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Thakur N, Rai S, Kant S, Pandey A, Sahu D, Misra P, Haldar P, Jha S, Kumar P, Das C. Effectiveness of targeted intervention program under the national AIDS control program among Hijra and transgender population: Evidence from Integrated Biological and Behavioral Surveillance, 2014-15. Int J STD AIDS 2024; 35:337-345. [PMID: 38108257 DOI: 10.1177/09564624231218760] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The hijra and transgender (H/TG) population in India is vulnerable to HIV/AIDS. India had instituted a targeted intervention (TI) program to reduce this vulnerability. We aimed to measure the effectiveness of the TI program for H/TG. MATERIALS AND METHODS The National Integrated Behavioral and Biological Survey (IBBS) was carried out in 2014-15. H/TG data from IBBS was analyzed. Bivariate and multivariate logistic regression were used to calculate the unadjusted and adjusted odds ratios with 95% confidence interval. Condom use during the last sexual intercourse, and the consistent condom use in the last one month were considered as indicators of program effectiveness. The Propensity Score Matching (PSM) method was used to assess the effectiveness. RESULTS We found that the participants who had received condoms from peer educator/outreach worker were 1.74 and 1.40 times more likely to use condoms in the last sexual intercourse (aOR: 1.74, CI: 1.35 - 2.26) and consistent condom use in the last one month (aOR: 1.40, CI: 1.12 - 1.74) respectively compared to the participants who did not receive the condom. The matched-samples estimate (i.e., average treatment effect on treated) for the condom use during the last sexual intercourse increased by 13.0%, i.e., 0.13 (CI; 0.08 - 0.18) and consistent condom use in the last one month increased by 5.0%, i.e., 0.05 (CI; 0.00 - 0.10) among those who had received condoms from the peer educator/outreach worker compared with those who had not received condom, respectively. CONCLUSIONS The TI program intervention for H/TG was effective in reducing HIV risk behavior as evidenced by increase in use of condom during last sexual intercourse, and consistent condom use in the last one month.
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Affiliation(s)
| | - Sanjay Rai
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, AIIMS, New Delhi, India
| | | | | | - Puneet Misra
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Partha Haldar
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Shreya Jha
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Pradeep Kumar
- National AIDS Control Organization, New Delhi, India
| | - Chinmoyee Das
- National AIDS Control Organization, New Delhi, India
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Misra P, Medigeshi GR, Kant S, Jaiswal A, Ahmad M, Rahman A, Guleria R, Rai SK, Deori TJ, Mandal S, Gongal G, Bairwa M, Haldar P, Kumar R, Garg N. Long-Term Kinetics of SARS-CoV-2 Neutralizing and Anti-Receptor Binding Domain Antibodies among Laboratory-Confirmed COVID-19 Cases in Delhi National Capital Region, India: A Prospective, One-Year Follow-Up Study. J Clin Med 2024; 13:762. [PMID: 38337457 PMCID: PMC10856624 DOI: 10.3390/jcm13030762] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Background: This study was conducted with the objective of measuring the neutralizing and anti-receptor binding domain antibody levels against SARS-CoV-2 among laboratory-confirmed COVID-19 cases and exploring its long-term kinetics over a period of 1 year. Methods: One hundred laboratory-confirmed COVID-19 cases were recruited. Serum samples of the participants were collected within three months from the date of the positive COVID-19 report. The participants were prospectively followed up every three months for symptoms and the collection of blood samples for three additional rounds. The presence of anti-SARS-CoV-2 antibodies (IgA, IgG, and IgM antibodies), anti-receptor binding domain antibodies (anti-RBD), and neutralizing antibodies were measured. Findings: Median plaque reduction neutralization test (PRNT) titers showed a rising trend in the first three rounds of follow-up. The quantitative anti-receptor binding domain ELISA (QRBD) values showed a declining trend in the initial three rounds. However, both the PRNT titers and QRBD values showed significantly higher values for the fourth round of follow-up. Total antibody (WANTAI) levels showed an increasing trend in the initial three rounds (statistically significant). Interpretation: Neutralizing antibodies showed an increasing trend. The anti-receptor binding domain antibodies showed a decreasing trend. Neutralizing antibodies and anti-RBD antibodies persisted in the majority.
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Affiliation(s)
- Puneet Misra
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; (S.K.); (S.K.R.); (T.J.D.); (S.M.); (G.G.); (M.B.); (P.H.); (R.K.)
| | - Guruprasad R. Medigeshi
- Translational Health Science and Technology Institute, Faridabad 121001, India; (G.R.M.); (N.G.)
| | - Shashi Kant
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; (S.K.); (S.K.R.); (T.J.D.); (S.M.); (G.G.); (M.B.); (P.H.); (R.K.)
| | - Abhishek Jaiswal
- Employee State Insurance Corporation Medical College & Hospital, Faridabad 121001, India;
| | - Mohammad Ahmad
- WHO Country Office, New Delhi 110011, India; (M.A.); (A.R.)
| | - Anisur Rahman
- WHO Country Office, New Delhi 110011, India; (M.A.); (A.R.)
| | - Randeep Guleria
- Institute of Internal Medicine & Respiratory and Sleep Medicine, Medanta, Gurugram 122001, India;
| | - Sanjay Kumar Rai
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; (S.K.); (S.K.R.); (T.J.D.); (S.M.); (G.G.); (M.B.); (P.H.); (R.K.)
| | - Trideep Jyoti Deori
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; (S.K.); (S.K.R.); (T.J.D.); (S.M.); (G.G.); (M.B.); (P.H.); (R.K.)
| | - Suprakash Mandal
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; (S.K.); (S.K.R.); (T.J.D.); (S.M.); (G.G.); (M.B.); (P.H.); (R.K.)
| | - Gaurav Gongal
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; (S.K.); (S.K.R.); (T.J.D.); (S.M.); (G.G.); (M.B.); (P.H.); (R.K.)
| | - Mohan Bairwa
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; (S.K.); (S.K.R.); (T.J.D.); (S.M.); (G.G.); (M.B.); (P.H.); (R.K.)
| | - Partha Haldar
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; (S.K.); (S.K.R.); (T.J.D.); (S.M.); (G.G.); (M.B.); (P.H.); (R.K.)
| | - Rakesh Kumar
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; (S.K.); (S.K.R.); (T.J.D.); (S.M.); (G.G.); (M.B.); (P.H.); (R.K.)
| | - Neha Garg
- Translational Health Science and Technology Institute, Faridabad 121001, India; (G.R.M.); (N.G.)
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Khaitan A, Rai SK, Krishnan A, Gupta SK, Kant S, Khilnani GC. "I Would Rather Die Drinking than take the Medicine": Role of Alcohol Use Disorder in Loss-to-follow-up of Tuberculosis Treatment in a Rural Area of Ballabgarh, Haryana. Indian J Community Med 2024; 49:152-156. [PMID: 38425976 PMCID: PMC10900456 DOI: 10.4103/ijcm.ijcm_211_23] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/19/2023] [Indexed: 03/02/2024] Open
Abstract
Introduction Alcohol use disorder (AUD) is a significant risk factor for tuberculosis (TB) treatment loss-to-follow-up (LTFU). This field-based study was undertaken to understand the role of AUD and TB treatment LTFU and the reasons behind this association in a rural area of Ballabgarh, Haryana. Material and Methods TB patients who had completed their treatment and who had been LTFU were included in the study, along with the National TB Elimination Program (NTEP) staff, healthcare providers, family, and community members from Ballabgarh block of the north Indian state of Haryana. In-depth interviews (IDIs) and focused group discussions (FGDs) were conducted to gauge the perceptions of stakeholders regarding reasons for LTFU, especially in the context of alcohol use. Inductive analysis of the transcripts was done in keeping with the grounded theory, and themes with their sub-themes were identified. A conceptual framework of TB-AUD was constructed, and potential areas for intervention were determined. Results Fifty-eight IDIs and four FGDs were conducted in mid-2018. Almost all key informants and many patient participants believed that alcohol use makes TB patients highly susceptible to treatment LTFU. Key themes identified were shared personality traits and attitudes, combined side effects of anti-tubercular drugs and alcohol use, lack of family support, and an adverse financial situation. Conclusion These findings call for a change in NTEP's approach to AUD-TB. Interventions may include collecting alcohol use information at patient enrolment and closure, integrating brief interventions for alcohol cessation in NTEP, and linking patients to deaddiction centers with the provision of appropriate dietary and financial support.
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Affiliation(s)
- Anwita Khaitan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay K. Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev K. Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Gopi C. Khilnani
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Kaur R, Kant S, Ahmad M, Kumar A, Meena S, Bairwa M, Kumar R, Rahman A. The Factors Associated With COVID-19 Infection Among Healthcare Workers at a Tertiary Care Institution in North India: A Case-Control Study. Cureus 2024; 16:e52475. [PMID: 38371055 PMCID: PMC10873760 DOI: 10.7759/cureus.52475] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
Background and objective Healthcare workers (HCWs) are at a higher risk of contracting coronavirus disease 2019 (COVID-19) since they regularly come into direct contact with infected patients and their surroundings. In light of this, it is critical to study the potential risk factors for SARS-CoV-2 infection among HCWs to help determine its transmission patterns and prevent infections among HCWs, as well as healthcare-associated COVID-19. Methods We conducted a case-control study at a tertiary healthcare center from December 2020 to August 2021. HCWs who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, by RT-PCR were included as cases and those who tested negative for RT-PCR and SARS-CoV-2 antibodies were recruited as controls. We interviewed 316 HCWs (187 cases and 129 controls) by using the WHO questionnaire titled "Protocol for assessment of potential risk factors for coronavirus disease 2019 among health workers in a health care setting" to assess infection prevention and control (IPC) knowledge and practices, including the use of personal protective equipment (PPE). The odds ratio (OR) for factors associated with infection was determined by multivariable logistic regression. Results The majority (87.2%) of the cases were symptomatic. Adherence to IPC measures was higher among controls as compared to cases. A significantly higher number of controls used PPE compared to cases. The proportions of HCWs involved in cleaning, patient transport, reception, and catering were higher among cases (37.9%) compared to controls (19.1%). In multivariable analysis, undergoing training on care for COVID-19 patients was associated with a lower risk of infection (OR: 0.40, 95% CI: 0.24-0.69). Conclusions Adherence to IPC and use of PPE were significantly higher among controls as compared to cases. Receiving training in COVID-19 patient care and compliance with IPC measures were associated with a lower risk of COVID-19 infection among HCWs in this study.
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Affiliation(s)
- Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | | | - Arvind Kumar
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Suneeta Meena
- Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Mohan Bairwa
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Rakesh Kumar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Anisur Rahman
- Health and Research Emergency Office, World Health Organization, New Delhi, IND
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Misra P, Singh AK, Mishra B, Behera B, Patro BK, Medigeshi GR, Joshi HS, Ahmad M, Chaturvedi PK, Chinnakali P, Haldar P, Bairwa M, Kharya P, Dhodapkar R, Rath R, Guleria R, Rai SK, Kar SS, Kant S, Sarkar S, Baidya S, Meena S, Mandal S, Kishore S, Majumder T, Hada V. Anti-SARS-CoV-2 antibody kinetics up to 6 months of follow-up: Result from a nation-wide population-based, age stratified sero-epidemiological prospective cohort study in India. PLoS One 2023; 18:e0287807. [PMID: 38079384 PMCID: PMC10712846 DOI: 10.1371/journal.pone.0287807] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Repeated serological testing tells about the change in the overall infection in a community. This study aimed to evaluate changes in antibody prevalence and kinetics in a closed cohort over six months in different sub-populations in India. The study included 10,000 participants from rural and urban areas in five states and measured SARS-CoV-2 antibodies in serum in three follow-up rounds. The overall seroprevalence increased from 73.9% in round one to 90.7% in round two and 92.9% in round three. Among seropositive rural participants in round one, 98.2% remained positive in round two, and this percentage remained stable in urban and tribal areas in round three. The results showed high antibody prevalence that increased over time and was not different based on area, age group, or sex. Vaccinated individuals had higher antibody prevalence, and nearly all participants had antibody positivity for up to six months.
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Affiliation(s)
- Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Kumar Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | - Baijayantimala Mishra
- Department Microbiology, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | - Bijayini Behera
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | - Binod Kumar Patro
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | | | - Hari Shanker Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Mohammad Ahmad
- World Health Organization, WHO Country Office, New Delhi, India
| | | | - Palanivel Chinnakali
- Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Mohan Bairwa
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep Kharya
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Rahul Dhodapkar
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ramashankar Rath
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | | | - Sanjay Kumar Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sitanshu Sekhar Kar
- Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sonali Sarkar
- Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Subrata Baidya
- Department of Community Medicine, Agartala Government Medical College, Agartala, India
| | - Suneeta Meena
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Suprakash Mandal
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Tapan Majumder
- Department of Microbiology, Agartala Government Medical College, Agartala, India
| | - Vivek Hada
- Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
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Haldar P, Tripathi M, Prasad K, Kant S, Dwivedi SN, Vibha D, Pandit AK, Srivastava AK, Kumar A, Ikram MA, Henning T. Association of obstructive sleep apnea and sleep quality with cognitive function: a study of middle-aged and elderly persons in India. Sleep Breath 2023:10.1007/s11325-023-02953-7. [PMID: 38055152 DOI: 10.1007/s11325-023-02953-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/28/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Symptoms of obstructive sleep apnea (OSA) and poor sleep quality affect around one in ten people in India. We aimed to determine if OSA symptoms and poor sleep quality are independently associated with cognition in middle-aged and elderly urban Indian populations. METHODS We studied the cross-sectional association between OSA symptoms (by Berlin Questionnaire), poor sleep quality (by Pittsburgh Sleep Quality Index), and cognitive function in adults ≥ 50 years. Using a standard neuropsychological battery for cognitive function, a G-factor was derived as the first rotated principal component assessing domains of information processing, memory, and executive function. The associations of exposures with cognitive measures were modeled using linear regression, adjusted for metabolic risk factors, lifestyle factors, and psychosocial problems, followed by stratified analysis by decadal age group. RESULTS A total of 7505 adults were enrolled. Excluding those with MMSE < 26 (n 710), of 6795 individuals (49.2% women), mean (SD) age 64.2 (9.0) years, 38.3% had high risk of OSA symptoms, and 15.9% had poor sleep quality. OSA symptoms were negatively associated with cognitive domains of information processing (adjusted beta coefficient of z-score - 0.02, p-value 0.006), memory (- 0.03, 0.014), and G-factor (- 0.11, 0.014) in full-model. Stratified analysis by age group showed significant adverse effects of OSA symptoms on cognition for middle-aged people (50-60 years) (- 0.26, 0.001), but not in later age groups. Poor sleep quality was also associated with lower cognitive scores for G-factor (- 0.48, < 0.001), memory (- 0.08, 0.005), and executive domains (- 0.12, < 0.001), but not with information domain. CONCLUSION The findings suggest that both symptoms of OSA and poor sleep quality have a direct adverse impact on cognition in an Indian setting. A modest effect of age on the relationship of OSA and cognition was also observed.
