ABSTRACT
BACKGROUND AND RATIONALE: Atherosclerotic vascular disease (AVD), including coronary heart disease (CHD), is on the rise in India. Mortality due to CHD is estimated to be 40% higher in Indian Asians compared with Europeans. Hyperhomocyst(e)inaemia (hypertHcy) is emerging as a novel independent risk factor for AVD. Moreover, there is increasing evidence of its association with CHD in subjects of Indian origin possibly because of inadequate folic acid and B(12) status. However, there is a lack of epidemiological data on its prevalence in Indians. A need to evaluate the optimum dose of folic acid required to reduce plasma homocyst(e)ine (tHcy) also exists. OBJECTIVES AND METHODS: The CARDIOVIT study, divided into two stages, is designed to determine the prevalence and relevance of hypertHcy in Indian subjects and also evaluate the tHcy-lowering effect of a marketed multivitamin formulation (Cardiovit). Stage I is a cross-sectional epidemiological study to estimate the prevalence of hypertHcy in a randomly selected population in South India. We planned to screen 2000 subjects between 25 and 64 years of age for established risk factors; plasma tHcy levels will be estimated and the correlation of AVD with established risk factors, plasma tHcy and nutritional factors was evaluated. Subjects having tHcy levels > 12 micromol/L are recruited in Stage II; a randomized, three-arm, double-blind, double-dummy, placebo-controlled, parallel-group, comparative study designed to evaluate the tHcy-lowering effect of a multivitamin formulation containing 300 microg folic acid, 1 microg vitamin B(12) and 1.5 mg vitamin B(6), along with Vitamins A, C, E and selenium. Subjects will be randomized into three groups (n = 64 completed subjects each) and receive either two placebos, or one placebo and multivitamin, or two multivitamin tablets for 6 weeks. Serum vitamin B(12), serum and red cell folate are estimated at baseline and at 6 weeks. Descriptive, univariate analysis, multiple logistic regression model and appropriate statistical tests will be used to analyse the prevalence of hypertHcy, association with risk factors of AVD, efficacy and safety of the multivitamin formulation and other data per protocol. CONCLUSIONS: CARDIOVIT is one of the first and largest studies in India to provide insight into the prevalence of hypertHcy, its association with AVD and conventional risk factors and the role of multivitamins in reducing it.
Subject(s)
Atherosclerosis/epidemiology , Cross-Sectional Studies , Dietary Supplements , Hyperhomocysteinemia/drug therapy , Hyperhomocysteinemia/epidemiology , Randomized Controlled Trials as Topic , Vitamins/therapeutic use , Adult , Antioxidants/therapeutic use , Atherosclerosis/complications , Atherosclerosis/drug therapy , Female , Folic Acid/therapeutic use , Homocysteine/blood , Homocysteine/drug effects , Humans , Hyperhomocysteinemia/complications , India/epidemiology , Male , Middle Aged , Prevalence , Risk Factors , Treatment Outcome , Vitamin B Complex/therapeutic useABSTRACT
There is a lack of data on the Anopheles fauna, its biology and the roles played by different vector species in the transmission of malaria in the mount Cameroon region. The biting habits, feeding behaviour and entomological inoculation rates of different Anopheles species during the dry and rainy season were investigated. A total of 2165 Anopheles was collected, 805 in the rainy season and 1360 in the dry season. Five Anopheles species were identified: Anopheles gambiae s.l., An. funestus, An. hancocki, An. moucheti and An. nili. An. gambiae, An. funestus and An. hancocki, recorded during both seasons, were the main vectors of malaria in the region. An. gambiae s.s. was the only member of the An. gambiae (Giles) complex. These three species had their peak activity between 1 and 2 am. A human blood index (HBI) of 98.29% was recorded for fed Anopheles. The sporozoite rate, for all vectors together, was significantly higher in the rainy season (9.4%) than in the dry season (4.2%) with all the species infected by Plasmodium falciparum. The average inoculation rate was 0.44 infective bites per man per night, which adds up to 161 infective bites per year in this study area. Analyses of relative abundance and infection rate of malaria vectors at different sites situated along a transect of 20 km during the dry season showed high heterogeneity in biting and sporozoite rates. No malaria vector was caught at 1200 m a.s.l. The mount Cameroon region should be considered an area of high malaria transmission intensity.
Subject(s)
Anopheles/physiology , Feeding Behavior , Insect Bites and Stings/epidemiology , Insect Vectors/physiology , Malaria, Falciparum/transmission , Altitude , Animals , Anopheles/classification , Anopheles/parasitology , Behavior, Animal , Cameroon/epidemiology , Humans , Insect Vectors/classification , Insect Vectors/parasitology , Plasmodium falciparum/isolation & purification , Seasons , Sporozoites/isolation & purificationABSTRACT
Studies indicate that 42-57 per cent of all child deaths in developing countries are due to the potentiating effects of malnutrition on infectious disease, of which over three-quarters can be attributed to mild-to-moderate malnutrition. Risk factors for underweight status in children under 3 years of age were assessed in Kerala, India. Mothers of 34 children weighing below -1 SD for their age and 59 children weighing more than 1 SD for their age, were interviewed for information about maternal health, child feeding patterns, and sibling gender and age data. Statistical analysis showed that current maternal weight (odds ratio = 8.25, p = 0.0009), current maternal body mass index (OR = 4.55, p = 0.03), infant birth weight (OR = 4.87, p = 0.01) and excessive maternal vomiting in pregnancy (OR = 4.48, p = 0.04) were significant risk factors for current child underweight status. Based on this observed relationship of maternal nutritional factors with child weight-for-age status, further studies on interventions to address the health problems of adolescent girls and all women of reproductive age in Kerala are suggested, in addition to continuing the emphasis in current rural health and nutrition programs for pregnant and lactating mothers.
Subject(s)
Child Nutrition Disorders/diagnosis , Child Nutrition Disorders/epidemiology , Adult , Case-Control Studies , Child, Preschool , Developing Countries , Female , Humans , Incidence , India/epidemiology , Infant , Infant, Newborn , Male , Mother-Child Relations , Odds Ratio , Population Surveillance , Pregnancy , Probability , Reference Values , Risk Assessment , Risk Factors , Rural Population , Severity of Illness Index , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
Out of hundred syringes and hundred needles (both presterile, disposable) tested, 41 syringes (41%) and 6 needles (6%) showed aerobic growth. Forty of the above syringes were tested simultaneously for fungi and anaerobes. Fungi isolated were 5.7% and no anaerobe was grown. Fifty glass syringes and fifty needles autoclaved in the departmental laboratory served as controls and did not show any growth. As a preventive measure, proper disposal of used disposable material should be made mandatory so that it does not find its way into the market. Or has the time come to switch back to the former conventional practice of using in house autoclaved articles?
Subject(s)
Disposable Equipment/standards , Medical Waste Disposal/standards , Needles/standards , Syringes/standards , Equipment Contamination , Humans , India , Sterilization/standardsABSTRACT
Four hundred ninety nine sera from pregnant mothers with bad obstetric history were tested for presence of antibodies to T.gondii by indirect haemagglutination test. Prevalence was 19.44 percent as 97 out of 499 sera were positive.
