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1.
J Epidemiol Glob Health ; 13(2): 173-179, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37162636

RESUMO

BACKGROUND: We estimated the incidence of Japanese encephalitis (JE) and acute encephalitis syndrome (AES) following routine immunization with the live-attenuated SA 14-14-2 JE vaccine. METHODS: We implemented enhanced surveillance of AES and JE hospitalizations in endemic districts in Maharashtra and Telangana States during 2015-2016 and 2018-2020. We estimated incidence and compared differences in the incidence of JE and AES between two states, and vaccinated and unvaccinated districts during two study periods. We also considered secondary data from public health services to understand long-term trends from 2007 to 2020. RESULTS: The annual AES incidence rate of 2.25 cases per 100,000 children in Maharashtra during 2018-2020 was significantly lower than 3.36 cases per 100,000 children during 2015-2016. The six JE-vaccinated districts in Maharashtra had significantly lower incidence rates during 2018-2020 (2.03, 95% CI 1.73-2.37) than in 2015-16 (3.26, 2.86-3.70). In addition, the incidence of both JE and AES in two unvaccinated districts was higher than in the vaccinated districts in Maharashtra. Telangana had a lower incidence of both JE and AES than Maharashtra. The AES incidence rate of 0.95 (0.77-1.17) during 2018-2020 in Telangana was significantly lower than 1.67 (1.41-1.97) during 2015-2016. CONCLUSIONS: The annual incidence rate of Japanese encephalitis was < 1 case per 100,000 children. It indicated accelerated control of Japanese encephalitis after routine immunization. However, the annual incidence of acute encephalitis syndrome was still > 1 case per 100,000 children. It highlights the need for improving surveillance and evaluating the impacts of vaccination.


Assuntos
Encefalopatia Aguda Febril , Encefalite Japonesa , Criança , Humanos , Encefalite Japonesa/epidemiologia , Encefalite Japonesa/prevenção & controle , Incidência , Encefalopatia Aguda Febril/epidemiologia , Índia/epidemiologia , Hospitalização
2.
J Med Virol ; 95(1): e28399, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36512338

RESUMO

Japanese encephalitis (JE) disease among children continues in central India despite vaccination implemented in the routine immunization program. Therefore, we planned to estimate the JE vaccination effectiveness among children by undertaking a 1:2 individually-matched population-based case-control study from August 2018 to October 2020. The laboratory-confirmed JE cases aged 1-15 years were enrolled along with neighborhood controls without fever and encephalitis matched on the residence area, age and sex. The JE vaccination history was enquired from parents and verified independently from the vaccination cards available at home and records at health facilities. We enrolled 35 JE cases and 70 matched controls. The vaccination effectiveness of 86.7% (95% confidence interval [CI]: 30.8-94.7) was estimated on the per-protocol analysis of 31 case-control sets. The screening method provided an effectiveness of 89.5% (CI: 78.9-94.7) on using the population vaccination coverage of 90% reported earlier in the same area. In conclusion, JE vaccination offered a moderate level of protection among children in JE medium-endemic central India, similar to reports from high-endemic areas in India. The operational aspects of vaccination program implementation need to be evaluated to assess the impact of vaccination on the disease burden of JE in medium-endemic regions of India.


Assuntos
Encefalite Japonesa , Criança , Humanos , Encefalite Japonesa/epidemiologia , Encefalite Japonesa/prevenção & controle , Estudos de Casos e Controles , Vacinação , Programas de Imunização , Índia/epidemiologia
3.
J Med Virol ; 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36114690