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Affiliation(s)
- Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India.
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Formerly at: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amit Kumar
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - MArfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tiemeier Henning
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Dey S, Kusuma YS, Kant S, Kumar D, Gopalan RB, Sridevi P, Aggarwal S. COVID-19 vaccine acceptance and hesitancy in Indian context: a systematic review and meta-analysis. Pathog Glob Health 2023:1-14. [PMID: 38014567 DOI: 10.1080/20477724.2023.2285184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/29/2023] Open
Abstract
Vaccination against COVID-19 is vital for achieving herd immunity, and the Government of India has adopted several strategies to achieve coverage. Vaccine hesitancy was identified as a potential obstacle in combating COVID-19. This study aimed to review the COVID-19 vaccine acceptance and hesitancy, and factors associated with vaccine hesitancy based on studies conducted in Indian populations. The data sources (PubMed, Scopus, and Google Scholar) were searched by following PRISMA guidelines, and the search was done in September 2022. We performed a meta-analysis through a random effect model to estimate pooled hesitancy rate with 95% confidence intervals (CI). A total of 3,339 records were searched, of which 46 studies were found to be eligible for inclusion in the review. The included studies covered 65,551 respondents, 55% were female. Studies reported COVID-19 vaccine acceptance rate of 65.7% in January-February 2021, which increased to 92.8% in May-August 2021. Likewise, the rate of vaccine hesitancy in December 2020 was 37%, dropping to 12.1% through November 2021. The estimated pooled COVID-19 vaccine hesitancy was 31% [95% CI: 27% - 36%, I2 = 99.3%]. Most studies highlighted that fear of the vaccine's side effects, efficacy, and safety were major barriers to vaccine acceptance. However, as the review indicates, it is important to consider and address all factors contributing to vaccine hesitancy.
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Affiliation(s)
- Sangeeta Dey
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Yadlapalli S Kusuma
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Dewesh Kumar
- Department of Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | | | - Parikipandla Sridevi
- Department of Biotechnology, Central Tribal University of Andhra Pradesh, Vizianagaram, India
| | - Sumit Aggarwal
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
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Singh T, Kaur R, Kant S, Mani K, Yadav K, Gupta SK. Effect of COVID-19 pandemic on utilization of maternal healthcare services in a rural area of Haryana - A record-based comparative study. J Family Med Prim Care 2023; 12:2640-2644. [PMID: 38186835 PMCID: PMC10771182 DOI: 10.4103/jfmpc.jfmpc_99_23] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 01/09/2024] Open
Abstract
Background The COVID-19 pandemic posed a challenge for the public health system, as all the health facilities and manpower were diverted for the delivery of COVID-19-related services. This affected the provision of routine health services, including maternal healthcare services. There is a paucity of data from rural and primary healthcare settings, as the earlier studies were either modelling-based or from tertiary care centres. Materials and Methods This record-based study was conducted in 12 subcentres in the district Faridabad of Haryana. Data of pregnant women registered during 1 April to 30 September in the years 2017-2020 were retrieved. The utilization of maternal healthcare services among women registered during 1 April 2020 to 30 September 2020 was compared with those registered in the same period during the preceding 3 years (2017-2019). Results There was a significant decline in utilization of maternal healthcare services. Services like minimum four antenatal visits declined from 67.8% to 48.3% (P < 0.0001), at least 100 iron-folic acid tablets (45.4-20.9%; P < 0.001), and examination at each visit (90.8-72.3%; P < 0.001). The proportion of pregnant women who received full antenatal care decreased from 26.0% to 10.7% (P < 0.001). There was a significant increase in delivery in private health facilities (40.9-49.9%) and delivery by caesarean section (21.6-27.3%; P = 0.002). Conclusion COVID-19 pandemic had an adverse effect on utilization of maternal healthcare services. Effective planning and coordination between different levels of government health facilities and primary care providers, including family physicians, can ensure uninterrupted provision of essential services during similar emergencies in future.
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Affiliation(s)
- Tejbeer Singh
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Kapil Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Sanjeev Kumar Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Rai SK, Thakur N, Jha S, Kumar P, Haldar P, Kant S, Misra P, Venkatesh S. Description of HIV risk behavior among adolescent female sex workers: Findings from the nationwide cross-sectional integrated biological and behavioral surveillance (IBBS) 2014-15 survey for HIV in India. J Family Med Prim Care 2023; 12:2645-2651. [PMID: 38186825 PMCID: PMC10771203 DOI: 10.4103/jfmpc.jfmpc_2508_22] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Adolescent female sex workers are at high risk of acquiring human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) infection. There was paucity of information regarding their sexual practices. The main objective of this study was to study the sexual behavior, condom use practices, and physical and sexual violence experienced by adolescent female sex workers (FSWs). Materials and Methods This study was a secondary data analysis of the data collected during the nationwide IBBS 2014-15 survey. All adolescent FSWs aged 15 to 19 years were included in the analysis. The primary outcome variable was HIV serostatus, and independent variables included sexual behavior and condom use practices and socio-demographic variables. Descriptive analyses were performed to estimate the prevalence of independent variables. Ethical approval of the original IBBS study was obtained by the Ethics Committee of National AIDS Control Organization. Results A total of 948 adolescent FSWs were included in the final analysis. The prevalence of HIV in adolescent FSWs was 1.2% [95% confidence interval, 0.1-1.9%]. The mean age [standard deviation (SD)] of FSWs was 18.2 (0.9) years. The mean (SD) age at first sexual intercourse was 15.6 (1.7) years, and the mean (SD) age of starting sex work was 16.6 (1.5) years. The majority of the FSWs (94%) had used condom during the last sexual intercourse with a commercial partner, and about one-thirds (66%) had consistently used condom with a commercial partner. About a quarter (26%) of the FSWs had anal intercourse with a commercial partner in the last 1 month. About one in five FSWs (21%) had experienced physical violence in the last 1 year. Conclusion Almost one-third of FSWs had high-risk sexual behavior like multiple clients, anal intercourse, inconsistent condom use, and so on. These behaviors in turn increase their vulnerability to HIV infection.
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Affiliation(s)
- Sanjay K. Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Nishakar Thakur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shreya Jha
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep Kumar
- National AIDS Control Organization, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Srinivas Venkatesh
- Department of Strategic Information, NACO, Ministry of Health and Family Welfare, Government of India, New Delhi, India
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Vashisht S, Jha S, Kant S, Thakur N, Rai S. Challenges Faced and Coping Strategies Adopted by Injecting Drug Users during COVID-19 Lockdown-A Qualitative Study. Indian J Community Med 2023; 48:846-851. [PMID: 38249706 PMCID: PMC10795882 DOI: 10.4103/ijcm.ijcm_649_22] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/30/2023] [Indexed: 01/23/2024] Open
Abstract
Background The lockdown due to COVID-19 pandemic has adversely affected the lives of vulnerable population, including the injecting drug users (IDUs). The objective of the study was to document the coping mechanism adopted by IDUs and suggest measures to mitigate the adverse effects, if similar situation were to arise in future. Materials and Methods A qualitative study was conducted at the Targeted Intervention Non-Government Organizations catering to IDUs in Delhi and Ghaziabad district of Uttar Pradesh. Four focus group discussions among 41 IDUs and 7 key informant interviews of the NGO staff were conducted in the study. The Hindi recordings were coded and the data analysis was performed manually using grounded theory approach. Results We found that the lockdown affected the lives of most of the IDUs and they found it difficult to access the harm reduction services. To cope with this, many IDUs started following alternate methods to support the drug habits. There was an increase in reuse of needles and syringes. Conclusion The lockdown during COVID-19 and the resulting challenges negatively impacted the physical and mental health of the IDUs. We recommend that in any similar future scenario, travel pass may be issued to the IDUs and the TI-NGO personnel.
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Affiliation(s)
- Shruti Vashisht
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shreya Jha
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Nishakar Thakur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Divakaran S, Krawisz AK, Secemsky EA, Kant S. Sex and Racial Disparities in Peripheral Artery Disease. Arterioscler Thromb Vasc Biol 2023; 43:2099-2114. [PMID: 37706319 PMCID: PMC10615869 DOI: 10.1161/atvbaha.123.319399] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
Several studies have shown that women and racial and ethnic minority patients are at increased risk of developing lower extremity peripheral artery disease and suffering adverse outcomes from it, but a knowledge gap remains regarding the underlying causes of these increased risks. Both groups are more likely to be underdiagnosed, have poorly managed contributory comorbidities, and incur disparities in treatment and management postdiagnosis. Opportunities for improvement in the care of women and racial and ethnic minorities with peripheral artery disease include increased rates of screening, higher rates of clinical suspicion (particularly in the absence of typical symptoms of intermittent claudication), and more aggressive risk factor management before and after the diagnosis of peripheral artery disease.
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Affiliation(s)
- Sanjay Divakaran
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Anna K Krawisz
- Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Eric A Secemsky
- Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Shashi Kant
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Misra P, Garg PK, Awasthi A, Kant S, Rai SK, Ahmad M, Guleria R, Deori TJ, Mandal S, Jaiswal A, Gongal G, Vishwakarma S, Bairwa M, Kumar R, Haldar P, Binayke A. Cell-Mediated Immunity (CMI) for SARS-CoV-2 Infection Among the General Population of North India: A Cross-Sectional Analysis From a Sub-sample of a Large Sero-Epidemiological Study. Cureus 2023; 15:e48824. [PMID: 38106811 PMCID: PMC10722242 DOI: 10.7759/cureus.48824] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 12/19/2023] Open
Abstract
Background Cell-mediated immunity (CMI), or specifically T-cell-mediated immunity, is proven to remain largely preserved against the variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including Omicron. The persistence of cell-mediated immune response in individuals longitudinally followed up for an extended period remains largely unelucidated. To address this, the current study was planned to study whether the effect of cell-mediated immunity persists after an extended period of convalescence or vaccination. Methods Whole blood specimens of 150 selected participants were collected and tested for Anti-SARS-CoV-2 Interferon-gamma (IFN-γ) response. Ex vivo SARS-CoV-2-specific interferon-gamma Enzyme-linked Immunospot (IFN-γ ELISpot) assay was carried out to determine the levels of virus-specific IFN-γ producing cells in individual samples. Findings Out of all the samples tested for anti-SARS-CoV-2 T-cell-mediated IFN-γ response, 78.4% of samples were positive. The median (interquartile range) spots forming units (SFU) per million levels of SARS-CoV-2-specific IFN-γ producing cells of the vaccinated and diagnosed participants was 336 (138-474) while those who were vaccinated but did not have the disease diagnosis was 18 (0-102); the difference between the groups was statistically significant. Since almost all the participants were vaccinated, a similar pattern of significance was observed when the diagnosed and the never-diagnosed participants were compared, irrespective of their vaccination status. Interpretations Cell-mediated immunity against SARS-CoV-2 persisted, irrespective of age and sex of the participant, for more than six months of previous exposure. Participants who had a history of diagnosed COVID-19 infection had better T-cell response compared to those who had never been diagnosed, in spite of being vaccinated.
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Affiliation(s)
- Puneet Misra
- Epidemiology and Public Health, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Pramod K Garg
- Gastroenterology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Amit Awasthi
- Allergy and Immunology, Centre for Immunobiology and Immunotherapy, Translational Health Science and Technology Institute, Faridabad, IND
| | - Shashi Kant
- Epidemiology and Public Health, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Sanjay K Rai
- Epidemiology and Public Health, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Mohammad Ahmad
- Epidemiology and Public Health, World Health Organization, New Delhi, IND
| | - Randeep Guleria
- Pulmonary, Critical Care, and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Trideep J Deori
- Epidemiology and Public Health, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Suprakash Mandal
- Epidemiology and Public Health, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Abhishek Jaiswal
- Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Gaurav Gongal
- Epidemiology and Public Health, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Siddhesh Vishwakarma
- Allergy and Immunology, Immunology Core Laboratory, Translational Health Science and Technology Institute, Faridabad, IND
| | - Mohan Bairwa
- Epidemiology and Public Health, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Rakesh Kumar
- Epidemiology and Public Health, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Partha Haldar
- Preventive Medicine, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Akshay Binayke
- Allergy and Immunology, Centre for Immunobiology and Immunotherapy, Translational Health Science and Technology Institute, Faridabad, IND
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Liu H, Caliz AD, Learnard H, Koupenova M, Keaney JF, Kant S, Zhu LJ, Vertii A. Inflammatory stress-mediated chromatin changes underlie dysfunction in endothelial cells. bioRxiv 2023:2023.10.11.561959. [PMID: 37905100 PMCID: PMC10614786 DOI: 10.1101/2023.10.11.561959] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Inflammatory stresses underlie endothelial dysfunction and contribute to the development of chronic cardiovascular disorders such as atherosclerosis and vascular fibrosis. The initial transcriptional response of endothelial cells to pro-inflammatory cytokines such as TNF-alpha is well established. However, very few studies uncover the effects of inflammatory stresses on chromatin architecture. We used integrative analysis of ATAC-seq and RNA-seq data to investigate chromatin alterations in human endothelial cells in response to TNF-alpha and febrile-range heat stress exposure. Multi-omics data analysis suggests a correlation between the transcription of stress-related genes and endothelial dysfunction drivers with chromatin regions exhibiting differential accessibility. Moreover, microscopy identified the dynamics in the nuclear organization, specifically, the changes in a subset of heterochromatic nucleoli-associated chromatin domains, the centromeres. Upon inflammatory stress exposure, the centromeres decreased association with nucleoli in a p38-dependent manner and increased the number of transcripts from pericentromeric regions. Overall, we provide two lines of evidence that suggest chromatin alterations in vascular endothelial cells during inflammatory stresses.
