[show abstract][hide abstract] ABSTRACT: A multicentric quasi-experimental study was conducted in Delhi, from March 2007 to September 2007, on i) the factors which stimulate the donors to donate blood, ii) major barriers and myths associated with blood donation and iii) clinicians perception of the rational use of blood. The study design included a face-to-face survey, with a pre-tested questionnaire paper in two leading blood banks of Delhi and by relevant interviewers from the community and medical fraternity. The sample size was 240-blood donors from two different blood banks and the control group included 100 potential donors from community and 50 clinicians from various hospitals. The data generated was analyzed using excel sheet and Epi-Info software. The study revealed the factors which influence the blood donation included replacement credit and family/peer pressure. Regarding myths and barriers, among potential donors, about a quarter of them felt that it is time consuming, and 20% felt it could lead to sexual impairment or is not rewarding. A total of 10% were not aware about the blood donation while 15% said that donation time was inconvenient. Of the 50 clinicians, a quarter of them were not aware of the rational use of blood.
The Journal of communicable diseases 09/2010; 42(3):185-90.
[show abstract][hide abstract] ABSTRACT: Information Communication Technology (ICT) has proven to be a strong public health tool. Keeping the future need of country and building National Disease Surveillance System, Integrated Disease Surveillance Project (IDSP) was launched by Hon'ble Union Minister of Health & Family Welfare in November 2004. It is a decentralized, State based surveillance program in the country. It is intended to detect early warning signals of impending outbreaks and help initiate an effective response in a timely manner. One of the major components of the project is the - use of Information Technology for collection, collation, compilation, analysis and dissemination of data besides distance education and video conferencing. A network of 800 sites across India has been established through Satellite, Broadband and High end Video conferencing equipments. The network is managed by a team of data managers and data entry operators at all state surveillance units and district surveillance units respectively. The network was proven to be extremely useful to respond to the current influenza A H1N1 pandemic. It is proposed to extend the network to cover private sector and provide convergence with other National Health Programs.
The Journal of communicable diseases 06/2010; 42(2):101-10.
[show abstract][hide abstract] ABSTRACT: Rapid clinical manifestation/progression of the meningococcal meningitis and lacunae in conventional bacteriological test often encourages indiscriminate use of antibiotics much before the etiology is established. Accordingly this study was planned to evaluate ctrA PCR for rapid molecular detection. In addition, multiplex PCR and sequencing was done for serogroup prediction to provide essential epidemiological and laboratory evidence for decision makers of health department of the country for choosing appropriate vaccine and phylogenetic analysis to establish its lineage.
73 CSF samples, collected from equal number of suspected cases, were investigated by both bacteriological (microscopy, culture, LA and drug sensitivity testing) as well as molecular tests i.e. PCR targeting conserved ctrA gene, multiplex PCR for serogroup characterization and DNA sequencing.
ctrA PCR revealed sensitivity, specificity, positive predictive value and negative predictive values of 93.15%, 100%,100%, and 88.23% respectively. Multiplex PCR based genogrouping followed by DNA sequencing, BLAST and phylogenetic analysis revealed complete homology with earlier submitted Neisseria meningitidis serogroup A strain Z2491 to suggest the sole involvement of only serogroup A in the outbreak. Two strains showed resistance to cefuroxime, ciprofloxacin, nalidixic acid. Only one strain showed resistance to ciprofloxacin, emphasizing the need for a constant surveillance system.
These diagnostic molecular tools are of paramount importance in establishing etiology, serogrouping, and epidemiological surveillance especially in developing countries like India.
Iranian Journal of Microbiology 06/2010; 2(2):73-9.
[show abstract][hide abstract] ABSTRACT: Malaria has been a complex public health problem affecting mainly the poor and the rural communities in India. Insecticide treated nets (ITN) and antimalarials are the two proven interventions for prevention and control of malaria. ITN has been amply demonstrated to be an effective intervention to protect children from malaria, and in preventing deaths due to falciparum malaria. Antimalarials are a therapeutic intervention for management of malaria, and prevention of complications due to Plasmodium falciparum infection. However, implementation of these interventions is fraught with problems of complex and multidimensional nature at the periphery. These can be addressed by optimizing the use of the 2 interventions, the insecticide treated nets and antimalarials, for area specific application and country specific needs, determined by the eco-epidemiological diversity of malaria in India. This article reviews the significant role of ITN in reducing child mortality, and the judicious use of antimalarials in the management of malaria patient, and the problems associated with the use of these interventions in protecting children against malaria in India.
