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Bhat J, Rao R, Kumar R, Yadav R, Singh P, Rao VG, Das A. TB free India: Reaching the unreached tribal population under National Tuberculosis Elimination Programme. Indian J Tuberc 2022; 69:4-7. [PMID: 35074149 DOI: 10.1016/j.ijtb.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/05/2021] [Indexed: 06/14/2023]
Abstract
India is the highest TB burden country in the world. The burden however is not uniform in different strata including tribal population - one of the key affected populations in the country. As the evidences from tribal population are hardly available, most of the policies and strategies implemented under National Tuberculosis Elimination Programme (NTEP) are usually based on the evidences from general populations. NTEP is continuously taking steps to strengthen TB services in tribal areas. The Social Action Plan including Tribal Action Plan is in place and the appropriate strategies are incorporated in the National Strategic Plan (NSP) to ensure universal access to quality TB services to vulnerable population groups. However, its implementation becomes challenging especially in tribal areas as different tribal groups have their own unique ways of dealing with health issues. These issues are therefore required to be addressed holistically involving all the stakeholders. In view of this a symposium was jointly organized by the Central TB Division (CTD), Govt. of India and ICMR - National Institute of Research in Tribal Health (NIRTH), Jabalpur on 17th and 18th December, 2019 at ICMR - NIRTH, Jabalpur. It provided an excellent platform for all the stakeholders from different parts of the country to share their experiences in tuberculosis particularly among marginalized populations. The recommendations emerged out of this interactive symposium highlight the sincere effort of NTEP to tackle TB situation in tribal population and show the way forward towards India's TB elimination goal by 2025 especially in hard to reach tribal areas.
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Affiliation(s)
- J Bhat
- ICMR, National Institute of Research in Tribal Health (NIRTH), Jabalpur, India
| | - R Rao
- Central TB Division, Ministry of Health & Family Welfare, Government of India, New Delhi
| | - R Kumar
- Central TB Division, Ministry of Health & Family Welfare, Government of India, New Delhi
| | - R Yadav
- ICMR, National Institute of Research in Tribal Health (NIRTH), Jabalpur, India
| | - P Singh
- ICMR, National Institute of Research in Tribal Health (NIRTH), Jabalpur, India
| | - V G Rao
- ICMR, National Institute of Research in Tribal Health (NIRTH), Jabalpur, India.
| | - A Das
- ICMR, National Institute of Research in Tribal Health (NIRTH), Jabalpur, India
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Thomas BE, Thiruvengadam K, Vedhachalam C, A S, Rao VG, Vijayachari P, Rajiv Y, V R, Bansal AK, Indira Krishna AK, Joseph A, J AP, Hussain T, Anand P, Das P, John KR, Devi K. R, P S, S A, Dusthakeer A, J B, K. Chadha V, G. S. T, Raghunath D, Das M, Khan AM, Kaur H. Prevalence of pulmonary tuberculosis among the tribal populations in India. PLoS One 2021; 16:e0251519. [PMID: 34086684 PMCID: PMC8177518 DOI: 10.1371/journal.pone.0251519] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/27/2021] [Indexed: 01/10/2023] Open
Abstract
Importance There is no concrete evidence on the burden of TB among the tribal populations across India except for few studies mainly conducted in Central India with a pooled estimation of 703/100,000 with a high degree of heterogeneity. Objective To estimate the prevalence of TB among the tribal populations in India. Design, participants, setting A survey using a multistage cluster sampling design was conducted between April 2015 and March 2020 covering 88 villages (clusters) from districts with over 70% tribal majority populations in 17 States across 6 zones of India. The sample populations included individuals ≥15 years old. Main outcome and measures Eligible participants who were screened through an interview for symptoms suggestive of pulmonary TB (PTB); Two sputum specimens were examined by smear and culture. Prevalence was estimated after multiple imputations for non-coverage and a correction factor of 1.31 was then applied to account for non-inclusion of X-ray screening. Results A total of 74532 (81.0%) of the 92038 eligible individuals were screened; 2675 (3.6%) were found to have TB symptoms or h/o ATT. The overall prevalence of PTB was 432 per 100,000 populations. The PTB prevalence per 100,000 populations was highest 625 [95% CI: 496–754] in the central zone and least 153 [95% CI: 24–281] in the west zone. Among the 17 states that were covered in this study, Odisha recorded the highest prevalence of 803 [95% CI: 504–1101] and Jammu and Kashmir the lowest 127 [95% CI: 0–310] per 100,000 populations. Findings from multiple logistic regression analysis reflected that those aged 35 years and above, with BMI <18.5 Kgs /m2, h/o ATT, smoking, and/or consuming alcohol had a higher risk of bacteriologically positive PTB. Weight loss was relatively more important symptom associated with tuberculosis among this tribal populations followed by night sweats, blood in sputum, and fever. Conclusion and relevance The overall prevalence of PTB among tribal groups is higher than the general populations with a wide variation of prevalence of PTB among the tribal groups at zone and state levels. These findings call for strengthening of the TB control efforts in tribal areas to reduce TB prevalence through tribal community/site-specific intervention programs.
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Affiliation(s)
- Beena E. Thomas
- Department of Social and Behavioral Research, ICMR – National Institute for Research in Tuberculosis, Chennai, India
- * E-mail:
| | - Kannan Thiruvengadam
- Department of Statistics, Epidemiology Unit, ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - Chandrasekaran Vedhachalam
- Department of Statistics, Epidemiology Unit, ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - Srividya A
- Department of Biostatistics, ICMR – Vector Control Research Centre, Pondicherry, India
| | - V. G. Rao
- Division of Communicable Diseases, ICMR – National Institute for Research in Tribal Health, Jabalpur, India
| | - Paluru Vijayachari
- ICMR – Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands
| | - Yadav Rajiv
- Division of Communicable Diseases, ICMR – National Institute for Research in Tribal Health, Jabalpur, India
| | - Raghavi V
- Department of Social and Behavioral Research, ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - Avi Kumar Bansal
- Department of Epidemiology, ICMR – National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | | | - Alex Joseph
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Anil Purty J
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Tahziba Hussain
- ICMR – Regional Medical Research Centre, Bhuvaneshwar, India
| | - Praveen Anand
- Department of Epidemiology, ICMR – Desert Medicine Research Centre, Jodhpur, India
| | - Pradeep Das
- Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | - K. R. John
- Department of Community Medicine, Apollo Institute of Medical Sciences & Research, Chittoor, India
| | - Rekha Devi K.
- ICMR – Regional Medical Research Centre, Dibrugarh, India
| | - Sunish P
- ICMR – Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands
| | - Azhagendran S
- Department of Social and Behavioral Research, ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - Azger Dusthakeer
- Department of Bacteriology, ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - Bhat J
- Division of Communicable Diseases, ICMR – National Institute for Research in Tribal Health, Jabalpur, India
| | - Vineet K. Chadha
- Central Leprosy Teaching and Training Institute, Chengalpet, India
| | - Toteja G. S.