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Affiliation(s)
- Haibo Liu
- Molecular, Cell and Cancer Biology Department, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Amada D. Caliz
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Heather Learnard
- Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Milka Koupenova
- Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - John F. Keaney
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Shashi Kant
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Lihua Julie Zhu
- Molecular, Cell and Cancer Biology Department, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Program in Molecular Medicine, Program in Bioinformatics and Integrative Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Anastassiia Vertii
- Molecular, Cell and Cancer Biology Department, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Program in Innate Immunity, University of Massachusetts Chan Medical School, Worcester, MA, USA
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Yadav K, K. J. S, Meena S, Kumar R, Kaur R, Bairwa M, Kant S, Misra P, Rai SK, Ahmad M, Rahman A. Household transmission investigation for Corona Virus Disease 2019 (COVID-19) in a rural and urban population of north India. PLoS One 2023; 18:e0287048. [PMID: 37796802 PMCID: PMC10553284 DOI: 10.1371/journal.pone.0287048] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 05/28/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Transmissibility within closed settings, such as households, can provide a strategic way to characterize the virus transmission patterns because the denominator can be well defined. We aimed to characterize the household transmission of Severe Acute Respiratory Syndrome Coronavirus (SARS CoV-2) and its associated risk factors. METHODS This prospective case-ascertained study was conducted among the household contacts of laboratory-confirmed SARS CoV-2 cases residing in Ballabgarh, Haryana. We enrolled 148 index cases and their 645 household contacts between December 16, 2020 and June 24, 2021. We defined household contact as any person who had resided in the same household as a confirmed COVID-19 case. Baseline data collection and sample collection for real time- reverse transcriptase polymerase chain reaction (RT-PCR) and IgM/IgG against SARS CoV-2 were done on day 1 visit, and followed for a period of 28 days. RT-PCR was repeated on day 14 or whenever the contact is symptomatic and blood sample for serology was repeated on day 28. We estimated household secondary infection rate (SIR) and other epidemiological indicators-median incubation period and serial interval. We employed binomial logistic regression to quantify risk factors associated with infection. RESULTS The household SIR was 30.5% (95% CI: 27.1-34.1%). The secondary clinical attack rate was 9.3% (95% CI: 7.2-11.8). The risk factors that showed higher susceptibility to infection were household contacts who were the primary care giver of the case, whose index cases were symptomatic, those with underlying medical conditions, those living in overcrowded households, who were sharing toilet with the index cases and also who were not wearing a mask when coming in contact with the case. The median (IQR) incubation period was 4 days (4, 5), mean (SD) serial interval 6.4 (±2.2) days, and median (IQR) serial interval 5 days (5, 7). CONCLUSION Households favour secondary transmission of SARS CoV- 2, hence, index cases are recommended to self-isolate and wear masks; and household contacts to follow strict COVID infection control measures within households when a family member is infected.
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Affiliation(s)
- Kapil Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Subhashini K. J.
- Consultant, WHO Unity Project, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Suneeta Meena
- Laboratory Medicine, Microbiology Division, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Mohan Bairwa
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay K. Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Mohammad Ahmad
- National Professional Officer (Research), World Health Organization Country Office for India, New Delhi, India
| | - Anisur Rahman
- Health Emergencies and Research Officer, World Health Organization Country Office for India, New Delhi, India
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Sethi AK, Haldar P, Rai SK, Kant S, Rajan S, Kumar P, Mishra JK, Singh B. Low awareness but high acceptability of pre-exposure prophylaxis for HIV among men who have sex with men and transgender persons in Delhi, India. Int J STD AIDS 2023; 34:763-776. [PMID: 37269245 DOI: 10.1177/09564624231174936] [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] [Indexed: 06/05/2023]
Abstract
Background: HIV pre-exposure prophylaxis (PrEP) is part of India's HIV prevention policy. We aimed to determine awareness of and willingness-to-use PrEP among men-who-have-sex-with-men (MSM) and transgender-persons (TG) in Delhi, India.Methods: A cross-sectional study was conducted at five purposively selected targeted-intervention projects in Delhi. Participants included self-identified MSM/TG aged ≥18 years, with negative/unknown HIV serostatus. A structured interview schedule, developed using formative research, was used. Primary outcomes were awareness of, and willingness-to-use PrEP. Socio-demographic and behaviour variables included age, living situation, education, anal-sex, condom-use and experiences of physical-violence. Determinants of outcome were identified in univariable logistic regression; variables associated at p < .25 were included in multivariable regression models.Results: Of 400 (224 MSM, 176 TG), mean ± SD age 25.7 ± 7.2 years, 14.5% (95% CI 11.0, 18.0) were aware of PrEP, while 63.3% (95% CI: 58.6, 68.1) reported willingness-to-use PrEP. PrEP-awareness was independently associated with formal-education (adjusted odds ratio; AOR = 1.20), professional occupation (AOR = 5.45) and condom-use (AOR = 3.07). Willingness-to-use PrEP was higher if participants had recent anal-sex (AOR = 2.29), had used condoms during anal-sex (AOR = 2.09), or recently experienced physical-violence (AOR = 3.65).Conclusions: PrEP awareness was low, but most were willing to use PrEP, implying that communication is key to PrEP awareness and uptake.
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Affiliation(s)
- Adhish Kumar Sethi
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Kumar Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shobini Rajan
- National AIDS Control Organization, New Delhi, India
| | | | | | - Bhawani Singh
- National AIDS Control Organization, New Delhi, India
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Dadhwal V, Sagar R, Bhattacharya D, Kant S, Misra P, Choudhary V, Vanamail P. Prevalence of postpartum depression & anxiety among women in rural India: Risk factors & psychosocial correlates. Indian J Med Res 2023; 158:407-416. [PMID: 37988000 DOI: 10.4103/ijmr.ijmr_3489_20] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND OBJECTIVES Postpartum depression and anxiety (PPD/A) impact a woman's physical and psychological wellbeing. In the absence of corroboratory evidence from the community setting in India, the present study was undertaken to examine the prevalence, psychosocial correlates and risk factors for PPD/A in the rural community of India. METHODS This cross-sectional study included 680 women during the postpartum period from a rural community in northern India. Screening for PPD/A was done using Edinburg Postnatal Depression Scale and State and Trait Anxiety Inventory. Diagnostic assessment of screened-positive women was done using Mini-International Neuropsychiatric Interview (MINI). The psychosocial evaluation was done on parameters including women's social support, bonding with the child, functionality, parental stress, interpersonal violence and marital satisfaction. RESULTS The overall prevalence of PPD/A/both in community women was 5.6 per cent, with a specific prevalence of 2.2 per cent for PPD, 0.74 per cent for PPA and 2.8 per cent for both disorders. Comparative analysis indicated that women with PPD/A/both experienced significantly higher levels of parenting stress, poor lifestyle (prior two weeks), less support from their partner, parents-in-law and parents, less marital satisfaction, high intimate partner violence, poor bonding with infants and higher infant-focussed anxiety. On multivariable logistic regression analysis, higher education, marital satisfaction, support from partners and in-laws were associated with reducing the risk of PPD/A/both. INTERPRETATION CONCLUSIONS Rural Indian women experience PPD/A/both which causes stress and impacts their functionality, bonding with the infant and relationship with their spouse and parents. Higher education, marital satisfaction and higher support from partners and in-laws reduce the risk of developing PPD/A/both.
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Affiliation(s)
- Vatsla Dadhwal
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | | | - Shashi Kant
- Department of Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Misra
- Department of Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vandana Choudhary
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
- Swayam Psychotherapy Centre, New Delhi, India
| | - Perumal Vanamail
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
- Department of Biostatistics & Research, Trichy SRM Medical College Hospital & Research Centre, Trichy, Tamil Nadu, India
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Debnath A, Salve HR, Sagar R, Krishnan A, Kumar R, Kant S. Mapping of mental health care facilities and psychiatrists in a North Indian district of India. Indian J Psychiatry 2023; 65:1078-1082. [PMID: 38108055 PMCID: PMC10725207 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_168_23] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/20/2023] [Accepted: 08/30/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Since 1990, the proportional contribution of mental disorders to India's total disease burden has nearly doubled, but the number of psychiatrists has not increased proportionately. Even after two decades of District Mental Health Programme (DMHP) launch, a considerable treatment gap still exists for mental illness. The present study aimed to map all health facilities providing mental health services and all psychiatrists in district Faridabad, Haryana. Methods The starting point was the information available with the DMHP and district health office. This was supplemented by web search and snowball sampling. All identified facilities were visited to map the mental health services provided. All the mental health care providers and health care facilities were mapped using "Google my Maps". 2011 census data on population were used. Results In Faridabad, 0.88 psychiatrists per lakh population were present. Most psychiatrists were concentrated in the urban area. The number of psychiatrists per lakh population was 1.1 in urban, compared to 0.54 in rural Faridabad. Clustering of mental health facilities was also observed more in urban areas (8.7 per 100 Sq Km) compared to rural areas (0.95 per 100 Sq Km) of district Faridabad. Conclusion There was a scarcity of psychiatric manpower and facilities in the district with a distinct urban skew.
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Affiliation(s)
- Aninda Debnath
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Harshal Ramesh Salve
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Kant S, Zhao Y, Kesarwani P, Chinnaiyan P. Exploiting Enhanced Lipid Metabolism in Glioblastoma through Diet Modification. Int J Radiat Oncol Biol Phys 2023; 117:e113-e114. [PMID: 37784654 DOI: 10.1016/j.ijrobp.2023.06.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Enhanced lipid metabolism has emerged as a central metabolic node in glioblastoma, serving as a 'gain of function' that allows these cells to efficiently adapt to their dynamic tumor microenvironment. Seemingly contradictory to this, pre-clinical studies have demonstrated anti-tumor activity in mice fed a high-fat/low-carbohydrate ketogenic diet (KD), both alone and in combination with radiation therapy (RT). In this study, we sought to identify mechanisms underlying the antitumor activity of a KD in glioblastoma from a metabolic perspective to better understand factors contributing to this apparent disconnect. MATERIALS/METHODS Immunocompromised and immunocompetent mice were injected orthotopically with human and mouse-derived glioblastoma cell lines and randomized to four treatment arms. Mice were fed ad libitum a standard diet (SD), KD (Bio-Serve), or a modified unsaturated fatty acid (uFA) rich diet (MD; 60/30/10: fat/protein/carb) alone or in combination with hypofractionated RT (6 Gy x 3). Global metabolomic profiling of tumors and serum were carried out using LC/GC-MS. Lipid droplets were analyzed by flow cytometer and confocal microscopy using BODIPY staining and free fatty acids were measured using a commercially available kit. RESULTS A KD demonstrated independent anti-tumor activity and potent synergy with RT in two aggressive glioblastoma models. Metabolomic profiling of tumors revealed significant changes in tumor metabolism in KD-fed mice when compared to SD, with an accumulation of uFAs being a key finding. We therefore sought to determine if this accumulation of fatty acids in KD mice contributed towards the observed anti-tumor activity. Consistent with in vivo results, in vitro studies using the uFA linoleic acid demonstrated anti-proliferative activity, reduced clonogenic capacity, and potent synergy when combined with RT in glioblastoma cells. Through a series of investigations, we went on to determine that this anti-tumor activity was attributed to the ability of uFA to override lipid storage homeostasis in glioblastoma cells, resulting in lipotoxicity. Based on these findings, we hypothesized high fat concentrations, rather than carbohydrate restriction, contributed to the anti-tumor activity of a KD. To test this, we generated a MD rich in uFA that did not require carbohydrate restriction. Similar to a KD, mice fed a MD demonstrated both independent anti-tumor activity and potent synergy when combined with RT. CONCLUSION High concentrations of uFA represents a key factor underlying the anti-tumor activity of a KD in glioblastoma by targeting lipid homeostasis. A MD consisting of high concentrations of uFA without carbohydrate restriction demonstrates promising anti-tumor activity in glioblastoma models. As a major limitation of a KD is tolerability, particularly in glioblastoma patients, a MD represents a promising form of dietary modification that may be translated clinically.
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Affiliation(s)
- S Kant
- Beaumont Health, Royal Oak, MI
| | - Y Zhao
- Beaumont Health, Royal Oak, MI
| | - P Kesarwani
- Department of Radiation Oncology, Beaumont Health, Royal Oak, MI
| | - P Chinnaiyan
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI
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Achary MGT, Kaur R, Vibha D, Mani K, Kant S, Gupta SK. Mild Cognitive Impairment among Elderly Persons Residing in an Urban Resettlement Colony in Delhi. Indian J Community Med 2023; 48:721-726. [PMID: 37970150 PMCID: PMC10637611 DOI: 10.4103/ijcm.ijcm_8_23] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/18/2023] [Indexed: 11/17/2023] Open
Abstract
Background Mild cognitive impairment (MCI) is a transitional state between normal cognition and clinical dementia. MCI is associated with an increased risk of dementia and mortality. Progression of MCI to dementia can be prevented by cognitive and lifestyle interventions. There is limited evidence on the burden and risk factors associated with MCI in India. To estimate the prevalence of MCI among elderly persons, and to study the factors associated with MCI. Materials and Methods This community-based cross-sectional study was carried out among 365 persons aged 60 years or older, residing in an urban resettlement colony of Delhi. Participants with dementia (score <23 on the Hindi version of the Mini-Mental State Examination) were excluded. Objective cognitive impairment and functional disability were assessed by the Montreal Cognitive Impairment-Basic (MoCA-B) tool and Barthel's Activities of Daily Living, respectively. The prevalence of MCI was estimated by Petersen's criteria, i.e., subjective memory impairment, objective cognitive impairment (MoCA score 19-25), functional independence, and absence of dementia. Univariate analysis was performed, followed by stepwise multivariate logistic regression. The association of socio-demographic and other health conditions with MCI was assessed. Results The prevalence of MCI was 9.3% [95% confidence interval (CI) 6.7-12.7], 13.3% (95% CI 8.8-19.7) among men, and 6.5% (95% CI 3.9-10.6) among women. The risk of MCI was higher among current smokers. Conclusions MCI was common among the elderly. Early detection of MCI may be included in health programs for elderly persons.
