Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 336
Filter
2.
J Family Med Prim Care ; 13(6): 2491-2498, 2024 Jun.
Article in English | MEDLINE | ID: mdl-39027826

ABSTRACT

Background: Pyrazinamide (PZA) is important for identification in multi-drug-resistant tuberculosis patients before starting therapy. PZA drug susceptibility testing (DST) is essential for the management of drug-resistant and susceptible TB patients. Aims: The degree of drug resistance among TB patients and discrepancy between DST results of the phenotype and genotype were assessed. Materials and Methods: Socio-demographic and clinical profiles of TB patients recruited in the study were documented. Sputum samples were processed for diagnosis using TrueNat Xpert MTB, TrueNat Xpert MTB Plus, and MGIT culture. Results: Rifampicin (RIF) line probe assay (LPA) showed the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 100%, whereas isoniazid (INH) LPA testing showed a sensitivity of 85.7%, a specificity and PPV of 100%, and NPV of 94.8%. The gene mutation for RIF resistance was between the codon, 530-533 of rpoB gene, and that for INH resistance was at the codon, 315 of katG gene. Conclusion: Our findings demonstrated high prevalence of mono- and poly-drug resistance as well as pyrazinamide resistance.

3.
PLoS One ; 19(7): e0305855, 2024.
Article in English | MEDLINE | ID: mdl-39012889

ABSTRACT

BACKGROUND: By encouraging treatment adherence and lowering mortality, dietary supplements can serve as adjuvant therapy for the success of medical interventions. We determined the effect of locally accessible food supplements on treatment outcomes, and health-related quality of life in patients with pulmonary tuberculosis initiating anti-tuberculosis treatment (ATT) in Odisha, India. METHOD: Between September 2017 and December 2018, implementation research in patients with newly diagnosed sputum smear-positive pulmonary tuberculosis initiating ATT in five districts of the tribal belt of Odisha, offered food supplements along with ATT in a phased manner. Clinical symptoms, anthropometry, sputum for M. tuberculosis (M. tb), health-related quality of life and return to normal function were assessed periodically, and favourable treatment outcome (cure or treatment completed) was measured at the end of treatment. The effect of the food supplement on unfavorable outcomes (treatment failure, death, or lost-to-follow-up) was modelled using mixed-effects Poisson regression to determine the risk factors. RESULTS: Among the 761 participants enrolled, 614 participants received the food supplement and 147 did not receive the food supplement. Among the 614 participants in the supplement group, 537 (87%) had a favorable outcome and among the 147 participants in the no-supplement group, 113 (77%) had a favorable outcome (p = 0.0017). Higher age (>55 years) [aRR = 2.1(95% CI: 1.1-3.8)], male gender [aRR = 1.7(95% CI: 1.2-2.9)], and smear grading ≥2+ [aRR = 1.5 (95% CI: 1.1-2.2)] were associated with unfavorable treatment outcomes. Nutritional status, quality of life and lung health showed significant improvement from baseline in the supplement group. CONCLUSION: Improvement in the nutritional status of the patient can be considered a predictor of treatment success rates. Early food supplementation has a positive impact on the nutritional status.


Subject(s)
Antitubercular Agents , Dietary Supplements , Quality of Life , Tuberculosis, Pulmonary , Humans , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/psychology , Male , Female , Adult , Middle Aged , Antitubercular Agents/therapeutic use , Treatment Outcome , India , Young Adult
4.
J Mol Diagn ; 2024 Jun 06.
Article in English | MEDLINE | ID: mdl-38851386

