Manoj Das

• MBBS, MD
• Director Projects at The INCLEN Trust International, New Delhi

This article presents an overview of the main challenges and lessons learned that were presented during the symposia organized by the Coalition to Strengthen the HPV Immunization Community (CHIC) in Africa and South Asia in 2022. Discussions at these meetings revolved around introduction, planning, implementation, and sustainability of HPV preventi...

Biomedical research collaborations are to be contextualized in the larger global health agenda which also opens up new information pathways, expands research networks, and brings additional resources. A qualitative inquiry was employed to understand the perceived benefits and challenges of research collaborations by biomedical scientists from India...

Background: Infected wounds pose a special challenge for management, with an increased risk of wound chronicity, systemic infection, and the emergence of antibiotic resistance. Silver nanoparticles have multimodal effects on bacteria clearance and wound healing. This study aimed to document the efficacy of a topical silver nanoparticle-based cream...

Here we conducted a multicenter open-label, randomized phase 2 and 3 study to assess the safety and immunogenicity of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-specific (BA.1/B.1.1.529), monovalent, thermostable, self-amplifying mRNA vaccine, GEMCOVAC-OM, when administered intradermally as a booster in healthy adults wh...

Both developed and developing countries carry a large burden of pediatric intussusception. Sentinel site surveillance-based studies have highlighted the difference in the regional incidence of intussusception. The objectives of this manuscript were to geospatially map the locations of hospital-confirmed childhood intussusception cases reported from...

Over the past several years, the Muzaffarpur district of Bihar (India) has witnessed recurrent outbreaks of acute encephalitis illness of unknown etiology, called acute encephalitis syndrome (AES) among young children, especially during the peak-summer season. Pesticide exposure, viral encephalitis, and litchi toxin intake have all been postulated...

Both developed and developing countries carry a large burden of pediatric intussusception. Epidemiological studies conducted so far have highlighted the huge difference in the regional prevalence of intussusception cases. Through the lens of interdisciplinary exploratory geospatial analysis this manuscript attempts to relook at the regional prevale...

Although vaccines are one of the most rigorously tested biological products, the safety concerns persist globally. The vaccine safety concerns linked to measles, pentavalent and human papillomavirus (HPV) vaccines have affected the vaccine coverage significantly in past. While surveillance of adverse events following immunization (AEFI) is part of...

Background: Periodic outbreaks of acute encephalopathy in children have been reported from Muzaffarpur, Bihar, India. No infectious cause has been identified for this. This study presents the clinical and metabolic profile of children hospitalized with acute encephalopathy and the potential role of ambient heat stress. Methods: This cross-sectional...

Background Home visitation has emerged as an effective model to provide high-quality care during pregnancy, childbirth, and post-natal period and improve the health outcomes of mother- new born dyad. This 360⁰ assessment documented the constraints faced by the community health workers (known as the Accredited Social Health Activists, ASHAs) to acco...

Background The novel coronavirus disease (COVID-19) has become pandemic. For effective disease control, quarantine of the infected and exposed cases for an optimal period is critical. Currently, infected individuals are quarantined for 14 days. We tried to check if the quarantine period practiced is optimal in the Indian context. Methods This cross...

With the recognition of different population behavior and relevance of socio-cultural factors in health, health services and public health program contexts, qualitative research is increasingly being used in health research, including clinical trials. Qualitative research follows an inductive framework to explore and gain an in-depth understanding...

Background: India has the largest burden of drug-resistant organisms compared with other countries around the world, including multiresistant and extremely drug-resistant tuberculosis and resistant Gram-negative and Gram-positive bacteria. Antibiotic resistant bacteria are found in all living hosts and in the environment and move between hosts and...

Aim: This study aimed to the status of the nurses and midwives human resource and training institutes in India and variations across states. Method: This cross-sectional study collected information available from open sources (all data for the states) and supplemented with grey literature, as of 2019. The census population data were used for est...

Objectives Despite periodic outbreaks, the causes and risk factors of acute encephalitis syndrome (AES) in children of Muzaffarpur, Bihar, India, remain unknown. We explored the correlation between AES caseload and the climate parameters. Methods Data for 1318 hospitalized children with AES during 2012–20 were used. The correlation between AES cas...

Multicenter studies are essential in clinical and public health research with several advantages compared to single-center studies. Multicenter studies are attractive and advantageous allowing quicker recruitment, diverse population coverage and increased generalizability. However, these studies often suffer from methodological, implementation and...

