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  1. Article ; Online: Quality of active case-finding for tuberculosis in India

    Hemant Deepak Shewade / G. Kiruthika / Prabhadevi Ravichandran / Swati Iyer / Aniket Chowdhury / S. Kiran Pradeep / Kathiresan Jeyashree / S. Devika / Joshua Chadwick / Jeromie Wesley Vivian / Dheeraj Tumu / Amar N. Shah / Bhavin Vadera / Venkatesh Roddawar / Sanjay K. Mattoo / Kiran Rade / Raghuram Rao / Manoj V. Murhekar

    Global Health Action, Vol 16, Iss

    a national level secondary data analysis

    2023  Volume 1

    Abstract: Background India has been implementing active case-finding (ACF) for TB among marginalised and vulnerable (high-risk) populations since 2017. The effectiveness of ACF cycle(s) is dependent on the use of appropriate screening and diagnostic tools and ... ...

    Abstract Background India has been implementing active case-finding (ACF) for TB among marginalised and vulnerable (high-risk) populations since 2017. The effectiveness of ACF cycle(s) is dependent on the use of appropriate screening and diagnostic tools and meeting quality indicators. Objectives To determine the number of ACF cycles implemented in 2021 at national, state (n = 36) and district (n = 768) level and quality indicators for the first ACF cycle. Methods In this descriptive study, aggregate TB program data for each ACF activity that was extracted was further aggregated against each ACF cycle at the district level in 2021. One ACF cycle was the period identified to cover all the high-risk populations in the district. Three TB ACF quality indicators were calculated: percentage population screened (≥10%), percentage tested among screened (≥4.8%) and percentage diagnosed among tested (≥5%). We also calculated the number needed to screen (NNS) for diagnosing one person with TB (≤1538). Results Of 768 TB districts, ACF data for 111 were not available. Of the remaining 657 districts, 642 (98%) implemented one, and 15 implemented two to three ACF cycles. None of the districts or states met all three TB ACF quality indicators’ cut-offs. At the national level, for the first ACF cycle, 9.3% of the population were screened, 1% of the screened were tested and 3.7% of the tested were diagnosed. The NNS was 2824: acceptable (≤1538) in institutional facilities and poor for population-based groups. Data were not consistently available to calculate the percentage of i) high-risk population covered, ii) presumptive TB among screened and iii) tested among presumptive. Conclusion In 2021, India implemented one ACF cycle with sub-optimal ACF quality indicators. Reducing the losses between screening and testing, improving data quality and sensitising stakeholders regarding the importance of meeting all ACF quality indicators are recommended.
    Keywords operational research ; tb acf cycle ; number needed to screen ; tb acf quality indicators ; high-risk groups ; india ; Public aspects of medicine ; RA1-1270
    Subject code 001
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher Taylor & Francis Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Burden of congenital rubella syndrome (CRS) in India based on data from cross-sectional serosurveys, 2017 and 2019-20.

    Devika Shanmugasundaram / Shally Awasthi / Bhagirathi Dwibedi / S Geetha / Manish Jain / Shikha Malik / Bhupeshwari Patel / Himabindu Singh / Shalini Tripathi / Rajlakshmi Viswanathan / Anjoo Agarwal / Rajeswari Bonu / Shuchi Jain / Saubhagya Kumar Jena / J Priyasree / K Pushpalatha / Syed Ali / Debasis Biswas / Amita Jain /
    Rahul Narang / Sudha Madhuri / Suji George / Ojas Kaduskar / G Kiruthika / R Sabarinathan / Gajanan Sapakal / Nivedita Gupta / Manoj V Murhekar

    PLoS Neglected Tropical Diseases, Vol 15, Iss 7, p e

    2021  Volume 0009608

    Abstract: Background India has set a goal to eliminate measles and rubella/Congenital Rubella Syndrome (CRS) by 2023. Towards this goal, India conducted nationwide supplementary immunization activity (SIA) with measles-rubella containing vaccine (MRCV) targeting ... ...