RESUMO

BACKGROUND: We aimed to estimate the coverage of Japanese encephalitis (JE) vaccination in central India to help explain the continued occurrence of JE disease despite routine vaccination. METHODS: We implemented a 30-cluster survey for estimating the coverage of JE vaccination in the medium-endemic areas implemented with JE vaccination in central India. The parents were enquired about the uptake of the JE vaccine by their children aged 2 to 6 years, followed by verification of the immunization cards at home along with reasons for non-vaccination. Vaccination coverage was reported as a percentage with 95% confidence intervals. RESULTS: We estimated high coverage of live-attenuated SA 14-14-2 JE vaccination in Maharashtra (94.8%, 95% CI 92.7-96.3) and Telangana (92.8%, 90.0-94.9). The vaccination card retention was 90.3% in Maharashtra and 70.4% in Telangana state. There were no gender differences in coverage in both states. A similar level of JE vaccination coverage was observed during the year 2013 to 2021 in both states. In Maharashtra, the maximum age-wise coverage was 96.6% in the >60 months age category, whereas in Telangana it was in the <24 months age category (97.2%). The timeliness of JE vaccination was appropriate and similar in both states. We found very good agreement between JE and Measles-Rubella vaccinations administered simultaneously. The reasons for non-vaccination were the shortage of vaccines and the parental migration for work. CONCLUSIONS: The coverage of Japanese encephalitis vaccination was high in medium-endemic regions in central India. Vaccination effectiveness studies may help further explain the continued incidence of Japanese encephalitis. This article is protected by copyright. All rights reserved.

4.
Cureus ; 14(7): e27115, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36000121

RESUMO

Introduction There are numerous reports of disrespectful, abusive, or neglectful treatment during childbirth from health facilities worldwide. Although India has substantially increased the number of hospital deliveries and reduced the maternal mortality ratio, the quality of intrapartum and immediate postpartum care for delivering mothers has not been given much importance. Therefore, assessing mistreatment and quality of care during childbirth is vital for promoting respectful maternity care.  Methods A descriptive hospital-based cross-sectional study was carried out in a tertiary care center in central India. A convenience sampling method was used, and a total of 150 consecutive consenting women aged 18-49 years who delivered in the study setting were included. Data was collected using a predesigned and pretested questionnaire based on seven major categories per the Respectful Maternity Care (RMC) Charter. Results All the 150 women in the present study, i.e., 100%, experienced at least one form of disrespect during their labor, childbirth, or postnatal period at the hospital. The mean scores for domains of non-confidential care (0.59), non-consented care (0.95), abandonment or denial of care (1.21), and physical abuse (1.26) are low. Conclusion The findings of the present study shed important light on the current state of respectful maternity care in the study area. Though mothers are noticing and reporting positive changes in maternity care practices, respectful maternity care still has a long way to go.

5.
J Clin Virol ; 153: 105194, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35687988

RESUMO

BACKGROUND: We enhanced surveillance of hospitalizations of all ages for acute encephalitis syndrome (AES) along with infectious aetiologies, including the Japanese encephalitis virus (JEV). METHODS: From October 2018 to September 2020, we screened neurological patients for AES in all age groups in Maharashtra and Telangana States. AES cases were enrolled at study hospitals along with other referrals and sampled with cerebrospinal fluid, acute and convalescent sera. We tested specimens for non-viral aetiologies viz. leptospirosis, typhoid, scrub typhus, malaria and acute bacterial meningitis, along with viruses - JEV, Dengue virus (DENV), Chikungunya virus (CHIKV), Chandipura virus (CHPV) and Herpes simplex virus (HSV). RESULTS: Among 4977 neurological hospitalizations at three study site hospitals over two years period, 857 (17.2%) were AES. However, only 287 (33.5%) AES cases were eligible. Among 278 (96.9%) enrolled AES cases, infectious aetiologies were identified in 115 (41.4%) cases, including non-viral in 17 (6.1%) cases - leptospirosis (8), scrub-typhus (3) and typhoid (6); and viral in 98 (35.3%) cases - JEV (58, 20.9%), HSV (22, 7.9%), DENV (15, 5.4%) and CHPV (3, 1.1%). JEV confirmation was significantly higher in enrolled cases than referred cases (10.2%) (p < 0.05). However, the contribution of JEV in AES cases was similar in both children and adults. JE was reported year-round and from adjacent non-endemic districts. CONCLUSIONS: The Japanese encephalitis virus continues to be the leading cause of acute encephalitis syndrome in central India despite vaccination among children. Surveillance needs to be strengthened along with advanced diagnostic testing for assessing the impact of vaccination.


