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Article ; Online: Determinants of postnatal care coverage among mothers and new-borns in India: Evidence from a nationally representative survey.

Krishnamoorthy, Yuvaraj / Majella, Marie Gilbert

The International journal of health planning and management

2021 Volume 36, Issue 4, Page(s) 1276–1286

Abstract: Despite efforts taken by the Government of India, still mothers and new-borns are excluded from the postnatal care services, especially during the critical first 24 h after delivery. Hence, we have done this study to find the determinants of postnatal ... ...

Abstract	Despite efforts taken by the Government of India, still mothers and new-borns are excluded from the postnatal care services, especially during the critical first 24 h after delivery. Hence, we have done this study to find the determinants of postnatal care for mothers and new-borns in India. We have analysed the NFHS-4 data gathered from Demographic Health Survey programme. Stratification and clustering in the sample design was accounted using svyset command. Point estimates were reported as proportions with 95% Confidence Interval (CI). In total, 190,797 women who had at least one live birth were included. About 25.2% and 27.1% of the new-born received post-natal care within 24 and 48 h of delivery. The proportion of women who received post-natal care within 24 and 48 h after delivery was 63.4% and 65.2% respectively. Higher socioeconomic status, women living in Southern region, utilization of proper antenatal and intranatal care, and Caesarian mode of delivery had significantly higher postnatal care coverage among mothers and new-borns. This finding informs the policy makers regarding the status of postnatal care coverage, that can be incorporated to identify target populations for further strengthening of service delivery.
MeSH term(s)	Female ; Humans ; India ; Maternal Health Services ; Mothers ; Patient Acceptance of Health Care ; Postnatal Care ; Pregnancy
Language	English
Publishing date	2021-04-17
Publishing country	England
Document type	Journal Article
ZDB-ID	632786-2
ISSN	1099-1751 ; 0749-6753
ISSN (online)	1099-1751
ISSN	0749-6753
DOI	10.1002/hpm.3179
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Article: Budget impact and cost-utility analysis of prophylactic emicizumab versus on-demand bypassing agents for adolescent severe haemophilia A patients with inhibitors in India.

Krishnamoorthy, Yuvaraj / Govindan, Dhanajayan / Kannan, Narasimhapriyan / Majella, Marie Gilbert / Hariharan, Vishnu Shankar / Valliappan, Vivek

Heliyon

2024 Volume 10, Issue 5, Page(s) e27089

Abstract: Introduction: Severe Haemophilia A patients with inhibitors are currently being treated with bypassing agents like activated prothrombin complex concentrates (aPCC) and recombinant factor VIIa. Emicizumab is a recombinant humanized monoclonal antibody, ... ...

Abstract	Introduction: Severe Haemophilia A patients with inhibitors are currently being treated with bypassing agents like activated prothrombin complex concentrates (aPCC) and recombinant factor VIIa. Emicizumab is a recombinant humanized monoclonal antibody, introduced to reduce the bleeding events, improve treatment adherence, and quality of life. However, cost-effectiveness and long-term sustainability of the intervention is not studied in a low middle income setting like India. Aim: The primary objective of this study was to evaluate the cost-utility of Emicizumab compared to traditional bypassing agents in the treatment of severe haemophilia A patients with inhibitors in India. Secondary objective was to analyze the budgetary impact of introducing Emicizumab for this patient population from the perspective of public health system in India. Methods: Markov model was created to compare the prophylactic emicizumab therapy against bypassing agents for a hypothetical cohort of 10-year-old adolescents in India. The time horizon was 10 years and model built based on health system perspective. Cost utility was expressed as costs per quality-adjusted life-years (QALYs) gained. All costs were expressed as 2021 US dollars. Probabilistic sensitivity analysis was performed to check the robustness of the estimates. Results: Prophylactic emicizumab was a cost saving intervention with negative Incremental Cost Utility Ratio (ICUR) against recombinant factor VIIa of -853,573 USD (INR -63,109,773), and negative ICUR of -211,675 USD (INR -15,650,403) against APCC. The estimated total budget for treating all the severe Haemophilia A patients with inhibitors in India was USD 59,042,000 (INR 4,365,329,312) for 10 years' time horizon (per patient cost of USD 295,210 [INR 21,826,646.56]). Conclusion: Prophylactic emicizumab therapy is a cost saving intervention when compared to both the bypassing agents as it is less costly and more effective for severe Haemophilia A patients with inhibitors in India.
Language	English
Publishing date	2024-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2024.e27089
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Article ; Online: Economic evaluation and budget impact analysis of dengue vaccination following pre-vaccination serological screening in India.