- Department of Epidemiology, ICMR – Desert Medicine Research Centre, Jodhpur, India
| | - Dasarathy Raghunath
- Tribal Task Force, ICMR – Former Dean, Armed Forces Medical College, Pune, India
| | - Madhuchhanda Das
- Division of Communicable Diseases (ECD), Indian Council of Medical Research, New Delhi, India
| | - A. M. Khan
- Division of Communicable Diseases (ECD), Indian Council of Medical Research, New Delhi, India
| | - Hapreet Kaur
- Division of Communicable Diseases (ECD), Indian Council of Medical Research, New Delhi, India
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Rao VG, Bhat J, Yadav R, Sharma RK, Muniyandi M. Declining tuberculosis prevalence in Saharia, a particularly vulnerable tribal community in Central India: evidences for action. BMC Infect Dis 2019; 19:180. [PMID: 30786860 PMCID: PMC6383441 DOI: 10.1186/s12879-019-3815-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 02/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background In spite of an alarmingly high tuberculosis (TB) burden amongst the Saharia tribe of central India, there is hardly any study to investigate the impact of DOTS implementation on the magnitude of tuberculosis disease and the changes over time. This article present the findings of TB prevalence surveys conducted amongst this indigenous population in two different time periods to know the change in the prevalence of TB. Methods A cross sectional survey was conducted among Saharia population in Shivpuri district, Madhya Pradesh during February 2013 to May 2013 and resurvey during March 2015 to July 2015. All individuals (≥15 years) were examined for chest symptoms suggestive of TB. Sputum samples were collected from all presumptive TB cases and were confirmed by laboratory examination by Ziehl-Neelsen smear microscopy and solid media culture methods. All detected cases were referred to health facility for anti-tuberculosis treatment as per RNTCP guidelines. Results There was significant reduction (trend Chi square 19.97; OR = 1.521; p = 0.000) in the prevalence of TB at the endline (1995 per 100,000) as compared to baseline (3003 per 100,000). The reduction was significant among males as compared to females (OR 1.55; p = 0.000) and in the age group of 25–34 years (OR 2.0; p = 0.007) and 45–54 years (OR 4.39; p = 0.003). There was significant reduction in the prevalence in both smear (OR 1.29; p = 0.02) and culture positive (OR 1.57; p = 0.000) TB at the endline survey. Conclusion The study findings highlight a reduction in the prevalence of TB among Saharia tribal population. Further studies are needed to identify the factors associated with reduction in prevalence among this population and also further surveys to monitor the prevalence trend over a period.
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Affiliation(s)
- V G Rao
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India.
| | - J Bhat
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India
| | - R Yadav
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India
| | - R K Sharma
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India
| | - M Muniyandi
- ICMR -National Institute for Research in Tuberculosis, (Indian Council of Medical Research), No. 1, Mayor Sathiyamoorthy Road, Chetpet, Chennai, 600031, India
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Bhat J, Helmuth J, Chitadze G, Kouakanou L, Peters C, Vingron M, Ammerpohl O, Kabelitz D. Stochastics of Cellular Differentiation Explained by Epigenetics: The Case of T-Cell Differentiation and Functional Plasticity. Scand J Immunol 2017; 86:184-195. [PMID: 28799233 DOI: 10.1111/sji.12589] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 08/06/2017] [Indexed: 12/19/2022]
Abstract
Epigenetic marks including histone modifications and DNA methylation are associated with the regulation of gene expression and activity. In addition, an increasing number of non-coding RNAs with regulatory activity on gene expression have been identified. Alongside, technological advancements allow for the analysis of these mechanisms with high resolution up to the single-cell level. For instance, the assay for transposase-accessible chromatin using sequencing (ATAC-seq) simultaneously probes for chromatin accessibility and nucleosome positioning. Thus, it provides information on two levels of epigenetic regulation. Development and differentiation of T cells into functional subset cells including memory T cells are dynamic processes driven by environmental signals. Here, we briefly review the current knowledge of how epigenetic regulation contributes to subset specification, differentiation and memory development in T cells. Specifically, we focus on epigenetic mechanisms differentially active in the two distinct T cell populations expressing αβ or γδ T cell receptors. We also discuss examples of epigenetic alterations of T cells in autoimmune diseases. DNA methylation and histone acetylation are subject to modification by several classes of 'epigenetic modifiers', some of which are in clinical use or in preclinical development. Therefore, we address the impact of some epigenetic modifiers on T-cell activation and differentiation, and discuss possible synergies with T cell-based immunotherapeutic strategies.
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Affiliation(s)
- J Bhat
- Institute of Immunology, University of Kiel and University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - J Helmuth
- Otto-Warburg-Laboratories: Epigenomics, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - G Chitadze
- Institute of Immunology, University of Kiel and University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - L Kouakanou
- Institute of Immunology, University of Kiel and University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - C Peters
- Institute of Immunology, University of Kiel and University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - M Vingron
- Department of Computational Molecular Biology, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - O Ammerpohl
- Institute of Human Genetics, University of Kiel and University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - D Kabelitz
- Institute of Immunology, University of Kiel and University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
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Rao VG, Muniyandi M, Bhat J, Yadav R, Sharma R. Research on tuberculosis in tribal areas in India: A systematic review. Indian J Tuberc 2017; 65:8-14. [PMID: 29332655 DOI: 10.1016/j.ijtb.2017.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 05/24/2017] [Accepted: 06/09/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND Tuberculosis (TB) remains a major public health problem in resource-poor countries including India. Scientific knowledge is used to guide policy and practice. There is however, a limited, systematically collected data required for guiding the scale-up of interventions particularly amongst vulnerable populations including tribal groups in the country. In view of this, a systematic review of the TB research studies carried out in tribal areas of different parts of the country was undertaken. OBJECTIVE To undertake a systematic review of the TB research studies carried out in tribal areas of India between 1996 and 2016. METHODS A systematic review of English articles published between 1996 and 2016 on any aspect of TB was done through internet searches using Literature search EndNote programme. The words used for searching were tuberculosis, India, tribal, indigenous, disadvantaged, adivasi. The most common topics classified as annual risk of tuberculosis infection (ARTI), prevalence of TB, laboratory studies, clinical symptoms of TB, risk factors for TB, knowledge attitude practice, community Directly Observed Treatment (DOT) providers, performance of Revised National Tuberculosis Control Programme (RNTCP), and drug resistant TB. Classification was also done on the basis of the type of tribe studied and place of study conducted. A total of 47 studies identified through the search were included in the review. RESULTS Of the 47 studies reviewed, 12 were on TB prevalence, 7 were laboratory studies, four on ARTI and 5 on performance of RNTCP in tribal areas. Among these, majority (23 studies) of the tribal studies did not mention the type of tribe. Ten studies were conducted among Saharia, a particularly vulnerable tribal group in the Indian state of Madhya Pradesh mainly by the National Institute for Research on Tribal Health, five were among the mixed tribes and very few on other tribes. CONCLUSION The systematic review indicates that the research studies on TB among tribal population are very few. There is a need to invest and encourage researcher to work on the research plans for the control of TB in tribal areas.
