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Thekkur P, Thiagesan R, Nair D, Karunakaran N, Khogali M, Zachariah R, Dar Berger S, Satyanarayana S, Kumar AMV, Bochner AF, McClelland A, Ananthakrishnan R, Harries AD. Using timeliness metrics for household contact tracing and TB preventive therapy in the private sector, India. Int J Tuberc Lung Dis 2024; 28:122-139. [PMID: 38454186 DOI: 10.5588/ijtld.23.0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Although screening of household contacts (HHCs) of TB patients and provision of TB preventive therapy (TPT) is a key intervention to end the TB epidemic, their implementation globally is dismal. We assessed whether introducing a '7-1-7' timeliness metric was workable for implementing HHC screening among index patients with pulmonary TB diagnosed by private providers in Chennai, India, between November 2022 and March 2023.METHODS This was an explanatory mixed-methods study (quantitative-cohort and qualitative-descriptive).RESULTS There were 263 index patients with 556 HHCs. In 90% of index patients, HHCs were line-listed within 7 days of anti-TB treatment initiation. Screening outcomes were ascertained in 48% of HHCs within 1 day of line-listing. Start of anti-TB treatment, TPT or a decision to receive neither was achieved in 57% of HHC within 7 days of screening. Overall, 24% of screened HHCs in the '7-1-7' period started TPT compared with 16% in a historical control (P < 0.01). Barriers to achieving '7-1-7' included HHC reluctance for evaluation or TPT, refusal of private providers to prescribe TPT and reliance on facility-based screening of HHCs instead of home visits by health workers for screening.CONCLUSIONS Introduction of a timeliness metric is a workable intervention that adds structure to HHC screening and timely management..
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Affiliation(s)
- P Thekkur
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;, The Union South-East Asia Office, New Delhi
| | - R Thiagesan
- Resource Group for Education and Advocacy for Community Health, Chennai, India
| | - D Nair
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;, The Union South-East Asia Office, New Delhi
| | - N Karunakaran
- Resource Group for Education and Advocacy for Community Health, Chennai, India
| | - M Khogali
- Institute of Public Health, College of Medicine and Health Sciences, University of the United Arab Emirates, Al Ain, UAE
| | - R Zachariah
- United Nations Children Fund, United Nations Development Programme, World Bank Special Programme for Research and Training in Tropical Diseases, WHO, Geneva, Switzerland
| | - S Dar Berger
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;, The Union South-East Asia Office, New Delhi
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;, The Union South-East Asia Office, New Delhi, Yenepoya Medical College, Yenepoya (deemed University), Mangalore, India
| | | | | | - R Ananthakrishnan
- Resource Group for Education and Advocacy for Community Health, Chennai, India
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Harries AD, Lin Y, Thekkur P, Nair D, Chakaya J, Dongo JP, Luzze H, Chimzizi R, Mubanga A, Timire C, Kavenga F, Satyanarayana S, Kumar AMV, Khogali M, Zachariah R. Why TB programmes should assess for comorbidities, determinants and disability at the start and end of TB treatment. Int J Tuberc Lung Dis 2023; 27:495-498. [PMID: 37353872 DOI: 10.5588/ijtld.23.0178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Affiliation(s)
- A D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Y Lin
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - P Thekkur
- International Union Against Tuberculosis and Lung Disease, Paris, France, The Union-South East (USEA) Office, New Delhi, India
| | - D Nair
- International Union Against Tuberculosis and Lung Disease, Paris, France, The Union-South East (USEA) Office, New Delhi, India
| | - J Chakaya
- Department of Medicine, Therapeutics, Dermatology and Psychiatry, Kenyatta University, Nairobi, Kenya, Respiratory Society of Kenya, Nairobi, Kenya
| | - J P Dongo
- The Union-Uganda Office, Kampala, Uganda
| | - H Luzze
- National Leprosy and Tuberculosis Programme, Ministry of Health, Kampala, Uganda
| | - R Chimzizi
- Ministry of Health/USAID STAR Project, Lusaka, Zambia
| | - A Mubanga
- National Tuberculosis Programme, Ministry of Health, Lusaka, Zambia
| | - C Timire
- International Union Against Tuberculosis and Lung Disease, Paris, France, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK, Ministry of Health and Child Care, AIDS and TB Department, Harare, Zimbabwe
| | - F Kavenga
- Ministry of Health and Child Care, AIDS and TB Department, Harare, Zimbabwe
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease, Paris, France, The Union-South East (USEA) Office, New Delhi, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease, Paris, France, The Union-South East (USEA) Office, New Delhi, India, Yenepoya Medical College, Yenepoya (deemed University), Mangalore, India
| | - M Khogali
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - R Zachariah
- Special Programme for Research and Training in Tropical Diseases (TDR), WHO, Geneva, Switzerland
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Anehosur V, Vadera H, Bhat A, Satyanarayana S, Kumar N. Does Pectoralis Major Myocutaneous Flap Cause the Shoulder Morbidity: A Clinical Comparative Study. Indian J Otolaryngol Head Neck Surg 2022; 74:2582-2588. [PMID: 36452735 PMCID: PMC9702499 DOI: 10.1007/s12070-020-02279-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 11/10/2020] [Indexed: 10/23/2022] Open
Abstract
The aim was to compare the morbidity of shoulder function following modified radical neck dissection with and without Pectoralis Major Myocutaneous muscle flap (PMMC) harvest in head and neck cancer patient to determine the effect of PMMC flap harvest on shoulder function and also to determine the effect of physiotherapy. Materials and methods: Prospective study involving two groups study group of 20 patients with MRND, with PMMC flap reconstruction as part of head and neck cancer surgery and control group of 20 patients who had undergone MRND(IJV & SAN sparing) without PMMC flap in same period were included. All patients were assessed at 3rd and 6th month following completion of surgery using subjective (Shoulder Disability Questionnaire) and objective (goniometer and manual muscle testing) parameters. 40 patients were included in the study, 33 (82.5%) male and 7 (17.5%) female with a mean age of 49 years with stage III/IV carcinoma In Group-1 and Group-2 the shoulder disability decreased significantly after physiotherapy intervention and also at 6thmonth postoperatively both groups showed improvements in shoulder range of motion and muscle strength. Harvesting of PMMC flap does not intensify the morbidity of shoulder which is common in RND and during MRND. A regimen of home-based exercises and patient education are effective tools to reduce shoulder disability and improving shoulder function.
