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Carlton JM, Sahu PK, Wassmer SC, Mohanty S, Kessler A, Eapen A, Tomko SS, Walton C, Joshi PL, Das D, Albert S, Peter BK, Pradhan MM, Dash AP, Das A. The Impact, Emerging Needs, and New Research Questions Arising from 12 Years of the Center for the Study of Complex Malaria in India. Am J Trop Med Hyg 2022; 107:90-96. [PMID: 36228922 PMCID: PMC9662226 DOI: 10.4269/ajtmh.21-1277] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 05/28/2022] [Indexed: 11/24/2022] Open
Abstract
The Center for the Study of Complex Malaria in India (CSCMi) was launched in 2010 with the overall goal of addressing major gaps in our understanding of "complex malaria" in India through projects on the epidemiology, transmission, and pathogenesis of the disease. The Center was mandated to adopt an integrated approach to malaria research, including building capacity, developing infrastructure, and nurturing future malaria leaders while conducting relevant and impactful studies to assist India as it moves from control to elimination. Here, we will outline some of the interactions and impacts the Center has had with malaria policy and control counterparts in India, as well as describe emerging needs and new research questions that have become apparent over the past 12 years.
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Affiliation(s)
- Jane M. Carlton
- Department of Biology, Center for Genomics and Systems Biology, New York University, New York, New York
- Department of Epidemiology, School of Global Public Health, New York University, New York, New York
- Address correspondence to Jane M. Carlton, Center for Genomics and Systems Biology, New York University, 12 Waverly Place, New York, NY 10003. E-mail:
| | - Praveen K. Sahu
- Department of Molecular and Infectious Diseases, Community Welfare Society Hospital, Rourkela, India
| | - Samuel C. Wassmer
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sanjib Mohanty
- Department of Molecular and Infectious Diseases, Community Welfare Society Hospital, Rourkela, India
| | - Anne Kessler
- Department of Biology, Center for Genomics and Systems Biology, New York University, New York, New York
| | - Alex Eapen
- IDVC Field Unit, National Institute of Malaria Research, Indian Council of Medical Research, National Institute of Epidemiology Campus, Chennai, India
| | - Sheena Shah Tomko
- Department of Biology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Catherine Walton
- Department of Earth and Environmental Sciences, School of Natural Sciences, University of Manchester, Manchester, United Kingdom
| | - Pyare L. Joshi
- Joint Scientific Advisory Committee, Indian Council of Medical Research, and Malaria No More, India Programme, New Delhi, India
| | - Deben Das
- District Headquarters Hospital, Keonjhar, India
| | - Sandra Albert
- Indian Institute of Public Health—Shillong, Shillong, India
- Martin Luther Christian University, Shillong, India
| | | | - Madan M. Pradhan
- Department of Health and Family Welfare, State Vector Borne Disease Control Programme, Bhubaneswar, India
| | - Aditya P. Dash
- Asian Institute of Public Health University, Bhubaneswar, India
| | - Aparup Das
- National Institute of Research in Tribal Health, Indian Council of Medical Research, Jabalpur, India
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Pradhan MM, Pradhan S, Dutta A, Shah NK, Valecha N, Joshi PL, Pradhan K, Grewal Daumerie P, Banerji J, Duparc S, Mendis K, Sharma SK, Murugasampillay S, Anvikar AR. Impact of the malaria comprehensive case management programme in Odisha, India. PLoS One 2022; 17:e0265352. [PMID: 35324920 PMCID: PMC8947122 DOI: 10.1371/journal.pone.0265352] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/28/2022] [Indexed: 11/19/2022] Open
Abstract
Background
The Comprehensive Case Management Project (CCMP), was a collaborative implementation research initiative to strengthen malaria early detection and complete treatment in Odisha State, India.
Methods
A two-arm quasi-experimental design was deployed across four districts in Odisha, representing a range of malaria endemicity: Bolangir (low), Dhenkanal (moderate), Angul (high), and Kandhamal (hyper). In each district, a control block received routine malaria control measures, whereas a CCMP block received a range of interventions to intensify surveillance, diagnosis, and case management. Impact was evaluated by difference-in-difference (DID) analysis and interrupted time-series (ITS) analysis of monthly blood examination rate (MBER) and monthly parasite index (MPI) over three phases: phase 1 pre-CCMP (2009–2012) phase 2 CCMP intervention (2013–2015), and phase 3 post-CCMP (2016–2017).