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Affiliation(s)
- V G Rao
- National Institute for Research in Tribal Health (Indian Council of Medical Research), Jabalpur, Madhya Pradesh, India.
| | - M Muniyandi
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - J Bhat
- National Institute for Research in Tribal Health (Indian Council of Medical Research), Jabalpur, Madhya Pradesh, India
| | - R Yadav
- National Institute for Research in Tribal Health (Indian Council of Medical Research), Jabalpur, Madhya Pradesh, India
| | - R Sharma
- National Institute for Research in Tribal Health (Indian Council of Medical Research), Jabalpur, Madhya Pradesh, India
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Earnshaw C, Edwin C, Bhat J, Krishnan M, Mamais C, Somashekar S, Sunil A, Williams S, Leong S. An analysis of the fate of 917 manuscripts rejected from Clinical Otolaryngology. Clin Otolaryngol 2017; 42:709-714. [DOI: 10.1111/coa.12820] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2016] [Indexed: 01/14/2023]
Affiliation(s)
- C.H. Earnshaw
- Mersey ENT Research Collaborative; Merseyside UK
- Institute of Translational Medicine; University of Liverpool; Liverpool UK
| | - C. Edwin
- Mersey ENT Research Collaborative; Merseyside UK
| | - J. Bhat
- Mersey ENT Research Collaborative; Merseyside UK
| | - M. Krishnan
- Mersey ENT Research Collaborative; Merseyside UK
| | - C. Mamais
- Mersey ENT Research Collaborative; Merseyside UK
| | | | - A. Sunil
- Mersey ENT Research Collaborative; Merseyside UK
| | | | - S.C. Leong
- Mersey ENT Research Collaborative; Merseyside UK
- Institute of Translational Medicine; University of Liverpool; Liverpool UK
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Rao V, Bhat J, Yadav R, Muniyandi M, Bhondeley M, Wares D. Smoking and alcohol consumption: Risk factors for pulmonary tuberculosis among the tribal community in central India. ACTA ACUST UNITED AC 2017; 64:40-43. [DOI: 10.1016/j.ijtb.2016.11.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 10/10/2016] [Accepted: 11/01/2016] [Indexed: 12/01/2022]
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Muniyandi M, Rao VG, Bhat J, Yadav R, Sharma RK, Bhondeley MK. Health literacy on tuberculosis amongst vulnerable segment of population: special reference to Saharia tribe in central India. Indian J Med Res 2016; 141:640-7. [PMID: 26139783 PMCID: PMC4510764 DOI: 10.4103/0971-5916.159566] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES Health literacy on tuberculosis (TB) is an understanding about TB to perform activities with regard to prevention, diagnosis and treatment. We undertook a study to assess the health literacy on TB among one of the vulnerable tribal groups (Saharia) in central India. METHODS In this cross-sectional study, 2721 individuals aged >15 yr from two districts of Madhya Pradesh State of India were interviewed at their residence during December 2012-July 2013. By using a short-form questionnaire, health literacy on cause, symptoms, mode of transmission, diagnosis, treatment and prevention of TB was assessed. RESULTS Of the 2721 (Gwalior 1381; Shivpuri 1340) individuals interviewed; 76 per cent were aged <45 yr. Living condition was very poor (62% living in huts/katcha houses, 84 per cent with single room, 89 per cent no separate kitchen, 97 per cent used wood/crop as a fuel). Overall literacy rate was 19 per cent, and 22 per cent had >7 members in a house. Of the 2721 respondents participated, 52 per cent had never heard of TB; among them 8 per cent mentioned cough as a symptom, 64 per cent mentioned coughing up blood, and 91 per cent knew that TB diagnosis, and treatment facilities were available in both government and private hospitals. Health literacy score among participants who had heard of TB was <40 per cent among 36 per cent of respondents, 41-60 per cent among 54 per cent and >60 per cent among 8 per cent of respondents. INTERPRETATION & CONCLUSIONS The finding that nearly half of the respondents had not heard of TB indicated an important gap in education regarding TB in this vulnerable population. There is an urgent need to implement targeted interventions to educate this group for better TB control.
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Affiliation(s)
- M Muniyandi
- National Institute for Research in Tribal Health (ICMR), Jabalpur, India
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Muniyandi M, Rao VG, Bhat J, Yadav R. Performance of Revised National Tuberculosis Control Programme (RNTCP) in tribal areas in India. Indian J Med Res 2016; 141:624-9. [PMID: 26139780 PMCID: PMC4510761 DOI: 10.4103/0971-5916.159553] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background & objectives: The Revised National Tuberculosis Control Programme (RNTCP) provides free diagnostic and treatment services to all tuberculosis (TB) patients registered under it. Equitable access, implying a preference for the most hard-to-reach groups particularly for tribal areas, is a major concern for RNTCP. This study was conducted to assess the performance of RNTCP in terms of case detection and cure rates in areas dominated by tribal groups in India. Methods: We used the RNTCP data collected by the Central TB Divison, Government of India. RNTCP has a systematic monitoring mechanism which tracks the outcome of every patient put on treatment. There is a standardized recording and reporting structure in place; indicators are monitored regularly at every level of the health system; and regular supervision ensures quality of the Programme. The main indicators include the number of cases diagnosed and the percentage of patients who are successfully treated. These indicators were used to assess the RNTCP performance in tribal areas. Results: We observed a poor performance in terms of case detection rate (CDR) in tribal and backward districts as compared with other districts in India. Among tribal districts 53 per cent in 2010, 45 per cent in 2011 and 56 per cent in 2012 had CDR of new smear positive <70%. It was also observed that 26 per cent of tribal dominated districts had CDR of <51 per cent in 2012. More than 50 per cent of tribal districts were not able to achieve more than 85 per cent of cure rate. Interpretation & conclusions: The findings of this study suggested that the overall RNTCP performance in tribal areas was not optimal, and the target of >85 per cent of core rate was achieved by less than half of the tribal districts.
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Affiliation(s)
- M Muniyandi
- National Institute for Research in Tribal Health (ICMR), Jabalpur, India
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Rao VG, Bhat J, Yadav R, Muniyandi M, Sharma R, Bhondeley MK. Pulmonary tuberculosis - a health problem amongst Saharia tribe in Madhya Pradesh. Indian J Med Res 2016; 141:630-5. [PMID: 26139781 PMCID: PMC4510762 DOI: 10.4103/0971-5916.159560] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background & objectives: The information on tuberculosis (TB) situation amongst Saharia, one of the particularly vulnerable tribal groups (PVTGs) in Madhya Pradesh, is not available from Gwalior division of the State. Hence, this study was undertaken to estimate the prevalence of pulmonary tuberculosis (PTB) disease amongst them. Methods: A community based cross-sectional TB prevalence survey was undertaken among Saharia PVTG in Gwalior district of Madhya Pradesh. A random sample of villages predominated by Saharia tribe was selected from all the blocks in proportion to the size of Saharia population in each block of the district. All eligible individuals were questioned for chest symptoms relating to TB. Two sputum samples were collected from each of the eligible individuals, transported to the laboratory, and were examined by Ziehl-Neelsen(ZN) smear microscopy and solid media culture methods. Results: Of the total 10,259 individuals eligible for screening, 9,653 (94.1%) were screened for symptoms. Overall prevalence of PTB was found to be 3294 per 100,000. The prevalence increased with age and the trend was significant (P<0.001). The prevalence of TB was significantly higher amongst males (5497/100,000) as compared to females (1376/100,000) (P<0.001). Interpretation & conclusions: The study results provide vital information on the current situation of pulmonary TB disease among the Saharia tribal community in Gwalior district of Madhya Pradesh. In view of high PTB disease prevalence among this PVTG, there is an urgent need to improve and further intensify TB control measures in this area.