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Affiliation(s)
- MG Thejas Achary
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Kumar Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Singh T, Kaur R, Kant S, Mani K, Yadav K, Gupta SK. Maternal Healthcare Services in a Rural Area of Haryana during the COVID-19 Pandemic: A Community-Based Study. Indian J Community Med 2023; 48:715-720. [PMID: 37970159 PMCID: PMC10637588 DOI: 10.4103/ijcm.ijcm_43_23] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/30/2023] [Indexed: 11/17/2023] Open
Abstract
Background It is well documented that the utilization of maternal healthcare services during pregnancy and childbirth plays a significant role in reducing maternal morbidity and mortality. Disruptions in maternal healthcare services during the coronavirus disease 2019 (COVID-19) pandemic have been reported. However, there is a paucity of literature from rural areas, as most of the previous studies are either record-based or conducted in tertiary care centers. This study aimed to determine the proportion of women who received the recommended maternal healthcare services during the COVID-19 pandemic and to study various factors associated with the utilization of services. Material and Methods In this community-based study, we assessed the utilization of maternal healthcare services among 520 women residing in the Ballabgarh Block of District Faridabad, Haryana, whose antenatal, intrapartum, and postnatal period coincided with the first wave of COVID-19 pandemic. Domiciliary visits were made, and women were interviewed retrospectively regarding maternal healthcare services utilized by them. The antenatal care (ANC) cards were reviewed, and details were corroborated. Results Full ANC was received by 15.3% of women, and 45% of women had less than four antenatal visits. 30.9% of participants had cesarean delivery. The proportion of cesarean delivery in private facilities was significantly higher than in government facilities [Odds Ratio (OR) (95% Confidence intervals (CI)) =10.04 (5.87-17.19); P < 0.001]. In multivariate logistic regression, gravidity was negatively associated with full ANC [OR (95% CI) =0.43 (0.25-0.74); P = 0.002]. Conclusion Fewer women received the recommended maternal healthcare services during the COVID-19 pandemic. Detailed assessment of health systems and factors affecting routine healthcare services, during the pandemic, can help improve the readiness and response in the future.
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Affiliation(s)
- Tejbeer Singh
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Kumar Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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21
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Kant S, Saha S, Lloret F, Cano J, Mukherjee R. A tetracobalt(II) cluster with a two vertex truncated dicubane topology endogenously supported by carboxylate-based (2-pyridyl)methylamine ligands: magneto-structural and DFT studies. Dalton Trans 2023; 52:11922-11933. [PMID: 37574905 DOI: 10.1039/d3dt01131c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
A reaction between CoCl2 and L3-(CO2-)2 (2 : 1 stoichiometry) in CH3OH affords a discrete complex [CoII4-{L3-(CO2-)2}2(μ3-OCH3)2(CH3OH)2(H2O)2Cl2] (1) [L3-(CO2-)2 = 3-[N-{2-(pyridin-2-yl)methyl}amino]-bis(propionate)]. The structure of 1 reveals two terminal mononuclear CoII{L3-(CO2-)2}Cl units connected by a dimeric CoII2(μ3-OCH3)2(CH3OH)2(H2O) unit present in the centre through two methoxo (μ3-OCH3)- and two carboxylate (μ-1,1-OCO-) bridges affording a tetranuclear coordination cluster of Co(II) with a defective dicubane topology. In 1, Co1 (terminal) has distorted octahedral CoIIN2O3Cl and the central Co2 has CoIIO6 coordination. Such coordination arrangements afford the observed topology. Variable-temperature magnetic studies reveal anti-ferromagnetic coupling in 1. Three magnetic exchange interactions (one anti-ferromagnetic and two ferromagnetic: J1 = +3.3 cm-1 (Co⋯Co 3.176 Å; μ-1,1-OCO- and μ3-OCH3 bridges), J2 = -2.5 cm-1 (Co⋯Co 3.228 Å; μ-1-OCO- and μ3-OCH3 bridges) and J3 = +10.6 cm-1 (Co⋯Co 3.084 Å; two μ3-OCH3 bridges)) have been identified, with the inclusion of the orbital reduction parameter (α = Aκ = 1.38), spin-orbit coupling (λ = -158 cm-1) and axial distortion (energy gap Δ = -975 cm-1 between singlet and doublet levels), rationalized by density functional theory (DFT) calculations.
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Affiliation(s)
- Shashi Kant
- Department of Chemistry, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh 208016, India.
- Department of Chemistry, Bhola Prasad Singh College, Bhore, Gopalganj (Jai Prakash University Chapra), Bihar 841426, India
| | - Sayan Saha
- Department of Chemistry, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh 208016, India.
| | - Francesc Lloret
- Departament de Química Inorgànica/Instituto de Ciencia Molecular (ICMOL), Universitat de València, Polígono de la Coma, s/n, 46980 Paterna, València, Spain
| | - Joan Cano
- Instituto de Ciencia Molecular/Departament de Química Inorgànica, Universitat de València, C/Catedrático José Beltrán 2, 46980 Paterna, València, Spain.
| | - Rabindranath Mukherjee
- Department of Chemistry, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh 208016, India.
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22
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Haldar P, Prasad K, Kant S, Dwivedi SN, Vibha D, Pandit AK, Srivastava AK, Kumar A, Ikram MA, Henning T. Metabolic risk factors and psychosocial problems independently explain poor sleep quality and obstructive sleep apnea symptoms among adults in urban India. Sleep Breath 2023; 27:1541-1555. [PMID: 36280653 DOI: 10.1007/s11325-022-02725-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/12/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
STUDY OBJECTIVES To determine if metabolic risk factors are associated with poor sleep quality and obstructive sleep apnea-like symptoms (OSA symptoms) independent of psychosocial problems and demographic and lifestyle factors in older Indian adults. METHODOLOGY We analyzed baseline data from adults (≥ 50 years) from a population-based cohort, the LoCARPoN study, in India. Variables were grouped as (a) demographic and lifestyle factors such as smoking, alcohol use, and physical activity; (b) psychosocial problems including symptoms of depression, anxiety, and perceived stress; and (c) metabolic risk factors including glycated hemoglobin, high-density lipoprotein, low-density lipoprotein, total cholesterol, body mass index, and hypertension. Variables were examined as predictors of poor sleep quality and OSA symptoms. Groups of variables were added stepwise to a logistic regression. Variance explained by nested models was quantified using McFadden's pseudo R2, and change was formally tested with the log-likelihood ratio test. RESULTS Among 7505 adults, the prevalence of poor sleep quality was 16.9% (95% CI: 16.0, 17.7), and OSA symptoms were present in 7.0% (95% CI: 6.4, 7.6). Psychosocial problems had a strong independent association with both poor sleep quality (pseudo R2 increased from 0.10 to 0.15, p < 0.001) and more OSA symptoms (pseudo R2 increased from 0.08 to 0.10, p < 0.001). Metabolic risk factors had a modest independent association with sleep quality (pseudo R2 increased from 0.14 to 0.15, p < 0.01), but a strong association with OSA symptoms (pseudo R2 increased from 0.08 to 0.10, p < 0.001). CONCLUSION Psychosocial and metabolic risk factors were independently associated with sleep quality and OSA symptoms. This fact implied that OSA symptoms may affect both mental health and physical health. Our findings have public health implications because the number and proportion of the elderly in India is increasing, while the prevalence of metabolic risk factors and psychosocial problems is high already. These facts have the potential to exacerbate not only the burden of sleep disorders and OSA symptoms but also associated cardiovascular and neurologic sequelae, further stretching the Indian health-care system.
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Affiliation(s)
- Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India.
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amit Kumar
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tiemeier Henning
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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23
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Misra P, Mandal S, Sharma G, Kant S, Rai S, Yadav K, Sangral M, Kardam P. Effect of Structured Yoga Program on Stress and Well-being Among Frontline Healthcare Workers During COVID-19 Pandemic. Cureus 2023; 15:e43081. [PMID: 37680404 PMCID: PMC10482358 DOI: 10.7759/cureus.43081] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/09/2023] Open
Abstract
CONTEXT Frontline healthcare workers are at risk of developing psychological distress during a pandemic. Yoga, a form of mind-body medicine can reduce body stress and increases well-being. AIMS To assess the effect of yoga on the stress and well-being of healthcare workers during the COVID-19 pandemic. SETTINGS AND DESIGN This single-arm pre-post study was conducted among frontline health workers (support staff, paramedics, and medics) posted at a secondary care hospital in a North Indian district. METHODS AND MATERIALS Basic demographic details, blood pressure, anthropometric variables like height, weight, and biochemical variables like glycosylated hemoglobin (Hb1Ac), fasting and post-prandial blood sugar, lipid profile, serum cortisol, and C-reactive protein were measured. Stress levels were assessed using the depression anxiety and stress scale (DASS)-21 while well-being was assessed using the World Health Organization (WHO)-5 well-being scale. Twelve weeks of supervised yoga session was provided for 1 hour per session, 3 times per week. STATISTICAL ANALYSIS The mean value was compared from baseline to post-intervention with paired t-test/Wilcoxon signed rank test. RESULT A total of 89 participants were enrolled, 53 (59.5%) being male. Two-thirds of the participants were aged 20-39 years. During follow-up, 80 participants completed 12 weeks of yoga sessions. Post-intervention DASS-21 score decreased and WHO-5 increased significantly. The glycosylated hemoglobin (HbA1c) level and cholesterol-HDL ratio decreased significantly. Other variables didn't change significantly. No adverse effects were reported by the participants. CONCLUSION Supervised structured yoga sessions helped decrease stress, depression, and anxiety and improved well-being. Therefore, it can be a feasible strategy to manage workplace-related stress and phycological morbidities.
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Affiliation(s)
- Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Suprakash Mandal
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Gautam Sharma
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, IND
| | - Shashi Kant
- Centre for Community Medcine, All India Institute of Medical Sciences, New Delhi, IND
| | - Sanjay Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Kapil Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Meenu Sangral
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Priyanka Kardam
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
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24
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Jha S, Kant S, Thakur N, Kumar P, Rai S, Haldar P, Kardam P, Misra P, Goswami K, Rajan S. Prevalence of HIV among inmates in four states of north India: findings from the 16th round of HIV sentinel surveillance. Int J Prison Health 2023; ahead-of-print. [PMID: 37501374 DOI: 10.1108/ijph-03-2022-0021] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
PURPOSE Prisoners are at a higher risk of HIV infection compared to the general population. The purpose of this study is to estimate the prevalence of HIV and related risk behaviours among inmates of the Central Prisons in four states of North India. DESIGN/METHODOLOGY/APPROACH The HIV sentinel surveillance was conducted in seven Central Prisons in four states of North India from February to April 2019. Four hundred inmates were included from each prison. The interviews were conducted at the Integrated Counselling and Testing Centre located within the prison premises. The Ethics Committee of the National AIDS Control Organization, New Delhi, granted ethical approval before the start of the surveillance. FINDINGS Overall, 2,721 inmates were enrolled in this study. The mean (SD) age was 38.9 (13.9) years. One-third of prison inmates had comprehensive knowledge about HIV/AIDS. The proportion of convict (54%) and undertrial (46%) inmates was almost equal. The overall prevalence of HIV infection among inmates was 0.96% (95% CI 0.65-1.40). The odds of being HIV positive were significantly higher in never married inmates, undertrials, inmates who were in the prison for more than three months to one year, inmates incarcerated for multiple times, inmates with history of injecting drug use and inmates with history of intercourse with a commercial sex worker. ORIGINALITY/VALUE The findings from the very first HIV sentinel surveillance in central prisons in North India have been presented in this paper. This has huge implications for future policy decisions.
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Affiliation(s)
- Shreya Jha
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Department of Strategic Information, National AIDS Control Organisation, New Delhi, India
| | - Nishakar Thakur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep Kumar
- Department of Strategic Information, National AIDS Control Organisation, New Delhi, India
| | - Sanjay Rai
- Department of Strategic Information, National AIDS Control Organisation, New Delhi, India
| | - Partha Haldar
- Department of Strategic Information, National AIDS Control Organisation, New Delhi, India
| | - Priyanka Kardam
- Department of Strategic Information, National AIDS Control Organisation, New Delhi, India
| | - Puneet Misra
- Department of Strategic Information, National AIDS Control Organisation, New Delhi, India
| | - Kiran Goswami
- Department of Strategic Information, National AIDS Control Organisation, New Delhi, India
| | - Shobini Rajan
- Department of Strategic Information, National AIDS Control Organisation, New Delhi, India
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25
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Daniel RA, Kalaivani M, Kant S, Gupta S. Prevalence of anaemia among adolescent girls (10-19 years) in India: A systematic review and meta-analysis. Natl Med J India 2023; 36:233-240. [PMID: 38692640 DOI: 10.25259/nmji_637_21] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Background Anaemia is a serious public health problem. It is the second-commonest contributing factor to years lost by adolescents to disability and death. Targeting adolescent girls will allow a window of opportunity to correct their nutritional health and improve their obstetric outcomes. Studies in India have reported varying prevalence rates of anaemia among adolescent girls. Hence, we did a systematic review and meta-analysis of community-based studies to obtain a comprehensive pooled estimate of the prevalence of anaemia among adolescent girls in India. Methods We did a systematic electronic search in PubMed, Embase, Cochrane Library and Google scholar to retrieve community-based studies that reported the prevalence of anaemia among adolescent girls (10-19 years) in India, without any date or language restriction. To estimate the pooled prevalence and heterogeneity, the random-effects model and I2 statistical methods were used. We did subgroup analyses based on geographical region, study setting, method used to measure haemoglobin concentration, and year of publication. Results We included 35 studies in this meta-analysis comprising 152 640 participants. The pooled prevalence of anaemia among adolescent girls was 65.7% (95% CI 59.3%- 71.9%). There was significant heterogeneity between the studies (I2 99.6%; p<0.001). Conclusion There is a high prevalence of anaemia among adolescent girls in India. While all regions of the country have a high prevalence, tribal areas need special attention. Targeted actions need to focus on the identification of determinants of anaemia apart from iron supplementation.