ABSTRACT

This study evaluated the performance of cobas MTB and cobas MTB-RIF/INH for the diagnosis of tuberculosis and detection of rifampicin (RIF) and isoniazid (INH) resistance. Adults presenting with pulmonary tuberculosis symptoms were recruited in South Africa, Moldova, and India. Performance of cobas MTB was assessed against culture, whereas cobas MTB-RIF/INH was assessed using phenotypic drug susceptibility testing and whole-genome sequencing as composite reference standards. Xpert MTB/RIF (Xpert) or Xpert MTB/RIF Ultra (Ultra) was used as a comparator. The overall sensitivity and specificity of cobas MTB were 95% (95% CI, 93%-96%) and 96% (95% CI, 95%-97%). Among smear-negatives, the sensitivity of cobas MTB was 75% (95% CI, 66%-83%). Among participants tested with both cobas MTB and Xpert, sensitivity was 96% (95% CI, 94%-97%) for cobas MTB and 95% (95% CI, 93%-97%) for Xpert. Among participants tested with both cobas MTB and Ultra, sensitivity was 88% (95% CI, 81%-92%) for cobas MTB and 89% (95% CI, 83%-93%) for Ultra. Sensitivity and specificity of cobas MTB-RIF/INH for RIF and INH detection were 90% (95% CI, 84%-94%) and 100% (95% CI, 99%-100%), and 89% (95% CI, 84%-93%) and 99.5% (95% CI, 98%-100%), respectively. The cobas MTB and cobas MTB-RIF/INH assays exhibited high performance in a diverse population and present a suitable option for molecular detection of tuberculosis and RIF and INH resistance.

5.
J Family Med Prim Care ; 13(4): 1169-1177, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38827697

ABSTRACT

Introduction: Teenage pregnancy is a subject of concern among adolescents. Inadequate knowledge and misperceptions about pregnancy are major contributing factors to teenage pregnancy. Without a proper understanding, adolescents are involved in unsafe sexual practices, which results in pregnancy. So, perception and understanding are important aspects to explore among adolescents. In this planned scope review, all eligible studies will be identified around the perception, practices, and understanding of teenage pregnancy among married and unmarried adolescent girls. Methods: The Arksey and O'Malley (2005) scoping review framework and the Joanna Briggs Institute Reviewers' Manual (2015) will be used for the planned scoping review. The population, concept, and context strategy (PCC) will be used to develop the research question, search strategy, and eligibility criteria. Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA ScR) will be used for the findings of the study. For the literature search, authors will use Google Scholar, PubMed, and ResearchGate electronic databases with specific words such as "teenage", "adolescence", "pregnancy", "perception", "knowledge", "awareness" and "abortion". Result: The planned scoping review will be helpful in addressing the lack of adolescent misperception, malpractices, and misunderstandings regarding teenage pregnancy. It can provide detailed information about teenage pregnancy in the Indian context. Conclusion: The evidence synthesis and gap analysis will be helpful in suggesting insights into the issue of teenage pregnancy, which will be helpful in future policies and programs.

6.
Sci Rep ; 14(1): 12866, 2024 06 04.
Article in English | MEDLINE | ID: mdl-38834635

ABSTRACT

While many studies have documented adverse impact of multiple chronic conditions or multimorbidity on COVID-19 outcomes in patients, there is scarcity of report on how physicians managed these patients. We investigated the experiences and challenges of clinicians in managing patients with multimorbidity throughout the COVID-19 pandemic in Odisha state, India. To understand the factors influencing illness management and the adaptive responses of physicians alongside the evolving pandemic, we followed a longitudinal qualitative study design. Twenty-three physicians comprising general practitioners, specialists, and intensivists, were telephonically interviewed in-depth. Saldana's longitudinal qualitative data analysis method was employed for data analysis. COVID-19 pandemic initially diverted the attention of health systems, resulting in reduced care. With time, the physicians overcame fear, anxiety, and feelings of vulnerability to COVID-19 and started prioritising patients with multimorbidity for treatment and vaccination. All physicians recommended teleconsultation and digital health records to benefit chronic illness care during future public health crises. The findings underscore the transformative potential of physician resilience and adaptation during the COVID-19 pandemic, emphasizing the importance of prioritizing patients with multimorbidity, incorporating teleconsultation, and implementing digital health records in healthcare systems to enhance chronic illness care and preparedness for future public health crises.


