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Article ; Online: A study on tuberculosis disease disclosure patterns and its associated factors

Karikalan Nagarajan / Malaisamy Muniyandi / Senthil Sellappan / Srimathi Karunanidhi / Keerthana Senthilkumar / Bharathidasan Palani / Lavanya Jeyabal / Rajendran Krishnan

PLoS ONE, Vol 18, Iss

Findings from a prospective observational study in Chennai

2023 Volume 1

Abstract: Background Disclosure of tuberculosis (TB) status by patients is a critical step in their treatment cascade of care. There is a lack of systematic assessment of TB disclosure patterns and its positive outcomes which happens dynamically over the disease ... ...

Abstract	Background Disclosure of tuberculosis (TB) status by patients is a critical step in their treatment cascade of care. There is a lack of systematic assessment of TB disclosure patterns and its positive outcomes which happens dynamically over the disease period of individual patients with their family and wider social network relations. Methods This prospective observational study was conducted in Chennai Corporation treatment units during 2019–2021. TB patients were recruited and followed-up from treatment initiation to completion. Information on disease disclosures made to different social members at different time points, and outcomes were collected and compared. Bivariate and multi variate analysis were used to identify the patients and contact characteristics predictive of TB disclosure status. Results A total of 466 TB patients were followed-up, who listed a total of 4039 family, extra familial and social network contacts of them. Maximum disclosures were made with family members (93%) and half of the relatives, occupational contacts and friendship contacts (44–58%) were disclosed within 15 days of treatment initiation. Incremental disclosures made during the 150–180 days of treatment were highest among neighbourhood contacts (12%), and was significantly different between treatment initiation and completion period. Middle aged TB patients (31 years and 46–55 years) were found less likely to disclose (AOR 0.56 and 0.46 respectively; p<0.05) and illiterates were found more likely to disclose their TB status (AOR 3.91; p<0.05). Post the disclosure, family contacts have mostly provided resource support (44.90%) and two third of all disclosed contacts have provided emotional support for TB patients (>71%). Conclusion Findings explain that family level disclosures were predominant and disclosures made to extra familial network contacts significantly increased during the latter part of treatment. Emotional support was predominantly received by TB patients from all their contacts post disclosure. Findings ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A study on tuberculosis disease disclosure patterns and its associated factors

Karikalan Nagarajan / Malaisamy Muniyandi / Senthil Sellappan / Srimathi Karunanidhi / Keerthana Senthilkumar / Bharathidasan Palani / Lavanya Jeyabal / Rajendran Krishnan

PLoS ONE, Vol 18, Iss 1, p e

Findings from a prospective observational study in Chennai.

2023 Volume 0280812

Abstract	Background Disclosure of tuberculosis (TB) status by patients is a critical step in their treatment cascade of care. There is a lack of systematic assessment of TB disclosure patterns and its positive outcomes which happens dynamically over the disease period of individual patients with their family and wider social network relations. Methods This prospective observational study was conducted in Chennai Corporation treatment units during 2019-2021. TB patients were recruited and followed-up from treatment initiation to completion. Information on disease disclosures made to different social members at different time points, and outcomes were collected and compared. Bivariate and multi variate analysis were used to identify the patients and contact characteristics predictive of TB disclosure status. Results A total of 466 TB patients were followed-up, who listed a total of 4039 family, extra familial and social network contacts of them. Maximum disclosures were made with family members (93%) and half of the relatives, occupational contacts and friendship contacts (44-58%) were disclosed within 15 days of treatment initiation. Incremental disclosures made during the 150-180 days of treatment were highest among neighbourhood contacts (12%), and was significantly different between treatment initiation and completion period. Middle aged TB patients (31 years and 46-55 years) were found less likely to disclose (AOR 0.56 and 0.46 respectively; p<0.05) and illiterates were found more likely to disclose their TB status (AOR 3.91; p<0.05). Post the disclosure, family contacts have mostly provided resource support (44.90%) and two third of all disclosed contacts have provided emotional support for TB patients (>71%). Conclusion Findings explain that family level disclosures were predominant and disclosures made to extra familial network contacts significantly increased during the latter part of treatment. Emotional support was predominantly received by TB patients from all their contacts post disclosure. Findings ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Revisiting the Chingleput BCG vaccination trial for the impact of BCG revaccination on the incidence of tuberculosis disease.