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Affiliation(s)
- Roy Arokiam Daniel
- Centre for Community Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Sanjeev Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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Mohapatra S, Ghosh D, Vivekanandan P, Chunchanur S, Venugopal S, Tak V, Panigrahy R, Chaudhuri S, Pundir S, Sharma T, Kocher D, Singh H, Gautam H, Sood S, Das BK, Kapil A, Kumar A, Kumari R, Kalaivani M, Rangaiah A, Salve HR, Malhotra S, Kant S, Hari P. Genome profiling of uropathogenic E. coli from strictly defined community-acquired UTI in paediatric patients: a multicentric study. Antimicrob Resist Infect Control 2023; 12:36. [PMID: 37072773 PMCID: PMC10114455 DOI: 10.1186/s13756-023-01233-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/22/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Urinary tract infection (UTI) in children is a common bacterial infection. The emergence of extended-spectrum beta-lactamases (ESBLs) poses a major challenge against the treatment of uropathogens. We aimed to characterize the E. coli isolates recovered from children with UTI for their resistance profile and circulating sequence types (ST). METHODS Children (> 1.5-18 years of age) from different community health centres of India with symptoms of UTI were enrolled. Isolates causing significant bacteriuria were identified by Matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) and tested for antimicrobial susceptibility by the automated system, VITEK-2 (Biomeriux, Durhum, US). Nineteen E. coli isolates (15 ESBL positive and 4 ESBL negative) were sequenced in Oxford Nanopore platform followed by core-genome phylogeny, accessory genome cluster analysis, identification of sequence types, mobile genetic elements, genetic antimicrobial resistance markers. The correlation between detection of antimicrobial resistance genes with phenotypic resistance profiles was also investigated. RESULTS Eleven percent of children had significant bacteriuria [male:female-1:1, > 50% were 11-18 years of age group]. E. coli was predominant (86%) followed by K. pneumoniae (11%). Susceptibility of E. coli was highest against fosfomycin (100%) followed by carbapenems (90.7%) and nitrofurantoin (88.8%). ST131 (15.8%) and ST167 (10.5%) found as high-risk clones with the presence of plasmid [IncFIB (63.1%), IncFIA (52.6%)], and composite transposon [Tn2680 (46.6%)] in many isolates. Few isolates coharboured multiple beta-lactamases including blaNDM-5 (33.3%), blaOXA-1 (53.3%), blaCTX-M-15 (60%) and blaTEM-4 (60%). CONCLUSIONS This study highlights horizontal transmission of resistance genes and plasmids in paediatric patients at community centers across the nation harbouring multidrug-resistant genes such as blaNDM-5 and blaCTX-M-15 associated with high-risk clones ST131 and ST167. The data is alarming and emphasizes the need for rapid identification of resistance markers to reduce the spread in community. To our knowledge, this is the first multicentric study targeting paediatric UTI patients from the community setting of India.
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Affiliation(s)
| | - Dipannita Ghosh
- Kusuma School of Biological Sciences, Indian Institute of Technology Delhi, New Delhi, India
| | - Perumal Vivekanandan
- Kusuma School of Biological Sciences, Indian Institute of Technology Delhi, New Delhi, India
| | - Sneha Chunchanur
- Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, India
| | - Shwetha Venugopal
- Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, India
| | - Vibhor Tak
- Department of Microbiology, AIIMS, Jodhpur, India
| | | | - Susmita Chaudhuri
- Translational Health Science and Technology Institute, Faridabad, India
| | - Swati Pundir
- Department of Microbiology, AIIMS, New Delhi, India
| | - Tanya Sharma
- Department of Biomedical Informatics, ICMR, New Delhi, India
| | | | - Harpreet Singh
- Department of Biomedical Informatics, ICMR, New Delhi, India
| | | | - Seema Sood
- Department of Microbiology, AIIMS, New Delhi, India
| | | | - Arti Kapil
- Department of Microbiology, AIIMS, New Delhi, India
| | | | - Rajesh Kumari
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | | | - Ambica Rangaiah
- Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, India
| | | | | | - Shashi Kant
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Pankaj Hari
- Department of Paediatrics, AIIMS, New Delhi, India
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M Lakshmi PV, Elangovan A, Bhatnagar T, Kant S, Rai SK, Saha MK, Godbole S, Mehendale S, Singh YM, Verma V, Rajan S, Kumar R. Comparison of prevention of parent-to-child HIV transmission programme & national biennial HIV sentinel surveillance data for tracking HIV epidemic in India. Indian J Med Res 2023; 156:373427. [PMID: 37006025 DOI: 10.4103/ijmr.ijmr_3311_21] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Background & objectives HIV sentinel surveillance (HSS) among antenatal women in India has been used to track the epidemic for many years. However, reliable tracking at the local level is not possible as ANC sentinel sites are limited in number and cover a smaller sample size at each site. Prevention of parent-to-child-transmission (PPTCT) programme data has a potential advantage due to better geographical coverage, which could provide more precise HIV case estimates; therefore, we compared HSS ANC data with PPTCT programme data for HIV tracking. Methods Out of the 499 surveillance sites, where HSS and PPTCT programme was being conducted in 2015, 210 sites (140 urban and 70 rural) were selected using a stratified random sampling method. HSS (n=72,981) and PPTCT (n=112,832) data records were linked confidentially. The socio-demographic characteristics of HSS and PPTCT attendees were compared. HIV prevalence from HSS ANC was compared with the PPTCT programme data using Chi-square test. State- and site-level correlation of HIV prevalence was also done. Concordance between HSS and PPTCT HIV positivity was estimated using kappa statistics. Results The age distribution of HSS and PPTCT attendees was similar (range: 23 to 27 yr); however, HSS ANC participants were better educated, whereas PPTCT recorded a higher proportion of homemakers. The correlation of HIV prevalence between HSS and PPTCT was high (r=0.9) at the State level and moderate at the site level (r=0.7). The HIV positivity agreement between HSS ANC and PPTCT was good (kappa=0.633). A similar prevalence was reported across 26 States, whereas PPTCT had a significantly lower prevalence than HSS in three States where PPTCT coverage was low. Overall HIV prevalence was 0.31 per cent in HSS and 0.22 per cent in PPTCT (P<0.001). Interpretation & conclusions High-quality PPTCT programme data can provide reliable HIV trends in India. An operational framework for PPTCT-based surveillance should be pilot-tested in a phased manner before replacing HSS with PPTCT.
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Affiliation(s)
- P V M Lakshmi
- Department of Community Medicine & School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Arumugan Elangovan
- Computing & Information Science Division, National Institute of Epidemiology-Indian Council of Medical Research, Chennai, Tamil Nadu, India
| | - Tarun Bhatnagar
- ICMR School of Public Health, National Institute of Epidemiology-Indian Council of Medical Research, Chennai, Tamil Nadu, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay K Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Malay K Saha
- Division of Virology, National HIV Reference Laboratory, ICMR-National Institute of Cholera & Enteric Diseases, Kolkata, West Bengal, India
| | - Sheela Godbole
- ICMR-National AIDS Research Institute, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Sanjay Mehendale
- P.D. Hinduja Hospital & Medical Research Center, Mumbai, Maharashtra, India
| | - Y Manihar Singh
- Department of Community Medicine-Epidemiology Unit, Regional Institute of Medical Sciences, Imphal West, Manipur, India
| | - Vinita Verma
- Department of Evaluation & Operational Research, Strategic Information, National AIDS Control Organization, Ministry of Health & Family Welfare, New Delhi, India
| | - Shobini Rajan
- Department of Evaluation & Operational Research, Strategic Information, National AIDS Control Organization, Ministry of Health & Family Welfare, New Delhi, India
| | - Rajesh Kumar
- Department of Community Medicine & School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Filewod B, Kant S, MacDonald H, McKenney D. Decision biases and environmental attitudes among conservation professionals. Conservat Sci and Prac 2023. [DOI: 10.1111/csp2.12921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Affiliation(s)
- Ben Filewod
- Grantham Research Institute on Climate Change and the Environment London School of Economics and Political Science Houghton Street London WC2A 2AE UK
- Integrated Ecology and Economics Division Canadian Forest Service 1219 Queen Street East Sault Ste. Marie P6A 2E5 Canada
| | - Shashi Kant
- Institute for Management & Innovation University of Toronto Mississauga 3359 Mississauga Road Mississauga L5L 1C6 Canada
| | - Heather MacDonald
- Integrated Ecology and Economics Division Canadian Forest Service 1219 Queen Street East Sault Ste. Marie P6A 2E5 Canada
| | - Daniel McKenney
- Integrated Ecology and Economics Division Canadian Forest Service 1219 Queen Street East Sault Ste. Marie P6A 2E5 Canada
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SIngh T, Kaur R, Kant S, Yadav K, Gupta S. Voices From the Community: Maternal Healthcare Experiences During the COVID-19 Pandemic. Cureus 2023; 15:e38323. [PMID: 37261156 PMCID: PMC10227872 DOI: 10.7759/cureus.38323] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on health services around the world. Many hospitals and clinics were overwhelmed by the influx of patients, leading to delays and disruptions in care. The fear of contracting the virus also led to a decrease in the number of people seeking medical care, even for urgent or life-threatening conditions. Various studies have reported a decrease in overall utilization of maternal health services. However, it remains vital to find the reasons for reduced utilization along with the experiences of the women as well as healthcare workers during the pandemic. Objective The objective of this study was to identify the facilitators and barriers to maternal healthcare services utilization during the COVID-19 pandemic. Methods It was a qualitative study conducted in a rural area of Haryana, India. Twelve in-depth interviews (IDIs) were conducted with health workers and four focused group discussions (FGDs) were conducted with pregnant women. Textual analysis was done for both IDIs as well as FGDs. Qualitative analysis was done manually. Results The identified themes were complete cessation of services, no outpatient department (OPD) services for many months, no antenatal care (ANC) services for two months, disruption of supply of medicines, unavailability of drugs, fear of getting COVID-19 infection, mandatory COVID-19 negative report for admission in hospital, and increased referral from government health facilities during the pandemic and lockdown. Conclusion Maternal healthcare services suffered during COVID-19 for various reasons including the closure of health facilities, limited supply of stocks, or fear of the disease among pregnant women. This evidence can be used to prepare as well as manage healthcare services in future.
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Affiliation(s)
- Tejbeer SIngh
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Kapil Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Sanjeev Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
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Pathak VK, Haldar P, Kant S, Krishnan A, Gupta SK. Predictors of Out-of-Pocket Expenditure on Health Incurred by Elderly Persons Residing in a Rural Area of Faridabad District. Cureus 2023; 15:e37626. [PMID: 37206499 PMCID: PMC10191236 DOI: 10.7759/cureus.37626] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND A significant portion of India's 1.2 billion population consists of elderly individuals, accounting for approximately 8.6%, who incur substantial out-of-pocket (OOP) healthcare expenses. Any policy for the elderly should encompass financial protection from illness-related expenditures. However, the lack of comprehensive information on OOP expenditure and its determinants precludes such action. METHODS We conducted a cross-sectional study of 400 elderly persons residing in the rural town of Ballabgarh. The participants were randomly selected using the health demographic surveillance system. We utilized questionnaires and tools to assess the costs associated with outpatient and inpatient services in the previous year, as well as gather information on socio-demographics (individual characteristics), morbidity (motivation for seeking care), and social engagement (health-seeking). RESULTS A total of 396 elderly persons participated, with a mean (SD) age of 69.4 (6.7), and 59.4% females. Nearly 96% and 50% of the elderly availed of outpatient and inpatient services, respectively, in the preceding year. The mean (IQR) annual OOP expenditure, as per the consumer price index 2021, was INR 12,543 (IQR, INR 8,288-16,787), with a median of INR 2,860 (IQR, INR 1,458-7,233), explained significantly by sex, morbidity status, social engagement, and mental health. CONCLUSION In low-middle-income countries like India, policymakers may consider pre-payment mechanisms like health insurance for the elderly, using such prediction scores.
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Affiliation(s)
- Vineet Kumar Pathak
- Community Medicine, Shree Guru Gobind Singh Tricentenary University (SGT University), Gurugram, IND
| | - Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Sanjeev K Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
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Haldar P, Kumar P, Rai S, Kant S, Raj Y, Reddy C, Rajan S, Pandey A, Venkatesh S, Goswami K, Misra P. Prevalence and determinants of heterosexual anal-intercourse among female sex workers in India: Findings from nationwide cross-sectional biological and behavioural survey. Int J STD AIDS 2023; 34:251-265. [PMID: 36630617 DOI: 10.1177/09564624221147960] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The vulnerability of female sex workers (FSWs) to HIV infection increases if unprotected heterosexual anal intercourse (HAI) is practiced. OBJECTIVES To estimate the prevalence of HAI among FSWs, and associated factors, and prevalence of consistent condom use (CCU) during HAI and associated factors. METHODS Analysis of cross-sectional data from nationwide biological and behavioural survey, conducted at 73 randomly selected domains with sample size of 27,000 in India. RESULTS A total of 25,932 FSWs were included in the analysis, after excluding 1075 (3.9%) FSWs for which the data were incomplete. The prevalence of HAI was 29.9% (95% CI, 29.3, 30.4); The CCU during HAI in the last one month was 58.9%. Younger age at the start of sex work, use of mobile phone/internet for soliciting client, home as a place of sex work, consumption of alcohol/drug, and physical violence against FSWs were associated with higher odds of HAI. Frequent contact with outreach workers, awareness of sexually transmitted infection, and older age at the start of sex work was associated with CCU. CONCLUSION Prevalence of HAI was high among FSW in India. The national program could target those factors that reduce the odds of HAI and/or promote CCU.
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Affiliation(s)
- Partha Haldar
- Centre for Community Medicine, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep Kumar
- National AIDS Control Organization, New Delhi, India
| | - Sanjay Rai
- Centre for Community Medicine, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Yujwal Raj
- 245567Formerly at National AIDS Control Organization, New Delhi, India
| | - Chandrasekhar Reddy
- 30117Formerly at Banaras Hindu University, Institute of Medical Sciences, Varanasi, India
| | - Shobini Rajan
- National AIDS Control Organization, New Delhi, India
| | - Arvind Pandey
- 28604Indian Council of Medial Research, New Delhi, India
| | - S Venkatesh
- National Center for Disease Control, New Delhi, India
| | - Kiran Goswami
- Centre for Community Medicine, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Misra
- Centre for Community Medicine, 28730All India Institute of Medical Sciences, New Delhi, India
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Santra A, Sharma KA, Singh N, Yadav K, Kant S. Role of Intravenous Iron Sucrose in Severe Anemia in Late Pregnancy: A Case Report From Rural Ballabgarh, Haryana. Cureus 2023; 15:e35472. [PMID: 37007326 PMCID: PMC10049923 DOI: 10.7759/cureus.35472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2023] [Indexed: 03/01/2023] Open
Abstract
Severe anemia is a high-risk factor in pregnancy and needs to be treated appropriately to prevent poor maternal and fetal outcomes. A pregnant woman with severe anemia reluctant for blood transfusion due to issues of accessibility was given four doses of 300 mg intravenous iron sucrose (IVIS) in 300 ml normal saline starting at 31 weeks 5 days of gestation and her hemoglobin level increased by 4.2 gm/dl over a period of five weeks without any complications and without any intake of iron and folic acid tablets during the entire duration. Intravenous iron sucrose is a useful intervention for severe anemia of pregnancy even in late pregnancy with rapid increase in haemoglobin levels and can be used regularly for treating severe anemia in pregnant women alternative to blood transfusion who have limited accessibility to blood transfusion facilities.