Results
During CCMP implementation, adjusting for control blocks, DID and ITS analysis indicated a 25% increase in MBER and a 96% increase in MPI, followed by a –47% decline in MPI post-CCMP, though MBER was maintained. Level changes in MPI between phases 1 and 2 were most marked in Dhenkanal and Angul with increases of 976% and 287%, respectively, but declines in Bolangir (−57%) and Kandhamal (−22%). Between phase 2 and phase 3, despite the MBER remaining relatively constant, substantial decreases in MPI were observed in Dhenkanal (−78%), and Angul (−59%), with a more modest decline in Bolangir (−13%), and an increase in Kandhamal (14%).
Conclusions
Overall, CCMP improved malaria early detection and treatment through the enhancement of the existing network of malaria services which positively impacted case incidence in three districts. In Kandhamal, which is hyperendemic, the impact was not evident. However, in Dhenkanal and Angul, areas of moderate-to-high malaria endemicity, CCMP interventions precipitated a dramatic increase in case detection and a subsequent decline in malaria incidence, particularly in previously difficult-to-reach communities.
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Affiliation(s)
- Madan M. Pradhan
- National Vector Borne Disease Control Programme, Government of Odisha, Bhubaneswar, India
- * E-mail:
| | - Sreya Pradhan
- National Vector Borne Disease Control Programme, Government of Odisha, Bhubaneswar, India
| | - Ambarish Dutta
- Indian Institute of Public Health, Bhubaneswar, India
- Kalinga Institute of Industrial Technology, Deemed to be University, Bhubaneswar, India
| | - Naman K. Shah
- University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Neena Valecha
- National Institute of Malaria Research, New Delhi, India
| | - Pyare L. Joshi
- Independent Malariologist, Gallup, Washington, D.C., United States of America
| | | | | | - Jaya Banerji
- Medicines for Malaria Venture, Geneva, Switzerland
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Anvikar AR, Sahu P, Pradhan MM, Sharma S, Ahmed N, Yadav CP, Pradhan S, Duparc S, Daumerie PG, Valecha N. Active Pharmacovigilance for Primaquine Radical Cure of Plasmodium vivax Malaria in Odisha, India. Am J Trop Med Hyg 2022; 106:831-840. [PMID: 35008062 PMCID: PMC8922502 DOI: 10.4269/ajtmh.21-0816] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/25/2021] [Indexed: 11/20/2022] Open
Abstract
Plasmodium vivax malaria elimination requires radical cure with chloroquine/primaquine. However, primaquine causes hemolysis in glucose-6-phosphate dehydrogenase-deficient (G6PDd) individuals. Between February 2016 and July 2017 in Odisha State, India, a prospective, observational, active pharmacovigilance study assessed the hematologic safety of directly observed 25 mg/kg chloroquine over 3 days plus primaquine 0.25 mg/kg/day for 14 days in 100 P. vivax patients (≥ 1 year old) with hemoglobin (Hb) ≥ 7 g/dL. Pretreatment G6PDd screening was not done, but patients were advised on hemolysis signs and symptoms using a visual aid. For evaluable patients, the mean absolute change in Hb between day 0 and day 7 was −0.62 g/dL (95% confidence interval [CI]: −0.93, −0.31) for males (N = 53) versus −0.24 g/dL (95%CI: −0.59, 0.10) for females (N = 45; P = 0.034). Hemoglobin declines ≥ 3 g/dL occurred in 5/99 (5.1%) patients (three males, two females); none had concurrent clinical symptoms of hemolysis. Based on G6PD qualitative testing after study completion, three had a G6PD-normal phenotype, one female was confirmed by genotyping as G6PDd heterozygous, and one male had an unknown phenotype. A G6PDd prevalence survey was conducted between August 2017 and March 2018 in the same region using qualitative G6PD testing, confirmed by genotyping. G6PDd prevalence was 12.0% (14/117) in tribal versus 3.1% (16/509) in nontribal populations, with G6PD Orissa identified in 29/30 (96.7%) of G6PDd samples. Following chloroquine/primaquine, notable Hb declines were observed in this population that were not recognized by patients based on clinical signs and symptoms.