Velayutham, Banurekha / Thiruvengadam, Kannan / Kumaran, Paramasivam Paul / Watson, Basilea / Rajendran, Krishnan / Padmapriyadarsini, Chandrasekaran

The Indian journal of medical research

2022 Volume 157, Issue 2&3, Page(s) 152–159

Abstract: Background & objectives: Vaccines play a crucial role in the prevention of tuberculosis (TB). Revaccination with Bacille Calmette-Guerin (BCG) for the prevention of TB is an important strategy that is currently gaining interest. The objective of this ... ...

Abstract	Background & objectives: Vaccines play a crucial role in the prevention of tuberculosis (TB). Revaccination with Bacille Calmette-Guerin (BCG) for the prevention of TB is an important strategy that is currently gaining interest. The objective of this study was to reanalyze the community-based Chingleput BCG vaccination trial for protective efficacy of BCG revaccination against incident TB disease. Methods: A retrospective analysis of the Chingleput BCG vaccination trial (conducted in 1968) data was carried out. Data on participants with evidence of prior BCG vaccination at trial intake and randomized to BCG vaccine [low dose (0.01 mg), high dose (0.1 mg)] and placebo arms were analyzed. The incidence of TB disease, which was based on sputum culture and/or chest X-ray was compared between the BCG and placebo arms over a 15 yr follow up period. Results: Of the 269,727 individuals randomized in the trial; 263,158 had no evidence of TB at baseline, of which 4436 (1.68%) had evidence of BCG vaccination at trial intake (2890 in the BCG vaccine and 1546 in the placebo arms, respectively). There were 77 (190 per 100,000) and 64 (296 per 100,000) incident TB cases in the BCG and placebo arm, respectively, at 15 yr post-vaccination. The incidence of TB disease was significantly lower in the BCG arm [Hazard ratio of BCG arm (95% confidence interval): 0.64 (0.46-0.89)]. Interpretation & conclusions: Retrospective data analysis of this community-based trial revealed that BCG revaccination in a community offered modest protection against the development of TB disease at the end of 15 years which, however, requires further evaluation.
MeSH term(s)	Humans ; BCG Vaccine/therapeutic use ; Immunization, Secondary ; Incidence ; Retrospective Studies ; Tuberculosis/epidemiology ; Tuberculosis/prevention & control ; Tuberculosis/drug therapy ; Vaccination
Chemical Substances	BCG Vaccine
Language	English
Publishing date	2022-09-23
Publishing country	India
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	390883-5
ISSN	0971-5916 ; 0019-5340
ISSN	0971-5916 ; 0019-5340
DOI	10.4103/ijmr.ijmr_1540_22
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Article ; Online: An influence of dew point temperature on the occurrence of Mycobacterium tuberculosis disease in Chennai, India

Rajendran Krishnan / Kannan Thiruvengadam / Lavanya Jayabal / Sriram Selvaraju / Basilea Watson / Muniyandi Malaisamy / Karikalan Nagarajan / Srikanth P. Tripathy / Ponnuraja Chinnaiyan / Padmapriyadarsini Chandrasekaran

Scientific Reports, Vol 12, Iss 1, Pp 1-

2022 Volume 10

Abstract: Abstract Climate factors such as dew point temperature, relative humidity and atmospheric temperature may be crucial for the spread of tuberculosis. This study was conducted for the first time to investigate the relationship of climatic factors with TB ... ...

Abstract	Abstract Climate factors such as dew point temperature, relative humidity and atmospheric temperature may be crucial for the spread of tuberculosis. This study was conducted for the first time to investigate the relationship of climatic factors with TB occurrence in an Indian setting. Daily tuberculosis notification data during 2008–2015 were generated from the National Treatment Elimination Program, and analogous daily climatic data were obtained from the Regional Meteorological Centre at Chennai city, Tamil Nadu, India. The decomposition method was adopted to split the series into deterministic and non-deterministic components, such as seasonal, non-seasonal, trend and cyclical, and non-deterministic climate factors. A generalized linear model was used to assess the relation independently. TB disease progression from latent stage infection to active was supported by higher dew point temperature and moderate temperature. It had a significant association with TB progression in the summer and monsoon seasons. The relative humidity may be favored in the winter and post-monsoon. The water tiny dew droplets may support the TB bacterium to recuperate in the environment.
Keywords	Medicine ; R ; Science ; Q
Subject code	550
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence of bacteriologically confirmed pulmonary tuberculosis and associated risk factors