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Gulati K, Dwivedi SN, Kant S, Vibha D, Pandit AK, Srivastava AK, Ikram MA, Tiemeier H, Prasad K. Challenges in setting up a large population-based prospective cohort study in India - learnings from the LoCARPoN cohort. Lancet Reg Health Southeast Asia 2023; 9:100112. [PMID: 37383044 PMCID: PMC10305979 DOI: 10.1016/j.lansea.2022.100112] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/27/2022] [Accepted: 11/02/2022] [Indexed: 06/30/2023]
Abstract
Population-based prospective cohort studies can yield vital new evidence. However, they are difficult to setup especially in non-western contexts such as India. We describe our experience in establishing the Longitudinal Cognition and Aging Research on Population of the National Capital Region (LoCARPoN) cohort, which was the first-of-its-kind public-funded study with target sample size of 15,000, 3 sites, and funds of approx. US$ five million for eight years (2014-2022). LoCARPoN aimed to study incident stroke and dementia in adults aged ≥50 years in urban and rural populations of north India. Among the numerous challenges encountered, important were inadequate funding, lack of adequate space for medical and field sites, difficulty in hiring manpower, lack of IT infrastructure, non-availability of storage facility for biological samples, and absence of dedicated MRI machines. Meticulous planning, adequate funding, trained personnel, institutional and community support are critical for establishing such cohorts in the non-western contexts. Funding The LoCARPoN cohort study was funded by the Department of Biotechnology (Grant No. BT/IN/Netherlands/03/KP/2012 dated 14/02/2014); and Department of Health Research (Grant No. R.11012/15/2018-HR, dated 09/08/2018), Government of India. The Erasmus component was funded through the Erasmus Medical Centre, Rotterdam, The Netherlands, and the Erasmus University, Rotterdam (Alzheimer NederlandWE.15-2014-09).
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Affiliation(s)
- Kamal Gulati
- Department of Centralized Core Research Facility, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - M. Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Professor of Social and Behavioral Science and The Sumner and Esther Feldberg Chair of Maternal and Child Health, Harvard T.H. Chan School of Public Health, USA
| | - Kameshwar Prasad
- Department of Neurology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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Dai Z, Hou Y, Kant S, Ma B. The influence of China's protected areas policy on households' risk perception, forest investment, and revenue. Environ Sci Pollut Res Int 2023; 30:27799-27814. [PMID: 36394811 DOI: 10.1007/s11356-022-23994-7] [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] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Protected areas are an essential policy tool for biodiversity conservation in China as elsewhere, yet the impact of protected area policies on the livelihood of local households in China remains unknown. We contend that the protected area policy achieves the two goals of ecological conservation and livelihood improvement simultaneously. In this study, we empirically investigated the influence of the protected area policy on local households' risk perception, forest investment, and forest revenue. We analyzed a sample consisting of households located inside or adjacent to two protected areas, namely, Wuyishan National Park and Longqishan Nature Reserve, both in Fujian Province. A total of 211 valid questionnaires were collected in 2021, and the data were analyzed using structural equation modeling. The results indicate that the establishment of protected areas has a positive impact on forest revenues, mediated by risk perception and forest investment, while the average levels of perceived damage increased and perceived security decreased due to the protected area policy. Our study has implications for policymakers seeking to improve biodiversity and household livelihood around protected areas.
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Affiliation(s)
- Zhe Dai
- Graduate Department of Forestry, John H. Daniels Faculty of Architecture, Landscape, and Design, University of Toronto, 33 Willcocks Street, Toronto, Canada
| | - Yilei Hou
- School of Economics and Management, Beijing Forestry University, Haidian, 100083, China
| | - Shashi Kant
- Graduate Department of Forestry, John H. Daniels Faculty of Architecture, Landscape, and Design, University of Toronto, 33 Willcocks Street, Toronto, Canada
- Institute for Management & Innovation, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, Canada
| | - Ben Ma
- School of Environment and Natural Resources, Renmin University of China, Haidian, 100872, China.
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Chauhan N, Dogra P, Sharma R, Kant S, Soni M. Randomized Controlled Trial Comparing Ferrous Sulfate and Iron Sucrose in Iron Deficiency Anemia in Pregnancy. Cureus 2023; 15:e34858. [PMID: 36923182 PMCID: PMC10010153 DOI: 10.7759/cureus.34858] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2023] [Indexed: 02/13/2023] Open
Abstract
INTRODUCTION Anemia among pregnant women is one of the major health concerns for healthcare workers. The management becomes a concern in the pregnancy where the question arises of which is better the intravenous iron sucrose or the oral ferrous sulfate tablets. To answer this, a randomized control trial comparing both the treatment options in a tertiary care government hospital was set up in the hilly terrains of India. This study discusses the effectiveness and practical aspect of using both, which seems to be the better out of both, and why. METHODS The study was conducted as a parallel-group, open-label randomized controlled trial (RCT) in the Department of Obstetrics and Gynecology of a tertiary care government hospital in India, with approximately 4,000 delivery loads annually. Ethical clearance was obtained from the institute's ethics committee (IEC), and the trial was registered with the Clinical Trial Registry of India (REF/2022/06/055013). Two hundred sixty-eight pregnant women between 18 and 45 years of age with moderate iron deficiency anemia (IDA) (hemoglobin (Hb) 7-9g/dl, microcytic-hypochromic, and serum ferritin <30ng/ml) were included in the study. Patients were randomly divided into two groups: group 1 with 134 patients to receive intravenous iron sucrose and group 2 with 134 patients to receive oral ferrous sulfate tablets. RESULTS The intravenous iron sucrose is superior in terms of tolerability and correction of iron deficiency anemia during pregnancy. CONCLUSION It yields a quicker rise in Hb and serum ferritin with no major side effects. In the difficult terrain of Himachal Pradesh, this makes IV iron sucrose a better option for anemic pregnant women who do not have easy access to health facilities resulting in a large number of them reaching hospitals with moderate to severe anemia at a later gestation.
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Affiliation(s)
- Neha Chauhan
- Obstetrics and Gynaecology, Shri Lal Bahadur Shastri Government Medical College & Hospital, Mandi, IND
| | - Poojan Dogra
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bilaspur, IND
| | - Reena Sharma
- Obstetrics and Gynaecology, Shri Lal Bahadur Shastri Government Medical College & Hospital, Mandi, IND
| | - Shashi Kant
- Obstetrics and Gynaecology, Shri Lal Bahadur Shastri Government Medical College & Hospital, Mandi, IND
| | - Mridul Soni
- Research, Shri Lal Bahadur Shastri Government Medical College & Hospital, Mandi, IND
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Vibha D, Prasad K, Dwivedi SN, Kant S, Pandit AK, Tiemeier H, Srivastava AK, Karthikeyan G, Garg A, Verma V, Kumar A, Nehra A, Ikram A. Carotid Intima-Media Thickness (cIMT) and Cognitive Performance: A Population-Based Cross-Sectional Study From North India. Alzheimer Dis Assoc Disord 2023; 37:35-41. [PMID: 36821176 DOI: 10.1097/wad.0000000000000542] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 11/27/2022] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Atherosclerosis has been shown to impact cognitive impairment, with most of the evidence originating from European, African, or East Asian populations that have employed carotid intima-media thickness (cIMT) as a biomarker for atherosclerosis. Vascular disease is related to dementia/cognitive decline. There is no community-based study from India that has looked at the association of cIMT with cognitive performance. METHODS In this cross-sectional study between December 2014 and 2019, we recruited 7505 persons [(mean age 64.6 (9.2) y) and 50.9% women] from a community-dwelling population in New Delhi. These persons underwent carotid ultrasound to quantify cIMT and a cognitive test battery that tapped into memory, processing speed, and executive function. We also computed the general cognitive factor (g-factor), which was identified as the first unrotated component of the principal component analysis and explained 37.4% of all variances in the cognitive tests. We constructed multivariate linear regression models adjusted for age, sex, education, and cardiovascular risk factors. Additional adjustment was made for depression, anxiety, and psychosocial support in the final model. RESULTS We found a significant association of higher cIMT with worse performance in general cognition (β=-0. 01(95% CI: -0.01; -0.01); P<0.001), processing speed (β=-0.20; 95% CI: -0.34; -0.07); P=0.003), memory (β=-0.29; 95% CI: -0.53; -0.05); P=0.016), and executive function (β=-0.54; 95% CI: -0.75; -0.33); P=<0.001). There was no statistically significant association of cIMT with Mini-Mental Status Examination score (β=0.02; 95% CI: -0.34; 0.40; 0.89). CONCLUSION The cross-sectional study found significant associations of increased cIMT with worse performance in global cognition, information processing, memory, and executive function.
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Affiliation(s)
| | - Kameshwar Prasad
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | | | | | | | - Henning Tiemeier
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, MA
| | | | | | - Ajay Garg
- Department of Neuroimaging and Intervention Neuroradiology
| | | | | | - Ashima Nehra
- Division of Neuropsychology, Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Arfan Ikram
- Department of Epidemiology, Erasmsus Medical Center, Rotterdam, The Netherlands
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Rai SK, Kant S, Jha S, Dasgupta R. Is Vaccination of Children Against Covid-19 Warranted? Indian J Community Med 2023; 48:202-203. [PMID: 37082405 PMCID: PMC10112747 DOI: 10.4103/ijcm.ijcm_443_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/20/2022] [Indexed: 02/11/2023] Open
Affiliation(s)
- Sanjay K. Rai
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Shreya Jha
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Rajib Dasgupta
- Centre for Social Medicine and Community Medicine, Jawaharlal Nehru University, New Delhi, India
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Sathiyamoorthy R, Chandra A, Poudel S, Kumar R, Salve HR, Yadav K, Kant S. Sub-optimal knowledge with positive attitude and belief of frontline health workers toward the use of information technologies: A mixed-method study from rural Haryana, India. J Educ Health Promot 2022; 11:419. [PMID: 36824093 PMCID: PMC9942148 DOI: 10.4103/jehp.jehp_406_22] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Information technology (IT) can be used by frontline health workers (FLWs) to connect and deliver care to the community. Various studies in India have assessed the beneficial impact of IT usage by FLWs, but for the long-term sustainability, the attitude and belief toward IT usage have not been adequately studied. We conducted this study to assess the knowledge and attitude and to explore the beliefs of FLWs toward the use of IT in a rural area of Haryana. MATERIALS AND METHODS We conducted a mixed-method study (qualitative and quantitative approach) in a rural setting of Haryana, India. We included FLWs of two primary health centers (PHCs). Data were collected from October 19, 2020 to December 31, 2020. We collected data from 75 accredited social health activists (ASHAs), 37 Anganwadi workers (AWWs), 28 multi-purpose workers (MPWs), two information assistants, and two medical officers using a semi-structured interview schedule. Their knowledge about the benefits of IT use, past use of IT applications and devices, and self-rating of knowledge regarding computers or laptops were collected. We used 14 attitude statements, each with a five-point Likert scale to assess the attitude; a total score ≥35 was considered a positive attitude. We conducted eight focus group discussions (FGDs) to explore the beliefs regarding IT usage (four FGDs with ASHAs, two FGDs with AWWs, and two FGDs with MPWs). A descriptive analysis was performed for the quantitative data, and a thematic analysis was performed for qualitative data. RESULTS Knowledge about the benefits of IT use was present among 77.8% of FLWs. Among the FLWs, 79.2% self-rated their knowledge of computers/laptops as 'do not have knowledge', 16% self-rated as 'low knowledge', and 4.8% self-rated as 'good knowledge'. The median total score for attitude statements among all the FLWs (n = 144) was 54 [inter-quartile range - 48-59]. Four themes emerged for beliefs toward IT usage, namely, positive beliefs, negative beliefs, challenges anticipated in adopting IT use, and facilitation factors. The positive beliefs were related to improvement in work efficiency and social status, less paperwork, timely report generation, and better learning. The negative beliefs were related to an increase in working hours, close monitoring, and feeling over-burdened. CONCLUSION We found that FLWs had knowledge regarding the benefits of IT use, but they lacked knowledge regarding laptop/computer use. They had a satisfactory level of confidence in using smartphones, and most of them were using mobile applications. The majority of the FLWs had a positive attitude and beliefs toward IT use and wanted to use it in the future.
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Affiliation(s)
- Ramadass Sathiyamoorthy
- Department of Community Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India
| | - Ankit Chandra
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sagar Poudel
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Rakesh Kumar
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Harshal R. Salve
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Kapil Yadav
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Mohapatra S, Venugopal SJ, Kalaivani M, Kant S, Tak V, Panigrahy R, Chunchanur SK, Kocher D, Behera B, Pundir S, Chaudhuri S, Gautam H, Sood S, Das BK, Kapil A, Kumar A, Kumari R, Ambica R, Hari P, Malhotra S, Salve HR, Venugopal SJ, Tak V, Panigrahy R, KChunchanur S, Chaudhuri S, Hari P, Das S, Raghav PR, Kant S. Antibiotic resistance of uropathogens among the community-dwelling pregnant and nonpregnant female: a step towards antibiotic stewardship. BMC Infect Dis 2022; 22:939. [PMID: 36513989 DOI: 10.1186/s12879-022-07914-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Indiscriminate and widespread use of antibiotics has resulted in emergence of many antibiotic-resistant organisms. Antibiotic administration during pregnancy is mostly avoided, unless there is compelling medical condition. We hypothesized that the uropathogens isolated from pregnant women would be more susceptible to antibiotics compared to those isolated from nonpregnant women, thus will be helpful in formulating separate empiric guideline for pregnant women based on the resistance pattern. METHODS This was a prospective cross-sectional study conducted over a period of 2 years in which females with the clinical diagnosis of either cystitis or asymptomatic bacteriuria during pregnancy were included from the community settings. Uropathogen species and their antimicrobial resistance pattern were compared between the pregnant and nonpregnant groups. After accounting for centre-to-centre variation and adjusting for age and socio-economic status, the adjusted odds ratio for antibiotic resistance was calculated and compared between pregnant and nonpregnant women using logistic regression analysis. RESULTS A total of 1758 women (pregnant: 43.3%; nonpregnant: 56.6%) were screened in the study over a period of 2 years, out of which 9.3% (163/1758) were having significant bacteriuria. Escherichia coli and Klebsiella pneumoniae were the two commonest uropathogen in both the groups; their prevalence being 83.6% in pregnant women and 85.2% in nonpregnant women, respectively. Resistance against ampicillin, cefixime, cefoxitin, ceftazidime, ceftriaxone and amoxicillin-clavulanic acid were found significantly lower in the pregnant women compared to nonpregnant. After adjusting the age and socio-economic status accounting for centre-to-centre variation, the odds of resistance for cefixime, amoxicillin-clavulanic acid and co-trimoxazole were found lower and statistically significant among the pregnant women group. CONCLUSIONS The antimicrobial resistance was significantly higher among the community-dwelling nonpregnant women compared to pregnant women in case of few antibiotics. The study highlighted the need of building local antibiogram that could help to initiate the empirical treatment and thus prevent emergence of antimicrobial resistance.