Krishnamoorthy, Yuvaraj / Majella, Marie Gilbert

Vaccine

2020 Volume 38, Issue 33, Page(s) 5154–5162

Abstract: Objectives: To evaluate the budget impact and cost-effectiveness of dengue vaccination following pre-vaccination serological screening in India.: Methods: We used a static cohort model (combination of decision tree and Markov model) to compare dengue ...

Abstract	Objectives: To evaluate the budget impact and cost-effectiveness of dengue vaccination following pre-vaccination serological screening in India. Methods: We used a static cohort model (combination of decision tree and Markov model) to compare dengue disease and cost burden with and without dengue vaccination program with serological screening for a hypothetical cohort of 10-year-old adolescents. Budget impact was expressed in terms of total budget required for implementation of vaccination programme. Program impact was expressed in terms of disability-adjusted life-years (DALYs) averted. Cost effectiveness was expressed as costs per DALY averted. All costs are expressed in 2018 US dollars. Sensitivity analysis was performed for ICERs in different vaccination scenarios. Results: The total budget for implementation of dengue vaccination programme is approximately around US$ 530 million (INR 3620 crores). Our model results suggest dengue vaccination result in a net gain of almost 86,000 DALYS. We found the Dengue vaccine to be a cost-effective intervention with an ICER of $3364 (INR 2,30,098) which is less than three-times GDP per capita of India ($6047; INR 413,601). One-way sensitivity analysis shows that the ICER is most affected by the overall incidence of dengue infections followed by vaccine price. Probabilistic sensitivity analysis shows that ICER for dengue vaccination varied from $1182 (INR 80,837) to $6367 (INR 435,439). Conclusion: Our study shows that dengue vaccine with pre-vaccination serological screening programme is a cost-effective intervention with the conservative estimates.
MeSH term(s)	Adolescent ; Child ; Cost-Benefit Analysis ; Dengue/prevention & control ; Humans ; Immunization Programs ; India ; Vaccination
Language	English
Publishing date	2020-06-20
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2020.06.028
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Article: Economic evaluation and budget impact analysis of dengue vaccination following pre-vaccination serological screening in India

Krishnamoorthy, Yuvaraj / Majella, Marie Gilbert

Vaccine. 2020 July 14, v. 38, no. 33

2020

Abstract: To evaluate the budget impact and cost-effectiveness of dengue vaccination following pre-vaccination serological screening in India.We used a static cohort model (combination of decision tree and Markov model) to compare dengue disease and cost burden ... ...

Abstract	To evaluate the budget impact and cost-effectiveness of dengue vaccination following pre-vaccination serological screening in India.We used a static cohort model (combination of decision tree and Markov model) to compare dengue disease and cost burden with and without dengue vaccination program with serological screening for a hypothetical cohort of 10-year-old adolescents. Budget impact was expressed in terms of total budget required for implementation of vaccination programme. Program impact was expressed in terms of disability-adjusted life-years (DALYs) averted. Cost effectiveness was expressed as costs per DALY averted. All costs are expressed in 2018 US dollars. Sensitivity analysis was performed for ICERs in different vaccination scenarios.The total budget for implementation of dengue vaccination programme is approximately around US$ 530 million (INR 3620 crores). Our model results suggest dengue vaccination result in a net gain of almost 86,000 DALYS. We found the Dengue vaccine to be a cost-effective intervention with an ICER of $3364 (INR 2,30,098) which is less than three-times GDP per capita of India ($6047; INR 413,601). One-way sensitivity analysis shows that the ICER is most affected by the overall incidence of dengue infections followed by vaccine price. Probabilistic sensitivity analysis shows that ICER for dengue vaccination varied from $1182 (INR 80,837) to $6367 (INR 435,439).Our study shows that dengue vaccine with pre-vaccination serological screening programme is a cost-effective intervention with the conservative estimates.
Keywords	Markov chain ; cost effectiveness ; decision support systems ; dengue ; disability-adjusted life year ; economic evaluation ; models ; prices ; vaccination ; vaccines ; India
Language	English
Dates of publication	2020-0714
Size	p. 5154-5162.
Publishing place	Elsevier Ltd
Document type	Article
Note	NAL-AP-2-clean
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2020.06.028
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Article ; Online: Secular trends of rabies in India, 2005-2020: importance of surveillance and implications for elimination strategies.

Rubeshkumar, Polani / Majella, Marie Gilbert / Jahan, Nuzrath / Sakthivel, Manikandanesan / Krishnamoorthy, Yuvaraj

The Lancet regional health. Southeast Asia

2023 Volume 20, Page(s) 100322

Language	English
Publishing date	2023-11-08
Publishing country	England
Document type	Journal Article
ISSN	2772-3682
ISSN (online)	2772-3682
DOI	10.1016/j.lansea.2023.100322
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Article ; Online: Preprints: Are they precedents or expedient substitutes for peer-reviewed journal publications?