Subject(s)
COVID-19 , Multimorbidity , Physicians , Qualitative Research , Humans , COVID-19/epidemiology , COVID-19/psychology , India/epidemiology , Longitudinal Studies , Male , Female , Physicians/psychology , Pandemics , Adult , Middle Aged , SARS-CoV-2 , Telemedicine
8.
J Multimorb Comorb ; 14: 26335565241258851, 2024.
Article in English | MEDLINE | ID: mdl-38846927

ABSTRACT

Objectives: This is the first systematic review and meta-analysis of the prevalence of multimorbidity, its risk factors including socioeconomic factors, and the consequences of multimorbidity on health systems and broader society in India. Methods: A systematic review of both published and grey literature from five databases (Medline, Embase, EBSCO, Scopus, and ProQuest) was conducted including original studies documenting prevalence or patient outcomes associated with multimorbidity among adults in India. We excluded studies that did not explicitly mention multimorbidity. Three independent reviewers did primary screening based on titles and abstracts followed by full-text review for potential eligibility. The risk of bias was independently assessed by two reviewers following the Appraisal Tool for Cross-Sectional Studies. We presented both qualitative and quantitative (through meta-analysis) summaries of the evidence. The protocol for this study was prospectively registered with PROSPERO (CRD42021257281). Results: The review identified 5442 articles out of which 35 articles were finally included in this study. Twenty-three studies were based on the primary data while 12 used secondary data. Eleven studies were conducted in hospital/primary care setting while 24 were community-based. The pooled prevalence of multimorbidity based on (n=19) studies included for meta-analysis was 20% (95% CI: 19% to 20%). The most frequent outcomes were increased healthcare utilization, reduced health-related quality of life, physical and mental functioning. Conclusion: We identified a wide variance in the magnitude of multimorbidity across age groups and regions with most of the studies from eastern India. Nation-wide studies, studies on vulnerable populations and interventions are warranted.

9.
BMC Womens Health ; 24(1): 363, 2024 Jun 22.
Article in English | MEDLINE | ID: mdl-38909198

ABSTRACT

INTRODUCTION: Intimate partner violence (IPV) can be described as a violation of human rights that results from gender inequality. It has arisen as a contemporary issue in societies from both developing and industrialized countries and an impediment to long-term development. This study evaluates the prevalence of IPV and its variants among the empowerment status of women and identify the associated sociodemographic parameters, linked to IPV. METHODS: This study is based on data from the National Family Health Survey (NFHS) of India, 2019-21 a nationwide survey that provides scientific data on health and family welfare. Prevalence of IPV were estimated among variouss social and demographic strata. Pearson chi-square test was used to estimate the strength of association between each possible covariate and IPV. Significantly associated covariates (from univariate logistic regression) were further analyzed through separate bivariate logistic models for each of the components of IPV, viz-a-viz sexual, emotional, physical and severe violence of the partners. RESULTS: The prevalence of IPV among empowered women was found to be 26.21%. Among those who had experienced IPV, two-thirds (60%) were faced the physical violence. When compared to highly empowered women, less empowered women were 74% more likely to face emotional abuse. Alcohol consumption by a partner was established to be attributing immensely for any kind of violence, including sexual violence [AOR: 3.28 (2.83-3.81)]. CONCLUSIONS: Our research found that less empowered women experience all forms of IPV compared to more empowered women. More efforts should to taken by government and other stakeholders to promote women empowerment by improving education, autonomy and decision-making ability.


