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Selvaraju S, Velayutham B, Rao R, Rade K, Thiruvengadam K, Asthana S, Balachandar R, Bangar SD, Bansal AK, Bhat J, Chopra V, Das D, Dutta S, Devi KR, Dwivedi GR, Kalliath A, Laxmaiah A, Madhukar M, Mahapatra A, Mohanty SS, Rangaraju C, Turuk J, Menon PA, Krishnan R, Singh M, Sekar K, Robinson A, Turuk A, Krishnan NN, Srinivasan N, Rexy C, Suresh M, Hanna LE, Choudhury AH, Parmar M, Ramachandran R, Kumar N, Joshi RP, Narasimhaiah S, Chandrasekaran P, Khan AM, Panda S, Bhargava B. Prevalence and factors associated with tuberculosis infection in India. J Infect Public Health 2023; 16:2058-2065. [PMID: 37948837 DOI: 10.1016/j.jiph.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The risk of tuberculosis (TB) disease is higher in individuals with TB infection. In a TB endemic country like India, it is essential to understand the current burden of TB infection at the population level. The objective of the present analysis is to estimate the prevalence of TB infection in India and to explore the factors associated with TB infection. METHODS Individuals aged > 15 years in the recently completed National TB prevalence survey in India who were tested for TB infection by QuantiFERON-TB Gold Plus (QFT-Plus) assay were considered for this sub-analysis. TB infection was defined as positive by QFT-Plus (value >0.35 IU/ml). The estimates for prevalence, prevalence ratio (PR) and adjusted risk ratio (aRR) estimates with 95% confidence intervals (CIs) were calculated. RESULTS Of the 16864 individuals analysed, the prevalence of TB infection was 22.6% (95% CI:19.4 -25.8). Factors more likely to be associated with TB infection include age > 30 years (aRR:1.49;95% CI:1.29-1.73), being male (aRR:1.26; 95%CI: 1.18-1.34), residing in urban location (aRR:1.58; 95%CI: 1.03-2.43) and past history of TB (aRR:1.49; 95%CI: 1.26-1.76). CONCLUSION About one fourth (22.6%) of the individuals were infected with TB in India. Individuals aged > 30 years, males, residing in urban location, and those with past history of TB were more likely to have TB infection. Targeted interventions for prevention of TB and close monitoring are essential to reduce the burden of TB in India.
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Affiliation(s)
- Sriram Selvaraju
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | | | | | | | | | - Smita Asthana
- ICMR - National Institute of Cancer Prevention and Research, Noida, India
| | | | | | - Avi Kumar Bansal
- ICMR - National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, India
| | - Jyothi Bhat
- ICMR - National Institute of Research in Tribal Health, Jabalpur, India
| | | | - Dasarathi Das
- ICMR - Regional Medical Research Centre, Bhubaneswar, India
| | - Shantha Dutta
- ICMR - National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | | | | | - Avula Laxmaiah
- ICMR - National Institute of Nutrition, Hyderabad, India
| | - Major Madhukar
- ICMR - Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | | | - Suman Sundar Mohanty
- ICMR - National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, India
| | | | | | | | | | - Manjula Singh
- Indian Council of Medical Research, New Delhi, India
| | - Krithikaa Sekar
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - Aby Robinson
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - Alka Turuk
- Indian Council of Medical Research, New Delhi, India
| | | | | | - Catherine Rexy
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - M Suresh