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Affiliation(s)
- V G Rao
- National Institute for Research in Tribal Health (ICMR), Jabalpur, India
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Bhat J, Rao VG, Yadav R, Muniyandi M, Sharma R, Karfarma C, Luke C. Situation of drug resistant tuberculosis in Saharia tribe of central India. Indian J Med Res 2016; 141:636-9. [PMID: 26139782 PMCID: PMC4510763 DOI: 10.4103/0971-5916.159562] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND & OBJECTIVES The information on multidrug resistant tuberculosis (MDR-TB) situation amongst Saharia, one of the Particularly Vulnerable Tribal Groups (PVTGs) in Madhya Pradesh, India, is not available. Hence, this study was undertaken to find the situation of MDR-TB amongst Saharia PVTG in two districts of Madhya Pradesh. METHODS Community based cross-sectional TB prevalence surveys were conducted among Saharia PVTG in Gwalior and Shivpuri districts of Madhya Pradesh. Chest symptomatics were identified from the individual registered for the study. Two sputum samples were collected from each of the eligible individuals, transported to the laboratory, and were examined by Ziehl-Neelsen (Z-N) smear microscopy and solid medium culture methods. Drug susceptibility testing of the isolates was done by indirect proportion method on solid medium. RESULTS MDR rate was 2.2 per cent of new cases and 8.2 per cent among the previously treated cases of TB in Gwalior while it was two per cent among the previously treated cases in Shivpuri district. INTERPRETATION & CONCLUSIONS Though the prevalence of tuberculosis in these districts was alarmingly high, the MDR rates were more or less similar to national average. However, the findings of this study highlight the need for active intervention so that the MDR-TB is kept under control.
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Affiliation(s)
- J Bhat
- National Institute for Research in Tribal Health (ICMR), Jabalpur, Madhya Pradesh, India
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Lau AS, Krishnan M, Williams SP, Mamais C, Sweed A, Bhat J, Somashekar S, Leong SC. A re-appraisal of publication rates of scientific papers presented at the Otorhinolaryngology Research Society meetings. Clin Otolaryngol 2016; 41:694-699. [PMID: 26589964 DOI: 10.1111/coa.12594] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To review the rate of publication of papers in peer-reviewed journals after oral presentations at the Otorhinolaryngology Research Society meetings between 1996 and 2013 and to compare trends with the previous review (1979-1995). DESIGN Literature review. SETTING Merseyside ENT Research Collaborative. PARTICIPANTS The abstracts of presentations at Otorhinolaryngology Research Society meetings are published in Clinical Otolaryngology. A structured search of PubMed was undertaken to identify published Otorhinolaryngology Research Society presentations. MAIN OUTCOME MEASURES Publication rates. RESULTS A total of 460 abstracts were identified. The interobserver reliability among reviewers was 98%. Of the total, 259 (56.3%) abstracts were published in peer-reviewed journals. The average time from Otorhinolaryngology Research Society presentation to publication was 27.7 months (median 23), which was not significantly different from the previous review. Publication by subspeciality was as follows: head and neck (45.6%), otology (30.5%), rhinology (22%) and others (1.9%). Most published Otorhinolaryngology Research Society presentations were published in Clinical Otolaryngology (22.4%), followed by the Journal of Laryngology and Otology (8.1%) and the Laryngoscope (7.3%). Clinical research was the most common category of abstracts being presented at Otorhinolaryngology Research Society meetings, followed by laboratory-based research. Over half (56.5%) of laboratory research presented were head and neck themed, while otology and rhinology predominated clinical research presentations. Over half (52.1%) of Otorhinolaryngology Research Society abstracts originated from units in the North of England. Bristol presented the most abstracts (30.1%), followed by Newcastle (25.1%). CONCLUSIONS The publication rate of Otorhinolaryngology Research Society presentations remains high and many are subsequently published in high-impact factor otolaryngology journals. More Otorhinolaryngology Research Society presentations are now published in American and European journals.
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Affiliation(s)
- A S Lau
- Merseyside ENT Research Collaborative, Liverpool, UK
| | - M Krishnan
- Merseyside ENT Research Collaborative, Liverpool, UK
| | - S P Williams
- Merseyside ENT Research Collaborative, Liverpool, UK
| | - C Mamais
- Merseyside ENT Research Collaborative, Liverpool, UK
| | - A Sweed
- Merseyside ENT Research Collaborative, Liverpool, UK.,Department of Otorhinolaryngology - Head and Neck Surgery, Ain Shams University, Egypt
| | - J Bhat
- Merseyside ENT Research Collaborative, Liverpool, UK
| | - S Somashekar
- Merseyside ENT Research Collaborative, Liverpool, UK
| | - S C Leong
- Merseyside ENT Research Collaborative, Liverpool, UK.,Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
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Bhardwaj A, Kalhan S, Bhatia P, Khetan M, John S, Bindal V, Bhat J, Wadhera S, Arora P, Saeed M, Anwar S. Topic: Abdominal Wall Hernia - Spigelian hernia, anatomy, incidence, repair. Hernia 2015; 19 Suppl 1:S344. [PMID: 26518838 DOI: 10.1007/bf03355384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A Bhardwaj
- Institute of Minimal Access Surgery, Sir Gangaram Hospital, New Delhi, India
| | | | | | | | | | | | | | | | | | - M Saeed
- Calderdale and Huddersfield NHS Trust, Huddersfield, UK
| | - S Anwar
- Calderdale and Huddersfield NHS Trust, Huddersfield, UK
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Rao VG, Bhat J, Yadav R, Muniyandi M, Bhondeley MK, Wares DF. Yield of pulmonary tuberculosis cases by symptoms: Findings from a community survey in Madhya Pradesh, central India. Indian J Tuberc 2015; 62:121-3. [PMID: 26117484 DOI: 10.1016/j.ijtb.2015.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 04/07/2015] [Indexed: 11/19/2022]
Abstract
A cross-sectional tuberculosis prevalence survey was undertaken in Jabalpur district, Madhya Pradesh, central India. All individuals were questioned for chest symptoms. Sputum samples were collected and examined for microscopy and culture. Overall prevalence of sputum positive pulmonary tuberculosis was found to be 255.3 per 100,000 population. Cough, with or without other symptoms, was present in 75.5% individuals and yielded 88.2% of the detected pulmonary tuberculosis cases. Elicitation of a previous history of treatment yielded 5.9%, and chest pain 4.5% cases. History of fever alone yielded no cases. The findings suggest that a history of fever alone may be safely excluded from the list of symptoms to be elicited in future TB prevalence surveys in India.
