiene (WASH) strategies. METHODS A school-based cross-sectional, mixed-method study was conducted in Ballabhgarh block, Faridabad district, India. A predesigned, pretested, structured questionnaire was administered to 106 class V students in five randomly selected rural government primary schools. Due permissions, consent and ethical clearances were taken. RESULTS The majority (>91%) of children were found to have low illness threat perception. The inability to visually see germs came out as one of the biggest barriers (46%) that were preventing children from practicing regular handwashing. Family, teachers and peers were found to be the most important sources of information for children and not any particular media channel. In fact, role of peers was found to be critical as 72% children said that they would wash hands if their friends were also washing hands. CONCLUSION This study suggests children's need for visible proof of germs and associated casual attitude toward illness threat as a hitherto unexplored potential barrier to practicing regular handwashing. In addition, the human channel of communication seems to be the most relevant regarding public health messaging in rural heartlands. Despite 100% penetration of mobile phones and commonplace presence of television, it is the community ecosystem that is still the most trusted sources of information and influence. The unique role of peers found in this study could have strategic implications for future behaviour change interventions making a case for peer-to-peer behaviour modeling.
Collapse
Affiliation(s)
- V Gupta
- Research Scholar, Department of Development Communication & Extension, Lady Irwin College, University of Delhi, Sikandra Road, New Delhi 110001, India
| | - S Anand
- Department of Development Communication & Extension, Lady Irwin College, University of Delhi, New Delhi, India
| |
Collapse
|
44
|
Infectious diseases in India: assessing the role of household amenities and socio-demographic determinants. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
45
|
Srivastava P, Mishra CP, Nath G. Everything is not on track in management of diarrhoea in under-five children: Evidence from rural area of India. J Family Med Prim Care 2021; 10:1582-1586. [PMID: 34123895 PMCID: PMC8144785 DOI: 10.4103/jfmpc.jfmpc_1641_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/06/2020] [Accepted: 12/01/2020] [Indexed: 11/05/2022] Open
Abstract
CONTEXT Diarrhea is one of the leading causes of death and morbidity in under-five children. Effective management can significantly influence survival of children with diarrhea. OBJECTIVES This study was carried out to assess extent of diarrhea, its source of treatment, and type of therapy. SETTINGS AND DESIGN This snapshot study was conducted in rural setting of India. METHODS AND MATERIAL This study was conducted on 217 under-five children selected through multistage sampling procedure. STATISTICAL ANALYSIS USED Statistical association of diarrhea with age and gender of children was established by computing Chi-square. RESULTS Period prevalence (Recall period 2 weeks of visit) of diarrhea in rural under-five children was 35.9% (95%C.I. 29.3-42.2%). Highest prevalence in age group 0-12 months (47.8%) and lowest in 49-59 months (18.2%). Number of episode per child is 1.08. Diarrhea was watery in 69.4%. Quacks were treatment provider for 36.4% cases. In 17.6% episodes, no treatment was taken. Only 9.4% episodes were treated in government facilities. For the treatment of diarrhea, antibiotic was used in 71.8% cases, ORS use was 33.3% cases, and zinc was used 21.8% of diarrhea episodes. CONCLUSIONS Diarrhea is a significant problem in under-five children from a rural area of India. In spite of existence of National Program for Control of Diarrheal Diseases (NPCDD) since four decades, management of diarrhea is not on track. Focusing on primary care provision to under-five children can help in bringing the management of diarrhea on track.