Plain English summary Information about exact cause of death and stillbirth are essential for appropriate care of children and pregnant women. Autopsy assists in establishing exact cause of death, but not preferred by the parents/families. Minimally invasive tissue sampling (MITS) is a suitable alternate to autopsy for establishing causes of death...

The first 1000 days are critical for human development. Children residing in urban slums are at higher risk of suboptimal development. This article reports the feasibility and early implementation experiences of child stimulation directed counselling integrated with nutrition and health services by community functionaries in Delhi slums. This imple...

The COVID‑19 pandemic has spread globally with 190.8 million infected cases and 4.1 million deaths as of July 18, 2021. In absence of any definite antiviral agent availability and therapeutic armamentarium, vaccines are considered critical. While 20 vaccines are in use, about 295 vaccines are underdevelopment globally using eleven technological pla...

Plain language summary India tops the chart of childhood deaths and stillbirths globally. The causes of many childhood deaths and stillbirths remain unknown or ill-defined in India. For planning the health policies, program and clinical practices, the cause of death (CoD) and stillbirth are primarily determined by verbal autopsy (VA) method, which...

With the recognition of different population behavior and relevance of socio-cultural factors in health, health services and public health program contexts, qualitative research is increasingly being used in health research, including clinical trials. Qualitative research follows an inductive framework to explore and gain an in-depth understanding...

Introduction Improving quality of care (QoC) for childbirth and sick newborns is critical for maternal and neonatal mortality reduction. Information on the process and impact of quality improvement at district and sub-district hospitals in India is limited. This implementation research was prioritized by the Haryana State (India) to improve the QoC...

With no definite therapeutic or preventive drug against COVID-19 virus, vaccine is critical to disrupt the pandemic. Two vaccines have received emergency use authorization in America and Europe and two vaccine in India. Indian introduced COVID-19 vaccination on January 16, 2021. Despite severe disruption of the lifestyle, socioeconomic activities a...

Objective To report background intussusception epidemiology in children under-two years in Coimbatore district of Tamil Nadu state, India, prior to rotavirus vaccine (RVV) introduction.Methods Prospective sentinel surveillance was done at four hospitals in Coimbatore during April 2016 to September 2017. The children aged >1 mo and < 24 mo with diag...

Objectives: To document and share the process of establishing the nationally representative multisite surveillance network for intussusception in India, coordination, data management and lessons learnt from the implementation. Design: This study combined both retrospective and prospective surveillance approaches. Setting: 19 tertiary care institut...

Objectives The study aimed to document the association between intussusception in Indian children and meteorological parameters and examine regional variations. Design A bidirectional (retrospective and prospective) surveillance between July 2010 and September 2017. Setting At 20 hospitals in India, retrospective case record review during July 20...

Objectives: The study aimed to document the association between intussusception in Indian children and meteorological parameters and examine regional variations. Design: A bidirectional (retrospective and prospective) surveillance between July 2010 and September 2017. Setting: At 20 hospitals in India, retrospective case record review during July 2...

Background Parents of dying children face unique challenge and expect compassionate support from health care providers (HCPs). This study explored the experiences of the parents and HCPs about the end-of-life care and breaking bad news and related positive and negative factors in Indian context. Methods This qualitative exploratory study was condu...

This is a Brighton Collaboration Case Definition of the term “Acute Respiratory Distress Syndrome - ARDS” to be utilized in the evaluation of adverse events following immunization. The Case Definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of va...

Background Grief following stillbirth and child death are one of the most traumatic experience for parents with psychosomatic, social and economic impacts. The grief profile, severity and its impacts in Indian context are not well documented. This study documented the grief and coping experiences of the Indian parents following stillbirth and child...

Background The immunization coverage progress in India is relatively slower than anticipated. The rising internet and media penetration and online news contents are likely to shape the public vaccine sentiments and attitude. The measles-rubella immunization campaign in India experienced challenges in some states due to the social media and messagin...

Background: The immunization coverage progress in India is relatively slower than anticipated. The rising internet and media penetration and online news contents are likely to shape the public vaccine sentiments and attitude. The measles-rubella immunization campaign in India experienced challenges in some states due to the social media and messagi...

Background: Intussusception is an adverse event associated with rotavirus vaccines (RVV). RVV was introduced phasewise in India since April 2016. Background intussusception rates are needed to document changes with RVV introduction. We describe the epidemiology of intussusception among children aged under-two years in Odisha, India. Methods: This b...

Background: India has the largest burden of drug-resistant organisms compared with other countries around the world, including multiresistant and extremely drug-resistant tuberculosis and resistant Gram-negative and Gram-positive bacteria. Antibiotic resistant bacteria are found in all living hosts and in the environment and move between hosts and...