The Indian Journal of Pediatrics 04/2010; 77(4):425-30. · 0.72 Impact Factor
[show abstract][hide abstract] ABSTRACT: East district of Sikkim has been considered as non-endemic for lymphatic filariasis (LF). However, a LF survey conducted during 2008 revealed microfilaria rate (mf rate) of 1.2%. The LF survey was carried out in 15 randomly selected villages and urban localities of East Sikkim. Out of 3,428 night blood smears collected and examined, 42 were found positive for Wuchereria bancrofti. Microfilaria (mf) carriers were detected from 5 surveyed villages and 5 urban localities of Singtam and Rangpoo with mf rate ranging from 0.5% to 4.2%. The mean mf density was 5.4 per 20cmm3 blood. All mf carriers were residents of east district, Sikkim except two persons who were from Bihar. The detection of microfilaria in young children who had never moved from the area indicates probable indigenous transmission. Out of 15 surveyed areas LF disease was found in 11 areas with prevalence ranging from 0.4% to 7.0%.(Disease rate was 1.6%) (1.7% for Males & 1.4% for females). One local individual was found with lymphoedema and also mf positive. Vector density ranged from 70 to 435 per ten-man-hours, sufficient for transmission of LF. 712 female Cx. quinquefasciatus were dissected to detect the filarial infection and none was found positive. The present survey findings indicate endemicity of filariasis in East district of Sikkim.
The Journal of communicable diseases 03/2010; 42(1):33-7.
[show abstract][hide abstract] ABSTRACT: The re-emergence of an epidemic strain of dengue virus type-3 (DENV-3) in Delhi in 2003 and its persistence in subsequent years marked a changing trend in dengue virus circulation in this part of India. Its evolving phylogeny over the past decade has not been studied in detail as yet.
Reverse transcription polymerase chain reaction and sequencing of the CprM gene junction of DENV-3 from different outbreaks since 2003 was carried out. Thirty CprM DENV-3 sequences from this study were compared with 46 other previously reported CprM DENV-3 sequences from India and other countries. Multiple sequence alignment and phylogenetic trees were constructed to determine the extent of genetic heterogeneity and trace the phylogeny of DENV-3.
Thirty CprM DENV-3 sequences (Accession numbers AY706096-99, DQ645945-52, EU181201-14, and EU846234-36) were submitted to GenBank. The CprM junction was found to be AT rich (approximately 53%). Nucleotide sequence alignment revealed only nucleotide substitutions. Phylogenetic analysis indicated sustained evolution of a distinct Indian lineage of DENV-3 genotype III in Delhi.
Active circulation of DENV-3 genotype III over the last decade in Delhi was evident and worrying. This genotype has been implicated in several outbreaks in South-East Asia and other parts of the world.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 02/2010; 43(1):53-61. · 1.63 Impact Factor
[show abstract][hide abstract] ABSTRACT: Andaman & Nicobar Islands (Indian Territory) are situated in the Bay of Bengal and endemic for malaria with perennial transmission. Anopheles sundaicus which prefers to breed in brackish water, is known as the main vector for malaria and maintains high endemicity of malaria. Tsunami waves entered the inhabited coastal areas, caused heavy devastation and left large areas inundated causing exceptionally high breeding sources for vector mosquitoes of malaria. The disaster created a new habitat suitable for the proliferation of malaria and other disease-carrying mosquitoes besides making thousands of people homeless. They were living in temporary open shelters, getting more exposed to mosquito bites. The population already had existing high parasite load. Hence, there was a real threat of malaria outbreak in the area. However, malaria was effectively controlled due to strategic planning and timely remedial measures. Malaria situation was monitored closely and epidemiological data of three subsequent years from 2005 to 2007 after tsunami were analysed and compared with pre-tsunami malaria data from 1986 to 2004. In this paper, effect of tsunami on malaria profile in these islands has been discussed along with action taken for its control.
