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1.
BMJ Open ; 14(7): e081856, 2024 Jul 04.
Article in English | MEDLINE | ID: mdl-38964800

ABSTRACT

INTRODUCTION: India's contribution to the malaria burden was highest in South-East Asia Region in 2021, accounting for 79% of the estimated malaria cases and 83% of malaria-related deaths. Intensified Malaria Control Programme supported by Global Funds to Fight against AIDS, Tuberculosis and Malaria has deployed crucial interventions to reduce the overall burden of malaria in India. Evaluation of utilisation of malaria elimination interventions by the community and assessment of the healthcare system is underway in eleven high malaria endemic states in India. Health system preparedness for malaria elimination, logistics, and supply chain management of diagnostic kits and anti-malarial drugs in addition to the knowledge, attitude and practice of the healthcare workers is also being assessed. METHODS AND ANALYSIS: The study is being undertaken in 11 malaria endemic states with a variable annual parasite incidence of malaria. In total, 47 districts (administrative unit of malaria control operations) covering 37 976 households are to be interviewed and assessed. We present here the protocol following which the study is being undertaken at the behest and approval of Ministry of Health and Family Welfare in India. ETHICS AND DISSEMINATION: No patients were involved in the study. Study findings will be shared with Institutional ethics board of National Institute for Malaria Research New Delhi (NIMR) in a timely, comprehensive, accurate, unbiased, unambiguous and transparent manner and to the National Vector-borne Disease (Malaria) Control Programme officers and the Community public who participated. Important findings will be communicated through community outreach meetings which are existing in the Health system. Results will be informed to study participants via local fieldwork supervised by District Malaria Officers. Also findings will be published in reputed journals based on Indian Council of Medical Research (ICMR) publication policy.The ICMR-NIMR ethics committee approved the study via letter No. NIMR/ECM/2023/Feb/14 dated 24 April 2023 for version 5. All standard ethical practices will be followed.


Subject(s)
Endemic Diseases , Malaria , Humans , India/epidemiology , Malaria/epidemiology , Malaria/prevention & control , Cross-Sectional Studies , Research Design , Antimalarials/therapeutic use , Health Knowledge, Attitudes, Practice , Delivery of Health Care
2.
Pest Manag Sci ; 2024 Jun 14.
Article in English | MEDLINE | ID: mdl-38872579

ABSTRACT

BACKGROUND: Development of insecticide resistance in the major malaria vectors has necessitated the development of novel vector control tools. One such strategy involves the use of toxic sugar baits that targets the sugar-feeding behaviour of mosquito vectors. In this study, we investigated the potential of polyols, as a toxic food (sugar) source in toxic sugar baits against the malaria vector Anopheles stephensi Liston. We examined the acute toxicity of six polyols, namely, erythritol, glycerol, mannitol, propylene glycol (PG), sorbitol, and xylitol on adult female An. stephensi mosquitoes at two different concentrations - 2% and 10%. We also studied changes in fecundity, egg hatchability and mid-gut peroxide levels induced by polyol exposure. RESULTS: Among the six polyol compounds tested, PG was most toxic and lethal followed by glycerol and erythritol (P < 0.001) compared to the control (sucrose). PG induced acute mortality at different tested concentrations. In the erythritol- and glycerol-fed groups, a dose-dependent effect on mortality was observed. Glycerol evidently reduced fecundity and egg-hatchability in gonotrophic cycles G1 and G2. Sucrose was the preferred food source (48%), followed by erythritol (18%), PG (10%) and glycerol (8%). Ingestion of polyols increased peroxide levels in mosquito guts, which persisted for extended durations ultimately resulting in rapid mortality (P < 0.05). CONCLUSION: The present study highlights the usefulness of sugar polyols for the development of toxic sugar baits with minimal yet effective ingredients. Further research could be focused on field experiments and on the exploration of synergistic effects of different polyols for optimization of field applications. © 2024 Society of Chemical Industry.

