Perceptions about controlled human infection model (CHIM) studies among members of ethics committees of Indian medical institutions: A qualitative exploration.

Introduction: Controlled Human Infection Model (CHIM) studies provide a unique platform for studying the pathophysiology of infectious diseases and accelerated testing of vaccines and drugs in controlled settings. However, ethical issues shroud them as the disease-causing pathogen is intentionally inoculated into healthy consenting volunteers, and effective treatment may or may not be available. We explored the perceptions of the members of institutional ethics committees (IECs) in India about CHIM studies. Methods: This qualitative exploratory study, conducted across seven sites in India, included 11 focused group discussions (FGD) and 31 in-depth interviews (IDI). A flexible approach was used with the aid of a topic guide. The data were thematically analyzed using grounded theory and an inductive approach. Emerging themes and sub-themes were analyzed, and major emergent themes were elucidated. Results: Seventy-two IEC members participated in the study including 21 basic medical scientists, 29 clinicians, 9 lay people, 6 legal experts and 7 social scientists. Three major themes emerged from this analysis-apprehensions about conduct of CHIM studies in India, a perceived need for CHIM studies in India and risk mitigation measures needed to protect research participants and minimize the associated risks. Conclusion: Development of a specific regulatory and ethical framework, training of research staff and ethics committee members, and ensuring specialized research infrastructure along with adequate community sensitization were considered essential before initiation of CHIM studies in India.

Prevalence of intestinal parasitic infection and its associated factors among children in Puducherry, South India: a community-based study.

There is paucity of studies at community level on prevalence of intestinal parasitic infection among under 18 years age group. This cross-sectional community-based research aimed to determine the prevalence of intestinal worm infections and its associated risk factors among 1 to 18 years age group in Puducherry, India. Sociodemographic, behavioral and other associated factors were collected using a structured questionnaire. One stool sample was collected from each participant and examined using direct (saline/iodine wet mount) and concentration (floatation/sedimentation) microscopic techniques. Log binomial regression analysis was used to find the factors independently associated with intestinal parasitic infection. Of 187 participants who provided the stool sample, 25 (13.4%) had at least one of the parasitic infections and among them 12 (6.4%) had Soil Transmitted Helminth infection (STH) and 13 (6.9%) had intestinal protozoan parasites. Parasitic infection is marginally higher among 1 to 7 years age group (14.4%) compared to 8 to 18 years age group (12.1%). After adjusting for confounding, urban residence (APR = 3.3, 95% CI 1.4-8.0) and open-air defecation (APR = 3.3, 95% CI 1.4-7.5) were significantly associated with intestinal parasitic infections. One out of eight children had any of the parasitic infection and nearly 50% of parasitic infections were caused by STH. Those children residing in urban areas and practice of open-air defecation had higher prevalence of parasitic infection.

Prevalence and association of depressive symptoms with spiritual intelligence among older adults: A community-based study in rural Puducherry, South India.

INTRODUCTION: Depression is more common among older adults, but there is a paucity of information about its association with spiritual intelligence. This study aimed to determine the prevalence and association of depressive symptoms with spiritual intelligence among older adults. MATERIALS AND METHODS: This community-based cross-sectional analytical study was conducted among 292 older adults in a rural area of Puducherry, India. A structured questionnaire was used to collect each participant's socio-demographic and behavioral factors; the presence of depressive symptoms was assessed by using Geriatric Depression Scale (short form), spiritual intelligence by the Spiritual Intelligence Self-Report Inventory-24 questionnaire and activities of daily living by Katz Index of Independence scale. Proportion for prevalence estimate, bivariate and multivariable log binomial regression analysis were done. RESULTS: The prevalence of depressive symptoms was 64.1 % (187/292; 95 % CI 58.3-69.3). Of total, 103 (35.3 %) had low, 92 (31.55 %) had moderate and 97 (33.2 %) had high spiritual intelligence. About 11 % (32/292) were partially or fully dependent. Depressive symptoms showed a significant association with marital status, education, sleep pattern, relationship with family members and spiritual intelligence in bivariate analysis. Depressive symptoms were high among those with low spiritual intelligence and disturbed sleep pattern with Adjusted Prevalence Ratio of 1.33 (95 %CI 1.26-1.4) and 1.06 (95 %CI 1.0-1.14) respectively. CONCLUSION: Majority of the older adults had depressive symptoms and significantly more among those with low spiritual intelligence and disturbed sleep. This study gives new evidence on spiritual intelligence among older adults in a community setting and the magnitude of association of depressive symptoms with spiritual intelligence.