Chandra Kumar Dolla / Bhaskaran Dhanaraj / Padmapriyadarsini Chandrasekaran / Sriram Selvaraj / Pradeep Aravindan Menon / Kannan Thiruvengadam / Rajendran Krishnan / Rajesh Mondal / Muniyandi Malaisamy / Srinivasa B Marinaik / Lakshmi Murali / Srikanth Prasad Tripathy

PLoS ONE, Vol 16, Iss 10, p e

A community survey in Thirvallur District, south India.

2021 Volume 0247245

Abstract: Background Tuberculosis (TB) prevalence surveys add to the active case detection in the community level burden of TB both national and regional levels. The aim of this study was to assess the prevalence of bacteriologically confirmed pulmonary ... ...

Abstract	Background Tuberculosis (TB) prevalence surveys add to the active case detection in the community level burden of TB both national and regional levels. The aim of this study was to assess the prevalence of bacteriologically confirmed pulmonary tuberculosis (PTB) in the community. Methods Household community-based tuberculosis disease survey was conducted targeting 69054 population from 43 villages of 5 blocks in Tiruvallure district adopting cluster sampling methodology of ≥15 years old adult rural population of South India during 2015-2018. All eligible individuals with suspected symptoms of PTB were screened with chest X-ray. Two sputum specimens (one spot and the other early morning sample) were collected for M.tb smear and culture examination. Conversely demographical, smoking and alcohol drinking habits information were also collected to explore the risk factor. Stepwise logistic regression was employed to associate risk factors for PTB. Results A total of 62494 were screened among 69054 eligible population, of whom 6340 were eligible for sputum specimen collection. Sputum for M.tb smear and culture examination were collected in 93% of participants. The derived prevalence of PTB was 307/100000 population (smear-positive 130; culture positive 277). As expected that PTB has decreased substantially compared to preceding surveys and it showed that older age, male, low BMI, diabetes, earlier history of TB and alcohol users were significantly associated (p < .0001) with an increased risk of developing PTB. Conclusion Upshot of the active survey has established a reduction in the prevalence of PTB in the rural area which can be accredited to better programmatic implementation and success of the National TB Control Programme in this district. It also has highlighted the need for risk reduction interventions accelerate faster elimination of TB.
Keywords	Medicine ; R ; Science ; Q
Subject code	310
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Detection of Uncommon Enteric Bacterial Pathogens from Acute Diarrheal Specimens Using SYBR-Green Real Time PCR.

Chowdhury, Goutam / Stine, Oscar C / Rajendran, Krishnan / Mukhopadhyay, Asish K / Okamoto, Keinosuke / Ramamurthy, Thandavarayan

Japanese journal of infectious diseases

2018 Volume 72, Issue 2, Page(s) 88–93

Abstract: Acute diarrheal disease is a major health problem, and the second most common cause of death in children under 5 years of age. Conventional diagnostic methods are laborious, time consuming, and occasionally inaccurate. We used SYBR-Green real-time PCR ... ...