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Affiliation(s)
- V G Rao
- Regional Medical Research Centre for Tribals (Indian Council of Medical Research), Jabalpur, Madhya Pradesh, India; Scientist F, Regional Medical Research Centre for Tribals (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur 482 003, Madhya Pradesh, India.
| | - J Bhat
- Regional Medical Research Centre for Tribals (Indian Council of Medical Research), Jabalpur, Madhya Pradesh, India
| | - R Yadav
- Regional Medical Research Centre for Tribals (Indian Council of Medical Research), Jabalpur, Madhya Pradesh, India
| | - M Muniyandi
- Regional Medical Research Centre for Tribals (Indian Council of Medical Research), Jabalpur, Madhya Pradesh, India
| | - M K Bhondeley
- Regional Medical Research Centre for Tribals (Indian Council of Medical Research), Jabalpur, Madhya Pradesh, India
| | - D F Wares
- Global TB Programme, World Health Organization, Geneva, Switzerland
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15
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Ramakrishnan P, Rane A, Dias A, Bhat J, Shukla A, Lakshmi S, Ansari BK, Ramaswamy RS, Reddy RA, Tribulato A, Agarwal AK, SatyaPrasad N, Mushtaq A, Rao PH, Murthy P, Koenig HG. Indian health care professionals' attitude towards spiritual healing and its role in alleviating stigma of psychiatric services. J Relig Health 2014; 53:1800-1814. [PMID: 24430129 DOI: 10.1007/s10943-014-9822-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Persons with mental illnesses in India and rest of developing world continue to consult religious/spiritual (R/S) healers or traditional, complementary and alternative medicine (TCAM) professionals prior to seeking psychiatric services that are devoid of spiritual components of care. We aim to understand TCAM and allopathic professionals' perspectives on patients' R/S needs within mental health services, cross-sectional study was conducted at five TCAM and two allopathic tertiary care hospitals in three different Indian states; 393 participants completed RSMPP, a self-administered, semi-structured survey questionnaire. Perspectives of TCAM and allopathic health professionals on role of spirituality in mental health care were compared. Substantial percentage, 43.7 % TCAM and 41.3 % allopathic, of participants believe that their patients approach R/S or TCAM practitioners for severe mental illness; 91.2 % of TCAM and 69.7 % of allopaths were satisfied with R/S healers (p = 0.0019). Furthermore, 91.1 % TCAM and 73.1 % allopaths (p = 0.000) believe that mental health stigma can be minimized by integrating with spiritual care services. Overall, 87 % of TCAM and 73 % of allopaths agreed to primary criterion variable: 'spiritual healing is beneficial and complementary to psychiatric care.' A quarter of allopaths (24.4 %) and 38 % of TCAM physicians reportedly cross-refer their grieving patients to religious/TCAM healer and psychiatrist/psychologist, respectively; on logistic regression, significant (p < 0.05) predictors were clinical interactions/references to r/s healers. Providing spiritual care within the setup of psychiatric institution will not only complement psychiatric care but also alleviate stigma against mental health services. Implications on developing spiritual care services like clinical chaplaincy are discussed.
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Affiliation(s)
- P Ramakrishnan
- AdiBhat Foundation, R-90, Greater Kailash-I, New Delhi, 110048, India,
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16
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Chaudhary N, Nakka KK, Chavali PL, Bhat J, Chatterjee S, Chattopadhyay S. SMAR1 coordinates HDAC6-induced deacetylation of Ku70 and dictates cell fate upon irradiation. Cell Death Dis 2014; 5:e1447. [PMID: 25299772 PMCID: PMC4237237 DOI: 10.1038/cddis.2014.397] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 08/11/2014] [Accepted: 08/14/2014] [Indexed: 11/30/2022]
Abstract
Acetylation status of DNA end joining protein Ku70 dictates its function in DNA repair and Bax-mediated apoptosis. Despite the knowledge of HDACs and HATs that are reported to modulate the acetylation dynamics of Ku70, very little is known about proteins that critically coordinate these key modifications. Here, we demonstrate that nuclear matrix-associated protein scaffold/matrix-associated region-binding protein 1 (SMAR1) is a novel interacting partner of Ku70 and coordinates with HDAC6 to maintain Ku70 in a deacetylated state. Our studies revealed that knockdown of SMAR1 results in enhanced acetylation of Ku70, which leads to impaired recruitment of Ku70 in the chromatin fractions. Interestingly, ionizing radiation (IR) induces the expression of SMAR1 and its redistribution as distinct nuclear foci upon ATM-mediated phosphorylation at serine 370. Furthermore, SMAR1 regulates IR-induced G2/M cell cycle arrest by facilitating Chk2 phosphorylation. Alternatively, SMAR1 provides radioresistance by modulating the association of deacetylated Ku70 with Bax, abrogating the mitochondrial translocation of Bax. Thus, we provide mechanistic insights of SMAR1-mediated regulation of repair and apoptosis via a complex crosstalk involving Ku70, HDAC6 and Bax.
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Affiliation(s)
- N Chaudhary
- Chromatin and Disease Biology Laboratory, National Centre for Cell Science, Pune University Campus, Pune, India
| | - K K Nakka
- Chromatin and Disease Biology Laboratory, National Centre for Cell Science, Pune University Campus, Pune, India
| | - P L Chavali
- Chromatin and Disease Biology Laboratory, National Centre for Cell Science, Pune University Campus, Pune, India
| | - J Bhat
- Department of Biophysics, Bose Institute, Kolkata, India
| | - S Chatterjee
- Department of Biophysics, Bose Institute, Kolkata, India
| | - S Chattopadhyay
- Chromatin and Disease Biology Laboratory, National Centre for Cell Science, Pune University Campus, Pune, India
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17
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Ramakrishnan P, Dias A, Rane A, Shukla A, Lakshmi S, Ansari BKM, Ramaswamy RS, Reddy AR, Tribulato A, Agarwal AK, Bhat J, SatyaPrasad N, Mushtaq A, Rao PH, Murthy P, Koenig HG. Perspectives of Indian traditional and allopathic professionals on religion/spirituality and its role in medicine: basis for developing an integrative medicine program. J Relig Health 2014; 53:1161-1175. [PMID: 23625126 DOI: 10.1007/s10943-013-9721-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Allopathic medical professionals in developed nations have started to collaborate with traditional, complementary, and alternative medicine (TCAM) to enquire on the role of religion/spirituality (r/s) in patient care. There is scant evidence of such movement in the Indian medical community. We aim to understand the perspectives of Indian TCAM and allopathic professionals on the influence of r/s in health. Using RSMPP (Religion, Spirituality and Medicine, Physician Perspectives) questionnaire, a cross-sectional survey was conducted at seven (five TCAM and two allopathic) pre-selected tertiary care medical institutes in India. Findings of TCAM and allopathic groups were compared. Majority in both groups (75% of TCAM and 84.6% of allopathic practitioners) believed that patients' spiritual focus increases with illness. Up to 58% of TCAM and allopathic respondents report patients receiving support from their religious communities; 87% of TCAM and 73% of allopaths believed spiritual healing to be beneficial and complementary to allopathic medical care. Only 11% of allopaths, as against 40% of TCAM, had reportedly received 'formal' training in r/s. Both TCAM (81.8%) and allopathic (63.7%) professionals agree that spirituality as an academic subject merits inclusion in health education programs (p = 0.0003). Inclusion of spirituality in the health care system is a need for Indian medical professionals as well as their patients, and it could form the basis for integrating TCAM and allopathic medical systems in India.