    Abstract Background India has set a goal to eliminate measles and rubella/Congenital Rubella Syndrome (CRS) by 2023. Towards this goal, India conducted nationwide supplementary immunization activity (SIA) with measles-rubella containing vaccine (MRCV) targeting children aged between 9 months to <15 years and established a hospital-based sentinel surveillance for CRS. Reliable data about incidence of CRS is necessary to monitor progress towards the elimination goal. Methods We conducted serosurveys in 2019-20 among pregnant women attending antenatal clinics of 6 hospitals, which were also sentinel sites for CRS surveillance, to estimate the prevalence of IgG antibodies against rubella. We systematically sampled 1800 women attending antenatal clinics and tested their sera for IgG antibodies against rubella. We used rubella seroprevalence data from the current survey and the survey conducted in 2017 among antenatal women from another 6 CRS surveillance sites to construct a catalytic models to estimate the incidence and burden of CRS. Result The seroprevalence of rubella antibodies was 82.3% (95% CI: 80.4-84.0). Rubella seropositivity did not differ by age group and educational status. Based on the constant and age-dependent force of infection models, we estimated that the annual incidence of CRS in India was 225.58 per 100,000 live births (95% CI: 217.49-232.41) and 65.47 per 100,000 live births (95% CI: 41.60-104.16) respectively. This translated to an estimated 14,520 (95% CI: 9,225-23,100) and 50,028 (95% CI: 48,234-51,543) infants with CRS every year based on age-dependent and constant force of infection models respectively. Conclusions Our findings indicated that about one fifth of women in the reproductive age group in India were susceptible for rubella. The estimates of CRS incidence will serve as a baseline to monitor the impact of MRCV SIAs, as well progress towards the elimination goal of rubella/CRS.
    Keywords Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
    Subject code 120
    Language English
    Publishing date 2021-07-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Congenital rubella syndrome surveillance in India, 2016–21

    Devika Shanmugasundaram / Sanjay Verma / Kuldeep Singh / Bhagirathi Dwibedi / Shally Awasthi / S. Mahantesh / Himabindu Singh / Sridhar Santhanam / Nivedita Mondal / Geetha S / Priya Sreenivasan / Shikha Malik / Manish Jain / Rajlakshmi Viswanathan / Shalini Tripathi / Bhupeshwari Patel / Gajanan Sapkal / R. Sabarinathan / Mini P. Singh /
    R.K. Ratho / Vijaylakshmi Nag / Ravishekhar Gadepalli / Tapas Kumar Som / Baijayantimala Mishra / Amita Jain / M. Ashok / Devara Sudha Madhuri / V Sudha Rani / Asha Mary Abraham / Deepa John / Rahul Dhodapkar / A. Syed Ali / Debasis Biswas / Deepashri Pratyeke / Ashish Bavdekar / Jayant Prakash / Varsha Singh / Nidhi Prasad / Jaydeb Ray / Agniva Majumdar / Shanta Dutta / Nivedita Gupta / Manoj Murhekar / Akhil Sharma / Aniruddha Ghosh / Arun Alexander / Arun Baranwal / Avinash Anantharaj / Adhisivam Bethou / Dolat S. Shekhawat / G. Kiruthika / Jagat Ram / Madhu Gupta / Mamatha Gowda / Manoj K Rohit / Nabaneeta Dash / Naveen Sankhyan / Nidhi Kaushal / Niranjan Hunasanahalli Shivanna / Nirupama Kasturi / P. Prem Kumar / Parul Chawla Gupta / Pradeep Kumar Gunasekaran / Pratibha Singh / Praveen Kumar / Sanjay Kumar Munjal / Siddharth Agarwal / Suhani Manasa / Suruchi Shukla / Urvashi Nehra / Valsan P Verghese / Varuna Vyas / Vikas Gupta

    Heliyon, Vol 9, Iss 5, Pp e15965- (2023)

    Analysis of five years surveillance data

    2023  

    Abstract: Background: In India, facility-based surveillance for congenital rubella syndrome (CRS) was initiated in 2016 to estimate the burden and monitor the progress made in rubella control. We analyzed the surveillance data for 2016–2021 from 14 sentinel sites ... ...