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Affiliation(s)
| | - Prajyoti Sahu
- National Vector Borne Disease Control Programme (NVBDCP), Odisha, India
| | - Madan M Pradhan
- National Vector Borne Disease Control Programme (NVBDCP), Odisha, India
| | - Supriya Sharma
- National Institute of Malaria Research, Dwarka, New Delhi, India
| | - Naseem Ahmed
- National Institute of Malaria Research, Dwarka, New Delhi, India
| | - Chander P Yadav
- National Institute of Malaria Research, Dwarka, New Delhi, India
| | - Sreya Pradhan
- National Vector Borne Disease Control Programme (NVBDCP), Odisha, India
| | | | | | - Neena Valecha
- National Institute of Malaria Research, Dwarka, New Delhi, India
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Rajvanshi H, Mishra K, Bharti PK, Sandhibigraha D, Nisar S, Jayswar H, Das A, Pradhan MM, Mohapatra PK, Govil PJ, Kshirsagar N, Dash AP, Singh S, Sahu RS, Kaur H, Dhingra N, Khan A, Lal AA. Learnings from two independent malaria elimination demonstration projects in India. Trans R Soc Trop Med Hyg 2021; 115:1229-1233. [PMID: 34563095 DOI: 10.1093/trstmh/trab148] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/10/2021] [Revised: 08/13/2021] [Accepted: 09/07/2021] [Indexed: 11/14/2022] Open
Abstract
PROBLEM India and sub-Saharan Africa contributes about 85% of the global malaria burden, and India is committed to eliminating malaria by 2030. APPROACH Two novel initiatives-the Malaria Elimination Demonstration Project (MEDP) in Madhya Pradesh and Durgama Anchalare Malaria Nirakaran (DAMaN) in Odisha-were initiated independently to demonstrate that indigenous malaria can be eliminated in a short period of time. LOCAL SETTING These initiatives focused on rural, tribal areas where there is a high malaria burden and complex epidemiology. RELEVANT CHANGES The case management and vector control strategies used in these programmes were based on the national guidelines, with context-specific changes and introduction of accountability at management, operational, technical and financial levels. The MEDP achieved a 91% reduction in malaria cases and recorded zero transmission for 6 consecutive and a total of 9 mo. The DAMaN project brought about an 88% reduction in malaria cases. LESSONS LEARNED Malaria elimination will require robust surveillance and case management, monitoring of vector control interventions, community-centric information education communication and behaviour change communication initiatives and management controls, as well as regular internal and external reviews.
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Affiliation(s)
- Harsh Rajvanshi
- Malaria Elimination Demonstration Project (MEDP), Mandla, Madhya Pradesh 481661, India
| | - Kirti Mishra
- Directorate of Public Health, Government of Odisha, Bhubaneshwar 751001, India
| | - Praveen K Bharti
- National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh 482003, India
| | | | - Sekh Nisar
- Malaria Elimination Demonstration Project (MEDP), Mandla, Madhya Pradesh 481661, India
| | - Himanshu Jayswar
- Directorate of Health Services, Government of Madhya Pradesh, Bhopal 462002, India
| | - Aparup Das
- National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh 482003, India
| | - Madan M Pradhan
- Directorate of Public Health, Government of Odisha, Bhubaneshwar 751001, India
| | - Pradipta K Mohapatra
- Health and Family Welfare Department, Government of Odisha, Bhubaneswar 751001, India
| | - Pallavi Jain Govil
- Scheduled Tribes and Scheduled Caste Welfare Department, Government of Madhya Pradesh, Bhopal 462001, India
| | - Nilima Kshirsagar
- Department of Health Research, Indian Council of Medical Research, Ministry of Health and Family Welfare, New Delhi 110029, India
| | - Aditya P Dash
- Asian Institute of Public Health University, Odisha, Bhubaneswar 751001, India
| | - Shrinath Singh
- Directorate of Health Services, Government of Madhya Pradesh, Bhopal 462002, India
| | - Ram Shankar Sahu
- Directorate of Health Services, Government of Madhya Pradesh, Bhopal 462002, India
| | - Harpreet Kaur
- Department of Health Research, Indian Council of Medical Research, Ministry of Health and Family Welfare, New Delhi 110029, India
| | - Neeraj Dhingra
- Directorate General of Health Services, National Vector Borne Disease Control Programme (NVBDCP), Ministry of Health and Family Welfare, New Delhi 110054, India
| | - Azadar Khan
- Malaria Elimination Demonstration Project (MEDP), Mandla, Madhya Pradesh 481661, India
| | - Altaf A Lal
- Malaria Elimination Demonstration Project (MEDP), Mandla, Madhya Pradesh 481661, India