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Affiliation(s)
- P Ramakrishnan
- AdiBhat Foundation, R-90, Greater Kailash-I, New Delhi, 110048, India,
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18
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Rao VG, Bhat J, Yadav R, Muniyandi M, Bhondeley MK, Sharada MA, Chadha VK, Wares DF. Tobacco smoking: a major risk factor for pulmonary tuberculosis - evidence from a cross-sectional study in central India. Trans R Soc Trop Med Hyg 2014; 108:474-81. [DOI: 10.1093/trstmh/tru082] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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Chitadze G, Bhat J, Lettau M, Janssen O, Kabelitz D. Generation of soluble NKG2D ligands: proteolytic cleavage, exosome secretion and functional implications. Scand J Immunol 2013; 78:120-9. [PMID: 23679194 DOI: 10.1111/sji.12072] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/14/2013] [Indexed: 12/23/2022]
Abstract
The activating natural killer group 2 member D (NKG2D) receptor is expressed on NK cells, cytotoxic T cells and additional T cell subsets. Ligands for human NKG2D comprise two groups of MHC class I-related molecules, the MHC class I chain-related proteins A and B (MICA/B) and 6 UL16-binding proteins (ULBP1-6). While NKG2D ligands are absent from most normal cells, expression is induced upon stress and malignant transformation. In fact, most solid tumours and leukaemia/lymphomas constitutively express at least one NKG2D ligand and thereby are susceptible to NKG2D-dependent immunosurveillance. However, soluble NKG2D ligands are released from tumour cells and can down-modulate NKG2D activation as a means of tumour immune escape. In some tumour entities, levels of soluble NKG2D ligands in the serum correlate with tumour progression. NKG2D ligands can be proteolytically shed from the cell surface or liberated from the membrane by phospholipase C in the case of glycosylphosphatidylinositol (GPI)-anchored molecules. Moreover, NKG2D ligands can be secreted in exosomal microvesicles together with other tumour-derived molecules. Depending on the specific tumour/immune cell setting, these various forms of soluble and/or exosome-bound NKG2D ligands can exert multiple effects on NKG2D/NKG2D ligand interactions. In this review, we focus on the role of various proteases in the shedding of human NKG2D ligands from tumour cells and discuss the not completely unanimous reported functional implications of soluble and exosome-secreted NKG2D ligands for immunosurveillance.
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Affiliation(s)
- G Chitadze
- Institute of Immunology, University of Kiel, Kiel, Germany
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20
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To K, Patodi N, Bhat J, Haque M. Toxic epidermal necrolysis. Assoc Med J 2013. [DOI: 10.1136/bmj.f685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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22
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Rao VG, Yadav R, Bhat J, Tiwari BK, Bhondeley MK. Knowledge and attitude towards tuberculosis amongst the tribal population of Jhabua, Madhya Pradesh. Indian J Tuberc 2012; 59:243-248. [PMID: 23342547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A community-based cross-sectional survey was carried out amongst the tribal population of Jhabuain Madhya Pradesh. A total of 1385 individuals from randomly selected villages were interviewed using structured questionnaire. Eighty five per cent respondents had knowledge of the symptoms of tuberculosis. About a quarter of the respondents were not aware of any method for preventing TB. Though majority of the respondents (68.2%) stated that TB is a curable disease, most of them (67.2%) were not aware of the DOTS programme. The study emphasizes the need for extensive health education programme to create awareness about tuberculosis in tribal population of the region.
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Affiliation(s)
- V G Rao
- Regional Medical Research Centre for Tribals (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur - 482 003, Madhya Pradesh.
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Rao VG, Bhat J, Yadav R, Gopi PG, Selvakumar N, Wares DF. No time to be complacent with the performance of tuberculosis control activities in tribal areas of India. Int J Tuberc Lung Dis 2011; 15:1276-7. [PMID: 21943864 DOI: 10.5588/ijtld.11.0427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bhat J, Selvakumar N, Rao VG, Gopi PG, Yadav R, Wares DF. Yield of culture of Mycobacterium tuberculosis complex in sputum samples transported from tribal areas. Int J Tuberc Lung Dis 2011; 15:478-82. [PMID: 21396206 DOI: 10.5588/ijtld.10.0234] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is little information on the recovery of Mycobacterium tuberculosis complex from sputum samples collected in the field for bacteriological examination. SETTING Tribal areas in the State of Madhya Pradesh, in central India. METHODS Sputum specimens collected from subjects with chest symptoms in a disease prevalence survey were refrigerated until transportation to the laboratory. The specimens were processed for microscopy and culture. The samples were grouped based on the delay in processing for culture from the day of collection into three groups: 0-3, 4-7 and ≥8 days, and the recovery of M. tuberculosis complex in these groups was analysed. The statistical analysis was performed using χ(2) test. RESULTS Of the 3651 processed specimens, 114 were positive for M. tuberculosis complex by culture and 96 by smear microscopy. The differences in the proportion of 'smear-positive, culture-positive', 'smear-positive, culture-negative' and 'smear-negative, culture-positive' samples between the three groups were not significant. CONCLUSION In difficult-to-reach areas with limited resources, refrigeration of sputum specimens until they are transported for processing at a reference laboratory for culture seems not to significantly affect the recovery of M. tuberculosis complex isolates.
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Affiliation(s)
- J Bhat
- Regional Medical Research Centre for Tribals, Jabalpur, India.
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Kluk J, Goulding JMR, Bhat J, Finch TM. Drug-induced bullous pemphigoid: cases triggered by intravenous iodine and etanercept. Clin Exp Dermatol 2011; 36:871-3. [DOI: 10.1111/j.1365-2230.2011.04102.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Joseph N, Nagaraj K, Bhat J, Babu R, Kotian S, Ranganatha Y, Hocksan A, Shetty V, Zaki N, Swasthik K, Hamzah N. Treatment outcomes among new smear positive and retreatment cases of tuberculosis in Mangalore, South India - a descriptive study. Australas Med J 2011; 4:162-7. [PMID: 23393507 DOI: 10.4066/amj.2011.585] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND India has the highest tuberculosis burden in the world. For successful implementation of the Revised National Tuberculosis Control Programme (RNTCP), treatment outcomes and factors which influence them need to be assessed on a regular basis. This study was thus done to find out the sputum conversion rates, treatment outcomes and sociodemographic factors of new smear positive cases (NSP) and retreatment cases of pulmonary tuberculosis of the Mangalore Tuberculosis Unit (TU) registered at the District Tuberculosis Centre (DTC), Mangalore. METHOD This record-based cross-sectional study was undertaken in June 2009. Information pertaining to NSP or Category I patients and retreatment patients or Category II patients between June 2008 to May 2009 (one year period) were recorded. RESULTS Of 286 tuberculosis patients, 74.1% were on Category I treatment. The sputum conversion rate among Category I and II patients was 91.5% and 73% respectively. Category I patients showed a cure rate of 77.4%, a default rate of 7.5% and a failure rate of 15.1%. Category II patients showed a cure rate of 47.3%, default rate of 20.3% and failure rate of 32.4%. The differences in treatment outcomes between the two categories of treatment were found to be statistically significant (X(2) = 23.737, P <0.001). A favourable treatment outcome in Category I was significantly more in patients aged 30 years or less when compared to the rest (X(2) = 15.7, P = 0.004). However, gender and place of residence did not have a significant influence on treatment outcomes among NSP patients. Among retreatment patients, age, gender and place of residence did not have a significant influence on treatment outcomes. CONCLUSION Sputum conversion rates were satisfactory but the treatment outcome rates were poorer in our study area compared to Indian national figures. Among the sociodemographic factors, age was found to significantly influence treatment outcomes in Category I patients.