3.
J Vector Borne Dis ; 61(2): 151-157, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38922649

ABSTRACT

BACKGROUND OBJECTIVES: Despite significant progress in malaria control throughout India, Chhattisgarh state continues to be a significant contributor to both malaria morbidity and mortality. This study aims to identify key factors associated with malaria endemicity, with a goal of focusing on these factors for malaria elimination by 2030. METHODS: We employed an analysis and narrative review methodology to summarize the existing evidence on malaria epidemiology in Chhattisgarh. Data encompassing environmental conditions, dominant malaria vectors and their distribution, and the impact of previous interventions on malaria control, were extracted from published literature using PubMed and Google Scholar. This information was subsequently correlated with malaria incidence data using appropriate statistical and geographical methods. RESULTS: Much of the malaria burden in Chhattisgarh state is concentrated in a few specific districts. The primary malaria vectors in these regions are Anopheles culicifacies and An. fluviatilis. High transmission areas are found in tribal belts which are challenging to access and are characterized by densely forested areas that provide a conducive habitat for malaria vectors. INTERPRETATION CONCLUSION: Conducive environmental conditions characterized by high forest cover, community behavior, and insurgency, contribute to high malaria endemicity in the area. Challenges include insecticide resistance in malaria vectors and asymptomatic malaria. Allocating additional resources to high-endemic districts is crucial. Innovative and focused malaria control programs of the country, such as DAMAN and Malaria Mukt Abhiyan, hold immense importance.


Subject(s)
Anopheles , Malaria , Mosquito Vectors , India/epidemiology , Humans , Malaria/prevention & control , Malaria/epidemiology , Animals , Anopheles/parasitology , Anopheles/physiology , Mosquito Vectors/parasitology , Mosquito Control/methods , Disease Eradication/methods , Incidence , Insecticide Resistance
4.
Am J Trop Med Hyg ; 110(3): 588-595, 2024 Mar 06.
Article in English | MEDLINE | ID: mdl-38350138

ABSTRACT

India has a substantial burden of undernutrition coupled with overweight and obesity at the other end of the spectrum of malnutrition. Nuh district, in the Haryana State in northern India, is an impoverished district in India. With an aim to investigate the problem of malnutrition in the community, a cross-sectional study was conducted in four villages of the Nuh district. Height/length, weight, and age data of children under 5 years were used to calculate three indices: weight-for-age, height-for-age, and weight-for-height. The body mass index was calculated for individuals older than 6 years. Associations between malnutrition and other factors were assessed using simple and multiple logistic regression to get adjusted coefficients. The total surveyed population comprised 11,496 individuals. Over 51% were female, and 13.2% of the surveyed population were children under 5 years. Almost half of the population was illiterate and unemployed. The prevalences of underweight, stunting, and wasting in children under 5 years were 37%, 53%, and 21%, respectively. The prevalences of underweight and stunting in the 6- to 19-year-old age group were 29% and 38%, respectively. The prevalence of overweight was 36% in the 20- to 40-year-old and > 60-year-old age groups, and 44% in the 41- to 60-year-old age group. Our findings reveal a considerable burden of undernutrition among children under 5 years and a dual burden of undernutrition and overnutrition in adults, highlighting the need to map these areas and sharpen our responses to mitigate the overwhelming and long-term consequences of malnutrition in the Nuh district.


Subject(s)
Malnutrition , Thinness , Child , Adult , Humans , Female , Infant , Child, Preschool , Adolescent , Young Adult , Middle Aged , Male , Prevalence , Thinness/epidemiology , Nutritional Status , Overweight/epidemiology , Cross-Sectional Studies , Malnutrition/epidemiology , Growth Disorders/epidemiology , India/epidemiology
6.
Hum Genomics ; 18(1): 7, 2024 Jan 30.
Article in English | MEDLINE | ID: mdl-38291512

ABSTRACT

The present study investigated two single nucleotide polymorphisms (SNPs)-rs479200 and rs516651 in the host EGLN1/PHD2 gene for their association with COVID-19 severity. A retrospective cohort of 158 COVID-19 patients from the Indian population (March 2020 to June 2021) was enrolled. Notably, the frequency of C allele (0.664) was twofold higher than T allele (0.336) in severe COVID-19 patients. Here, we report a novel finding that the C allele of rs479200 in the EGLN1 gene imparts a high risk of severe COVID-19 (odds ratio-6.214 (1.84-20.99) p = 0.003; 9.421 (2.019-43.957) p = 0.004), in additive inheritance model (adjusted and unadjusted, respectively).