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Krishna S, Mishra S, Tiwari P, Vishwakarma AK, Khandai S, Shrivastava S, Verma AK, Tiwari S, Barman H, Jhariya S, Tiwari P, Tidgam AS, Varun BM, Singh S, Yerane N, Tembhurne CR, Mandavi PL, Tekam SS, Malik M, Behera KP, Jayswar H, Sonwani K, Diggikar MS, Pradhan MM, Khasotiya SS, Kumar A, Dhingra N, Bustos MDG, Christophel EM, Ringwald P, Kumari R, Shukla MM, Singh N, Das A, Bharti PK. Therapeutic efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in four malaria endemic states of India. Malar J 2021; 20:229. [PMID: 34020652 PMCID: PMC8139028 DOI: 10.1186/s12936-021-03762-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/10/2021] [Accepted: 05/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Malaria is a major public health problem in India and accounts for about 88% of malaria burden in South-East Asia. India alone accounted for 2% of total malaria cases globally. Anti-malarial drug resistance is one of the major problems for malaria control and elimination programme. Artemether-lumefantrine (AL) is the first-line treatment of uncomplicated Plasmodium falciparum in north eastern states of India since 2013 after confirming the resistance against sulfadoxine-pyrimethamine. In the present study, therapeutic efficacy of artemether-lumefantrine and k13 polymorphism was assessed in uncomplicated P. falciparum malaria. Methods This study was conducted at four community health centres located in Koraput district of Odisha, Bastar district of Chhattisgarh, Balaghat district of Madhya Pradesh and Gondia district of Maharashtra state. Patients with uncomplicated P. falciparum malaria were administered with fixed dose combination (6 doses) of artemether-lumefantrine for 3days and clinical and parasitological response was recorded up to 28days as per World Health Organization protocol. Nucleotide sequencing of msp1 and msp2 gene was performed to differentiate between recrudescence and reinfection. Amplification and sequencing of k13 propeller gene region covering codon 450680 was also carried out to identify the polymorphism. Results A total 376 malaria patients who fulfilled the enrolment criteria as well as consented for the study were enrolled. Total 356 patients were followed up successfully up to 28days. Overall, the adequate clinical and parasitological response was 98.9% and 99.4% with and without PCR correction respectively. No case of early treatment failure was observed. However, four cases (1.1%) of late parasitological failure were found from the Bastar district of Chhattisgarh. Genotyping of msp1 and msp2 confirmed 2 cases each of recrudescence and reinfection, respectively. Mutation analysis of k13 propeller gene showed one non-synonymous mutation Q613H in one isolate from Bastar. Conclusions The study results showed that artemether-lumefantrine is highly effective in the treatment of uncomplicated P. falciparum malaria among all age groups. No functional mutation in k13 was found in the study area. The data from this study will be helpful in implementation of artemether-lumefantrine in case of treatment failure by artesunate plus sulfadoxine-pyrimethamine.
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Affiliation(s)
- Sri Krishna
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Sweta Mishra
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Prakash Tiwari
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Anup K Vishwakarma
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Sushrikanta Khandai
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Suyesh Shrivastava
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Anil K Verma
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Shashikant Tiwari
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Hari Barman
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Surendra Jhariya
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Pradeep Tiwari
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | | | - Brij M Varun
- District Malaria Office, Balaghat, Madhya Pradesh, India
| | - Sunil Singh
- Community Health Centre Damoh, Balaghat, Madhya Pradesh, India
| | - Naresh Yerane
- Community Health Centre Darekasa, Gondia, Maharashtra, India
| | | | - Prem L Mandavi
- Community Health Centre, District Bastar, Darbha, Chhattisgarh, India
| | - Shyam S Tekam
- District Malaria Office, District Bastar, Jagdalpur, Chhattisgarh, India
| | - Manas Malik
- Community Health Centre Bandhgram, District Koraput, Dasmantpur, Odisha, India
| | - Kali P Behera
- District Malaria Office, District Koraput, Dasmantpur, Odisha, India
| | - Himanshu Jayswar
- Directorate of Health Services, Satpura Bhawan, Bhopal, Madhya Pradesh, India
| | - Khemraj Sonwani
- Directorate of Health Services, Indravati Bhawan, Raipur, Chhattisgarh, India
| | | | - Madan M Pradhan
- State NVBDCP, Public Health Directorate, Bhubaneswar, Odisha, India
| | - Sher S Khasotiya
- National Vector Borne Disease Control Programme (NVBDCP), New Delhi, India
| | - Avdhesh Kumar
- National Vector Borne Disease Control Programme (NVBDCP), New Delhi, India
| | - Neeraj Dhingra
- National Vector Borne Disease Control Programme (NVBDCP), New Delhi, India
| | | | | | - Pascal Ringwald
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Roop Kumari
- World Health Organization, Country Office for India, New Delhi, India
| | - Man M Shukla
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Neeru Singh
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Aparup Das
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Praveen K Bharti
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India.