Background: India has the largest burden of drug‑resistant organisms compared with other countries around the world, including multiresistant and extremely drug‑resistant tuberculosis and resistant Gram‑negative and Gram‑positive bacteria. Antibiotic resistant bacteria are found in all living hosts and in the environment and move between hosts and...

Background: An association between rotavirus vaccination and intussusception has been documented in post-licensure studies in some countries. We evaluated the risk of intussusception associated with monovalent rotavirus vaccine (Rotavac) administered at 6, 10 and 14 weeks of age in India. Methods: Active prospective surveillance for intussuscept...

Background: India contributes the highest share of under-five and neonatal deaths and stillbirths globally. Diagnostic autopsy, although useful for cause of death identification, have limited acceptance. Minimally invasive tissue sampling (MITS) is an alternative to autopsy for identification of the cause of death (CoD). A formative research linke...

Abstract Background India introduced rotavirus vaccines (RVV, monovalent, Rotavac™ and pentavalent, Rotasiil™) in April 2016 with 6, 10 and 14 weeks schedule and expanded countrywide in phases. We describe the epidemiology of intussusception among children aged 2–23 months in India. Methods The prospective surveillance at 19 nationally representati...

Background: Social, behavioural and community engagement (SBCE) interventions are essential for global maternal, newborn and child health (MNCH) strategies. Past efforts to synthesise research on SBCE interventions identified a need for clear priorities to guide future research. WHO led an exercise to identify global research priorities for SBCE i...

BACKGROUND India has the largest burden of drug‑resistant organisms compared with other countries around the world, including multiresistant and extremely drug‑resistant tuberculosis and resistant Gram‑negative and Gram‑positive bacteria. Antibiotic resistant bacteria are found in all living hosts and in the environment and move between hosts and e...

Objective Intussusception has been linked with rotavirus vaccine (RVV) as a rare adverse reaction. In view of limited background data on intussusception in India and in preparation for RVV introduction, a surveillance network was established to document the epidemiology of intussusception cases in Indian children. Methods Intussusception in childr...

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...

The whole globe is reeling under the COVID‑19 pandemic now. With the scale and severity of infection, number of deaths and lack of any definite therapeutic armamentarium, the vaccine development has been accelerated at a never‑before pace. A wide variety of vaccine technologies and platforms are being attempted. Out of the over 108 efforts, 100 are...

Pediatrician's Viewpoint This commentary presents the relevance of the findings of an article published with citation "Ojha S, Szatkowski L, Sinha R, Yaron G, Fogarty A, Allen SJ, et al. Rojiroti microfinance and child nutrition: A cluster randomized trial. Arch Dis Child. 2020;105:229-35."

Aims: This project tests a novel, targeted home visitation program for child development targeted behaviour change during first 1000 days for families in Delhi urban slums. Background: First 1000 days have highest brain development potential and is dependent on the available nutrition, health, social and cognitive stimulus. Over 1.3 million childre...

The objective of this cluster randomized trial was to determine if Rojiroti microfinance, for poor Indian women in the state of Bihar, improves child nutrition. Women with children under 5 years formed self-help groups, and saved their money to provide loans to group members. After an interval of 6 months, they received larger external loans and to...

Background: Government of India is introducing new and relatively costly vaccines under immunization program. Monitoring of vaccine wastage is needed to guide the program implementation and forecasting. Under pilot introduction of rotavirus vaccine in two districts both 5- and 10-doses vials were used, which was considered as an opportunity for do...

Background: Safety of pentavalent (DTwP-HBV-Hib) vaccine has been a public concern in India and other countries. This study attempted to document the association of serious adverse events following immunization (AEFI, including hospitalizations and deaths of all causes) with the 3 doses of pentavalent and oral poliovirus (OPV) vaccines. Methods: A...

This article is a response to the Letter in BMJ with reference "Doctors criticise Indian government’s advice to delay oxytocin at childbirth. BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6611 (Published 20 November 2019).

The article provides the definition for Neonatal Seizures for collection of of neonatal and vaccine safety research.

Background Government of India is introducing new and relatively costly vaccines under immunization program. Monitoring of vaccine wastage is needed to guide the program implementation and forecasting. Under pilot introduction of rotavirus vaccine in two districts both 5- and 10-doses vials were used, which was considered as an opportunity for docu...

As part of the Smart Safety Surveillance for vaccines, India focused on the newly introduced Rotavirus vaccines and has available safety data from various sources. As part of special safety/impact studies, data are being collected at various sites including sentinel sites such as AEFI Secretariat (Immunization Division) Ministry of Health and Famil...