Subject(s)
Health Surveys , Intimate Partner Violence , Humans , Female , Intimate Partner Violence/statistics & numerical data , Intimate Partner Violence/psychology , India/epidemiology , Prevalence , Adult , Cross-Sectional Studies , Middle Aged , Young Adult , Adolescent , Empowerment
10.
Int J Mycobacteriol ; 13(2): 165-170, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38916387

ABSTRACT

BACKGROUND: Mycobacterium tuberculosis (Mtb) is the causative agent of tuberculosis (TB), with a high global prevalence and mortality rate. To control the gruesome pathogen, a deep understanding of pathophysiology and host-pathogen interaction is essential for early diagnosis and novel drug development. Cytokines play a crucial role in infection and susceptibility, and their expressions could serve as potential biomarkers to enhance our understanding of Mtb pathophysiology for improved therapeutic approaches. This cross-sectional study investigates the levels of four important T-cell immune-mediated cytokines: interleukins (IL-6 and IL-10), interferon-gamma (IFN-γ), and tumor necrosis factor-alpha in 80 cohort samples, with 20 people in each group. METHODS: Following proper ethics and patient consent, we collected blood samples and isolated serum from all four groups: TB, type 2 diabetes mellitus (T2DM), type 2 diabetes-TB comorbidity (T2DM + TB), and a healthy individual as a control group (C). Furthermore, cytokine expression was measured in individual serum samples through the enzyme-linked immunosorbent assay method using commercial kits (Diaclone, French). Statistical significance was observed by analyzing triplicate data using t-tests and the one-way ANOVA method with GraphPad Prism 10. RESULTS: The results showed that all four cytokine levels were higher (P ≤ 0.0001) than the control, especially IL-6, IL-10, and IFN-γ, which were found to be upregulated in T2DM + TB samples (P ≤ 0.0001) than individual TB or T2DM samples. CONCLUSION: The high levels of cytokines in comorbidity cases raise the risk of insulin resistance and the severity of TB infection. These levels of expression could be used to keep track of the Mtb infection status or severity, aid in early diagnosis as a possible biomarker, and suggest possible treatment plans.


Subject(s)
Comorbidity , Cytokines , Diabetes Mellitus, Type 2 , Interferon-gamma , Mycobacterium tuberculosis , Tuberculosis, Pulmonary , Humans , Diabetes Mellitus, Type 2/complications , Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Pulmonary/blood , Cross-Sectional Studies , Male , Middle Aged , Female , Adult , Cytokines/blood , Mycobacterium tuberculosis/immunology , Interferon-gamma/blood , Biomarkers/blood , Interleukin-10/blood , Tumor Necrosis Factor-alpha/blood , Interleukin-6/blood , Aged
11.
J Public Health Policy ; 45(2): 344-356, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38789651

ABSTRACT

Physicians' hold pivotal roles in improving non-communicable diseases (NCDs). Studies conducted in India revealed that physicians' feel unprepared to address NCDs risk reduction and provide counseling. We conducted a gap analysis using desk reviews to identify inclusion of NCD risk reduction in medical curricula, and a scoping review to assess knowledge, attitude, perception, and practice related to NCD risk reduction among the undergraduate medical students in India. We also conducted key-informant interviews to understand perceptions among medical students and physicians. We found a lack of knowledge about NCDs and strong interest and perceived need for NCD risk reduction training among both medical students and their teachers. Our findings suggest promoting NCD prevention by physicians and allied health workers in clinical settings can enable the learning environment for medical students to adopt these practices.


Subject(s)
Noncommunicable Diseases , Risk Reduction Behavior , Students, Medical , Humans , Noncommunicable Diseases/prevention & control , India , Students, Medical/psychology , Curriculum , Health Knowledge, Attitudes, Practice , Education, Medical, Undergraduate/organization & administration , Physicians/psychology
12.
PLOS Glob Public Health ; 4(5): e0001835, 2024.
Article in English | MEDLINE | ID: mdl-38709793