Subject(s)
COVID-19 , Humans , Alleles , Retrospective Studies , COVID-19/epidemiology , COVID-19/genetics , Polymorphism, Single Nucleotide/genetics , Asian People , Genetic Predisposition to Disease , Gene Frequency , Hypoxia-Inducible Factor-Proline Dioxygenases/genetics
7.
Int J Antimicrob Agents ; 63(3): 107071, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38154659

ABSTRACT

BACKGROUND: India is on track to eliminate malaria by 2030 but emerging resistance to first-line antimalarials is a recognised threat. Two instances of rapid development, spread, and natural selection of drug-resistant mutant parasites in India (chloroquine across the country and artesunate + sulfadoxine-pyrimethamine [AS+SP] in the northeastern states) translated into drug policy changes for Plasmodium falciparum malaria in 2010 and 2013, respectively. Considering these rapid changes in the SP drug resistance-conferring mutation profile of P. falciparum, there is a need to systematically monitor the validated mutations in Pfdhfr and Pfdhps genes across India alongside AS+SP therapeutic efficacy studies. There has been no robust, systematic countrywide surveillance reported for these parameters in India, hence the current study was undertaken. METHODS: Studies that reported data on WHO-validated SP resistance markers in P. falciparum across India from 2008 to January 2023 were included. Five major databases, PubMedⓇ, Web of ScienceTM, ScopusⓇ, EmbaseⓇ, and Google Scholar, were exhaustively searched. Individual and pooled prevalence estimates of mutations were obtained through random- and fixed-effect models. Data were depicted using forest plots created with a 95% confidence interval. The study is registered with PROSPERO (CRD42021236012). RESULTS: A total of 37 publications, and 533 Pfdhfr and 134 Pfdhps National Centre of Biotechnology Information (NCBI) DNA sequences were included from >4000 samples. The study included information from 80 districts, 21 states and 3 union territories (UTs) from India. The two PfDHFR mutations, C59R (62%) and S108N (74%), were the most prevalent mutations (pooled estimates 61% and 71%, respectively) and appeared to be stabilised/fixed. Although rarest overall, the prevalence of I164L was observed to be as high as 32%. The PfDHFR double mutants were the most prevalent overall (51%; pooled 42%). The prevalence of triple and quadruple mutations was 6% and 5%, respectively, and is an immediate concern for some states. The most prevalent PfDHPS mutation was A437G (39%), followed by K540E (25%) and A581G (12%). There was a low overall prevalence of PfDHFR/PfDHPS quintuple and sextuple mutations but surveillance for these mutations is critical for some areas. CONCLUSION: The analyses span the two critical policy changes, highlight the areas of concern, and guide policymakers in strategising and refining the anti-malaria drug policy for malaria elimination. The results of the analyses also highlight the SP-resistance hot spots, critical gaps and challenges, and indicate that focal and local malaria genetic surveillance (including drug-resistance markers) is needed until malaria is successfully eliminated.


Subject(s)
Antimalarials , Malaria, Falciparum , Sulfadoxine , Humans , Plasmodium falciparum/genetics , Pyrimethamine/pharmacology , Malaria, Falciparum/drug therapy , Malaria, Falciparum/epidemiology , Antimalarials/pharmacology , India/epidemiology , Artesunate , Drug Combinations
8.
PLOS Glob Public Health ; 3(6): e0001878, 2023.
Article in English | MEDLINE | ID: mdl-37379340