Background: Millennium Development Goal 4 (MDGs) mobilised countries to reduce child mortality by two thirds the 1990 rate in 2015. While India did not reach MDG 4, it considerably reduced child mortality in the MDG-era. Efficient and targeted interventions and adequate monitoring are necessary to further progress in improvements to child health....

Introduction Coping occurs when health system personnel must make additional, often undocumented efforts to compensate for existing system and management deficiencies. While such efforts may be done with good intentions, few studies evaluate the broader impact of coping. Methods We developed a computational simulation model of Bihar, India’s routi...

Objective: Electronic fetal monitoring (EFM) using cardiotocograph (CTG) is commonly used both to assess fetal wellbeing in late antepartum and for intervention during intrapartum period. We validated the performance of indigenously developed mobile cardiotocograph (CTG) device with wireless probes compared to standard CTG device. Materials and met...

Objective To compare the preductal oxygen saturation (SpO2) and heart rate (HR) in newborns during the initial 5 minutes after birth with delayed cord clamping (DCC) and early cord clamping (ECC) practices at sea level. Study Design This prospective observational study included newborns born at >34 weeks vaginally (Dharampur, Gujarat) or through ca...

Objective: To document the impact of neonatal resuscitation capacity building of birth attendants at district and sub-district level on fresh stillbirth within the public health system in India. Design: An implementation research using pre-post study design. Setting: 3 high-infant and neonatal mortality districts (Gonda, Aligarh and Raebareli)...

Background.: All ethics committees (ECs) that review and monitor clinical trials in India must be registered with the regulatory authority. We ascertained the status of registration and re-registration of ECs till December 2017. Methods.: The ECs registered and re-registered with the Indian regulatory authority till December 2017 were extracted....

Objective: To compare the preductal oxygen saturation (SpO2) and heart rate (HR) in newborns during the initial 5 minutes after birth with delayed cord clamping (DCC) and early cord clamping (ECC) practices at sea level. Study Design: This prospective observational study included newborns born at >34 weeks vaginally (Dharampur, Gujarat) or through...

Objective: To document the impact of neonatal resuscitation capacity building of birth attendants at district and sub-district level on fresh stillbirth within the public health system in India. Design: An implementation research using pre-post study design. Setting: 3 high-infant and neonatal mortality districts (Gonda, Aligarh and Raebareli) of U...

Objectives: This paper concerns a systematic analysis of dengue illness and costs in India from 2013 to 2016. A previous study for 2006-2012 found that that projected annual number of dengue cases (5.78 million) was 282 times the officially reported number (20,474), highlighting enormous uncertainty. Methods: This study updated primary data for Ind...

Background Around 5.4 million under-five deaths occur globally annually. Over 2.5 million neonatal deaths and an equivalent stillbirths also occur annually worldwide. India is largest contributor to these under-five deaths and stillbirths. To meet the National Health Policy goals aligned with sustainable development targets, adoption of specific st...

The Intensified Mission Indradhanush strategy showed that cross-sectoral participation can increase vaccination rates in children at high risk. Strengthening of the system and practice changes could make it more effective. Sustained high level political support, advocacy, and supervision across sectors, together with flexibility to reallocate finan...

Objectives To develop and assess Pediatric Appropriateness Evaluation Protocol for India (PAEP-India) for inter-rater reliability and appropriateness of hospitalization. Design Cross-sectional study. Setting The available PAEP tools were reviewed and adapted for Indian context by ten experienced pediatricians following semi-Delphi process. Two PA...

Background Outreach sessions constitute a major share of routine immunization service under national program in India. Objective To document the organisation, logistics, vaccine handling and services delivered during outreach sessions in India. Method This cross-sectional study was undertaken at 136 outreach sessions across 27 districts in three...

Temperature excursion and exposure to sub‑zero temperatures may reduce the potency of the freeze‑sensitive vaccines. This study assessed temperature during vaccine transfers at various levels under the Universal Immunization Program. This cross‑sectional study undertaken in 21 districts of three states of India – Bihar (n = 8), Kerala (n = 8), and...

Background: Inadequate administrative health data, suboptimal public health infrastructure, rapid and unplanned urbanization, environmental degradation, and poor penetration of information technology make the tracking of health and well-being of populations and their social determinants in the developing countries challenging. Technology-integrated...

