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Controlling the drug-resistant tuberculosis epidemic in India: challenges and implications
Aliabbas A. Husain, Andreas Kupz, Rajpal S. Kashyap
Epidemiol Health. 2021;43:e2021022.   Published online April 7, 2021
DOI: https://doi.org/10.4178/epih.e2021022
  • 15,992 View
  • 436 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
India has a higher tuberculosis (TB) burden than any other country, accounting for an estimated one-fourth of the global burden. Drug-resistant tuberculosis (DR-TB) presents a major public health problem in India. Patients with DR-TB often require profound changes in their drug regimens, which are invariably linked to poor treatment adherence and sub-optimal treatment outcomes compared to drug-sensitive TB. The challenge of addressing DR-TB is critical for India, as India contributes over 27% of global DR-TB cases. In recent decades, India has been proactive in its battle against TB, even implementing a revised National Strategic Plan to eliminate TB by 2025. However, to achieve this ambitious goal, the country will need to take a multifaceted approach with respect to its management of DR-TB. Despite concerted efforts made by the National TB Elimination Program, India faces substantial challenges with regard to DR-TB care, especially in peripheral and resource-limited endemic zones. This article describes some of the major challenges associated with mitigating the growing DR-TB epidemic in India and their implications.
Summary
Key Message
India is regarded as highest drug-resistant TB burden country accounting for estimated 27% of global cases. Challenge of addressing drug resistant TB is critical for India to achieve TB elimination targets of National TB program. Several heterogeneous factors have mediated the success of DR-TB management in India. In this article, we discuss, in brief, some of the major challenges and implications associated with reducing the growing DR-TB epidemic in India.

Citations

Citations to this article as recorded by  
  • Rifampicin-resistant Tuberculosis: A Global Health Dilemma
    Rahnuma Ahmad, Susmita Sinha, Kona Chowdhury, Mainul Haque
    Advances in Human Biology.2024; 14(2): 87.     CrossRef
  • Whole-genome sequencing of clinical isolates from tuberculosis patients in India: real-world data indicates a high proportion of pre-XDR cases
    Aparna Bhanushali, Sachin Atre, Preethi Nair, Geethanjali Anilkumar Thandaseery, Sanchi Shah, Sanjana Kuruwa, Amrutraj Zade, Chaitali Nikam, Mangala Gomare, Anirvan Chatterjee, Arryn Craney
    Microbiology Spectrum.2024;[Epub]     CrossRef
  • Double trouble: compounding effects of COVID-19 pandemic and antimicrobial resistance on drug resistant TB epidemiology in India
    Aliabbas A. Husain, Rajpal Singh Kashyap
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Snapshot of Mycobacterium tuberculosis Phylogenetics from an Indian State of Arunachal Pradesh Bordering China
    Shiv kumar Rashmi Mudliar, Umay Kulsum, Syed Beenish Rufai, Mika Umpo, Moi Nyori, Sarman Singh
    Genes.2022; 13(2): 263.     CrossRef
Original Articles
Diabetes and prediabetes prevalence among young and middle-aged adults in India, with an analysis of geographic differences: findings from the National Family Health Survey
Siddardha G. Chandrupatla, Isma Khalid, Tejdeep Muthuluri, Satyanarayana Dantala, Mary Tavares
Epidemiol Health. 2020;42:e2020065.   Published online September 18, 2020
DOI: https://doi.org/10.4178/epih.e2020065
  • 13,624 View
  • 352 Download
  • 11 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
This study aimed to approximate the prevalence of hyperglycemia in India.
METHODS
The study was conducted using the Demographic and Health Survey 2015-16 (also known as the National Family Health Survey-4), which surveyed 811,808 individuals using a stratified, multistage, cluster sampling design. This cross-sectional survey recorded socio-demographic and anthropometric data, including blood glucose levels, of adults aged 18 years to 54 years.
RESULTS
The final analysis included 718,597 individuals, of whom 49.90% (weighted) were males. The overall prevalence of diabetes was 6.65% and that of prediabetes was 5.57%. A positive association was seen with urban residence, geographic region, sex, age, body mass index, socioeconomic status, and hypertension. Approximately two-thirds of individuals with diabetes lived in urban areas, and about half of the urban population was considered overweight/obese. South India showed a higher prevalence of diabetes (prevalence ratio, 2.01; p<0.001) than northern India.
CONCLUSIONS
Hyperglycemia (diabetes and prediabetes) has a high prevalence in India and is a major public health issue. Diabetes is unevenly distributed based on geographic location and urbanization. Prevention, early detection, and treatment strategies should consider this uneven distribution of diabetes.
Summary