Abstract	Acute diarrheal disease is a major health problem, and the second most common cause of death in children under 5 years of age. Conventional diagnostic methods are laborious, time consuming, and occasionally inaccurate. We used SYBR-Green real-time PCR for the detection of 10 uncommon bacterial pathogens using fecal specimens from acute diarrheal patients. In the SYBR-Green real-time PCR assay, the products formed were identified based on a melting point temperature curve analysis, and the assay was validated with the respective reference strain. In a retrospective study, we tested 1,184 stool specimens previously examined using conventional culture methods. Enterotoxigenic Bacteriodes fragilis was detected in 6.7% of the samples followed by enterotoxigenic Bacillus cereus (5.1%), Clostridium perfringens (3.9%), and Aeromonas hydrophila (3.8%). In the prospective study, A. hydrophila, Staphylococcus aureus, and C. perfringens were predominantly detected in 11 > 5 years of age, using real-time PCR. The real-time PCR assay is comprehensive, rapid, accurate, and well suited for surveillance or diagnostic purposes to detect uncommon bacterial pathogens, and should be useful in initiating appropriate care and thereby reducing patient risk.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacteria/classification ; Bacteria/genetics ; Bacteria/isolation & purification ; Bacterial Infections/diagnosis ; Bacterial Infections/microbiology ; Child ; Child, Preschool ; Diarrhea/diagnosis ; Diarrhea/microbiology ; Feces/microbiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Organic Chemicals/metabolism ; Real-Time Polymerase Chain Reaction/methods ; Retrospective Studies ; Staining and Labeling/methods ; Transition Temperature ; Young Adult
Chemical Substances	Organic Chemicals ; SYBR Green I (163795-75-3)
Language	English
Publishing date	2018-10-31
Publishing country	Japan
Document type	Evaluation Studies ; Journal Article
ZDB-ID	1478383-6
ISSN	1884-2836 ; 1344-6304
ISSN (online)	1884-2836
ISSN	1344-6304
DOI	10.7883/yoken.JJID.2018.142
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Article: Economic Evaluation of Implementing a Rapid Point-of-Care Screening Test for the Identification of Hepatitis C Virus under National Viral Hepatitis Control Programme in Tamil Nadu, South India.

Malaisamy, Muniyandi / Nagarajan, Karikalan / Kirti, Tyagi / Malkeet, Singh / Venkatesan, Prakash / Senthilkumar, S / Sananthya, Karthikeyan / Rajendran, Krishnan / Kavitha, Rajsekar / Vivekanandan, Shanmugam / Selvavinayagam, T S

Journal of global infectious diseases

2021 Volume 13, Issue 3, Page(s) 126–132

Abstract: Introduction: Viral hepatitis is a crucial public health problem in India. Hepatitis C virus (HCV) elimination is a national priority and a key strategy has been adopted to strengthen the HCV diagnostics services to ensure early and accurate diagnosis.!# ...

Abstract	Introduction: Viral hepatitis is a crucial public health problem in India. Hepatitis C virus (HCV) elimination is a national priority and a key strategy has been adopted to strengthen the HCV diagnostics services to ensure early and accurate diagnosis. Methods: To conduct an economic evaluation of implementing a rapid point-of-care screening test for the identification of HCV among the selected key population under the National Viral Hepatitis Control Programme in Tamil Nadu, South India. Economic evaluation of a point-of-care screening test for HCV diagnosis among the key population attending the primary health care centers. A combination of decision tree and Markov model was developed to estimate cost-effectiveness of point-of-care screening test for HCV diagnosis at the primary health care centers. Total costs, quality-adjusted life years (QALYs) of the intervention and comparator, and incremental cost-effectiveness ratio (ICER) were calculated. The model parameter uncertainties which would influence the cost-effectiveness outcome has been evaluated by one-way sensitivity analysis and probabilistic sensitivity analysis. Results: When compared to the tertiary level diagnostic strategy for HCV, the point-of-care screening for selected key population at primary health care level results in a gain of 57 undiscounted QALYs and 38 discounted QALYs, four undiscounted life years and two discounted life years. The negative ICER of the new strategy indicates that it is less expensive and more effective compared with the current HCV diagnosis strategy. Conclusions: The proposed strategy for HCV diagnosis in the selected key population in Tamil Nadu is dominant and cost-saving compared to the current strategy.
Language	English
Publishing date	2021-08-31
Publishing country	India
Document type	Journal Article
ZDB-ID	2545454-7
ISSN	0974-8245 ; 0974-777X
ISSN (online)	0974-8245
ISSN	0974-777X
DOI	10.4103/jgid.jgid_394_20
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The changing face of human resource management in Indonesia

Habir, Ahmad D / Rajendran, Krishnan

The changing face of management in South East Asia , p. 30-58

2008 , Page(s) 30–58

Author's details	Ahmad D. Habir and Krishnan Rajendran
Keywords	Personalmanagement ; Humanressourcen ; Management ; Indonesien
Language	English
Publisher	Routledge
Publishing place	London [u.a.]
Document type	Article
ISBN	978-041-540-543-0 ; 041-540-543-2
Database	ECONomics Information System

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Article ; Online: Association of Tuberculosis With Household Catastrophic Expenditure in South India.