Introduction: Vitamin D deficiency is an issue of concern in the Asian population. In the light of the fact that breast milk is an inadequate source of vitamin D, supplementation becomes essential for all term healthy babies for healthy peak bone mass. However, there is a lack of guidelines and research on this issue in India. Aim: To document chan...

Background: The media news influence shapes the public sentiments and behaviour. The recent experiences indicate significant influence of online news and social media on immunization behaviour in India. The objective was to study the profile and sentiments of online media news on vaccine and vaccination in India. Methods: We searched the online new...

Background Neurodevelopmental disorders (NDDs) compromise the development and attainment of full social and economic potential at individual, family, community, and country levels. Paucity of data on NDDs slows down policy and programmatic action in most developing countries despite perceived high burden. Methods and findings We assessed 3,964 chi...

Aim This implementation research aims to improve quality of care for mothers and newborns in three districts of Haryana, India at different public health facilities. Background The decline in key maternal and newborn health indicators in India is relatively slower than expected and missed the millennium development goals. The multi‐fold rise in in...

Background: Neonatal death remains a global challenge contributing to 45% of underfive deaths. With rising institutional delivery, to accelerate decline in neonatal mortality rate (NMR) improvement in the quality of perinatal care requires attention. Objectives: This implementation research targeted improving service delivery readiness for quality...

India has recently introduced a rotavirus vaccine under a universal immunization program. There is limited information on intussusception, an adverse event, following immunization in children from India. We are conducting sentinel surveillance for intussusception in children aged under two years at 19 hospitals. The sentinel sites' selection follow...

Background: Despite significant progress in reduction in neonatal mortality, perinatal mortality in India is relatively stagnant. There is also mismatch between quantitative gain in the institutional delivery and reduction in maternal and perinatal mortality. Quality of care has emerged as a critical determinant of facility level care for perinatal...

In India, research prioritization in Maternal, Newborn, and Child Health and Nutrition (MNCHN) themes has traditionally involved only a handful of experts mostly from major cities. The Indian Council of Medical Research (ICMR)-INCLEN collaboration undertook a nationwide exercise engaging faculty from 256 institutions to identify top research priori...

Background: Outreach sessions constitute a major share of routine immunization service under national program in India. Objective: To document the organisation, logistics, vaccine handling and services delivered during outreach sessions in India. Method: This cross-sectional study was undertaken at 136 outreach sessions across 27 districts in three...

Objective: To document the prevalence of non-alcoholic fatty liver disease (NAFLD) and metabolic parameters among normalweight and overweight schoolchildren. Study design: Cross-sectional study. Setting: Thirteen private schools in urban Faridabad, Haryana. Participants: 961 school children aged 5-10 years. Methods: Ultrasound testing was done, and...

Background: Retention of neonatal resuscitation skill among birth attendants have been a challenge in developing countries. The objective of the study was to document the performance of skill labs and its impact on the skill and knowledge of the birth attendants in India.Methods: In three districts of Uttar Pradesh, impact assessment of twelve skil...

Rationale: Assured quality vaccines and safe immunization practices are pre-requisite to successful immunization programs. All vaccines go through stringent safety checks during pre-licensure stage. Adverse Events Following Immunization (AEFI) Surveillance program is an integral part of routine immunization program in India to monitor the vaccine...

Background: Blood pressure in children is a known predictor cardiovascular health and outcome in adulthood. Prevalence of hypertension in Indian adults is rising over the years. It is anticipated that the blood pressure in Indian children might have also increased over the years. This study was undertaken to document the prevalence of hypertension...

Background Health research in low– and middle– income countries (LMICs) is often driven by donor priorities rather than by the needs of the countries where the research takes place. This lack of alignment of donor’s priorities with local research need may be one of the reasons why countries fail to achieve set goals for population health and nutrit...

In India, research prioritization in Maternal, Newborn, and Child Health and Nutrition (MNCHN) themes has traditionally involved only a handful of experts mostly from major cities. The Indian Council of Medical Research (ICMR)-INCLEN collaboration undertook a nationwide exercise engaging faculty from 256 institutions to identify top research priori...

In India, research prioritization in Maternal, Newborn, and Child Health and Nutrition (MNCHN) themes has traditionally involved only a handful of experts mostly from major cities. The Indian Council of Medical Research (ICMR)-INCLEN collaboration undertook a nationwide exercise engaging faculty from 256 institutions to identify top research priori...

Phenomena of thrifty phenotype and thrifty genotype, due to conditioning of intrauterine growth as a response to the nutritional and physical environment and selection of genetics of some population over some time to a deprived situation, makes individuals permanently highly susceptible for some diseases like emerging lifestyle and chronic diseases...