ABSTRACT

INTRODUCTION: The objectives of this study were: 1) to describe the socio-demographics and classify the chief complaints and reasons to encounter facilities of patients presenting to public healthcare facilities; 2) to explore differences in these complaints and: International Classification of Primary Care-3 (ICPC-3) groups across socio-demographic and health system levels. METHODS: This is a cross-sectional study conducted in three districts of Odisha, India. Within each district, the district hospital (DH), one Sub-district hospital (SDH) (if available), two Community health centers (CHCs), and two Primary health care centers (PHCs) were selected. Thus, a total of three DHs, three SDHs, six CHCs, and six PHCs were covered. Two tertiary healthcare facilities were also included. Patients aged 18 years and older, attending the Outpatient Departments (OPD) of sampled health facilities were chosen as study participants through systematic random sampling. RESULTS: A total of 3044 patients were interviewed. In general, 65% of the sample reported symptoms as their chief complaint for reason of encounter, whereas 35% reported disease and diagnosis. The most common reasons to encounter health facilities were fever, hypertension, abdominal pain, chest pain, arthritis, skin disease, cough, diabetes, and injury. Among the symptoms, the highest number of patients reported the general category (29%), followed by the digestive system (16%). In the disease category, the circulatory system has the highest proportion, followed by the musculatory system. In symptom categories, general, digestive, and musculatory systems were the key systems for the reasons of encounter in outpatient departments irrespective of different groups of the population. In terms of different tiers of health systems, the top three reasons to visit OPD were dominated by the circulatory system, respiratory system, and musculatory system. CONCLUSION: This is the first Indian study using the ICPC-3 classification for all three levels of health care. Irrespective of age, socio-economic variables, and tiers of healthcare, the top three groups to visit public health facilities according to the ICPC-3 classification were consistent i.e., general, digestive, and circulatory. Implementation of standard management and referral guidelines for common diseases under these groups will improve the quality and burden at public health facilities in India.

13.
Bull World Health Organ ; 102(6): 421-431, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38812804

ABSTRACT

Objective: To identify literature on health literacy levels and examine its association with tuberculosis treatment adherence and treatment outcomes. Methods: Two authors independently searched Pubmed®, Embase, CINAHL, PsycINFO, Scopus, LILACS, Global Health Medicus and ScienceDirect for articles reporting on health literacy levels and tuberculosis that were published between January 2000 and September 2023. We defined limited health literacy as a person's inability to understand, process, and make decisions from information obtained concerning their own health. Methodological quality and the risk of bias was assessed using the JBI critical appraisal tools. We used a random effects model to assess the pooled proportion of limited health literacy, the association between health literacy and treatment adherence, and the relationship between health literacy and tuberculosis-related knowledge. Findings: Among 5813 records reviewed, 22 studies met the inclusion criteria. The meta-analysis revealed that 51.2% (95% confidence interval, CI: 48.0-54.3) of tuberculosis patients exhibit limited health literacy. Based on four studies, patients with lower health literacy levels were less likely to adhere to tuberculosis treatment regimens (pooled odds ratio: 1.95; 95% CI: 1.37-2.78). Three studies showed a significant relationship between low health literacy and inadequate knowledge about tuberculosis (pooled correlation coefficient: 0.79; 95% CI: 0.32-0.94). Conclusion: Health literacy is associated with tuberculosis treatment adherence and care quality. Lower health literacy might hamper patients' ability to follow treatment protocols. Improving health literacy is crucial for enhancing treatment outcomes and is a key strategy in the fight against tuberculosis.


Subject(s)
Health Literacy , Tuberculosis , Humans , Tuberculosis/prevention & control , Tuberculosis/drug therapy , Health Knowledge, Attitudes, Practice , Medication Adherence
14.
Braz J Microbiol ; 55(2): 1065-1081, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38561499

