Temperature integrity and exposure of vaccines to suboptimal temperatures in cold chain devices at different levels in three states of India.

OBJECTIVE: To document the temperature integrity at the vaccine storage devices at various levels in three states of India. METHODS: A total of 213 health facilities including 196 facilities (district and sub-district levels) from 27 select districts and 17 division or state level vaccine stores in three states were included. At these facilities, temperature in 223 vaccine storage devices was recorded for at least 7 consecutive days using electronic temperature datalogger. RESULTS: During the observation period, overall the vaccines were exposed to temperature < 0 °C for 14.8% of the storage time with 8.6, 6.7 and 18% at state/division, district and sub-district vaccine stores, respectively. The vaccines were also exposed to temperature > 8 °C for 6.6% of the storage time including 1.3, 13 and 5.1% at state/division, district and sub-district vaccine stores, respectively. Continuous episodes of temperature deviation for 45 min or longer to < 0 °C and > 8 °C was observed in 7.2 and 6.4% of the observation period, respectively. These temperature deviations were not captured by the routine temperature monitoring practice. CONCLUSION: The vaccines were exposed to freezing temperature for a considerable period at all level stores, which was more than the exposure to higher temperature. To ensure vaccine potency and immunogenicity, stringent temperature integrity maintenance is needed at all levels.

A Study on MTHFR C677T Gene Polymorphism and Alcohol Dependence among Meiteis of Manipur, India.

Chronic alcohol consumption is reported to be associated with increase in plasma homocysteine levels which is further influenced by the polymorphism in methylenetetrahydrofolate reductase (MTHFR) gene. The present study aims to understand the extent of the MTHFR C677T polymorphism in alcohol dependent (AD) cases of Meiteis of Manipur, a Mendelian population of India. MTHFR C677T polymorphism was screened in 313 controls and 139 alcohol dependent (AD) cases who all met DSM-IV criteria for alcohol dependence. Both AD cases and controls were unrelated up to 1st cousin. Among the control group, different drinking patterns like abstainer/nondrinkers (NDs), occasional drinkers (ODs), and moderate drinkers (MDs) are included. Both the groups were found to be in Hardy-Weinberg equilibrium (P > 0.05). Genotypic and allelic frequency distribution of MTHFR C677T polymorphism did not differ significantly between AD cases and controls (P > 0.05). However, individuals carrying mutant (T) allele show more than 1-fold increased risk for AD though not significant (OR = 1.43; 95% CI 0.41-5.01, P > 0.05). In conclusion, MTHFR C677T polymorphism is not found to be risk marker for AD in present studied population. However, higher prevalence of the mutant T allele may exacerbate deleterious health risk in future especially among alcohol drinkers.