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Affiliation(s)
- N Joseph
- Assistant Professor, Department of Community Medicine, Manipal University, Mangalore, India
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Yadav R, Rao VG, Bhat J, Gopi PG, Wares DF. Annual risk of tuberculosis infection among the tribal children of Jhabua, Madhya Pradesh. Indian Pediatr 2011; 48:43-45. [PMID: 20972304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Accepted: 02/26/2010] [Indexed: 05/30/2023]
Abstract
A cross sectional tuberculin survey was undertaken to estimate the Annual Risk of Tuberculosis Infection (ARTI) amongst tribal children aged 1-9 years in Jhabua district, Madhya Pradesh, India. Of the 1056 test-read children, 774 (73.3%) had no BCG scar. The prevalence of infection was estimated as 6.3% (95% CI: 4.8-7.7) and ARTI as 1.2% (95% CI: 0.9-1.5). The findings suggest that the tuberculosis situation in the tribal population of Jhabua district is not that different from the situation among the non-tribal population in the country. However, there is a need to further intensify tuberculosis control measures in the area.
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Affiliation(s)
- R Yadav
- Regional Medical Research Centre for Tribals (RMRCT) (Indian Council of Medical Research), Nagpur Road, PO Garha, Jabalpur 482 003, MP, India
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Rao VG, Bhat J, Yadav R, Gopi PG, Selvakumar N, Wares DF. Diagnosis of pulmonary tuberculosis by symptoms among tribals in central India. Natl Med J India 2010; 23:372-373. [PMID: 21563337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Yadav R, Rao VG, Bhat J, Gopi PG, Wares DF. Annual risk of tuberculosis infection among the tribal children of Jhabua, Madhya Pradesh. Indian Pediatr 2010. [DOI: 10.1007/s13312-011-0022-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Yadav R, Rao VG, Bhat J, Gopi PG, Selvakumar N, Wares DF. Prevalence of pulmonary tuberculosis amongst the Baigas--a primitive tribe of Madhya Pradesh, Central India. Indian J Tuberc 2010; 57:114-116. [PMID: 21114182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND A community-based cross-sectional tuberculosis (TB) disease prevalence survey was undertaken amongst the Baiga primitive tribal community of Baiga Chak in central India. MATERIAL AND METHODS A population of 2,359 was covered under the study. Sputum samples were collected from chest symptomatics and examined for smear microscopy and culture. RESULTS Overall prevalence of PTB was 146 (95% C.I: 0-318) per 100,000 population. CONCLUSION The findings suggest that TB is not a major public health problem amongst this tribal group. However, there is still the need to maintain and further strengthen TB control measures on a sustained and long term basis in the area.
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Affiliation(s)
- R Yadav
- Regional Medical Research Centre for Tribals (RMRCT), Indian Council of Medical, Research, Jabalpur, Madhya Pradesh
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Rao VG, Bhat J, Yadav R, Gopi PG, Selvakumar N, Wares DF. Prevalence of pulmonary tuberculosis among the Bharia, a primitive tribe of Madhya Pradesh, central India. Int J Tuberc Lung Dis 2010; 14:368-370. [PMID: 20132630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
A cross-sectional survey was undertaken to estimate the prevalence of pulmonary tuberculosis (TB) among the primitive Bharia tribe of Madhya Pradesh, India. Virtually the entire community in Patalkot valley of Chhindwara District was covered. Individuals aged > or =15 years were questioned about chest symptoms relating to TB. Sputum samples were collected and examined by smear microscopy and culture. The overall prevalence of pulmonary TB was found to be 432 per 100 000 population-not dissimilar to that seen in the wider population in India. There is, however, an urgent need to strengthen TB services in the area to improve access for this group.
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Affiliation(s)
- V G Rao
- Regional Medical Research Centre for Tribals, Indian Council of Medical Research, Jabalpur, India.
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Rao VG, Anvikar A, Savargaonkar D, Bhat J. Sexually transmitted infections in tribal populations of central India. Eur J Clin Microbiol Infect Dis 2009; 28:1391-3. [PMID: 19657683 DOI: 10.1007/s10096-009-0783-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Accepted: 07/10/2009] [Indexed: 11/29/2022]
Abstract
This community-based cross-sectional study was carried out in 17 tribal villages of the Kundam block of the Jabalpur district of India. Individuals with sexually transmitted disease (STD) syndromes were enumerated and the specimens were collected for the laboratory diagnosis of sexually transmitted infections (STIs). Trichomoniasis, gonorrhoea, bacterial vaginosis and syphilis sero-reactivity were diagnosed by standard microbiological techniques. Chlamydia infection was detected by using polymerase chain reaction (PCR). A definite laboratory diagnosis of STIs could be established in 36.5% individuals. The most common STI in females was trichomoniasis, while in males, gonorrhoea was the most common. The highest proportion of individuals with STIs (39.2%) was in the age group 30-39 years. There is a need to focus on the primary prevention of STIs in the area.
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Affiliation(s)
- V G Rao
- Regional Medical Research Centre for Tribals, Indian Council of Medical Research, Nagpur Road, P.O. Garha, Jabalpur, 482 003, Madhya Pradesh, India.
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Rao VG, Anvikar A, Savargaonkar D, Bhat J, Yadav R, Tiwary BK, Abbad A. Prevalence of sexually transmitted disease syndromes in tribal population of central India. J Epidemiol Community Health 2009; 63:805-6. [PMID: 19556616 DOI: 10.1136/jech.2008.082909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND A syndromic approach has been advocated for identification and management of sexually transmitted diseases (STDs) in countries where diagnostic laboratory tests are not consistently available. A community-based cross-sectional study was conducted to discover the prevalence of STD syndromes in tribal population of central India. METHODS All married men and women in the age group of 15-49 years from selected villages were enumerated by house-to-house visit. Individuals were interviewed using pre-coded, pre-tested questionnaires about STD syndromes of urethral discharge, vaginal discharge, dysurea, genital ulcer, inguinal swelling, scrotal swelling and lower abdominal pain. RESULTS Of the 2568 individuals interviewed, 326 (12.7%) had at least one STD syndrome. The prevalence was almost double in women (17.6%) than in men (8.4%). The highest prevalence (16.2%) was observed in the age group 30-34 years followed by 35-39 years (14.7%). The commonest syndrome in women was vaginal discharge (16.0%) while in men the commonest syndrome was dysurea (1.8%). CONCLUSION The low level of STD syndromes among tribal populations offers an opportunity to prevent a potential epidemic in this disadvantaged community. As no baseline data are available, the findings form the basis for future work in this area.