Citations

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  • Therapeutic Fasting and Vitamin D Levels: A New Dimension in Type 2 Diabetes Mellitus Prevention and Management—A Brief Report
    Pradeep M.K. Nair, Karishma Silwal, Prakash Babu Kodali, Gulab Rai Tewani
    Journal of Health and Allied Sciences NU.2024;[Epub]     CrossRef
  • Gestational diabetes mellitus in early pregnancy amongst Asian Indian women: Evidence for poor pregnancy outcomes despite treatment
    John Punnose, Rajeev Kumar Malhotra, Komal Sukhija, Rashika Rijhwani M, Naimaa Choudhary, Asha Sharma, Prassan Vij, Pinky Bahl
    Diabetic Medicine.2023;[Epub]     CrossRef
  • Diabetes mellitus early warning and factor analysis using ensemble Bayesian networks with SMOTE-ENN and Boruta
    Xuchun Wang, Jiahui Ren, Hao Ren, Wenzhu Song, Yuchao Qiao, Ying Zhao, Liqin Linghu, Yu Cui, Zhiyang Zhao, Limin Chen, Lixia Qiu
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  • Comparison of clinical characteristics and disease burden between early- and late-onset type 2 diabetes patients: a population-based cohort study
    Mingqi Wang, Yifei He, Qiao He, Fusheng Di, Kang Zou, Wen Wang, Xin Sun
    BMC Public Health.2023;[Epub]     CrossRef
  • ANTHROPOLOGICAL AND BIOCHEMICAL METABOLIC FACTORS IN THE NORMOGLYCEMIC, PRE-DIABETIC, AND DIABETIC METABOLIC POPULATION
    Jitender Sorout, Sudhanshu Kacker, Neha Saboo, Munesh Kumar
    Eastern Ukrainian Medical Journal.2023; 11(4): 384.     CrossRef
  • Socio-economic inequalities in diabetes and prediabetes among Bangladeshi adults
    Abdur Razzaque Sarker, Moriam Khanam
    Diabetology International.2022; 13(2): 421.     CrossRef
  • Regional estimates of noncommunicable diseases associated risk factors among adults in India: results from National Noncommunicable Disease Monitoring Survey
    Thilagavathi Ramamoorthy, Sravya Leburu, Vaitheeswaran Kulothungan, Prashant Mathur
    BMC Public Health.2022;[Epub]     CrossRef
  • Efficacy Analysis of Team-Based Nursing Compliance in Young and Middle-Aged Diabetes Mellitus Patients Based on Random Forest Algorithm and Logistic Regression
    Dongni Qian, Hong Gao, Yao Chen
    Computational and Mathematical Methods in Medicine.2022; 2022: 1.     CrossRef
  • Factors Influencing Optimal Glucose Control among Type II Diabetes Patients: From the Health Behaviour Models’ Perspective
    Eslavath Rajkumar, GT Kruthika, Padiri Angiel Ruth, R Lakshmi, Daniel Monica, John Romate, Abraham John
    The Open Public Health Journal.2022;[Epub]     CrossRef
Major enteropathogens in humans, domestic animals, and environmental soil samples from the same locality: prevalence and transmission considerations in coastal Odisha, India
Arpit Kumar Shrivastava, Nirmal Kumar Mohakud, Swagatika Panda, Saumya Darshana Patra, Subrat Kumar, Priyadarshi Soumyaranjan Sahu
Epidemiol Health. 2020;42:e2020034.   Published online May 26, 2020
DOI: https://doi.org/10.4178/epih.e2020034
  • 16,535 View
  • 160 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
Objectives
Regions with limited sanitation facilities have higher rates of infections with various enteric pathogens. It is therefore important to identify different hosts and their relative contribution to pathogen shedding into the environment, and to assess the subsequent health risks to humans.
Methods
In this study, human faecal (n=310), animal faecal (n=150), and environmental (soil) samples (n=40) were collected from the same locality and screened for selected enteric pathogens by immunochromatography and/or polymerase chain reaction.
Results
At least 1 microbial agent was detected in 49.0%, 44.7%, and 40.0% of the samples from human, animals, and soil, respectively. Among humans, rotavirus was predominantly detected (17.4%) followed by enteropathogenic <i>Escherichia coli</i> (EPEC) (15.4%), Shigella (13.8), and Shiga toxin-producing <i>E. coli</i> (STEC) (9.7%). Among animals, STEC was detected most frequently (28.0%), and EPEC was the major enteric pathogen detected in soil (30.0%). The detection rate of rotavirus was higher among younger children (≤2 years) than among older children. Single infections were more commonly detected than multiple infections in humans (p<0.01), unlike the observations in animal and soil samples. For diarrhoeagenic <i>E. coli</i> and <i>Shigella</i>, most of the human and animal isolates showed close relatedness, suggesting possible cross-infection between humans and domesticated animals in the area studied.
Conclusions
The present study provides an improved understanding of the distribution of major enteric pathogens coexisting in humans and animals in the region, thereby suggesting a high potential for possible transmission among livestock and communities residing in the studied locality.
Summary