[show abstract][hide abstract] ABSTRACT: Glutathione S-transferases (GSTs), protect cells from reactive chemical intermediates and oxidative stress. Among different classes of GSTs, GSTM1 (Mu) and GSTT1 (theta) are found to be genetically deleted. Present study was intended to genotype homozygous null distribution of GSTM1 and GSTT1 in healthy individuals of Delhi, located in Northern India. Out of 309 healthy individuals included in this study, we have found genetic deletion in 21% and 27.4%, GSTM1 and GSTT1 genes, respectively. A small proportion (0.7%) population showed deletion of both the genes. The prevalence of the GSTM1(*)0/0 and GSTT1(*)0/0 genotypes varied within India compared to communities in Chinese, Japanese, Korean and Caucasian.
Environmental Toxicology and Pharmacology 07/2009; 28(1):25-9. · 2.01 Impact Factor
[show abstract][hide abstract] ABSTRACT: Red Baby Syndrome is a new disease seen in infants and young children. Dramatic onset of clinical symptoms with high intensity, short duration and lack of similarity with other cutaneous lesions makes it distinct. Of 50 such patients studied over a period of 5 years, half were below one year of age. Abrupt onset of high fever and generalized erythema involving the entire skin, which is swollen and tender is characteristic. These children were highly irritable and had paradoxical cry when cuddled. Rapid resolution of symptoms occurred in 7-10 days with extensive desquamation. Routine investigations were normal, C-reactive protein was raised only in 10 patients. Human Parvo virus B-19 IgM antibodies were positive in 15 out of 24 patients. Real time polymerase chain reaction was positive for human parvovirus B 19 DNA in one. Histopathological changes in the skin biopsy showed post infectious vascular injury pattern.
The Indian Journal of Pediatrics 04/2009; 76(3):309-12. · 0.72 Impact Factor
[show abstract][hide abstract] ABSTRACT: Lucknow district was endemic for lymphatic filariasis (LF). During March 2008, LF survey was carried out in 14 randomly selected villages (six Primary Health Centres) and 4 Mohallas of Lucknow city. Out of 3,654 night blood smears (NBS) collected and examined, 209 were found positive for Wuchereria bancrofti (micrifilaria rate: 5.7%). Microfilaria (mf) carriers were detected from all surveyed villages and Mohallas. The age of these positive persons ranged from 6-70 years. In all areas, prevalence of microfilaraemia generally increased with age up to 21-30 years. Males (6.7%) were more affected than females (3.9%). All mf carriers were residents of Lucknow district. Overall disease rate was 4.7%. In all, 175 individuals had disease manifestations of LF. Out of 108 males, 81 had hydrocele(75%). Disease rate was similar in males (4.7%) and females (4.8%). The mean mf density was 9.5 per 20 cmm blood, but no significant difference between males (9.4) and females (9.9). Vector density ranged from 150 to 810 per ten-man-hours. Infectivity and infection rates were 0.14%. The present survey indicates that filariasis is one of the major public health problems in surveyed areas.
The Journal of communicable diseases 03/2009; 41(1):39-44.
[show abstract][hide abstract] ABSTRACT: Samples from babies exhibiting clinical symptoms suggestive of congenital infection are referred regularly to NICD, New Delhi,, from Government Hospitals located in Delhi and a home for abandoned children (Palna), for the diagnosis of etiological agents like toxoplasma, rubella, CMV and herpes. Blood samples of mothers of most of the affected babies are also received.
Evaluation of rapid and accurate technique for the diagnosis of congenital CMV infection.
One hundred and twenty five blood samples suggestive of symptomatic congenital CMV infection were selected from samples received at NICD during the period June 2005-March 2007. A request to collect and send the urine samples of the selected babies was sent to the respective hospitals. Serum samples of the babies were tested for CMV-IgM antibodies using micro-capture ELISA. Mothers' serum samples were subjected to CMV-IgM and IgG class antibodies assay by commercial ELISA kits. DNA isolation and amplification was performed in urine samples and some of the serum samples using a commercial PCR kit for detection of HCMV. Blood and urine samples from 20 normal babies were included in the study.