ABSTRACT

Malaria is a climate-sensitive disease and different climatic conditions affect the propagation of malaria vectors thereby influencing malaria incidence. The present study was undertaken to delineate malaria distribution across different climate types and sub-types in India and assess its significance as a malariometric in the ongoing elimination activities. All Indian districts were classified into three major climatic zones (Tropical, Temperate, and others (Arid, Cold, and Polar) based on the Köppen-Geiger climate classification system. The Annual Parasite Incidence (API) of malaria was analyzed in these climatic zones using the Kruskal Wallis test, and a post hoc comparison was done using the rank-sum test with an adjusted p-value for the level of significance. Further logistic regression was used to investigate the association of these climatic zones with high malaria incidence (i.e., API>1). The majority of Indian districts fall in Temperate (N = 270/692 (39.0%)) and Tropical (N = 260/692 (37.6%)) regions, followed by Arid (N = 140/692 (20.2%)), Polar (N = 13/692 (1.9%)) and Cold (N = 9/692 (1.3%)) regions. Three climate zones: Arid, Polar, and Cold were similar in terms of malaria incidence over the years and thus were grouped into one. It was found that the tropical and temperate zones display a significantly higher burden of malaria as compared to others for the studied years (2016-2021). Future projections of climate suggest a significant expansion of tropical monsoon climate towards central and northern India, along with a growing footprint of tropical wet savannah climate in the northeast of India by 2100, which could increase the risk of malaria transmission in these regions. The heterogeneous climatic zones of India play an important role in malaria transmission and can be used as a malariometric for the stratification of districts destined for malaria elimination.

9.
Future Med Chem ; 15(8): 679-697, 2023 04.
Article in English | MEDLINE | ID: mdl-37170810

ABSTRACT

Aim: The objective of the present study is to design and synthesize diverse piperazine-1,2,3-triazole scaffolds as key pharmacophores possessing antimicrobial/anticancer activities. Materials & methods: Twenty-four scaffolds were synthesized via a click-inspired synthetic protocol and were assayed for anticancer activity using the methyl thiazolyl tetrazolium assay and for antimicrobial potency by serial dilution. Results: Among all the tested 1,2,3-triazole scaffolds, compounds 7i (IC50: 5.22 ± 0.05 µM) and 7a (IC50: 5.34 ± 0.13 µM) exhibited good anticancer activity, and 7x also showed notable antimicrobial activity. Molecular docking studies of potent analogs 7i and 7a were performed to provide an insight into their binding interactions. Conclusion: Compound 7x is considered a valuable lead compound for further optimization of anticancer and antimicrobial agents.


Subject(s)
Anti-Infective Agents , Antineoplastic Agents , Molecular Docking Simulation , Triazoles/chemistry , Piperazine/pharmacology , Anti-Infective Agents/chemistry , Structure-Activity Relationship , Antineoplastic Agents/chemistry , Molecular Structure
10.
PLOS Glob Public Health ; 3(4): e0000946, 2023.
Article in English | MEDLINE | ID: mdl-37027349

ABSTRACT

India experienced the second wave of SARS-CoV-2 infection from April 3 to June 10, 2021. During the second wave, Delta variant B.1617.2 emerged as the predominant strain, spiking cases from 12.5 million to 29.3 million (cumulative) by the end of the surge in India. Vaccines against COVID-19 are a potent tool to control and end the pandemic in addition to other control measures. India rolled out its vaccination programme on January 16, 2021, initially with two vaccines that were given emergency authorization-Covaxin (BBV152) and Covishield (ChAdOx1 nCoV- 19). Vaccination was initially started for the elderly (60+) and front-line workers and then gradually opened to different age groups. The second wave hit when vaccination was picking up pace in India. There were instances of vaccinated people (fully and partially) getting infected, and reinfections were also reported. We undertook a survey of staff (front line health care workers and supporting) of 15 medical colleges and research institutes across India to assess the vaccination coverage, incidence of breakthrough infections, and reinfections among them from June 2 to July 10, 2021. A total of 1876 staff participated, and 1484 forms were selected for analysis after removing duplicates and erroneous entries (n = 392). We found that among the respondents at the time of response, 17.6% were unvaccinated, 19.8% were partially vaccinated (received the first dose), and 62.5% were fully vaccinated (received both doses). Incidence of breakthrough infections was 8.7% among the 801 individuals (70/801) tested at least 14 days after the 2nd dose of vaccine. Eight participants reported reinfection in the overall infected group and reinfection incidence rate was 5.1%. Out of (N = 349) infected individuals 243 (69.6%) were unvaccinated and 106 (30.3%) were vaccinated. Our findings reveal the protective effect of vaccination and its role as an essential tool in the struggle against this pandemic.