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  • In vitro antioxidant and antidiarrheal activities of aqueous and n-hexane extracts of Cucurbita maxima seed in castor oil-induced diarrheal rats
    Habibu Tijjani, Adamu Matinja, Marwanatu Yahya, Emmanuel Aondofa, Akibu Sani
    Natural Resources for Human Health.2022; 2(2): 246.     CrossRef
Cohort Profile
Cohort profile: the Kisalaya cohort of mother-infant dyads in rural south India (2008-2012)
Smitha Chandrashekarappa, Krupa Modi, Karl Krupp, Kavitha Ravi, Anisa Khan, Vijaya Srinivas, Poornima Jaykrishna, Anjali Arun, Murali Krishna, Purnima Madhivanan
Epidemiol Health. 2020;42:e2020010.   Published online March 11, 2020
DOI: https://doi.org/10.4178/epih.e2020010
  • 11,540 View
  • 166 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Abstract
The <i>Kisalaya</i> cohort was established in 2008, providing integrated antenatal care (ANC) and human immunodeficiency virus (HIV) testing in order to reduce adverse birth outcomes and pediatric HIV infections. The program used a mobile clinic model to deliver health education, ANC, and HIV/sexually transmitted infection testing and management to pregnant women in rural communities in southern India. This cohort includes pregnant women residing in 144 villages of the Mysuru <i>taluk (a rural region) who received ANC through the mobile clinic and delivered their infants between 2008 and 2011. Of the 1,940 women registered for ANC at primary healthcare centers during this time period, 1,675 (75.6%) were enrolled in the <i>Kisalaya</i> cohort. Once women enrolled in the <i>Kisalaya</i> cohort gave birth, the cohort expanded to include the mother-infant dyads with a retention rate of 100% at follow-up visits at 15 days and at 6 months post-delivery. The baseline data collected during the <i>Kisalaya</i> study included both questionnaire-based data and laboratory-based investigations. Presently, a study entitled “<i>Early life influences on adolescent mental health: a life course study of the Kisalaya birth cohort in south India</i>” is in the process of data collection (2019-2020).
Summary

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  • Vulnerability to Sexually Transmitted Infections (STI) / Human Immunodeficiency Virus (HIV) among adolescent girls and young women in India: A rapid review
    Sohini Paul, Anupam Sharma, Radhika Dayal, Mahika Mehta, Sudeshna Maitra, Kuhika Seth, Monal Nagrath, Sowmya Ramesh, Niranjan Saggurti, Ajoke Basirat Akinola
    PLOS ONE.2024; 19(2): e0298038.     CrossRef
Original Articles
The double burden of malnutrition among adults in India: evidence from the National Family Health Survey-4 (2015-16)
Mili Dutta, Y Selvamani, Pushpendra Singh, Lokender Prashad
Epidemiol Health. 2019;41:e2019050.   Published online December 18, 2019
DOI: https://doi.org/10.4178/epih.e2019050
  • 14,956 View
  • 307 Download
  • 34 Web of Science
  • 40 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
India still faces the burden of undernutrition and communicable diseases, and the prevalence of overweight/obesity is steadily increasing. The discourse regarding the dual burden of underweight and overweight/obesity has not yet been widely explored in both men and women. The present study assessed the determinants of underweight and overweight/obesity in India among adult men and women aged 15-49.
METHODS
Population-based cross-sectional and nationally representative data from the National Family Health Survey-4 (2015-16), consisting of a sample of men and women, were analyzed. Stratified 2-stage sampling was used in the NFHS-4 study protocol. In the present study, bivariate and adjusted multinomial logistic regression analyses were performed to determine the correlates of underweight and overweight/obesity.
RESULTS
The results suggested a persistently high prevalence of underweight coexisting with an increased prevalence of overweight/obesity in India. The risk of underweight was highest in the central and western regions and was also relatively high among those who used either smoking or smokeless tobacco. Overweight/obesity was more prevalent in urban areas, in the southern region, and among adults aged 35-49. Furthermore, level of education and wealth index were positively associated with overweight/obesity. More educated and wealthier adults were less likely to be underweight.
CONCLUSIONS
In India, underweight has been prevalent, and the prevalence of overweight/obesity is increasing rapidly, particularly among men. The dual burden of underweight and overweight/obesity is alarming and needs to be considered; public health measures to address this situation must also be adopted through policy initiatives.
Summary