Twenty Seven serum samples (21.6%) of infants, of the 125 tested, were positive for CMV-IgM antibodies. Twenty five samples (20%) showed amplification of CMV-DNA. All 25 samples positive for PCR were positive for CMV IgM antibodies. Sera of 73 mothers, out of 75 tested (97.3%), were positive for CMV IgG antibodies. However, none of them was positive for CMV IgM antibodies. Mothers of all 27 positive babies were positive for CMV-IgG antibodies. Serum and urine samples from 20 normal babies were negative for ELISA and PCR.
micro-capture ELISA technique was found to be more sensitive than PCR (92.6%) for detection of congenital CMV infection. ELISA is also rapid, less cumbersome and cost effective for diagnosis of CMV infection.
Indian journal of medical microbiology 01/2009; 27(3):222-5.
[show abstract][hide abstract] ABSTRACT: Because of the emergence of multidrug-resistant tuberculosis in recent times, the rapid detection of resistance to the first-line anti-tuberculosis drug rifampicin was felt worldwide. Accordingly, this study was conducted to evaluate the diagnostic potential of polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) for checking its utility as a rapid screening test for determination of rifampicin drug resistance.
A total of 34 isolates of Mycobacterium tuberculosis (M. tuberculosis) (22 rifampicin resistant, 11 rifampicin sensitive and one control H37Rv) strains were analysed by PCR-SSCP and DNA sequencing within the 157-bp region of the rpo B gene (Ala 500-Val 550).
Rifampicin resistance was detected successfully by PCR-SSCP in 20/22(90.90%) of rifampicin-resistant strains showing a total of nine different mutations in seven codon positions: codon 513 (CAA-->CCA), 516 (GAC-->GTC), 507 (GGC-->GAC), 526 (CAC-->GAC, TAC), 531 (TCG-->TTG, TGG), 522 (TCG-->TGG) and 533 (GTG-->CCG). Two rifampicin-resistant strains showed an identical PCR-SSCP pattern with the wild type H37Rv; 77.27% rifampicin-resistant strains showed a single point mutation and 9.09% had no mutation. Three rifampicin-resistant strains showed characteristic double mutations at codon positions 526 and 531. Sensitivity and specificity were calculated as 90.90% and 100%.
Rifampicin-resistant genotypes were mainly found in codon positions 516, 526 and 531. PCR-SSCP seems to be an efficacious method of predicting rifampicin resistance and substantially reduces the time required for susceptibility testing from 4 to 6 weeks to a few weeks.
Indian journal of medical microbiology 01/2009; 27(3):226-30.
[show abstract][hide abstract] ABSTRACT: Dengue virus type 1 (DENV-1) have been mostly circulating silently with dominant serotypes DENV-2 and DENV-3 in India. However recent times have marked an increase in DENV-1 circulation in yearly outbreaks. Many studies have not been carried out on this virus type, leaving a lacunae pertaining to the circulating genotypes, since its earliest report in India. In the present study, we sequenced CprM gene junction of 13 DENV-1 isolated from Delhi and Gwalior (North India) between 2001-2007 and one 1956 Vellore isolate as reference. For comparison, we retrieved 11 other Indian and 70 global reference sequences from NCBI database, making sure that Indian and global isolates from all decades are available for comparative analysis.
The region was found to be AT rich with no insertion or deletion. Majority of the nucleotide substitutions were silent, except 3 non-conservative amino acid changes (I --> T, A --> T and L --> S at amino acid positions 59,114 and 155 respectively) in the Indian DENV-1 sequences, sequenced in this study. Except two 1997-98 Delhi isolates, which group in genotype I; all other Indian isolates group in genotype III. All Indian genotype III DENV-1 exhibited diversity among them, giving rise to at least 4 distinct lineages (India 1-4) showing proximity to isolates from diverse geographic locations.
The extensive phylogenetic analysis revealed consistent existence of multiple lineages of DENV-1 genotype III during the last 5 decades in India.