Lu, Emily / Kumar, Amudha / Chidambaram, Vignesh / Majella, Marie Gilbert / Geetha, Harinivas Shanmugavel / Zimmerman, Alyssa / Karakousis, Petros C

The American journal of the medical sciences

2024

Language	English
Publishing date	2024-03-22
Publishing country	United States
Document type	Letter
ZDB-ID	82078-7
ISSN	1538-2990 ; 0002-9629
ISSN (online)	1538-2990
ISSN	0002-9629
DOI	10.1016/j.amjms.2024.03.017
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Article ; Online: Oxidized hemoglobin triggers polyreactivity and autoreactivity of human IgG via transfer of heme

Cyril Planchais / Remi Noe / Marie Gilbert / Maxime Lecerf / Srini V. Kaveri / Sébastien Lacroix-Desmazes / Lubka T. Roumenina / Jordan D. Dimitrov

Communications Biology, Vol 6, Iss 1, Pp 1-

2023 Volume 15

Abstract: Oxidized hemoglobin induces polyreactivity and autoreactivity of human IgG through direct transfer and binding of heme to the variable region of IgG, which contributes to a better understanding of the physiopathology of hemolytic diseases. ...

Abstract	Oxidized hemoglobin induces polyreactivity and autoreactivity of human IgG through direct transfer and binding of heme to the variable region of IgG, which contributes to a better understanding of the physiopathology of hemolytic diseases.
Keywords	Biology (General) ; QH301-705.5
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Equity in coverage of maternal and newborn care in India: evidence from a nationally representative survey.

Krishnamoorthy, Yuvaraj / Majella, Marie Gilbert / Rajaa, Sathish

Health policy and planning

2020 Volume 35, Issue 5, Page(s) 616–623

Abstract: Despite efforts taken by the Government of India, mothers and newborns are excluded from the maternal and child health services, especially those in poorer and weaker sections of the society. Hence, we have utilized the most recent National Family Health ...

Abstract	Despite efforts taken by the Government of India, mothers and newborns are excluded from the maternal and child health services, especially those in poorer and weaker sections of the society. Hence, we have utilized the most recent National Family Health Survey (NFHS-4) data to assess the socio-economic inequities in antenatal care (ANC), intranatal care and postnatal care (PNC) coverage for mothers and newborns in India. We have analysed the NFHS-4 data gathered from the Demographic Health Survey programme. Stratification and clustering in the sample design were accounted for using 'svyset' command. Point estimates were reported as proportions with 95% confidence interval. The concentration curve and index were used to represent the socio-economic inequities. Theil index was computed to report inequities across geographical regions and place of residence. In total, 190 797 women who had at least one live birth in the preceding 5 years were included. About 52.1% of women had at least four ANC visits and 81.4% had institutional delivery. About 25.2% and 27.1% of the newborn received PNC within 24 and 48 h of delivery. The proportion of women who received PNC within 24 and 48 h after the delivery was 63.4% and 65.2%, respectively. Maximum inequity was observed for ANC (concentration index-0.195) followed by receipt of PNC by mothers within 24 and 48 h (concentration index-0.106 and 0.103). Women from the rural areas had a disproportionately high proportion of home deliveries (Theil index-3813.6). The findings from this study inform the policymakers and planners about the socio-economic inequity existing across various maternal and child health indicators. This will help them in making informed decisions and strengthen the maternal and child health programme in our country.
MeSH term(s)	Adult ; Delivery, Obstetric/statistics & numerical data ; Female ; Healthcare Disparities/statistics & numerical data ; Home Childbirth/statistics & numerical data ; Humans ; India ; Infant, Newborn ; Maternal Health Services/statistics & numerical data ; Postnatal Care/statistics & numerical data ; Pregnancy ; Prenatal Care/statistics & numerical data ; Rural Population/statistics & numerical data ; Socioeconomic Factors
Language	English
Publishing date	2020-03-29
Publishing country	England
Document type	Journal Article
ZDB-ID	632896-9
ISSN	1460-2237 ; 0268-1080
ISSN (online)	1460-2237
ISSN	0268-1080
DOI	10.1093/heapol/czaa020
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Article ; Online: Impact of tobacco industry pricing and marketing strategy on brand choice, loyalty and cessation in global south countries: a systematic review.