11.
PLOS Glob Public Health ; 3(1): e0001292, 2023.
Article in English | MEDLINE | ID: mdl-36962890

ABSTRACT

India has committed to zero indigenous malaria cases by 2027 and elimination by 2030. Of 28 states and 8 union territories of India, eleven states were targeted to reach the elimination phase by 2020. However, state-level epidemiology indicates that several states of India may not be on the optimum track, and few goals set in National Framework for Malaria Elimination (NFME) for 2020 remain to be addressed. Therefore, tracking the current progress of malaria elimination in India at the district level, and identifying districts that are off track is important in understanding possible shortfalls to malaria elimination. Annual malaria case data from 2017-20 of 686 districts of India were obtained from the National Center for Vector-Borne Diseases Control (NCVBDC) and analysed to evaluate the performance of districts to achieve zero case status by 2027. A district's performance was evaluated by calculating the annual percentage change in the total number of malaria cases for the years 2018, 2019 and 2020 considering the previous year as a base year. The mean, median and maximum of these annual changes were then used to project the number of malaria cases in 2027. Based on these, districts were classified into four groups: 1) districts that are expected to reach zero case status by 2027, 2) districts that would achieve zero case status between 2028 and 2030, 3) districts that would arrive at zero case status after 2030, and 4) districts where malaria cases are on the rise. Analysis suggest, a cohort of fifteen districts require urgent modification or improvement in their malaria control strategies by identifying foci of infection and customizing interventions. They may also require new interventional tools that are being developed recently so that malaria case reduction over the years may be increased.

12.
BMJ Glob Health ; 8(1)2023 01.
Article in English | MEDLINE | ID: mdl-36653068

ABSTRACT

INTRODUCTION: Malaria and malnutrition are key public health challenges in India. However, the relationship between them is poorly understood. Here, we aimed to elucidate the potential interactions between the two health conditions by identifying the areas of their spatial overlap. METHODS: We have analysed the district-wise undernutrition and malaria data of 638 districts of India across 28 states and 8 union territories. Data on malnutrition parameters viz. stunting, wasting, underweight and anaemia, sourced from the fourth National Family Health Survey (2015-2016), and malaria Annual Parasite Index (API) data of the same year (i.e, 2015), sourced from National Center of Vector Borne Diseases Control were analysed using local Moran's I Index and logistic regression. RESULTS: Among all the malnutrition parameters, we found underweight in children and anaemia in men to co-occur with malaria in the districts of Chhattisgarh, Jharkhand, Madhya Pradesh and Odisha. Further, districts with more than 36% underweight children (OR (95% CI): 2.31 (1.53 to 3.48)) and/or more than 23.6% male population with anaemia (OR (95% CI): 2.06 (1.37 to 3.11)) had higher odds of being malaria endemic districts (ie, Annual Parasite Index >1). CONCLUSION: Malaria and malnutrition co-occur in the malaria-endemic parts of India. The high prevalence of undernutrition in children and anaemia among men may contribute to malaria endemicity in a particular region. Therefore, future research should be prioritised to generate data on the individual level. Further, malaria control interventions could be tailored to integrate nutrition programmes to disrupt indigenous malaria transmission in endemic districts.