Collapse
Affiliation(s)
- Prerna Srivastava
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - C. P. Mishra
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Gopal Nath
- Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| |
Collapse
|
46
|
Akintunde TY, Chen S, Ibrahim E, Tassang AE. Maternal Self-rated Capability Status and Its Association with Under-Five Children Morbidity. J Prim Care Community Health 2021; 12:21501327211002102. [PMID: 33715503 PMCID: PMC7968025 DOI: 10.1177/21501327211002102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Under-five morbidity is a significant public health concern in developing countries, and maternal intervention remains vital to achieving under-five optimal health. Objective: The study examined the influence of maternal self-rated capability status (SCS) on under-five morbidity in Ibadan North Local Government Area (LGA), Oyo State, Nigeria. Methods: The study interviewed 683 nursing mothers surveyed from 20 primary healthcare centers (PHCs) from 13th to 27th September 2018 in the LGA of study. We employed logistic regression models to examine the association of 4 domains of maternal SCS on under-five morbidity incidence controlling for the potential confounding effects of maternal, child, and household sociodemographic attributes. Results: Under-five children of mothers with poor status in the knowledge of child morbidity, experience-informed action, child morbidity exposure, and childcare vulnerability domains are, respectively, 497%, 323%, 400%, and 318% more likely to be at risk of morbidity than their peers born to mothers with good status. In addition, the odds of morbidity were lower for children born to women with more than 1 under-five children (AOR: 0.49, 95% CI: 0.27, 0.88), while the odds were higher for those from households that are food-insecure (AOR: 3.16, 95% CI: 1.31, 7.65) and dispose of wastes within the compound (AOR: 2.67, 95% CI: 1.31, 5.45) relative to children in the comparative categories. Conclusion: Our findings revealed the significance of maternal SCS as a crucial pathway for understanding and reducing under-five morbidity. Community interventions should prioritize empowering nursing mothers with prevention and care information necessary to reduce the under-five morbidity burden at the community level.
Collapse
Affiliation(s)
- Tosin Yinka Akintunde
- Department of Sociology, Hohai University, Nanjing, China.,Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Shaojun Chen
- Department of Sociology, Hohai University, Nanjing, China
| | - Elhakim Ibrahim
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.,Department of Demography, The University of Texas at San Antonio, San Antonio, TX, USA
| | | |
Collapse
|
47
|
Patel S, Khokhariya R, Rathod J, Chatterji D, Patel J. Water safety planning in India: Assessment of water quality in urban Vadodora. ENVIRONMENTAL DISEASE 2021. [DOI: 10.4103/ed.ed_21_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
48
|
Paul P. Socio-demographic and environmental factors associated with diarrhoeal disease among children under five in India. BMC Public Health 2020; 20:1886. [PMID: 33287769 PMCID: PMC7722298 DOI: 10.1186/s12889-020-09981-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 11/26/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Globally, diarrhoea is the second leading cause of death in children under five and a major public health problem. Despite several health care initiatives taken by the government, a large proportion of children still experience diarrhoeal diseases which cause high childhood death in India. This study aims to examine the socio-demographic and environmental factors associated with diarrhoea in children under five in India. METHODS A cross-sectional study was designed using secondary data from the recent round of the National Family Health Survey (NFHS-4), conducted in 2015-16. A total of 247,743 living children below 5 years of age were included in the analysis. Bivariate and multivariate logistic regression models were carried out to assess the factors associated with childhood diarrhoeal disease. RESULTS In India, about 9% of under-five children experience diarrhoeal disease in the past 2 weeks preceding the survey. Children living in rural areas (Adjusted odds ratio [aOR]: 1.05; 95% CI: 1.01, 1.09), children belonged to scheduled tribe (aOR: 0.83; 95% CI: 0.79, 0.89) and other castes (aOR: 0.92; 95% CI: 0.88, 0.97), Muslim children (aOR: 1.18; 95% CI: 1.13, 1.24), and children resided in the central (aOR: 1.61; 95% CI: 1.52, 1.70) and west (aOR: 1.08; 95% CI: 1.01, 1.15) regions were significantly associated with higher likelihood of diarrhoea in the past 2 weeks. Concerning environmental factors, child stool disposal (aOR: 1.06; 95% CI: 0.98, 1.09), floor materials (aOR: 1.08; 95% CI: 1.03, 1.12) and roof materials (aOR: 1.08; 95% CI: 1.04, 1.13) of the household were found to be significant predictors of childhood diarrhoea occurrence. CONCLUSIONS Diarrhoeal disease is common among children who lived in rural areas, scheduled castes, Muslims, and children from poor families. Regarding environmental factors, stool disposal practices in the household, dirt floor, and thatch roof materials of the household unit are risk factors for diarrhoeal disease. Targeted approach should be initiated to mitigate the problem of the poor health status of children by providing adequate health care. The policy-makers and stakeholders should address adverse environmental conditions by the provision of latrine and improved housing facilities.