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Ompad DC, Kessler A, Van Eijk AM, Padhan TK, Haque MA, Sullivan SA, Tozan Y, Rocklöv J, Mohanty S, Pradhan MM, Sahu PK, Carlton JM. The effectiveness of malaria camps as part of the Durgama Anchalare Malaria Nirakaran (DAMaN) program in Odisha, India: study protocol for a cluster-assigned quasi-experimental study. Glob Health Action 2021; 14:1886458. [PMID: 33866961 PMCID: PMC8183513 DOI: 10.1080/16549716.2021.1886458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Indexed: 02/04/2023] Open
Abstract
The Indian state of Odisha has a longstanding battle with forest malaria. Many remote and rural villages have poor access to health care, a problem that is exacerbated during the rainy season when malaria transmission is at its peak. Approximately 62% of the rural population consists of tribal groups who are among the communities most negatively impacted by malaria. To address the persistently high rates of malaria in these remote regions, the Odisha State Malaria Control Program introduced 'malaria camps' in 2017 where teams of health workers visit villages to educate the population, enhance vector control methods, and perform village-wide screening and treatment. Malaria rates declined statewide, particularly in forested areas, following the introduction of the malaria camps, but the impact of the intervention is yet to be externally evaluated. This study protocol describes a cluster-assigned quasi-experimental stepped-wedge study with a pretest-posttest control group design that evaluates if malaria camps reduce the prevalence of malaria, compared to control villages which receive the usual malaria control interventions (e.g. IRS, ITNs), as detected by PCR.
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Affiliation(s)
- Danielle C. Ompad
- School of Global Public Health, New York University, New York, NY, USA,CONTACT Danielle C. Ompad NYU School of Global Public Health, 715 Broadway, Room 1011, New York, NY10003USA
| | - Anne Kessler
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA
| | - Anna Maria Van Eijk
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA
| | - Timir K. Padhan
- Department of Molecular & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, India
| | - Mohammed A. Haque
- Department of Molecular & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, India
| | - Steven A. Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA
| | - Yesim Tozan
- School of Global Public Health, New York University, New York, NY, USA
| | - Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Sanjib Mohanty
- Department of Molecular & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, India
| | - Madan M. Pradhan
- Department of Health & Family Welfare, State Vector Borne Disease Control Programme, Bhubaneswar, Odisha, India
| | - Praveen K. Sahu
- Department of Molecular & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, India
| | - Jane M. Carlton
- School of Global Public Health, New York University, New York, NY, USA,Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA
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Pradhan MM, Anvikar AR, Daumerie PG, Pradhan S, Dutta A, Shah NK, Joshi PL, Banerji J, Duparc S, Mendis K, Murugasampillay S, Valecha N. Comprehensive case management of malaria: Operational research informing policy. J Vector Borne Dis 2019; 56:56-59. [PMID: 31070167 DOI: 10.4103/0972-9062.257776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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
In 2013, the Odisha state Vector Borne Disease Control Programme led a five year operational research project, under programmatic conditions, in close collaboration with several partners. This Comprehensive Case Management Project covered a population of 900,000 across paired control and intervention blocks in four districts, each with different transmission intensities. Key gaps in access to malaria services were identified through household surveys and a detailed situation analysis. The interventions included ensuring adequate stocks of rapid diagnostic tests and antimalarial drugs at the village level, the capacity building of health workers and ASHAs, setting up microscopy centres at the primary health care level, and conducting mass screening and treatment in poorly accessible areas. The programme strengthened the routine health system, and improved malaria surveillance as well as the access to and quality of care. Initially, the programme led to increased case reporting due to improved detection, followed by a decline in malaria incidence. Lessons from the project were then scaled up statewide in the form of a new initiative-Durgama Anchalare Malaria Nirakaran (DAMaN).