Subject(s)
Anemia , Malaria , Malnutrition , Child , Humans , Male , Female , Thinness/epidemiology , Malaria/epidemiology , Malnutrition/epidemiology , Anemia/epidemiology , Anemia/parasitology , India/epidemiology
13.
Pest Manag Sci ; 79(1): 474-480, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36176013

ABSTRACT

BACKGROUND: Attractive toxic sugar bait (ATSB) is a novel vector control tool that exploits the sugar feeding behavior of mosquitoes. The current study aims to evaluate the efficacy of ivermectin-based ATSB against insecticide susceptible and resistant strains of major Indian malaria vectors - Anopheles culicifacies and Anopheles stephensi. ATSB with different concentrations of ivermectin were tested against mosquito vectors under standard laboratory conditions. RESULTS: Dose-response analysis of ivermectin-ATSB showed 7.8 and 19.8 ppm as 50% and 90% lethal concentration (LC50 and LC90 ) values for insecticide susceptible An. culicifacies. In the case of insecticide susceptible An. stephensi, the LC90 value was 35 ppm which was significantly higher in comparison to the LC90 for An. culicifacies. The LC50 of insecticide-resistant An. culicifacies and An. stephensi were 10.6 and 15.9 ppm respectively whereas LC90 values were 36.9 and 61.0. Ivermectin-ATSB resulted in 99 ± 0.8% mortality of An. culicifacies and 93 ± 3.8% mortality of An. stephensi at an ivermectin concentration of 25 ppm. In another set of experiments, the ATSB solution containing standardized dose of ivermectin was sprayed on Allysum plant and mortality of both Anopheline vectors was recorded. Here, we observed > 90% mortality in both An. stephensi and An. culicifacies. CONCLUSION: Our study demonstrates the potential of ivermectin-based ATSB in killing Indian malaria vectors irrespective of the method of application. Further field trials with ivermectin containing ATSB may pave the way for its usage in the national vector control program. © 2022 Society of Chemical Industry.


Subject(s)
Anopheles , Malaria , Animals , Sugars , Ivermectin/pharmacology , Mosquito Vectors
14.
J Family Med Prim Care ; 11(9): 5393-5403, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36505586

ABSTRACT

Background: Dengue and chikungunya have been emerging as major vector-borne diseases. The global burden of the diseases is rising as a public health problem. The complexity of disease is governed by multiple constraints including only symptomatic treatment and inflicts heavy social and economic burden on society. The present study is designed to assess the economic burden of dengue and chikungunya infection by calculating cost per patient in Gujarat, India. Methods: A total of 210 patients were enrolled in the study from Ahmedabad and Kheda district of Gujarat from May 2018 to December 2019 of which 150 had dengue and 60 chikungunya infections, subject to the willingness of participation in the survey. Information on wage loss days, cost associated with medicines, diagnosis, special food and travel cost, etc., for the calculation of the direct and indirect costs associated with dengue and chikungunya were collected from these participants using a structured questionnaire. Informed consent was taken before including any participant in the study. Results: In the dengue sample, 86 were males (57.3%) and the rest were females, and in the chikungunya sample, 31 were males (51.7%) and the rest females. The median age of the participants with dengue and chikungunya was 18 (p25 to p75: 8 to 26) and 30 (p25 to p75: 21 to 45) years respectively. Median family income was recorded as Rs 15,000 (p25 to p75: 9000 to 25500) and Rs 12,000 (p25 to p75: 9000 to 18500) for the dengue and chikungunya cases, respectively. The average duration of the illness was observed to be higher in chikungunya (median days (P25 to p75): 15 (7-45)) than dengue (median days (P25 to p75): 10 (5-15)). The median indirect cost in the case of dengue was Rs 1,931 (p25 to p75: 300 to 4500) while Rs 2,550 (p25 to p75: 0 to 5250) was observed for chikungunya cases. Two types of direct cost, namely, direct cost related to medical expenses and direct cost related to other expenses were calculated. Direct cost related to medical expenses was observed to be higher in dengue (Md (P25 to p75): Rs 2,450 (400-5000)) than chikungunya (Md (P25 to p75): Rs 1,500 (150-5200)) while indirect cost related to other expenses were comparable between dengue (Md (P25 to p75): Rs 1,575 (1300-2600)) and chikungunya (Md (P25 to p75): Rs 1500 (850-2850)). The average total cost for one dengue episode was estimated to be Rs 6,860 (3700-12525) whereas it was Rs 7,000 (2550-14000) for one episode of Chikungunya. Conclusions: Overall, patients have to bear high costs while suffering from dengue and chikungunya infections. Furthermore, the duration of illness while suffering from viral diseases also contributes to the substantial economic burden. Improved knowledge about the impact of the cost and the economic burden associated with dengue and chikungunya will help policymakers allocate and appropriate resources accordingly.