Assuntos
Encefalopatia Aguda Febril , Vírus da Encefalite Japonesa (Espécie) , Encefalite Japonesa , Leptospirose , Febre Tifoide , Encefalopatia Aguda Febril/epidemiologia , Encefalopatia Aguda Febril/etiologia , Adulto , Criança , Encefalite Japonesa/diagnóstico , Encefalite Japonesa/epidemiologia , Hospitalização , Humanos , Índia/epidemiologia , Simplexvirus
6.
Cureus ; 14(1): e20983, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35154959

RESUMO

Introduction Initially, coronavirus disease 2019 (COVID-19) vaccination was started in India for the elderly above 60 years of age. Adults with any comorbidity have been gradually included in the vaccination drive. It is empirical to gain insight into the satisfaction of these beneficiaries with the vaccination as it may act as an influencing factor for receiving the vaccine. Materials and methods This was a descriptive cross-sectional study carried out at the COVID-19 vaccination clinic of the Government Medical College and Hospital, Nagpur, among individuals above 60 years of age and those from 45 to 60 years of age with comorbidity. The survey tool was a predesigned structured questionnaire that had close-ended questions on various aspects of awareness about the COVID-19 vaccines and their satisfaction with the immunization center. Interviews were conducted by two interviewers on each day. Data were analyzed using open software Epi Info (CDC, Atlanta, Georgia). The chi-square test was applied as a test of significance. Results A total of 290 subjects participated in the study. The majority had correct knowledge about COVID-19 vaccination and appropriate COVID-19 behavior after vaccination. Fever and body ache were known to most of the subjects as adverse effects following immunization. Social media was the most common source of knowledge. The majority of the subjects were satisfied with the services provided at the vaccination center, but there was no difference as per age, gender, or residential status of the subjects. Conclusion Despite mixed rumors about the COVID-19 vaccine, the majority of the study subjects were well satisfied with the vaccination. They were apparently having fair awareness about the vaccine.

7.
Sci Total Environ ; 764: 142801, 2021 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-33148430

RESUMO

Whether weather plays a part in the transmissibility of the novel Coronavirus Disease-19 (COVID-19) is still not established. We tested the hypothesis that meteorological factors (air temperature, relative humidity, air pressure, wind speed and rainfall) are independently associated with transmissibility of COVID-19 quantified using the basic reproduction rate (R0). We used publicly available datasets on daily COVID-19 case counts (total n = 108,308), three-hourly meteorological data and community mobility data over a three-month period. Estimated R0 varied between 1.15 and 1.28. Mean daily air temperature (inversely), wind speed (positively) and countrywide lockdown (inversely) were significantly associated with time dependent R0, but the contribution of countrywide lockdown to variability in R0 was over three times stronger as compared to that of temperature and wind speed combined. Thus, abating temperatures and easing lockdown may concur with increased transmissibility of COVID-19 in India.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis , Humanos , Índia , Conceitos Meteorológicos , SARS-CoV-2 , Temperatura , Tempo (Meteorologia) , Vento
8.
Indian J Community Med ; 38(3): 162-7, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24019602

RESUMO

BACKGROUND: Some of the highest exposures to air pollutants in developing countries occur inside homes where biofuels are used for daily cooking. Inhalation of these pollutants may cause deleterious effects on health. OBJECTIVES: To assess the respiratory and other morbidities associated with use of various types of cooking fuels in rural area of Nagpur and to study the relationship between the duration of exposure (exposure index [EI]) and various morbidities. MATERIALS AND METHODS: A total of 760 non-smoking, non-pregnant women aged 15 years and above (mean age 32.51 ΁ 14.90 years) exposed to domestic smoke from cooking fuels from an early age, working in poorly ventilated kitchen were selected and on examination presented with various health problems. Exposure was calculated as the average hours spent daily for cooking multiplied by the number of years. Symptoms were enquired by means of a standard questionnaire adopted from that of the British Medical Research Council. Lung function was assessed by the measurement of peak expiratory flow rate (PEFR). PEFR less than 80% of the predicted was considered as abnormal pulmonary function. RESULTS AND CONCLUSIONS: Symptoms like eye irritation, headache, and diminution of vision were found to be significantly higher in biomass users (P < 0.05). Abnormal pulmonary function, chronic bronchitis, and cataract in biomass users was significantly higher than other fuel users (P < 0.05). Moreover an increasing trend in prevalence of symptoms/morbid conditions was observed with increase in EI. The presence of respiratory symptoms/morbid conditions was associated with lower values of both observed and percent predicted PEFR (P < 0.05 to 0.001). Thus women exposed to biofuels smoke suffer more from health problems and respiratory illnesses when compared with other fuel users.