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Affiliation(s)
- Sarita Mohapatra
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Shwetha J Venugopal
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Rajashree Panigrahy
- Department of Microbiology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, India
| | - Sneha K Chunchanur
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Deepak Kocher
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Birasen Behera
- Department of Microbiology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, India
| | - Swati Pundir
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Susmita Chaudhuri
- Translational Health Science and Technology Institute, Faridabad, India
| | - Hitender Gautam
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Sood
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Bimal Kumar Das
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Arti Kapil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - R Ambica
- Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Pankaj Hari
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sumit Malhotra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Harsal Ramesh Salve
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Misra P, Kant S, Guleria R, Ahmad M, Mandal S, Chaturvedi PK, Medigeshi GR, Meena S, Rai SK, Rahman A, Sangral M, Yadav K, Bairwa M, Haldar P. Test concordance and diagnostic accuracy of three serological assays for detection of anti-SARS-CoV-2 antibody: result from a population-based sero-epidemiological study in Delhi. BMC Infect Dis 2022; 22:915. [PMID: 36476336 PMCID: PMC9730588 DOI: 10.1186/s12879-022-07805-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/26/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Several methodological tests are available to detect SARS-CoV-2 antibody. Tests are mostly used in the aid of diagnosis or for serological assessment. No tests are fully confirmatory and have variable level of diagnostic ability. We aimed at assessing agreement with three serological tests: quantitative anti receptor binding domain ELISA (Q-RBD), qualitative ELISA (WANTAI SARS-CoV-2 Ab) and qualitative chemiluminescence assay (CLIA). METHODS This study was a part of a large population based sero-epidemiological cohort study. Participants aged 1 year or older were included from 25 randomly selected clusters each in Delhi urban (urban resettlement colony of South Delhi district) and Delhi rural (villages in Faridabad district, Haryana). Three type of tests were applied to all the baseline blood samples. Result of the three tests were evaluated by estimating the total agreement and kappa value. RESULTS Total 3491 blood samples collected from March to September, 2021, out of which 1700 (48.7%) from urban and 1791 (51.3%) from rural. Overall 44.1% of participants were male. The proportion of sero-positivity were 78.1%, 75.2% and 31.8% by Wantai, QRBD and CLIA tests respectively. The total agreement between Wantai and QRBD was 94.5%, 53.1% between Wantai and CLIA, and 56.8% between QRBD and CLIA. The kappa value between these three tests were 0.84 (95% CI 0.80-0.87), 0.22 (95% CI 0.19-0.24) and 0.26 (95% CI 0.23-0.28). CONCLUSIONS There was strong concordance between Wantai and QRBD test. Agreement between CLIA with other two tests was low. Wantai and QRBD tests measuring the antibody to same S protein can be used with high agreement based on the relevant scenario.
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Affiliation(s)
- Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Shashi Kant
- grid.413618.90000 0004 1767 6103Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Randeep Guleria
- grid.413618.90000 0004 1767 6103All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Mohammad Ahmad
- grid.417256.3WHO Country Office, World Health Organization, New Delhi, India
| | - Suprakash Mandal
- grid.413618.90000 0004 1767 6103Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - P. K. Chaturvedi
- grid.413618.90000 0004 1767 6103Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Guruprasad R. Medigeshi
- grid.464764.30000 0004 1763 2258Translational Health Science and Technology Institute, Faridabad, 121001 India
| | - Suneeta Meena
- grid.413618.90000 0004 1767 6103Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Sanjay Kumar Rai
- grid.413618.90000 0004 1767 6103Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | | | - Meenu Sangral
- grid.413618.90000 0004 1767 6103Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Kapil Yadav
- grid.413618.90000 0004 1767 6103Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Mohan Bairwa
- grid.413618.90000 0004 1767 6103Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Partha Haldar
- grid.413618.90000 0004 1767 6103Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
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Dadhwal V, Sagar R, Choudhary V, Kant S, Perumal V, Misra P, Bhattacharya D. A Single-Arm Pilot Study of Multicomponent Psychoeducational Intervention for Postpartum Depression and Anxiety in a Rural Community. Indian J Psychol Med 2022; 44:567-574. [PMID: 36339693 PMCID: PMC9615458 DOI: 10.1177/02537176211072690] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The prevalence of postpartum depression (PPD) and anxiety (PPA) is rising in India and efforts at generating local evidence for psychological intervention are scanty. We conducted a single-arm pilot study in an Indian rural community to test the impact of multicomponent psychoeducational intervention (MCPI) on women with PPD and PPA. METHODS Forty-three women with PPD/PPA/both received MCPI, which comprised three phases with in-person sessions held once weekly for a minimum of six and a maximum of ten weeks. Primary outcome variables were scores on depression and anxiety, assessed using the Edinburg postnatal depression scale and the state and trait anxiety inventory, along with evaluating the compliance rate to the intervention. The Mini-international neuropsychiatric interview (MINI) neuropsychiatric interview was used to confirm the diagnosis of depression and anxiety. Secondary outcome variables assessed were social support, functionality, parental stress, interpersonal violence, and marital satisfaction. We used Cohen's d effect size method for assessing the mean differences. RESULTS MCPI resulted in the improvement of 72% women (95% CI = 56.3%-84.7%). The overall compliance rate to the intervention was 85.63%, which was higher for responders than nonresponders (92.9% vs. 69.8%; P < 0.001). MCPI resulted in statistically significant improvement in the mean score of depression (P = 0.001, d = 0.95) and anxiety (P = 0.001, d = 1.30). On secondary outcome variables, significant improvement was obtained in the overall present social support (P = 0.001; d = 4.65), present social support from partner (P = 0.027; d = 0.45) and parents (P = 0.001; d = 0.74), future social support from parents (P = 0.001; d = 0.81), the performance of household responsibility (P = 0.001; d = 0.97), lifestyle in the last two weeks (P = 0.001; d = 3.57), parental stress (P = 0.001; d = 1.04), and marital satisfaction (P = 0.014; d = 0.52). CONCLUSION This pilot study shows that MCPI has a promising role in relieving depression and anxiety. It also improved the perception of social support from partner and parents, functionality, marital satisfaction, and reduced parental stress.
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Affiliation(s)
- Vatsla Dadhwal
- Dept. of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Rajesh Sagar
- Dept. of Psychiatry, All India institute of Medical Sciences, New Delhi, Delhi, India
| | - Vandana Choudhary
- Dept. of Psychiatry (Clinical Psychology), All India institute of Medical Sciences, New Delhi, Delhi, India
| | - Shashi Kant
- Dept. of Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Vanamail Perumal
- Dept. of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Puneet Misra
- Dept. of Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Debabani Bhattacharya
- Dept. of Psychiatry (Clinical Psychology), All India institute of Medical Sciences, New Delhi, Delhi, India
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Vertii A, Ivshina M, Kant S, van Wijnen AJ. Editorial: The 4th dimension of the 3d chromatin organization: Dynamics and functional consequences. Front Cell Dev Biol 2022; 10:1065753. [DOI: 10.3389/fcell.2022.1065753] [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] [Received: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022] Open
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Misra P, Jha S, Misra A, Kant S. Reporting of randomized controlled trials as per CONSORT guidelines. J Family Med Prim Care 2022; 11:6598. [PMID: 36618162 PMCID: PMC9810895 DOI: 10.4103/jfmpc.jfmpc_799_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/28/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Puneet Misra
- Centre for Community Medicine, AIIMS, New Delhi, India,Address for correspondence: Dr. Puneet Misra, Room No. 28, Centre for Community Medicine, Old OT Block, AIIMS, New Delhi - 110 029, India. E-mail:
| | - Shreya Jha
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Anoop Misra
- Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, AIIMS, New Delhi, India
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Lewis HC, Marcato AJ, Meagher N, Valenciano M, Villanueva‐Cabezas J, Spirkoska V, Fielding JE, Karahalios A, Subissi L, Nardone A, Cheng B, Rajatonirina S, Okeibunor J, Aly EA, Barakat A, Jorgensen P, Azim T, Wijesinghe PR, Le L, Rodriguez A, Vicari A, Van Kerkhove MD, McVernon J, Pebody R, Price DJ, Bergeri I, Alemu MA, Alvi Y, Bukusi EA, Chung PS, Dambadarjaa D, Das AK, Dub T, Dulacha D, Ebrahim F, González‐Duarte MA, Guruge D, Heraud J, Heredia‐Melo DC, Herman‐Roloff A, Herring BL, Inbanathan FY, Islam F, Jeewandara KC, Kant S, Khan W, Lako R, Leite J, Malavige GN, Mandakh U, Mariam W, Mend T, Mize VA, Musa S, Nohynek H, Olu OO, Osorio‐Merchán MB, Pereyaslov D, Randremanana RV, de Dieu Randria MJ, Ransom J, Saxena S, Sharma P, Sreedevi A, Satheesh M, Subhashini KJ, Tippet‐Barr BA, Usha A, Wamala JF, Watare SH, Yadav K. Transmission of SARS-CoV-2 in standardised first few X cases and household transmission investigations: A systematic review and meta-analysis. Influenza Other Respir Viruses 2022; 16:803-819. [PMID: 36825117 PMCID: PMC9343340 DOI: 10.1111/irv.13002] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022] Open
Abstract
We aimed to estimate the household secondary infection attack rate (hSAR) of SARS-CoV-2 in investigations aligned with the WHO Unity Studies Household Transmission Investigations (HHTI) protocol. We conducted a systematic review and meta-analysis according to PRISMA 2020 guidelines. We searched Medline, Embase, Web of Science, Scopus and medRxiv/bioRxiv for "Unity-aligned" First Few X cases (FFX) and HHTIs published 1 December 2019 to 26 July 2021. Standardised early results were shared by WHO Unity Studies collaborators (to 1 October 2021). We used a bespoke tool to assess investigation methodological quality. Values for hSAR and 95% confidence intervals (CIs) were extracted or calculated from crude data. Heterogeneity was assessed by visually inspecting overlap of CIs on forest plots and quantified in meta-analyses. Of 9988 records retrieved, 80 articles (64 from databases; 16 provided by Unity Studies collaborators) were retained in the systematic review; 62 were included in the primary meta-analysis. hSAR point estimates ranged from 2% to 90% (95% prediction interval: 3%-71%; I 2 = 99.7%); I 2 values remained >99% in subgroup analyses, indicating high, unexplained heterogeneity and leading to a decision not to report pooled hSAR estimates. FFX and HHTI remain critical epidemiological tools for early and ongoing characterisation of novel infectious pathogens. The large, unexplained variance in hSAR estimates emphasises the need to further support standardisation in planning, conduct and analysis, and for clear and comprehensive reporting of FFX and HHTIs in time and place, to guide evidence-based pandemic preparedness and response efforts for SARS-CoV-2, influenza and future novel respiratory viruses.
