Prevalence of pulmonary tuberculosis--a baseline survey in central India.

BACKGROUND: The present study provides an estimate of the prevalence of bacteriologially positive pulmonary tuberculosis in Jabalpur, a district in central India. METHODOLOGY/PRINCIPAL FINDINGS: A community based cross-sectional survey was undertaken in Jabalpur District of the central Indian state of Madhya Pradesh. A stratified cluster sampling design was adopted to select the sample. All eligible individuals were questioned for pulmonary symptoms suggestive of TB disease. Two sputum samples were collected from all eligible individuals and were examined by Ziehl-Neelsen smear microscopy and solid media culture methods. Of the 99,918 individuals eligible for screening, 95,071 (95.1%) individuals were screened. Of these, 7,916 (8.3%) were found to have symptoms and sputum was collected from 7,533 (95.2%) individuals. Overall prevalence of bacteriologically positive PTB was found to be 255.3 per 100,000 population (95% C.I: 195.3-315.4). Prevalence was significantly higher (p<0.001) amongst males (355.8; 95% C.I: 304.4-413.4) compared with females (109.0; 95% C.I: 81.2-143.3). Prevalence was also significantly higher in rural areas (348.9; 95% C.I: 292.6-412.8) as compared to the urban (153.9; 95% C.I: 123.2-190.1). CONCLUSIONS/SIGNIFICANCE: The TB situation in Jabalpur district, central India, is observed to be comparable to the TB situation at the national level (255.3 versus 249). There is however, a need to maintain and further strengthen TB control measures on a sustained and long term basis in the area to have a significant impact on the disease prevalence in the community.

Selected risk factors associated with pulmonary tuberculosis among Saharia tribe of Madhya Pradesh, central India.

Tuberculosis (TB) is a major public health problem among the Saharia, a marginalized tribal group in Madhya Pradesh state, central India. However, there is no information on the risk factors associated with the development of TB disease in this community. A cross-sectional TB prevalence survey was conducted among the Saharia residing in Sheopur district of Madhya Pradesh. Information on tobacco smoking and alcohol consumption was collected from all the individuals. Persons aged ≥45 years, males, smokers and alcohol consumers had higher risks of developing TB disease. There is an urgent need to develop and implement culturally appropriate awareness raising activities to target smoking and alcohol consumption to support the efforts to control TB in this community.

Pulmonary tuberculosis: a public health problem amongst the Saharia, a primitive tribe of Madhya Pradesh, Central India.

OBJECTIVES: To estimate the prevalence of pulmonary tuberculosis (TB) disease amongst the Saharia, a 'primitive' tribe of Madhya Pradesh, Central India. METHODS: A community-based cross-sectional TB prevalence survey was undertaken in the Saharia, a 'primitive' tribal community of Madhya Pradesh. A representative random sample of villages predominated by tribal populations was chosen from the selected block of Sheopur District. All eligible individuals were screened for chest symptoms related to TB. Sputum samples were collected from all eligible individuals, transported to the laboratory, and examined by Ziehl-Neelsen smear microscopy and solid media culture methods. RESULTS: Of the 11,468 individuals eligible for screening, 11,116 (96.9%) were screened for symptoms. The overall prevalence of pulmonary TB disease was 1518 per 100,000 population. Prevalence increased with age and the trend was statistically significant (p<0.001). The prevalence of pulmonary TB was also significantly higher in males (2156/100,000) than females (933/100,000) (p<0.001). CONCLUSION: The findings suggest that TB disease remains a major public health problem in the Saharia 'primitive' tribal community of Madhya Pradesh, Central India.

Prevalence of pulmonary tuberculosis amongst the tribal population of Madhya Pradesh, central India.

BACKGROUND: This was a prevalence survey of pulmonary tuberculosis (PTB) disease in the tribal population of Madhya Pradesh state, central India. METHODS: A community-based cross-sectional tuberculosis (TB) disease prevalence survey was undertaken among adults aged > or = 15 years in the tribal population of Madhya Pradesh. A multistage stratified cluster sampling was adopted. A representative random sample of villages predominated by tribal populations was selected from 11 districts. All eligible individuals were questioned for chest symptoms relating to TB. Sputum samples were collected from all eligible individuals, transported to the laboratory, and examined by Ziehl-Neelsen (ZN) smear microscopy and solid media culture methods. RESULTS: Of the 23,411 individuals eligible for screening, 22,270 (95.1%) were screened for symptoms. The overall proportion of symptomatic individuals was 7.9%. Overall prevalence (culture and/or smear positive) of PTB was 387 [95% confidence interval (CI): 273-502] per 100,000 population. The prevalence increased with age and was also significantly higher among males (554/100,000; 95% CI: 415-693) as compared with females (233/100,000; 95% CI: 101-364) (P < 0.001). CONCLUSION: The findings suggest that the TB situation amongst the tribal population is not that different from the situation among the non-tribal population in the country. However, TB remains a major public health problem amongst the tribal population and there is a need to maintain and further strengthen TB control measures on a sustained and long-term basis.

Seroprevalence of sexually transmitted viruses in the tribal population of Central India.

OBJECTIVE: To determine the seroprevalence of human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV, HCV), and herpes simplex virus type 2 (HSV-2) in the tribal population of central India. METHODS: A community-based cross-sectional survey was carried out in the tribal population of Jabalpur district. Blood samples were drawn from 326 patients with sexually transmitted infections (STIs) and 526 randomly selected adults. These were tested for HIV, HBV, HCV, and HSV-2 using commercial ELISA kits. RESULTS: The prevalence of IgG antibodies to HSV-2 was 20.8% in STI patients compared to 12.4% in the general population. The HBV carriage rate was 3.4% in STI patients against 2.9% in the general population. HCV prevalence was 3.9% in STI patients and 4.6% in the general population. No HIV infection was found in the study population. CONCLUSIONS: In view of the high prevalence of viral STIs in the tribal community of Central India, there is a need to strengthen the STI control program in this under-privileged group.

Role of Escherichia coli in acute diarrhoea in tribal preschool children of central India.

Five hundred and eighty preschool children belonging to tribal areas of Madhya Pradesh were followed up daily for the presence of diarrhoea for a period of 1 year. In all, 1236 episodes of diarrhoea were recorded with an average of 2.13 episodes per child per year. Stool samples were collected during 780 episodes. They were cultured to isolate Escherichia coli as well as non-E. coli enteropathogens. Ten different genes were detected to identify all diarrhoeagenic E. coli using multiplex polymerase chain reaction. Enteroaggregative E. coli was the commonest diarrhoeagenic E. coli and was isolated from 64 children, followed by enteropathogenic E. coli (27), enterotoxigenic E. coli (10) and enterohaemorrhagic E. coli (2). Other enteropathogens detected were bacteria such as Shigella sp, Vibrio cholerae and Salmonella sp, parasites such as Giardia lamblia and Entameba histolytica, and rotavirus. Most of the bacterial pathogens were multi-drug resistant. The study shows that diarrhoeagenic E. coli contribute significantly to the burden of acute diarrhoea in tribal preschool children.