10.
Indian J Physiol Pharmacol ; 57(2): 184-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24617169

RESUMO

Routine exposure to domestic cooking fuels is an important source of indoor air pollution causing deterioration of lung function. We conducted a community based cross-sectional study in 760 non-smoking rural women involved in household cooking with four types of cooking fuels i.e. Biomass, Kerosene stove, Liquid Petroleum Gas (LPG) and Mixed (combination of two and more cooking fuels). Peak Expiratory Flow Rate (PEFR) less than 80% of the predicted was considered as abnormal PEFR. The overall prevalence of abnormal PEFR was found to be 29.1% with greater predominance among biomass fuel users (43.3%) with high risk ratio (1.86) as compared to kerosene (0.63), LPG (0.75) and mixed (0.66) fuel users. However the pair wise comparison of different groups of cooking fuels by Marascuilo procedure reported significant differences within different groups except kerosene--mixed group. The study also demonstrated a negative correlation between observed PEFR and exposure indices in different cooking fuels (r = -0.51). Our results indicate that prolonged exposure to cooking fuels particularly biomass fuels as a source of cooking adversely affects PEFR in nonsmoking rural women.


Assuntos
Poluição do Ar em Ambientes Fechados , Pico do Fluxo Expiratório , Culinária , Estudos Transversais , Feminino , Humanos , Saúde da População Rural
11.
Indian J Physiol Pharmacol ; 50(1): 60-6, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16850905

RESUMO

The objectives of the present study were to study the (i) prevalence of hypertension and hearing impairment in iron and steel industry workers, (ii) association between hypertension and hearing impairment, (iii) association between hypertension and hearing impairment, with duration of exposure, and (iv) correlation between levels of sound and noise induced health problems viz. hypertension and hearing impairment in a cross sectional study involving Workers working in iron and steel industry at Nagpur. Of a total of 804 workers, 770 workers participated in the study. There were five sections in the factory; Steel melting section (SMS), rolling mill section (RMS), quality control department (QCD), maintenance department (MD) and administration department (AD). Workers working in SMS, RMS, & QCD formed a continuously exposed group (CEG); workers of MD and AD formed intermittently exposed group (IEG). Workers were interviewed, examined and information was collected in a pre-tested pro-forma. Blood pressure was measured, and tuning fork tests were done to assess hearing ability. Prevalence of hypertension among CEG (25.51%) was significantly higher than IEG (14.05%). (X2-14.28, df-1, P<0.001). There was positive association between duration of exposure and prevalence of hypertension. The prevalence of hearing impairment was significantly more in CEG (20.5%) as compared to IEG (8.91%). (X2-11.69, df-1, P<0.001). Occurrence of hearing impairment was also directly proportional to the duration of exposure. The correlation between level of sound exposure and hearing impairment was found to be significant (r=0.98; P<0.05), the correlation between level of sound and hypertension was found to be statistically insignificant (r=0.84; P>0.05). The results of the present study indicate that hypertension and hearing impairment are commoner in workers continuously exposed to high levels of occupational noise.


Assuntos
Perda Auditiva Provocada por Ruído/epidemiologia , Hipertensão/epidemiologia , Metalurgia , Ruído Ocupacional/efeitos adversos , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Estudos Transversais , Perda Auditiva Provocada por Ruído/etiologia , Humanos , Hipertensão/etiologia , Índia , Doenças Profissionais/etiologia
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