ABSTRACT

Mucormycosis is the third most frequent invasive mycosis, following candidiasis and aspergillosis. It is frequently neglected due to its rare occurrence; but recently attend the status of notifiable disease due to its higher incidence in both developed and developing nations. India has received global notice since its estimated instances were greater than the global estimated figures. Mucormycosis has several clinical manifestations, including rhino-orbital-cerebral (ROCM), pulmonary, gastrointestinal, cutaneous, renal, and diffuse Mucormycosis. ROCM is the most frequent clinical manifestation in India, although pulmonary mucormycosis is prevalent worldwide. This review also discusses host defenses, pre disposing risk factors and fungal virulence factors that impair host's ability to prevent fungus invasion and disease establishment. The diagnosis of the disease depends on clinical interventions, histological or microbiological procedures along with molecular methods to obtain timely results. But there are still unmet challenges for rapid diagnosis of the disease. Treatment of the disease is achieved by multimodal approaches such as reversal of underlying predisposing factors, rapid administration of antifungals in optimal doses and surgical procedures to remove infected tissues. Liposomal Amphotericin B, Posaconazole and Isavuconazoles are preferred as the first line of treatment procedures. clinical trials. Different studies have improved the existing drug and under clinical trials while several studies predicted the new potential targets as CotH and Ftr1 as shown in infection and in vitro models. Therefore, current scenario demands a multidisciplinary approach is needed to investigate the prevalence, pathogenesis which is highly important for the advancement of rapid diagnosis and effective treatment.


Subject(s)
Antifungal Agents , Mucormycosis , Rare Diseases , Humans , Mucormycosis/epidemiology , Mucormycosis/microbiology , Mucormycosis/drug therapy , Mucormycosis/diagnosis , Antifungal Agents/therapeutic use , Rare Diseases/microbiology , India/epidemiology , Risk Factors
15.
Front Health Serv ; 4: 1365485, 2024.
Article in English | MEDLINE | ID: mdl-38567089

ABSTRACT

Introduction: Cataracts are the leading cause of blindness among older people, but they can be treated with corrective surgery. India boasts the oldest blindness control programme in the world. We aimed to assess the prevalence of cataract surgery, and we compared the determinants of undergoing cataract surgery and identified the unmet needs for cataract surgery among older adults in India. Methods: We included 52,380 individuals aged ≥50 years from the Longitudinal Ageing Study in India, wave-1. The primary outcome measures of our study were the prevalence of cataract surgery and the unmet need for cataract surgery. Multivariate analysis was executed to investigate the association between socio-demographic variables and outcomes, expressing the results as adjusted odds ratios with 95% confidence intervals (CIs). Results: The overall prevalence of cataracts was 14.85%. The coverage of cataract surgery was 76.95%, with 23% having unmet needs for cataract surgery. Notably, cataract surgery coverage was higher at 78.30% (95% CI: 76.88-79.48) among participants aged 66-80 years, while the percentage of those who did not undergo cataract surgery was higher at 24.62% (95% CI: 23.09-26.20) among participants aged 50-60 years. The most deprived group had a higher odds ratio [adjusted odds ratio: 1.20 (95% CI: 1.00-1.44)] (p < 0.05) of having unmet needs for cataract surgery. Conclusions: There is a considerable burden of age-related cataracts in India. While the coverage of cataract surgery is high, the unmet need for cataract surgery cannot be overlooked. The existing blindness control programme has contributed significantly to increasing the coverage of cataract surgery, but it still needs to be strengthened, especially to reach the most deprived sections of society.