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | | | | | | | | | | | | | | | | | - A M Khan
- ICMR - National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, India; Indian Council of Medical Research, New Delhi, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
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Murhekar MV, Bhatnagar T, Thangaraj JWV, Saravanakumar V, Kumar MS, Selvaraju S, Rade K, Kumar CPG, Sabarinathan R, Turuk A, Asthana S, Balachandar R, Bangar SD, Bansal AK, Chopra V, Das D, Deb AK, Devi KR, Dhikav V, Dwivedi GR, Khan SMS, Kumar MS, Laxmaiah A, Madhukar M, Mahapatra A, Rangaraju C, Turuk J, Yadav R, Andhalkar R, Arunraj K, Bharadwaj DK, Bharti P, Bhattacharya D, Bhat J, Chahal AS, Chakraborty D, Chaudhury A, Deval H, Dhatrak S, Dayal R, Elantamilan D, Giridharan P, Haq I, Hudda RK, Jagjeevan B, Kalliath A, Kanungo S, Krishnan NN, Kshatri JS, Kumar A, Kumar N, Kumar VGV, Lakshmi GGJN, Mehta G, Mishra NK, Mitra A, Nagbhushanam K, Nimmathota A, Nirmala AR, Pandey AK, Prasad GV, Qurieshi MA, Reddy SD, Robinson A, Sahay S, Saxena R, Sekar K, Shukla VK, Singh HB, Singh PK, Singh P, Singh R, Srinivasan N, Varma DS, Viramgami A, Wilson VC, Yadav S, Yadav S, Zaman K, Chakrabarti A, Das A, Dhaliwal RS, Dutta S, Kant R, Khan AM, Narain K, Narasimhaiah S, Padmapriyadarshini C, Pandey K, Pati S, Patil S, Rajkumar H, Ramarao T, Sharma YK, Singh S, Panda S, Reddy DCS, Bhargava B. SARS-CoV-2 seroprevalence among the general population and healthcare workers in India, December 2020-January 2021. Int J Infect Dis 2021; 108:145-155. [PMID: 34022338 PMCID: PMC8132496 DOI: 10.1016/j.ijid.2021.05.040] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/12/2021] [Accepted: 05/16/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Earlier serosurveys in India revealed seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) of 0.73% in May-June 2020 and 7.1% in August-September 2020. A third serosurvey was conducted between December 2020 and January 2021 to estimate the seroprevalence of SARS-CoV-2 infection among the general population and healthcare workers (HCWs) in India. METHODS The third serosurvey was conducted in the same 70 districts as the first and second serosurveys. For each district, at least 400 individuals aged ≥10 years from the general population and 100 HCWs from subdistrict-level health facilities were enrolled. Serum samples from the general population were tested for the presence of immunoglobulin G (IgG) antibodies against the nucleocapsid (N) and spike (S1-RBD) proteins of SARS-CoV-2, whereas serum samples from HCWs were tested for anti-S1-RBD. Weighted seroprevalence adjusted for assay characteristics was estimated. RESULTS Of the 28,598 serum samples from the general population, 4585 (16%) had IgG antibodies against the N protein, 6647 (23.2%) had IgG antibodies against the S1-RBD protein, and 7436 (26%) had IgG antibodies against either the N protein or the S1-RBD protein. Weighted and assay-characteristic-adjusted seroprevalence against either of the antibodies was 24.1% [95% confidence interval (CI) 23.0-25.3%]. Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI 23.5-27.8%). CONCLUSIONS Nearly one in four individuals aged ≥10 years from the general population as well as HCWs in India had been exposed to SARS-CoV-2 by December 2020.
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Affiliation(s)
- Manoj V Murhekar
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India.