    Abstract Background: In India, facility-based surveillance for congenital rubella syndrome (CRS) was initiated in 2016 to estimate the burden and monitor the progress made in rubella control. We analyzed the surveillance data for 2016–2021 from 14 sentinel sites to describe the epidemiology of CRS. Method: We analyzed the surveillance data to describe the distribution of suspected and laboratory confirmed CRS patients by time, place and person characteristics. We compared clinical signs of laboratory confirmed CRS and discarded case-patients to find independent predictors of CRS using logistic regression analysis and developed a risk prediction model. Results: During 2016–21, surveillance sites enrolled 3940 suspected CRS case-patients (Age 3.5 months, SD: 3.5). About one-fifth (n = 813, 20.6%) were enrolled during newborn examination. Of the suspected CRS patients, 493 (12.5%) had laboratory evidence of rubella infection. The proportion of laboratory confirmed CRS cases declined from 26% in 2017 to 8.7% in 2021. Laboratory confirmed patients had higher odds of having hearing impairment (Odds ratio [OR] = 9.5, 95% confidence interval [CI]: 5.6–16.2), cataract (OR = 7.8, 95% CI: 5.4–11.2), pigmentary retinopathy (OR = 6.7, 95 CI: 3.3–13.6), structural heart defect with hearing impairment (OR = 3.8, 95% CI: 1.2–12.2) and glaucoma (OR = 3.1, 95% CI: 1.2–8.1). Nomogram, along with a web version, was developed. Conclusions: Rubella continues to be a significant public health issue in India. The declining trend of test positivity among suspected CRS case-patients needs to be monitored through continued surveillance in these sentinel sites.
    Keywords Congenital Rubella Syndrome ; Surveillance ; India ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
    Subject code 120
    Language English
    Publishing date 2023-05-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: ­­Eleven tips for operational researchers working with health programmes

    Hemant Deepak Shewade / Asha Frederick / Madhanraj Kalyanasundaram / Joshua Chadwick / G. Kiruthika / T. Daniel Rajasekar / K. Gayathri / R. Vijayaprabha / R. Sabarinathan / Shri Vijay Bala Yogendra Shivakumar / Kathiresan Jeyashree / P. K. Bhavani / S. Aarthi / K. V. Suma / Delphina Peter Pathinathan / Raghavan Parthasarathy / M. Bhavani Nivetha / Jerome G. Thampi / Deiveegan Chidambaram /
    Tarun Bhatnagar / S. Lokesh / Shanmugasundaram Devika / Timothy S. Laux / Stalin Viswanathan / R. Sridhar / K. Krishnamoorthy / M. Sakthivel / S. Karunakaran / S. Rajkumar / M. Ramachandran / K. D. Kanagaraj / M. Kaleeswari / V. P. Durai / R. Saravanan / A. Sugantha / S. Zufire Hassan Mohamed Khan / P. Sangeetha / R. Vasudevan / R. Nedunchezhian / M. Sankari / N. Jeevanandam / S. Ganapathy / V. Rajasekaran / T. Mathavi / A. R. Rajaprakash / Lakshmi Murali / U. Pugal / K. Sundaralingam / S. Savithri / S. Vellasamy / D. Dheenadayal / P. Ashok / K. Jayasree / R. Sudhakar / K. P. Rajan / N. Tharageshwari / D. Chokkalingam / S. M. Anandrajkumar / T. S. Selvavinayagam / C. Padmapriyadarsini / Ranjani Ramachandran / Manoj V. Murhekar

    Global Health Action, Vol 16, Iss

    our experience based on implementing differentiated tuberculosis care in south India

    2023  Volume 1

    Abstract: Due to the workload and lack of a critical mass of trained operational researchers within their ranks, health systems and programmes may not be able to dedicate sufficient time to conducting operational research (OR). Hence, they may need the technical ... ...

    Abstract Due to the workload and lack of a critical mass of trained operational researchers within their ranks, health systems and programmes may not be able to dedicate sufficient time to conducting operational research (OR). Hence, they may need the technical support of operational researchers from research/academic organisations. Additionally, there is a knowledge gap regarding implementing differentiated tuberculosis (TB) care in programme settings. In this ‘how we did it’ paper, we share our experience of implementing a differentiated TB care model along with an inbuilt OR component in Tamil Nadu, a southern state in India. This was a health system initiative through a collaboration of the State TB cell with the Indian Council of Medical Research institutes and the World Health Organisation country office in India. The learnings are in the form of eleven tips: four broad principles (OR on priority areas and make it a health system initiative, implement simple and holistic ideas, embed OR within routine programme settings, aim for long-term engagement), four related to strategic planning (big team of investigators, joint leadership, decentralised decision-making, working in advance) and three about implementation planning (conducting pilots, smart use of e-tools and operational research publications at frequent intervals). These may act as a guide for other Indian states, high TB burden countries that want to implement differentiated care, and for operational researchers in providing technical assistance for strengthening implementation and conducting OR in health systems and programmes (TB or other health programmes). Following these tips may increase the chances of i) an enriching engagement, ii) policy/practice change, and iii) sustainable implementation.
    Keywords triaging for severe illness ; ending tb deaths ; differentiated tb care ; operational research ; technical support ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher Taylor & Francis Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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