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Affiliation(s)
- M M Pradhan
- National Vector Borne Disease Control Programme, Government of Odisha, Bhubaneswar, Odisha, India
| | | | | | - S Pradhan
- National Vector Borne Disease Control Programme, Government of Odisha, Bhubaneswar, Odisha, India
| | - A Dutta
- Indian Institute of Public Health, Bhubaneswar, Odisha, India
| | - N K Shah
- Independent Malariologist, Ganiyari, India
| | - P L Joshi
- Independent Malariologist, New Delhi, India
| | - J Banerji
- Medicines for Malaria Venture, Geneva, Switzerland
| | - S Duparc
- Medicines for Malaria Venture, Geneva, Switzerland
| | - K Mendis
- Independent Malariologist, Colombo, Sri Lanka
| | | | - N Valecha
- ICMR-National Institute of Malaria Research, New Delhi, India
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Shrestha R, Pradhan R, Pradhan MM, You C. Hormonal Changes in Intracranial Hemorrhage. JNMA J Nepal Med Assoc 2017; 56:163-167. [PMID: 28598456] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION The purpose of this study was to investigate the changes of serum ACTH and Thyroid hormone level in the acute phase of ICH. METHODS Sixty patients with spontaneous ICH were assessed regarding hormonal changes by measuring ACTH and Thyroid hormone level. The relationships of hormone concentrations to clinical and radiological parameters were evaluated at hospital admission (t0), 5 days (t1) and 10 days (t2). The results were statistically analyzed. RESULTS ACTH, TSH, Thyroxine, and free Thyroxine were not significantly different among the three time periods (P > 0.05), while Triiodothyronine (T3) and free Triiodothyronine (FT3) were significantly different (P < 0.05). T3 and FT3 were not significantly different among patients with hemorrhage of different locations (P>0.05). There were significant negative correlations between T3 and FT3 with volume of ICH (r=-0.63 and r=-0.25) and there were positive correlations between T3 and FT3 with GCS (r=0.63 and r=0.37) respectively on admission day (p <0.05). CONCLUSIONS Hormonal secretion patterns is associated with the severity of ICH. This is an important index to evaluate the disease severity and prognosis.
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Affiliation(s)
- R Shrestha
- Department of Orthopaedics, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal, Department of Neurosurgery, West China Hospital, Sichuan University, China
| | - R Pradhan
- Paropkar Maternity and Women's Hospital, Thapathali, Nepal
| | - M M Pradhan
- Department of Surgery, Sumeru Hospital, Nepal
| | - C You
- West China Hospital, Sichuan University, China
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Nayak P, Pradhan A, Mallick R, Sethi S, Patnaik B, Pradhan MM, Shrivastava A, Venkatesh S, Dash KC. Japanese Encephalitis Outbreak Among Children in Mayurbhanj, Odisha-India, 2015. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Priyakanta Nayak
- Epidemiology, National Centre for Disease Control, New Delhi, India
| | - Arghya Pradhan
- Idsp, Directorate of Public Health, Odisha, Bhubaneswar, India
| | | | - S. Sethi
- Directorate of Public Health, Odisha, Bhubaneswar, India
| | - Bikash Patnaik
- Directorate of Public Health, Odisha, Bhubaneswar, India
| | | | | | - S. Venkatesh
- National Centre for Disease Control, New Delhi, India
| | - Kailash C. Dash
- Public Health, Directorate of Public Health, Odisha, Bhubaneswar, India
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Das A, Friedman J, Kandpal E, Ramana GNV, Gupta RKD, Pradhan MM, Govindaraj R. Strengthening malaria service delivery through supportive supervision and community mobilization in an endemic Indian setting: an evaluation of nested delivery models. Malar J 2014; 13:482. [PMID: 25491041 PMCID: PMC4320454 DOI: 10.1186/1475-2875-13-482] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 11/27/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Malaria continues to be a prominent global public health challenge. This study tested the effectiveness of two service delivery models for reducing the malaria burden, e.g. supportive supervision of community health workers (CHW) and community mobilization in promoting appropriate health-seeking behaviour for febrile illnesses in Odisha, India. METHODS The study population comprised 120 villages from two purposively chosen malaria-endemic districts, with 40 villages randomly assigned to each of the two treatment arms, one with both supportive supervision and community mobilization and one with community mobilization alone, as well as an observational control arm. Outcome measures