| | - Tarun Bhatnagar
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - V Saravanakumar
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - Sriram Selvaraju
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Kiran Rade
- WHO Country Office for India, New Delhi, India
| | - C P Girish Kumar
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - R Sabarinathan
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Alka Turuk
- Indian Council of Medical Research, New Delhi, India
| | - Smita Asthana
- ICMR National Institute of Cancer Prevention and Research, NOIDA, Uttar Pradesh, India
| | - Rakesh Balachandar
- ICMR National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | | | - Avi Kumar Bansal
- ICMR National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Vishal Chopra
- State TB Training and Demonstration Centre, Patiala, Punjab, India
| | - Dasarathi Das
- ICMR Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Alok Kumar Deb
- ICMR National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Kangjam Rekha Devi
- ICMR Regional Medical Research Centre, N.E. Region, Dibrugarh, Assam, India
| | - Vikas Dhikav
- ICMR National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | | | | | - M Sunil Kumar
- State TB Training and Demonstration Centre, Thiruvananthapuram, Kerala, India
| | - Avula Laxmaiah
- ICMR National Institute of Nutrition, Hyderabad, Telangana, India
| | - Major Madhukar
- ICMR Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | | | - Chethana Rangaraju
- National Tuberculosis Institute, Bangalore and Lady Willingdon State TB Centre, Bengaluru, Karnataka, India
| | | | - Rajiv Yadav
- ICMR National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Rushikesh Andhalkar
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - K Arunraj
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Pravin Bharti
- ICMR National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | | | - Jyothi Bhat
- ICMR National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | | | - Debjit Chakraborty
- ICMR National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Anshuman Chaudhury
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Hirawati Deval
- ICMR Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Sarang Dhatrak
- ICMR National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Rakesh Dayal
- State TB Training and Demonstration Centre, Ranchi, Jharkhand, India
| | - D Elantamilan
- ICMR National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | | | - Inaamul Haq
- Government Medical College Srinagar, Srinagar, Jammu, India
| | - Ramesh Kumar Hudda
- ICMR National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | - Babu Jagjeevan
- ICMR National Institute of Nutrition, Hyderabad, Telangana, India
| | - Arshad Kalliath
- State TB Training and Demonstration Centre, Thiruvananthapuram, Kerala, India
| | - Srikanta Kanungo
- ICMR Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | | | - Alok Kumar
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Niraj Kumar
- ICMR Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - V G Vinoth Kumar
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Ganesh Mehta
- ICMR National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Nandan Kumar Mishra
- ICMR National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Anindya Mitra
- State TB Training and Demonstration Centre, Ranchi, Jharkhand, India
| | - K Nagbhushanam
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - A R Nirmala
- National Tuberculosis Institute, Bangalore and Lady Willingdon State TB Centre, Bengaluru, Karnataka, India
| | | | | | | | | | - Aby Robinson
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Seema Sahay
- ICMR National AIDS Research Institute, Pune, Maharashtra, India
| | - Rochak Saxena
- State TB Training and Demonstration Centre, Raipur, Chhattisgarh, India
| | - Krithikaa Sekar
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Hari Bhan Singh
- ICMR National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Prashant Kumar Singh
- ICMR National Institute of Cancer Prevention and Research, NOIDA, Uttar Pradesh, India
| | - Pushpendra Singh
- ICMR National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Rajeev Singh
- ICMR Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Nivetha Srinivasan
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Ankit Viramgami
- ICMR National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | | | - Surabhi Yadav
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Suresh Yadav
- ICMR National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | - Kamran Zaman
- ICMR Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Amit Chakrabarti
- ICMR National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Aparup Das
- ICMR National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - R S Dhaliwal
- ICMR National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | - Shanta Dutta
- ICMR National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Rajni Kant
- ICMR Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - A M Khan
- Indian Council of Medical Research, New Delhi, India
| | - Kanwar Narain
- ICMR Regional Medical Research Centre, N.E. Region, Dibrugarh, Assam, India
| | - Somashekar Narasimhaiah
- National Tuberculosis Institute, Bangalore and Lady Willingdon State TB Centre, Bengaluru, Karnataka, India
| | | | - Krishna Pandey
- ICMR Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | - Sanghamitra Pati
- ICMR Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Shripad Patil
- ICMR National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | | | | | - Y K Sharma
- State TB Training and Demonstration Centre, Raipur, Chhattisgarh, India
| | - Shalini Singh
- ICMR National Institute of Cancer Prevention and Research, NOIDA, Uttar Pradesh, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
| | - D C S Reddy
- Independent Consultant, Lucknow, Uttar Pradesh, India
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