15.
J Perinatol ; 42(11): 1489-1495, 2022 11.
Article in English | MEDLINE | ID: mdl-36184641

ABSTRACT

OBJECTIVE: To study the growth and neurodevelopmental outcome of very and moderate preterm infants (VMPT) compared to term appropriate-for-age (term AGA) infants at 18-months corrected age. METHODS: This prospective cohort study enrolled consecutively born 212 VMPT infants and 250 term AGA controls delivered during study period. OUTCOME MEASURES: Major neurodevelopmental impairment (NDI) defined as any one of cerebral palsy, motor (MoDQ) or mental developmental quotient (MoDQ) <70 on Developmental Assessment Scale for Indian infants, visual or hearing impairment, or epilepsy, and growth outcomes. RESULTS: Among 195 VMPT and 240 term AGA infants who completed follow-up, the frequency of major NDI was 12.8% and 2.5% respectively (RR 5.1; 95% CI [2.13-12.19]). Major NDI was higher among infants <28 weeks gestation (39%) and birthweight <1000 grams (27%). A quarter of VMPT infants exhibited wasting and 18% stunting than 7% each among controls. CONCLUSION: VMPT infants had a higher frequency of major NDI and growth failure at 18-months.


Subject(s)
Infant, Premature, Diseases , Infant, Premature , Infant , Infant, Newborn , Humans , Prospective Studies , Gestational Age , Birth Weight
17.
Acta Trop ; 233: 106542, 2022 Sep.
Article in English | MEDLINE | ID: mdl-35643184

ABSTRACT

Globally haemonchosis in sheep is a known devastating disease imposing considerable economic loss. Understanding the environmental risk factors and their role is essentially required to manage the disease successfully. In this study, 14 years' disease data was analysed to predict the risk factors responsible for the occurrence of the disease. Season-wise analysis revealed high incidence during monsoon and post-monsoon and least in winter and summer seasons. The linear discriminant analysis (LDA) revealed the significant environmental and remote sensing risk factors contributing to haemonchosis incidence as enhanced vegetation index, leaf area index, potential evapotranspiration and specific humidity. Further, significant ecological and environmental risk factors identified using LDA were subjected to the climate-disease modelling and risk maps were generated. Basic reproduction number (R0) was estimated and was ranged from 0.76 to 2.08 for >1000 egg per gram of faeces (EPG) in four districts whereas R0 values of 1.09-1.69 for >2000 EPG in three districts indicating the severity of the infection. The random forest and adaptive boosting models emerged out as best fitted models for both the EPG groups. The results of the study will help to focus on high-risk areas of haemonchosis in sheep to implement the available control strategies and better animal production globally.


Subject(s)
Haemonchiasis , Nematode Infections , Sheep Diseases , Animals , India/epidemiology , Machine Learning , Remote Sensing Technology , Risk Factors , Seasons , Sheep , Sheep Diseases/epidemiology
18.
Preprint in English | medRxiv | ID: ppmedrxiv-22272214