16.
Indian J Tuberc ; 71(2): 147-152, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38589118

ABSTRACT

BACKGROUND: Modelling studies have indicated that approximately 20% of all tuberculosis (TB) cases may suffer from diabetes mellitus (DM). DM increases the risk of developing active TB disease by 2-3 times. People living with HIV (PLHIV) are more likely to develop TB disease, and TB is a leading cause of hospitalization and death among PLHIV. Despite the substantial burden of DM and HIV in India, few studies have evaluated the prevalence of DM and HIV among active cases of TB, and its impact on the treatment outcome for TB. This study evaluated the burden of HIV and DM in TB cases from Odisha during 2019, and its impact on the TB treatment outcome. METHODS: The study utilized data on TB patients of Odisha during 2019, from the NIKSHAY portal, the health management information system (HMIS) of TB in India. This is a retrospective observational registry-based cohort study, which evaluated a linkage between socio-demographic predictors, clinical diagnostic and treatment predictors, time of treatment predictors, and co-morbidity with TB. Data were retrieved electronically in Microsoft-Excel and analysis was done using STATA 16 (StataCorp. 2019, College Station, TX: StataCorp LLC). RESULTS: Data for 47,831 TB cases of Odisha as study population was extracted from the Nikshay application for the year 2019. The highest prevalence (31.1%, 14,863/47,831) of TB was observed among young participants aged 15-30 years, whereas the prevalence was least among children <14 years (4.4%, 2124/47,831). Males had a higher prevalence of TB (66.7%, 31,878/47,831). Of the 47,831 TB cases included in the study, 7.6% (3659/47,831) had diabetes mellitus (DM), along with TB. 1.2% (571/47,831) had HIV along with TB, while only 0.08% (37/47,831) had both DM and HIV along with TB. 88.2% (3148/3569) of cases with DM and TB had a favorable outcome, compared to 82.3% (449/541) of cases with HIV and TB. People with TB who did not have DM had a significantly higher favorable outcome (OR 1.6, 95% CI 1.5-1.8) compared to those with TB and DM. Similarly, TB cases who did not have HIV infection had a significantly higher favorable outcome (OR 2.4, 95% CI 1.9-3.0) compared to those with TB and HIV. CONCLUSION: Our study showed that presence of DM and/or HIV in TB patients had an impact on the TB treatment outcome. There is a crucial need to prevent comorbidities such as DM and HIV from occurring and to prioritize early diagnosis and management of these conditions.


Subject(s)
Diabetes Mellitus , HIV Infections , Tuberculosis , Child , Humans , Male , Cohort Studies , Diabetes Mellitus/epidemiology , HIV , HIV Infections/complications , HIV Infections/epidemiology , India/epidemiology , Tuberculosis/complications , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Female , Adolescent , Young Adult , Adult
17.
Comput Biol Chem ; 110: 108070, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38678726

ABSTRACT

Cumulative global prevalence of the emergent monkeypox (MPX) infection in the non-endemic countries has been professed as a global public health predicament. Lack of effective MPX-specific treatments sets the baseline for designing the current study. This research work uncovers the effective use of known antiviral polyphenols against MPX viral infection, and recognises their mode of interaction with the target F13 protein, that plays crucial role in formation of enveloped virions. Herein, we have employed state-of-the-art machine learning based AlphaFold2 to predict the three-dimensional structure of F13 followed by molecular docking and all-atoms molecular dynamics (MD) simulations to investigate the differential mode of F13-polyphenol interactions. Our extensive computational approach identifies six potent polyphenols Rutin, Epicatechingallate, Catechingallate, Quercitrin, Isoquecitrin and Hyperoside exhibiting higher binding affinity towards F13, buried inside a positively charged binding groove. Intermolecular contact analysis of the docked and MD simulated complexes divulges three important residues Asp134, Ser137 and Ser321 that are observed to be involved in ligand binding through hydrogen bonds. Our findings suggest that ligand binding induces minor conformational changes in F13 to affect the conformation of the binding site. Concomitantly, essential dynamics of the six-MD simulated complexes reveals Catechin gallate, a known antiviral agent as a promising polyphenol targeting F13 protein, dominated with a dense network of hydrophobic contacts. However, assessment of biological activities of these polyphenols need to be confirmed through in vitro and in vivo assays, which may pave the way for development of new novel antiviral drugs.


Subject(s)
Antiviral Agents , Molecular Dynamics Simulation , Polyphenols , Antiviral Agents/chemistry , Antiviral Agents/pharmacology , Polyphenols/chemistry , Polyphenols/pharmacology , Catechin/chemistry , Catechin/analogs & derivatives , Catechin/pharmacology , Molecular Docking Simulation
18.
Front Public Health ; 12: 1347183, 2024.
Article in English | MEDLINE | ID: mdl-38660358