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Affiliation(s)
- V G Rao
- Regional Medical Research Centre for Tribals, (Indian Council of Medical Research), Nagpur Road, PO Garha, Jabalpur - 482 003 (Madhya Pradesh), India.
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Bhat J, Rao V, Yadav R, Gadge V, Shukla G, Tiwari B, Ukey M, Rao S, Karforma C. Pulmonary Tuberculosis Among Tribal Population of Jhabua, Madhya Pradesh, India. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Prasad SC, Prasad KC, Bhat J. Vocal cord hemangioma. Med J Malaysia 2008; 63:419-420. [PMID: 19803307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Laryngeal hemangiomas are relatively rare. Laryngeal hemangiomas occur in two main forms--infantile and adult laryngeal hemangiomas. While infantile hemangiomas are usually found to occur in the subglottis, adult hemangiomas occur commonly in the supraglottic regions of the larynx. Laryngeal hemangioma with cavernous features isolated to the free edge of the vocal fold is a very rare clinical finding. We present a case of hemangioma of the right vocal cord in an adult, which was managed successfully in our center.
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Affiliation(s)
- S C Prasad
- Department of Otolaryngology - Head & Neck, Surgery, Kasturba Medical College, Mangalore, Karnataka State, India.
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Rao VG, Gopi PG, Yadav R, Subramani R, Bhat J, Anvikar AR, Sadacharam K, Tiwari BK, Gadge V, Bhondeley MK, Shukla GP, Ukey M, Jain S, Wares DF. Annual risk of tuberculosis infection among tribal population of central India. Trop Med Int Health 2008; 13:1372-7. [PMID: 18983281 DOI: 10.1111/j.1365-3156.2008.02152.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To estimate the annual risk of tuberculosis infection (ARTI) among tribal children of Madhya Pradesh, central India. METHODS Community-based, cross-sectional tuberculin survey among children aged 1-9 years in the tribal population of Madhya Pradesh. Multistage stratified cluster sampling was used to select a representative random sample of villages predominated by tribal population from selected districts. A total of 4802 children were tuberculin-tested with 1TU of PPD RT 23 and the reaction sizes read after 72 h. RESULTS A total of 3062 (64%) children had no BCG scar. The frequency distribution of children by reaction sizes indicated a fair mode at 18 mm in the right hand side of the distribution. By mirror-image technique, the prevalence of infection among children with no recognizable BCG scar was estimated as 6.8% (95% CI: 4.8-8.9%). The ARTI was computed as 1.3% (0.9-1.7%). The corresponding figures for children irrespective of scar status were 7.1% (95% CI: 5.5-8.8%) and 1.3% (1.0-1.7%) respectively. CONCLUSIONS The risk of tuberculosis infection in tribal population of Madhya Pradesh, central India is not different from other areas of the country. There is, however, a need to further intensify tuberculosis control measures on a sustained and long-term basis.
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Affiliation(s)
- V G Rao
- Regional Medical Research Centre for Tribals, Jabalpur, India.
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Rao VG, Gopi PG, Yadav R, Sadacharam K, Bhat J, Subramani R, Anvikar AR, Tiwari BK, Vasantha M, Bhondeley MK, Gadge V, Eusuff SI, Shukla GP. Tuberculous infection in Saharia, a primitive tribal community of Central India. Trans R Soc Trop Med Hyg 2008; 102:898-904. [PMID: 18632124 DOI: 10.1016/j.trstmh.2008.05.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Revised: 05/27/2008] [Accepted: 05/27/2008] [Indexed: 10/21/2022] Open
Abstract
A cross-sectional tuberculin survey was carried out to estimate the prevalence of tuberculous infection and the annual risk of tuberculosis infection (ARTI) among children of Saharia, a primitive ethnic group in Madhya Pradesh, Central India. A total of 1341 children aged 1-9 years were subjected to tuberculin testing with 1 TU of PPD RT 23 and the reaction sizes were read after 72 h. The proportion of BCG scar-positive children was 34.6%. The frequency distribution of children by reaction sizes indicated a clear-cut anti-mode at 11 mm and a mode at 18 mm at the right-hand side of the distribution. The prevalence of infection among children irrespective of BCG scar was estimated as 20.4% (95% CI 18.2-22.5%) and the ARTI was 3.9% (95% CI 3.5-4.3%). The corresponding figures were 21.1% (95% CI 18.3-23.8%) and 3.9% (95% CI 3.4-4.5%) among BCG scar-negative children and 19.0% (95% CI 15.4-22.5%) and 4.0% (95% CI 3.2-4.8%) among BCG scar-positive children. The findings of the present study show a high prevalence of tuberculous infection and high ARTI in this primitive ethnic group. There is an urgent need to further intensify tuberculosis control measures on a sustained and long-term basis in this area.
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Affiliation(s)
- V G Rao
- Regional Medical Research Centre for Tribals, Indian Council of Medical Research, Nagpur Road, P.O. Garha, Jabalpur 482 003, India.
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Kaur MR, Grindulis K, Maheshwari M, Ellis CJ, Bhat J, Tan CY. Delayed diagnosis of leprosy due to presentation with a rheumatoid-like polyarthropathy. Clin Exp Dermatol 2008; 32:784-5. [PMID: 17953648 DOI: 10.1111/j.1365-2230.2007.02525.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M R Kaur
- Department of Dermatology, City Hospital, Birmingham, UK.
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Abstract
HIV-1 infects brain cells, and this results in damage to the functioning of both the central and peripheral nervous systems. Progressive decline in communication behaviours can be seen from early stages of infection. Among the communication problems observed in those infected with HIV are speech, language, cognition and swallowing. This study was undertaken with the aim of creating a profile of the vocal impairments in individuals affected with HIV/AIDS, which would in turn support evidence-based practices in the assessment and management of such individuals. Eight participants were included in the study. Subjective analysis was carried out by a speech pathologist and objective analysis of acoustic parameters, by the use of Kay Elemetrics MDVP software. The results of the study reveal that all participants had affected parameters in the voice analysis, which ranged across subjects from one parameter to all parameters. Even in the absence of direct pathology to the voice production mechanism, almost all of the parameters of voice are affected in HIV-infected persons. As this is a preliminary study, it is too early to conclude that there is a correlation between vocal deviancies and medical conditions.
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Affiliation(s)
- M Mathew
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Manipal University, Mangalore, Karnataka 575001, India.
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Affiliation(s)
- J Bhat
- Department of Dermatology, University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, UK
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Steranka F, Bhat J, Collins D, Cook L, Craford M, Fletcher R, Gardner N, Grillot P, Goetz W, Keuper M, Khare R, Kim A, Krames M, Harbers G, Ludowise M, Martin P, Misra M, Mueller G, Mueller-Mach R, Rudaz S, Shen YC, Steigerwald D, Stockman S, Subramanya S, Trottier T, Wierer J. High Power LEDs - Technology Status and Market Applications. ACTA ACUST UNITED AC 2002. [DOI: 10.1002/1521-396x(200212)194:2<380::aid-pssa380>3.0.co;2-n] [Citation(s) in RCA: 184] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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