Muniyandi, Malaisamy / Thomas, Beena Elizabeth / Karikalan, Nagarajan / Kannan, Thiruvengadam / Rajendran, Krishnan / Saravanan, Balakrishnan / Vohra, Vikram / Okorosobo, Tuoyo / Lönnroth, Knut / Tripathy, Srikanth Prasad

JAMA network open

2020 Volume 3, Issue 2, Page(s) e1920973

Abstract: Importance: The high household costs associated with tuberculosis (TB) diagnosis and treatment can create barriers to access and adherence, highlighting the urgency of achieving the World Health Organization's End TB Strategy target that no TB-affected ... ...

Abstract	Importance: The high household costs associated with tuberculosis (TB) diagnosis and treatment can create barriers to access and adherence, highlighting the urgency of achieving the World Health Organization's End TB Strategy target that no TB-affected households should face catastrophic costs by 2020. Objective: To estimate the occurrence of catastrophic costs associated with TB diagnosis and treatment and to identify socioeconomic indicators associated with catastrophic costs in a setting where TB control strategies have been implemented effectively. Design, setting, and participants: In this cross-sectional study, 455 patients with TB in the Chennai metropolitan area of South India who were treated under the TB control program between February 2017 and March 2018 were interviewed. Patients were interviewed by trained field investigators at 3 time points: at the initiation of treatment, at the end of the intensive phase of treatment, and at the end of the continuation phase of treatment. A precoded interview schedule was used to collect information on demographic, socioeconomic, and clinical characteristics and direct medical, direct nonmedical, and indirect costs. Data analysis was performed from August 2018 to November 2019. Main outcomes and measures: Direct, indirect, and total costs to patients with TB. Catastrophic costs associated with TB were defined as costs exceeding 20% of the household's annual income. A binary response model was used to determine the factors that were significantly associated with catastrophic costs. Results: Of 455 patients with TB interviewed, 205 (53%) were aged 19 to 45 years (mean [SD] age, 38.4 [16.0] years), 128 (33%) were female, 72 (19%) were illiterate, 126 (33%) were employed, and 186 (48%) had a single earning member in the family (percentages are based on the 384 patients who were interviewed through the end of the continuation phase of treatment). Sixty-one percent of patients (234 patients) had pulmonary smear positive TB. The proportion of patients with catastrophic costs was 31%. Indirect costs contributed more toward catastrophic cost than did direct costs. Multivariate logistic regression analysis found that unemployment (adjusted odds ratio, 0.2; 95% CI, 0.1-0.5; P < .001) and higher annual household income (Rs 1-200 000, adjusted odds ratio, 0.4; 95% CI, 0.2-0.7; P = .004; Rs >200 000, adjusted odds ratio, 0.2; 95% CI, 0.1-0.5; P < .001) were associated with a decreased likelihood of experiencing catastrophic costs. Conclusions and relevance: Despite the implementation of free diagnostic and treatment services under a national TB control program, TB-affected households had a high risk of catastrophic costs and further impoverishment. There is an urgent demand to provide additional financial protection for patients with TB.
MeSH term(s)	Adult ; Cost of Illness ; Cross-Sectional Studies ; Female ; Health Care Costs/statistics & numerical data ; Humans ; India/epidemiology ; Male ; Middle Aged ; Tuberculosis/economics ; Tuberculosis/epidemiology ; Young Adult
Language	English
Publishing date	2020-02-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2019.20973
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Typhoid fever in rural communities of West Bengal, India--an age-wise perspective.

Ghosh, Subrata / Batabyal, Prasenjit / Rajendran, Krishnan / Palit, Anup

Japanese journal of infectious diseases

2010 Volume 63, Issue 3, Page(s) 219–221

MeSH term(s)	Adolescent ; Adult ; Age Factors ; Child ; Child, Preschool ; Humans ; India/epidemiology ; Middle Aged ; Rural Population ; Salmonella typhi/isolation & purification ; Typhoid Fever/epidemiology
Language	English
Publishing date	2010-05
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1478383-6
ISSN	1884-2836 ; 1344-6304
ISSN (online)	1884-2836
ISSN	1344-6304
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