ABSTRACT

Scrub typhus, caused by Orientia tsutsugamushi, is a re-emerging zoonotic disease in the tropics with considerable morbidity and mortality rates. This disease, which is mostly prevalent in rural areas, remains underdiagnosed and underreported because of the low index of suspicion and non-specific clinical presentation. Limited access to healthcare, diagnostics, and treatment in rural settings further makes it challenging to distinguish it from other febrile illnesses. While easily treatable, improper treatment leads to severe forms of the disease and even death. As there is no existing public health program to address scrub typhus in India, there is an urgent need to design a program and test its effectiveness for control and management of the disease. With this backdrop, this implementation research protocol has been developed for a trial in few of the endemic "pockets" of Odisha, an eastern Indian state that can be scalable to other endemic areas of the country, if found effective. The main goal of the proposed project is to include scrub typhus as a differential diagnosis of fever cases in every tier of the public health system, starting from the community level to the health system, for the early diagnosis among suspected cases and to ensure that individuals receive complete treatment. The current study aimed to describe the protocol of the proposed Scrub Typhus Control Program (STCP) in detail so that it can receive valuable views from peers which can further strengthen the attempt.


Subject(s)
Early Diagnosis , Orientia tsutsugamushi , Public Health , Scrub Typhus , Scrub Typhus/diagnosis , Humans , India , Orientia tsutsugamushi/isolation & purification
19.
Front Public Health ; 12: 1283054, 2024.
Article in English | MEDLINE | ID: mdl-38577281

ABSTRACT

Background: According to the Global Burden of Disease (GBD) 2019 report, up to 1.5 million disability-adjusted life years (DALYs) are lost due to soil-transmitted helminths (STHs), and 5.9 million people are at risk of acquiring STHs. Regions with the highest prevalence of STH infections include Sub-Saharan Africa, China, South America, and Asia. While there are numerous fragmented studies on STH, comprehensive information on the prevalence and geographic distribution of different species, as well as their regional variations in the context of STHs is limited. The present systematic review and meta-analysis study attempts to provide a summary of the prevalence, geographical variation, and determinants of STHs among schoolchildren aged 5 to 18 years. Methods: An extensive literature search was carried out using PubMed, Embase, Cinhal, and Psychinfo for studies published between 1999 and 2022 that reported the rate of STH infection in school-going children aged 5-18 years. A random effects model was employed in this meta-analysis due to expected heterogeneity. Subgroup analysis was carried out based on sex and STH species because of expected geographical variation. Results: A total of 19,725 of the 49,630 children examined were infected with STH, yielding an overall pooled prevalence of 37.16% (95% CI: 29.74-44.89). The prevalence was highest in the Western Pacific region at 50.41% (95% CI: 33.74-67.04) followed by Europe at 39.74% (95% CI: 20.40-61.0) and Africa at 37.10% (95% CI: 26.84-47.95). Ascaris lumbricoides was found to be the most prevalent helminth with a prevalence of 24.07% (95% CI: 17.07-31.83). Conclusion: The Western Pacific region is classified as a High-risk Zone (HRZ), while Southeast Asia, Africa, Europe, and the Eastern Mediterranean are classified as moderate-risk zones (MRZs). We found a 12% reduction in the pooled prevalence of STH infection from 1999 to 2012. Ascaris lumbricoides was the predominant species among schoolchildren. Mass Drug Administration (MDA) of Albendazole tablets and improved water, sanitation, and hygiene (WASH) practices are effective in controlling and preventing STH. Ensuring their implementation and access is crucial to addressing the problem. Systematic review registration: https://www.crd.york.ac.uk/prospero/#loginpage, CRD42022333341.


Subject(s)
Helminthiasis , Helminths , Animals , Child , Humans , Ascaris lumbricoides , Developing Countries , Helminthiasis/epidemiology , Helminthiasis/prevention & control , Prevalence , Soil/parasitology , Child, Preschool , Adolescent
20.
Front Med (Lausanne) ; 11: 1401711, 2024.
Article in English | MEDLINE | ID: mdl-38590319
SELECTION OF CITATIONS
SEARCH DETAIL
...