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Affiliation(s)
- Hannah C. Lewis
- World Health OrganizationGenevaSwitzerland,World Health Organization, Regional Office for AfricaBrazzavilleRepublic of Congo
| | - Adrian J. Marcato
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Niamh Meagher
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | - Marta Valenciano
- World Health OrganizationGenevaSwitzerland,EpiconceptParisFrance
| | - Juan‐Pablo Villanueva‐Cabezas
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,The Nossal Institute for Global HealthThe University of MelbourneMelbourneAustralia
| | - Violeta Spirkoska
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Victorian Infectious Diseases Reference LaboratoryRoyal Melbourne Hospital, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - James E. Fielding
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia,Victorian Infectious Diseases Reference LaboratoryRoyal Melbourne Hospital, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | | | - Anthony Nardone
- World Health OrganizationGenevaSwitzerland,EpiconceptParisFrance
| | - Brianna Cheng
- World Health OrganizationGenevaSwitzerland,School of Population and Global HealthMcGill UniversityMontrealQuebecCanada
| | | | - Joseph Okeibunor
- World Health Organization, Regional Office for AfricaBrazzavilleRepublic of Congo
| | - Eman A. Aly
- World Health Organization, Regional Office for the Eastern MediterraneanCairoEgypt
| | - Amal Barakat
- World Health Organization, Regional Office for the Eastern MediterraneanCairoEgypt
| | | | - Tasnim Azim
- World Health Organization, Regional Office for South‐East AsiaNew DelhiIndia
| | | | - Linh‐Vi Le
- World Health Organization, Regional Office for the Western PacificManilaPhilippines
| | - Angel Rodriguez
- World Health Organization, Regional Office for the Americas (Pan American Health Organization)WashingtonDCUSA
| | - Andrea Vicari
- World Health Organization, Regional Office for the Americas (Pan American Health Organization)WashingtonDCUSA
| | | | - Jodie McVernon
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia,Murdoch Children's Research InstituteMelbourneAustralia
| | - Richard Pebody
- World Health Organization Regional Office for EuropeCopenhagenDenmark
| | - David J. Price
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | | | | | | | - Yasir Alvi
- Department of Community Medicine Hamdard Institute of Medical Sciences and Research New Delhi India
| | | | - Pui Shan Chung
- World Health Organization, Regional Office for the Western Pacific Manila Philippines
| | - Davaalkham Dambadarjaa
- School of Public Health Mongolian National University of Medical Sciences Ulaanbaatar Mongolia
| | - Ayan K. Das
- Department of Microbiology Hamdard Institute of Medical Science and Research New Delhi India
- Hakeem Abdul Hameed Centenary Hospital New Delhi India
| | - Timothée Dub
- Department of Health Security Finnish Institute for Health and Welfare Helsinki Finland
| | | | - Faiqa Ebrahim
- World Health Organization Country Office Addis Ababa Ethiopia
| | | | | | | | | | | | - Belinda L. Herring
- World Health Organization, Regional Office for Africa Brazzaville Republic of Congo
| | | | - Farzana Islam
- Hamdard Institute of Medical Sciences and Research (HIMSR) New Delhi India
| | - Kamal Chandima Jeewandara
- Allergy Immunology and Cell Biology Unit, Department of Immunology and Molecular Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura Nugegoda Sri Lanka
| | - Shashi Kant
- Centre for Community Medicine All India Institute of Medical Sciences New Delhi India
| | - Wasiq Khan
- World Health Organization, Regional Office for the Eastern Mediterranean Cairo Egypt
| | | | - Juliana Leite
- World Health Organization, Regional Office for the Americas (Pan American Health Organization) Washington DC USA
| | | | - Undram Mandakh
- Mongolian National University of Medical Sciences Ulaanbaatar Mongolia
| | - Warisha Mariam
- Department of Community Medicine Maulana Azad Medical College New Delhi India
| | - Tsogt Mend
- National Center for Communicable Diseases Ulaanbaatar Mongolia
| | | | - Sanjin Musa
- Institute for Public Health of the Federation of Bosnia and Herzegovina Sarajevo Bosnia and Herzegovina
- Sarajevo School of Science and Technology Sarajevo Bosnia and Herzegovina
| | - Hanna Nohynek
- Department of Health Security Finnish Institute for Health and Welfare Helsinki Finland
| | | | | | | | | | | | - James Ransom
- Centers for Disease Control and Prevention Juba South Sudan
| | - Sonal Saxena
- Department of Microbiology Maulana Azad Medical College New Delhi India
| | - Pragya Sharma
- Department of Community Medicine Maulana Azad Medical College New Delhi India
| | - Aswathy Sreedevi
- Department of Community Medicine Amrita Institute of Medical Sciences Kochi Kerala India
| | - Mini Satheesh
- Kerala University of Health Sciences Kerala India
- Government Medical College Thiruvananthapuram Kerala India
| | - K. J. Subhashini
- Centre for Community Medicine All India Institute of Medical Sciences New Delhi India
| | - Beth A. Tippet‐Barr
- U.S. Centers for Disease Control and Prevention Nairobi Kenya
- Nyanja Health Research Institute Salima Malawi
| | - Anuja Usha
- Regional Prevention of Epidemic and Infectious Disease Cell Government of Kerala Kerala India
| | | | | | - Kapil Yadav
- Centre for Community Medicine All India Institute of Medical Sciences New Delhi India
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Vashisht S, Jha S, Thakur N, Khaitan A, Rai S, Haldar P, Kant S, Kardam P, Sangral M. Comparing the Effects of Oral HIV Self-Testing With Those of Standard HIV Testing for Men Who Have Sex With Men (MSM): A Systematic Review and Meta-Analysis. Cureus 2022; 14:e28157. [PMID: 36158381 PMCID: PMC9491680 DOI: 10.7759/cureus.28157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
The WHO recommends HIV self-testing (HIVST) as an innovative strategy and an additional testing approach to attain UNAIDS targets to end HIV by 2030. HIVST is a process whereby a person collects his or her own specimen (either oral fluid or blood), performs an HIV test, and interprets the result. It has been described as a discreet and convenient way to reach the hidden, unreached key populations (KPs) who do not know their HIV status or do not get tested. Among the KPs, men who have sex with men (MSM) is one such group that by far remains hidden due to feared stigma and discrimination associated both with their sexuality and HIV. Fear of pain and blood while HIV testing also deters MSM from getting tested. In this review, we assessed the effect of oral HIVST on the uptake and frequency of testing and risk behavior as compared to standard HIV testing. For this review, we systematically searched various electronic databases for clinical trials comparing HIVST to standard HIV testing from January 1, 2011, to December 31, 2021. A meta-analysis of studies was conducted using a random-effects model for relative risks (RRs) and 95% confidence intervals (CIs). The protocol was registered with PROSPERO, and PRISMA guidelines for systematic reviews and meta-analyses were followed. The quality of the clinical trials was assessed using Cochrane’s risk of bias tool version 2.0 (RoB 2.0). We identified eight studies comparing HIVST to standard HIV testing services (HTSs). The eight randomized controlled trials (RCTs) enrolled 5,297 participants, of which 5,212 were MSM and 85 were transgender (TG) women. Seven RCTs were conducted in high-income countries (HICs): four in the USA, two in Australia, and one in Hong Kong. One was conducted in a low-middle-income country (LMIC) in Myanmar.In all the studies, HIVST intervention was provided with oral HIVST kits, except for one study in which both blood-based and oral HIVST kits were used. Meta-analysis (five RCTs) showed that HIVST increased the uptake of HIV testing by 1.43 times compared to standard of care (SoC) (RR = 1.43; 95% CI = 1.25, 1.64). Meta-analysis (four RCTs) found that HIVST increased the mean number of HIV tests by 2.34 during follow-up (mean difference = 2.34; 95% CI = 1.66, 3.02). Meta-analysis (four RCTs) showed that HIVST doubled the detection of new HIV infections among those tested (RR = 2.10; 95% CI = 1.35, 3.28) and reported higher repeat testing as compared to the control arm (RR = 2.04; 95% CI = 1.22, 3.42). A meta-analysis of three trials found no significant difference in risk behavior in respect of condomless anal intercourse (CAI) (odds ratio (OR) = 0.90; 95% CI = 0.67, 1.22) and multiple male partnership (RR = 0.89; 95% CI = 0.83, 0.94). Oral HIVST could increase the HIV testing and detection of new HIV infections among MSM who may not otherwise test, as compared to standard testing services alone. However, further research from low-middle-income countries is required for generalizability.
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Misra P, Kant S, Guleria R, Rai SK, Jaiswal A, Mandal S, Medigeshi GR, Ahmad M, Rahman A, Sangral M, Yadav K, Bairwa M, Haldar P, Kumar P. Antibody Response to SARS-CoV-2 among COVID-19 Confirmed Cases and Correlates with Neutralizing Assay in a Subgroup of Patients in Delhi National Capital Region, India. Vaccines (Basel) 2022; 10:vaccines10081312. [PMID: 36016201 PMCID: PMC9412620 DOI: 10.3390/vaccines10081312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022] Open
Abstract
Background: The plaque reduction neutralization test (PRNT) is the gold standard to detect the neutralizing capacity of serum antibodies. Neutralizing antibodies confer protection against further infection. The present study measured the antibody level against SARS-CoV-2 among laboratory-confirmed COVID-19 cases and evaluated whether the presence of anti-SARS-CoV-2 antibodies indicates virus neutralizing capacity. Methods: One hundred COVID-19 confirmed cases were recruited. Their sociodemographic details and history of COVID-19 vaccination, contact with positive COVID-19 cases, and symptoms were ascertained using a self-developed semi-structured interview schedule. Serum samples of the participants were collected within three months from the date of the positive report of COVID-19. The presence of anti-SARS-CoV-2 antibodies (IgA, IgG and IgM antibodies), receptor binding domain antibodies (anti-RBD), and neutralizing antibodies were measured. Findings: Almost all the participants had anti-SARS-CoV-2 antibodies (IgA, IgG and IgM) (99%) and anti-RBD IgG antibodies (97%). However, only 69% had neutralizing antibodies against SARS-CoV-2. Anti-RBD antibody levels were significantly higher among participants having neutralizing antibodies compared with those who did not. Interpretation: The present study highlights that the presence of antibodies against SARS-CoV-2, or the presence of anti-RBD antibodies does not necessarily imply the presence of neutralizing antibodies.
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Affiliation(s)
- Puneet Misra
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
- Correspondence: ; Tel.: +91-9810696386
| | - Shashi Kant
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Randeep Guleria
- Director, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Sanjay K. Rai
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Abhishek Jaiswal
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Suprakash Mandal
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | | | | | | | - Meenu Sangral
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Kapil Yadav
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Mohan Bairwa
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Partha Haldar
- Centre for Community Medicine, Old OT-Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Parveen Kumar
- Translational Health Science and Technology Institute, Faridabad 121001, India
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Nethan ST, Lakshmi K, Ralhan R, Mishra D, R. P, Bahadur S, Kant S, Gupta SD, Pandey RM, Julka PK, Rath GK, Mehrotra R, Srivastava A. Assessment of the Prevalence and Relationship of Tobacco Use and Associated Oral Lesions in an Urban Population of New Delhi: a Cross-Sectional Study. Indian J Surg 2022. [DOI: 10.1007/s12262-021-03055-y] [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: 11/30/2022] Open
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Kusuma YS, Kant S. COVID-19 vaccine acceptance and its determinants: A cross-sectional study among the socioeconomically disadvantaged communities living in Delhi, India. Vaccine X 2022; 11:100171. [PMID: 35607603 PMCID: PMC9116429 DOI: 10.1016/j.jvacx.2022.100171] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 02/08/2022] [Accepted: 05/13/2022] [Indexed: 01/13/2023] Open
Abstract
Background Vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the most desired solution to combat COVID-19. We examined the willingness to accept the vaccine and reasons for vaccine hesitancy, and identified some factors associated with the vaccine hesitancy among the socio-economically disadvantaged urban population from Delhi, India. Methods We conducted a cross-sectional survey of a randomly selected sample of 1539 households from 31 urban clusters. Data on socio-demographics, health beliefs, and willingness to accept the SARS-CoV-2 vaccine were collected through a face-to-face interviewer-administered, pre-tested questionnaire from an adult member. Vaccine acceptance/hesitancy was analysed by various socio-demographic and health belief variables. Multinomial regressions were carried out to identify the factors associated with the vaccine hesitancy. Results Overall, 64.9% (95% CI: 62.5 to 67.3) of the respondents would accept the vaccine, 17.4% (95% CI: 15.6 to 19.4) were undecided, and 17.7% (95% CI: 15.8 to 19.7) would not accept the vaccine. The reasons for not accepting the vaccine were: belief that they had immunity (12.9%), the corona was a hoax (11.8%), the vaccine was not necessary (7.4%), and did not want to disturb the natural bodily systems by the vaccine (5.6%). The undecided group mainly would like to wait and see (37.7%), decide when the vaccine become available (11.6%), will take if everyone in their community takes (10.4%). Multinomial logistic regression identified older age, low perceived susceptibility of contracting COVID-19, low perceived severity of COVID-19, low self-efficacy to protect against COVID-19, and unawareness and non-use of Arogyasetu App as significant predictors of vaccine hesitancy. Conclusions Two-thirds of Delhi's low-income groups would accept the vaccine against SARS-CoV-2. Vaccine hesitancy was associated with older age, low perceived susceptibility, low perceived severity, and low self-efficacy to protect themselves from COVID-19. Hence, efforts are needed to address these issues and vaccine concerns to increase the vaccine uptake.
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Affiliation(s)
- Yadlapalli S. Kusuma
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110 029, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110 029, India
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Kumar P, Das C, Kumar A, Sahu D, Rai SK, Godbole S, Arumugam E, P. V. M. L, Dutta S, Devi HS, Vardhana Rao Mendu V, Kant S, Pandey A, Reddy DCS, Mehendale S, Rajan S. Diversity in HIV epidemic transitions in India: An application of HIV epidemiological metrices and benchmarks. PLoS One 2022; 17:e0270886. [PMID: 35849570 PMCID: PMC9292090 DOI: 10.1371/journal.pone.0270886] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background The Joint United Nations Programme on AIDS (UNAIDS) has emphasized on the incidence-prevalence ratio (IPR) and incidence-mortality ratio (IMR) to measure the progress in HIV epidemic control. In this paper, we describe the status of epidemic control in India and in various states in terms of UNAIDS’s recommended metrices. Method The National AIDS Control Programme (NACP) of India spearheads work on mathematical modelling to estimate HIV burden based on periodically conducted sentinel surveillance for providing guidance to program implementation and policymaking. Using the results of the latest round of HIV Estimations in 2019, IPR and IMR were calculated. Results National level IPR was 0.029 [0.022–0.037] in 2019 and ranged from 0.01 to 0.15 in various States and Union Territories (UTs). Corresponding Incidence-Mortality Ratio was at 0.881 [0.754–1.014] nationally and ranged between 0.20 and 12.90 across the States/UTs. Conclusions Based on UNAIDS recommended indicators for HIV epidemic control, namely IPR and IMR; national AIDS response in India appears on track. However, the program success is not uniform and significant heterogeneity as well as expanding epidemic was observed at the level of States or UTs. Reinforcing States/UTs specific and focused HIV prevention, testing and treatment initiatives may help in the attainment of 2030 Sustainable Development Goals of ending AIDS as a public health threat by 2030.
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Affiliation(s)
- Pradeep Kumar
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
- * E-mail:
| | - Chinmoyee Das
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Arvind Kumar
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Damodar Sahu
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
| | - Sanjay K. Rai
- All India Institute of Medical Sciences, New Delhi, India
| | - Sheela Godbole
- Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | - Elangovan Arumugam
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | - Lakshmi P. V. M.
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shanta Dutta
- Indian Council of Medical Research-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | | | - Shashi Kant
- All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Pandey
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
- Indian Council of Medical Research, New Delhi, India
| | | | - Sanjay Mehendale
- Indian Council of Medical Research, New Delhi, India
- PD Hinduja Hospital and Medical Research Center, Mumbai, India
| | - Shobini Rajan
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
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Malhotra S, Kant S, Rath R, Ahamed F, Sathiyamoorthy R, Gupta SK. Excess Screen Time and its Associated Factors among Young Men in a Rural Community of North India. Indian J Public Health 2022; 66:327-330. [PMID: 36149114 DOI: 10.4103/ijph.ijph_2027_21] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Screen-based media usage among young people is blooming rapidly due to technological and digital revolution. We conducted community-based cross-sectional study to determine the prevalence of excess screen time and its association with sociodemographic and behavioral patterns in a rural block of Haryana, India. A semi-structured interview schedule was administered by trained physicians to ascertain screen time in a typical day and various socioeconomic and behavioral factors among a random sample of 860 young men aged 18-24 years. The prevalence of excess screen time was 61.8% (95% confidence interval [CI] 58.4-65.1). It was significantly associated with education (adjusted odds ratio [AOR] 1.7, 95% CI 1.1-2.6) and occupation (AOR 2.2, 95% CI 1.2-3.9) of the father and their sleep duration of ≤8 h (AOR 1.6, 95% CI 1.2-2.3). Limiting the screen time as per international standards and behavioral interventions are needed for this young population.
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Affiliation(s)
- Sumit Malhotra
- Additional Professor, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Professor and Head, All India Institute of Medical Sciences, New Delhi, India
| | - Ramashankar Rath
- Assistant Professor, Department of Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Farhad Ahamed
- Assistant Professor, Department of Community and Family Medicine, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | | | - Sanjeev Kumar Gupta
- Professor, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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