Krishnamoorthy, Yuvaraj / Majella, Marie Gilbert / Murali, Sharan

International journal of public health

2020 Volume 65, Issue 7, Page(s) 1057–1066

Abstract: Objectives: We undertook this review to assess the impact of pricing strategies on brand choice, loyalty and quitting behaviour in Global South countries.: Methods: We systematically retrieved articles from Medline, CENTRAL, ScienceDirect, Google ... ...

Abstract	Objectives: We undertook this review to assess the impact of pricing strategies on brand choice, loyalty and quitting behaviour in Global South countries. Methods: We systematically retrieved articles from Medline, CENTRAL, ScienceDirect, Google Scholar from inception up to January 2020. Studies which reported tobacco industry's pricing strategies were eligible. We summarized the data as themes and codes using the principles of inductive qualitative thematic analysis within structured rational constructivist framework. Results: In total, 13 studies met inclusion criteria were included. Major strategies adopted by tobacco industries to tackle the pricing and taxation changes were increased tax absorption, differential taxation based on price, cigarette length/size which ensures modest increase in the net price of cigarettes. This in turn influences the tobacco users in terms of brand loyalty and switching as they prefer to stay with factory-made cigarettes or shift to a cheaper alternative or illegal product rather than decreasing/quitting tobacco use. Conclusions: Absorption of excise tax and differential taxation are the common pricing strategies adopted by tobacco industries in Global South. These strategies together with external determinants impact the price-related tobacco control interventions.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Costs and Cost Analysis/economics ; Costs and Cost Analysis/statistics & numerical data ; Female ; Humans ; Male ; Marketing/economics ; Marketing/statistics & numerical data ; Middle Aged ; Smoking Cessation/economics ; Smoking Cessation/statistics & numerical data ; Taxes/economics ; Taxes/statistics & numerical data ; Tobacco Industry/legislation & jurisprudence ; Tobacco Industry/methods ; Tobacco Industry/statistics & numerical data ; Tobacco Products/economics ; Tobacco Products/statistics & numerical data
Language	English
Publishing date	2020-07-25
Publishing country	Switzerland
Document type	Journal Article ; Systematic Review
ZDB-ID	2274130-6
ISSN	1661-8564 ; 1661-8556
ISSN (online)	1661-8564
ISSN	1661-8556
DOI	10.1007/s00038-020-01422-2
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Article: Prevalence of malnutrition and its associated sociodemographic and clinical factors among adolescents in selected schools of Urban Puducherry, India.

Wangaskar, Sneha Anil / Sahu, Swaroop Kumar / Majella, Marie Gilbert / Rajaa, Sathish

The Nigerian postgraduate medical journal

2021 Volume 28, Issue 4, Page(s) 285–290

Abstract: Background: In India, adolescents constitute 21% of the total population. Majority of boys and girls in developing countries enter adolescence as undernourished, making them more vulnerable to several diseases.: Objective: Among adolescents in ... ...

Abstract	Background: In India, adolescents constitute 21% of the total population. Majority of boys and girls in developing countries enter adolescence as undernourished, making them more vulnerable to several diseases. Objective: Among adolescents in selected schools of urban Puducherry, we determined the prevalence of malnutrition and also assessed the sociodemographic and clinical factors associated with undernutrition. Materials and methods: A cross-sectional analytical study was conducted among adolescents (10-18 years) in selected public schools of Urban Puducherry. Data were collected using semi-structured and pre-tested questionnaires. The data collection period was between September and October 2019. Malnutrition was assessed by the World Health Organisation recommended Height-for-age and body mass index-for-age cut-offs using AnthroPlus software. Results: A total of 144 (28.9%) boys and 355 (71.1%) girls were included in the study (N = 499). The prevalence of malnutrition was 46.8% (95% confidence interval [CI]: 42.5-51.3). The prevalence of undernutrition was 33.3% (Stunting [21.6%] and Thinness [15%]). The prevalence of overweight and obesity were 10.2% and 5.8%, respectively. Male gender was found to be an independent risk factor of undernutrition (annual percentage rate = 1.4; 95% CI: 1.0-1.9); and known risk factors such as socio-economic status, parental education were not significantly associated with undernutrition. Conclusions: One in every two school-going adolescents was malnourished. Despite the high prevalence of undernourishment, over nourishment was also commonly observed. Educating parents and students about growth monitoring and dietary habits might help in bringing down the burden of malnutrition.
MeSH term(s)	Adolescent ; Cross-Sectional Studies ; Female ; Humans ; Male ; Malnutrition/epidemiology ; Nigeria ; Prevalence ; Schools
Language	English
Publishing date	2021-12-01
Publishing country	Nigeria
Document type	Journal Article
ZDB-ID	2171096-X
ISSN	1117-1936
ISSN	1117-1936
DOI	10.4103/npmj.npmj_684_21
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