included changes in the utilization of bed nets and timely care-seeking for fever from a trained provider compared to the control group. Analysis was by intention-to-treat. RESULTS Significant improvements were observed in the reported utilization of bed nets in both intervention arms (84.5% in arm A and 82.4% in arm B versus 78.6% in the control arm; p < 0.001). While overall rates of treatment-seeking were equal across study arms, treatment-seeking from a CHW was higher in both intervention arms (28%; p = 0.005 and 27.6%; p = 0.007) than in the control arm (19.2%). Fever cases were significantly more likely to visit a CHW and receive a timely diagnosis of fever in the combined interventions arm than in the control arm (82.1% vs. 67.1%; p = 0.025). Care-seeking from trained providers also increased with a substitution away from untrained providers. Further, fever cases from the combined interventions arm (60.6%; p = 0.004) and the community mobilization arm (59.3%; p = 0.012) were more likely to have received treatment from a skilled provider within 24 hours than fever cases from the control arm (50.1%). In particular, women from the combined interventions arm were more likely to have received timely treatment from a skilled provider (61.6% vs. 47.2%; p = 0.028). CONCLUSION A community-based intervention combining the supportive supervision of community health workers with intensive community mobilization and can be effective in improving care-seeking and preventive behaviour and may be used to strengthen the national malaria control programme.
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Affiliation(s)
- Ashis Das
- />Health, Nutrition and Population, The World Bank, 1818 H St NW, Washington, DC 20433 USA
| | - Jed Friedman
- />Development Research Group, The World Bank, 1818 H St NW, Washington, DC 20433 USA
| | - Eeshani Kandpal
- />Development Research Group, The World Bank, 1818 H St NW, Washington, DC 20433 USA
| | - Gandham N V Ramana
- />Health, Nutrition and Population, The World Bank, Delta Center, Menengai Rd, Upper Hill, Nairobi, Kenya
| | - Rudra Kumar Das Gupta
- />National Vector Borne Disease Control Programme, 22, Shamnath Marg, New Delhi, India
| | - Madan M Pradhan
- />Department of Health and Family Welfare, Bhubaneswar, India
| | - Ramesh Govindaraj
- />Health, Nutrition and Population, The World Bank, 70 Lodi Estate, New Delhi, India
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Abstract
We report a functional assay of Protein C on whole plasma using a snake venom called Protac-C. This method is simple, avoids absorption-elution techniques. Also this method can be adopted to a microtitre plate system testing of large number of samples. Functional levels by this test correlated well with the antigenic levels (r = .8) measured by ELISA. Protein C functional and antigenic values in 58 healthy volunteers were 82% and 95.5% respectively. The warfarinized samples showed a lower mean.
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Affiliation(s)
- I V Nathan
- Department of Pediatrics, National University of Singapore
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Pradhan MM. Reradiation theory. Appl Opt 1982; 21:4395-4397. [PMID: 20401082 DOI: 10.1364/ao.21.004395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Pradhan MM, Garg RK. Pyroelectric null detector for absolute radiometry. Appl Opt 1982; 21:4456-4458. [PMID: 20401098 DOI: 10.1364/ao.21.004456] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A pyroelectric detector has been so designed that the sensing element is comprised of two uniformly poled crystal plates joined together so that the polarity of the domains reverses across the junction. The front electrode of the detector is used for absorption of radiation and the back electrode for producing electric heating pulses. An in-phase signal taken by a photodiode is used to produce electric heating pulses in the detector through a heater amplifier. A null output is obtained when radiation power is equal to electric heating power. The pyroelectric null detector (PND) has been used for absolute measurement of radiation.
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Bose SL, Pradhan MM. Response of hookworm anaemia to different types of iron therapy. J Assoc Physicians India 1969; 17:523-7. [PMID: 5364358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Bose SL, Kar B, Pradhan MM. Gastric acid secretion in ankylostomiasis with anaemia. J Assoc Physicians India 1968; 16:771-6. [PMID: 5715503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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