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Ecological context of infant mortality in high-focus states of India
Laishram Ladusingh, Ashish Kumar Gupta, Awdhesh Yadav
Epidemiol Health. 2016;38:e2016006.   Published online March 5, 2016
DOI: https://doi.org/10.4178/epih.e2016006
  • 19,174 View
  • 199 Download
  • 8 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
This goal of this study was to shed light on the ecological context as a potential determinant of the infant mortality rate in nine high-focus states in India.
METHODS
Data from the Annual Health Survey (2010-2011), the Census of India (2011), and the District Level Household and Facility Survey 3 (2007-08) were used in this study. In multiple regression analysis explanatory variable such as underdevelopment is measured by the non-working population, and income inequality, quantified as the proportion of households in the bottom wealth quintile. While, the trickle-down effect of education is measured by female literacy, and investment in health, as reflected by neonatal care facilities in primary health centres.
RESULTS
A high spatial autocorrelation of district infant mortality rates was observed, and ecological factors were found to have a significant impact on district infant mortality rates. The result also revealed that non-working population and income inequality were found to have a negative effect on the district infant mortality rate. Additionally, female literacy and new-born care facilities were found to have an inverse association with the infant mortality rate.
CONCLUSIONS
Interventions at the community level can reduce district infant mortality rates.
Summary

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Factors associated with seeking treatment for postpartum morbidities in rural India
Aditya Singh, Abhishek Kumar
Epidemiol Health. 2014;36:e2014026.   Published online October 30, 2014
DOI: https://doi.org/10.4178/epih/e2014026
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AbstractAbstract PDF
Abstract
OBJECTIVES
To understand the prevalence of postpartum morbidities and factors associated with treatment-seeking behaviour among currently married women aged 15-49 residing in rural India.
METHODS
We used data from the nationally representative District Level Household Survey from 2007-2008. Cross-tabulation was used to understand the differentials for the prevalence of postpartum morbidities and treatment-seeking behaviours across selected background characteristics. Two-level binary logistic regression was applied to understand the factors associated with treatment-seeking behaviour.
RESULTS
Approximately 39.8% of rural women suffered from at least one of the six postpartum morbidities including high fever, lower abdominal pain, foul-smelling vaginal discharge, excessive bleeding, convulsions, and severe headache. Morbidities were more prevalent among poor, illiterate, Muslim, and high-parity women. About 55.1% of these rural women sought treatment/consultation for their problems. The odds of seeking treatment/consultation increased as economic status and years of schooling among both the woman and her husband increased. Poor, uneducated, unemployed, Hindu, and tribal women were less likely to seek treatment/consultation for postpartum morbidities than their counterparts were. The odds of seeking treatment/consultation decreased as the distance to the nearest private health facility increased. Most women visited a private hospital (46.3%) or a friend/family member’s home (20.8%) for treatment/consultation. Only a small percentage visited publicly funded health institutions such as a primary health centre (8.8%), community health centre (6.5%), health sub-centre (2.8%), or district hospital (13.1%). Rural women from the northeast region of India were 50% less likely to seek treatment/consultation than women from the central region were.
CONCLUSIONS
Providing antenatal and delivery care, and ensuring nearby government healthcare facilities are available to serve rural women might increase the likelihood of care-seeking for postpartum morbidities. Targeted interventions for vulnerable groups should be considered in future policies to increase the likelihood women will seek treatment or advice postpartum.
Summary

Citations

Citations to this article as recorded by  
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Epidemiol Health : Epidemiology and Health