Collapse
Affiliation(s)
- Pintu Paul
- Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi, 110067, India.
| |
Collapse
|
49
|
Monaghan TM, Sloan TJ, Stockdale SR, Blanchard AM, Emes RD, Wilcox M, Biswas R, Nashine R, Manke S, Gandhi J, Jain P, Bhotmange S, Ambalkar S, Satav A, Draper LA, Hill C, Kashyap RS. Metagenomics reveals impact of geography and acute diarrheal disease on the Central Indian human gut microbiome. Gut Microbes 2020; 12:1752605. [PMID: 32459982 PMCID: PMC7781581 DOI: 10.1080/19490976.2020.1752605] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The Central Indian gut microbiome remains grossly understudied. Herein, we sought to investigate the burden of antimicrobial resistance and diarrheal diseases, particularly Clostridioides difficile, in rural-agricultural and urban populations in Central India, where there is widespread unregulated antibiotic use. We utilized shotgun metagenomics to comprehensively characterize the bacterial and viral fractions of the gut microbiome and their encoded functions in 105 participants. RESULTS We observed distinct rural-urban differences in bacterial and viral populations, with geography exhibiting a greater influence than diarrheal status. Clostridioides difficile disease was more commonly observed in urban subjects, and their microbiomes were enriched in metabolic pathways relating to the metabolism of industrial compounds and genes encoding resistance to 3rd generation cephalosporins and carbapenems. By linking phages present in the microbiome to their bacterial hosts through CRISPR spacers, phage variation could be directly related to shifts in bacterial populations, with the auxiliary metabolic potential of rural-associated phages enriched for carbon and amino acid energy metabolism. CONCLUSIONS We report distinct differences in antimicrobial resistance gene profiles, enrichment of metabolic pathways and phage composition between rural and urban populations, as well as a higher burden of Clostridioides difficile disease in the urban population. Our results reveal that geography is the key driver of variation in urban and rural Indian microbiomes, with acute diarrheal disease, including C. difficile disease exerting a lesser impact. Future studies will be required to understand the potential role of dietary, cultural, and genetic factors in contributing to microbiome differences between rural and urban populations.
Collapse
Affiliation(s)
- Tanya M. Monaghan
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK,Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK,CONTACT Tanya M. Monaghan NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Tim J. Sloan
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | | | - Adam M. Blanchard
- School of Veterinary Medicine and Science, Sutton Bonington Campus, University of Nottingham, Leicestershire, UK
| | - Richard D. Emes
- School of Veterinary Medicine and Science, Sutton Bonington Campus, University of Nottingham, Leicestershire, UK,Advanced Data Analysis Centre, Sutton Bonington Campus, University of Nottingham, Leicestershire, UK
| | - Mark Wilcox
- Leeds Teaching Hospitals NHS Trust and University of Leeds, UK
| | - Rima Biswas
- Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India
| | - Rupam Nashine
- Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India
| | - Sonali Manke
- Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India
| | - Jinal Gandhi
- Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India
| | - Pratishtha Jain
- Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India
| | - Shrejal Bhotmange
- Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India
| | - Shrikant Ambalkar
- Department of Clinical Microbiology and Infection, King’s Mill Hospital, Sherwood Forest Hospitals NHS Trust, Sutton in Ashfield, UK
| | | | | | - Colin Hill
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Rajpal Singh Kashyap
- Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India,Rajpal Singh Kashyap Biochemistry Research Centre, Central India Institute of Medical Sciences, 88/2 Bajaj Nagar, Nagpur, Maharashtra, India
| |
Collapse
|
50
|
Banerjee S, Singh A, Bhattacharya S, Koner S. Demystifying the Aquatic Paradox: The Infant Mortality in India. JOURNAL OF HEALTH MANAGEMENT 2020. [DOI: 10.1177/0972063420942854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
It is evident that better access to improved water sources will lead to the lessening of infant mortality rate (IMR). However, for India, such inference is ambiguous. There is a strong group of academicians such as Sahu et al. (2015) , Arun et al. (2017) and Tripathy and Mishra (2017) and organizations such as UNICEF that firmly believe that if access to the improved water sources can be improved, then there would be tremendous social welfare and much betterment to the IMR. On the other hand, Banerjee et al. (2020) have refuted such claims and opined that access to improved water sources increases the IMR. The empirical validation of their claim has been flawless, but they are somewhat silent on why such a direct relationship between IMR and improved water source exists. They have made a comment based on assumptions that it might be complacency that develops with access to improved water sources that refrain the people to consider any type of water treatment before passing it to infants for drinking. Such a comment might be valid, but neither is it built upon a sound literature review nor does it stand on strong empirics. At this juncture, the present article tests the claim of Banerjee et al. (2020) based on pure empirics.
Collapse
|