ABSTRACT

BackgroundCoronavirus disease-2019 (COVID-19) symptoms can range from asymptomatic, moderate to severe manifestations that result in an overall global case fatality rate of 2-7 %. While each variant has had it challenges, and some variants are more severe than others, risk factors of severe COVID-19 are still under investigation. In this context, the host genetic predisposition is also a crucial factor to investigate. In the present study, we investigated host genotypes of the SNP rs479200 of the host EGLN1 gene, previously implicated in high altitude pulmonary edema (HAPE), some of whose symptoms such as hypoxia profoundly overlap with severe COVID-19. MethodsAfter informed consent, 158 RT-PCR confirmed COVID-19 patients (March 2020 to June 2021) were enrolled in the study. Based on their clinical manifestations, disease severity was categorized by the clinical team. Blood samples were drawn and DNA was extracted from the clot to infer different genotypes of the SNP rs479200 of the host EGLN1 gene. PCR-RFLP analysis of the SNP rs479200 (C > T) was performed with an amplicon size of 367 bp. Various genotypes (TT, TC and CC) were assigned based on the presence/absence of a restriction site (T/GTACA) for restriction enzyme BsrGI. Allele frequencies, Hardy-Weinberg Equilibrium (HWE) and multinomial logistic regression were performed using statistical tool SPSS version 23 (IBM). FindingsWe observed that the severe COVID-19 category was composed of comparatively younger patients with mean age (34.9{+/-}15.6), compared to asymptomatic and moderate categories whose mean age was 49.7{+/-}17.9 and 54.3{+/-}15.7, respectively. Preponderance of males and high heterozygosity (TC) was observed across the clinical categories. Notably, the frequency of C allele (0.664) was 2-fold higher than the T allele (0.336) in severe COVID-19 patients, whereas the allele frequencies were similar in asymptomatic and moderate category of COVID-19 patients. Multinomial logistic regression showed an association of genotypes with increasing clinical severity; odds ratio (adjusted OR-11.414 (2.564-50.812)) and (unadjusted OR-6.214 (1.84-20.99)) for the genotype CC in severe category of COVID-19. Interestingly, the TC genotype was also found to be positively associated with severe outcome (unadjusted OR-5.816 (1.489-22.709)), indicating association of C allele in imparting the risk of severe outcome. InterpretationThe study provides strong evidence that the presence of C allele of SNP (rs479200) of the EGLN1 gene associates with severity in COVID-19 patients. Thus, the presence of C allele may be a risk factor for COVID-19 severity. This study opens new avenues towards risk assessment that include EGLN1 (rs479200) genotype testing and identifying patients with C allele who might be prioritized for critical care.

19.
Lancet Reg Health Southeast Asia ; 5: 100030, 2022 Oct.
Article in English | MEDLINE | ID: mdl-37383658

ABSTRACT

Background: A digital dashboard can be an invaluable resource for the research community and can help analyze and visualize data as per the inputs provided by the user. In India, large data sets on malaria are available though presently no digital dashboard is being used to monitor and analyze the malaria data. Methods: We have developed a dashboard (National Institute of Malaria Research-Malaria Dashboard (NIMR-MDB)) in R software using 19 different packages within which shiny and ggplot2 are used more intensively. NIMR-MDB can be used offline by running the app on any R software installed computer. Furthermore, NIMR-MDB can be accessed across different computers within an organization using a local server, or it may be made publicly available by publishing it online with secured access. There are two options for publishing the shiny dashboard online 1) via a personal Linux server for hosting this application or 2) by hosting the application on a certified online platform such as 'shinyapps.io' at a reasonable cost without setting up a server. Findings: The NIMR-MDB is a versatile interface that allows prompt and interactive analyses of malaria epidemiological data. The primary interface of NIMR-MDB is like a web page with 14 tabs (or pages) where each Tab corresponds to a particular set of analysis. Users may move from one Tab to another via icons. Each Tab allows flexibility in correlating various epidemiological parameters like SPR, API, AFI, ABER, RT, malaria cases, deaths, BSC and BSE. The malaria epidemiological data can be analyzed in the required granularity (national level, state level or district level), and its enhanced visualization allows for facile usage and extensive analysis. Interpretation: This NIMR-MDB developed here will play an important role in the analysis of epidemiological data and in strategizing malaria control in India. Researchers and policymakers may use it as a prototype for developing other dashboards for various diseases globally. Funding: There is no specific grant received from any funding agency for this work yet.

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