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Affiliation(s)
- Venkatesh Anehosur
- SDM Craniofacial Surgery and Research Centre, SDM College of Dental Science and Hospital, Shri Dharmasthala Manjunatheshwar University, Dharwad, Karnataka India
| | - Hitesh Vadera
- Department of Oral and Maxillofacial Surgery, AMC Dental College Khokhara, Ahmedabad, India
| | - Adithi Bhat
- SDM College of Dental Sciences and Hospital Shri Dharmasthala Manjunatheshwar University, Dharwad, Karnataka India
| | | | - Niranjan Kumar
- Department of Plastic and Reconstructive Surgery, SDM Craniofacial Centre, Shri Dharmasthala Manjunatheshwar University, SDM College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka 580009 India
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Pradhan P, Rajbhandari P, Nagaraja SB, Shrestha P, Grigoryan R, Satyanarayana S, Davtyan H. Prevalence of methicillin-resistant Staphylococcus aureus in a tertiary hospital in Nepal. Public Health Action 2021; 11:46-51. [PMID: 34778015 PMCID: PMC8575383 DOI: 10.5588/pha.21.0042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
SETTING: Patan Hospital, Lalitpur, Nepal. OBJECTIVES: To describe 1) the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and its antibiotic sensitivity pattern; 2) the demographic and clinical characteristics associated with MRSA infections; and 3) the treatment outcomes of in-patients with MRSA infection among patients with S. aureus infection between January 2018 and December 2020. DESIGN: This was a cross-sectional study using electronic and paper-based hospital records of patients with S. aureus infection. RESULTS: Of the 1,804 patients with S. aureus infection, 1,027 patients (57%, 95% CI 55–59) had MRSA. The MRSA were susceptible to vancomycin (100%), linezolid (96%), doxycycline (96%), chloramphenicol (86%) and cotrimoxazole (70%), and resistant to erythromycin (68%), clindamycin (56%), gentamycin (58%), ciprofloxacin (92%) and ofloxacin (91%). The prevalence of MRSA was higher in 2019, among out-patients, and in respiratory samples, and lower in blood samples. Of the 142 in-patients with MRSA, 93% had a successful clinical outcome (cured/improved). CONCLUSION: More than 50% of patients with S. aureus infection had MRSA that were resistant to commonly available antibiotics. This calls for strengthening surveil-lance and good infection control practices in this hospital.
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Affiliation(s)
- P Pradhan
- Department of Medical Microbiology and Immunology, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - P Rajbhandari
- Department of Medical Microbiology and Immunology, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - S B Nagaraja
- Department of Community Medicine, ESIC Medical College and Post Graduate Institute of Medical Science and Research, Bangalore, India
| | - P Shrestha
- World Health Organization Health Emergencies Programme, Kathmandu, Nepal
| | - R Grigoryan
- Tuberculosis Research and Prevention Center, Yerevan, Armenia
| | - S Satyanarayana
- Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - H Davtyan
- Tuberculosis Research and Prevention Center, Yerevan, Armenia
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Satyanarayana S, Bhatia V, Mandal PP, Kanchar A, Falzon D, Sharma M. Urgent need to address the slow scale-up of TB preventive treatment in the WHO South-East Asia Region. Int J Tuberc Lung Dis 2021; 25:382-387. [PMID: 33977906 DOI: 10.5588/ijtld.20.0941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In September 2018, all countries made a commitment at the first ever United Nations High-Level Meeting (UNHLM) on TB, to provide TB preventive treatment (TPT) to at least 30 million people at high-risk of TB disease between 2018 and 2022. In the WHO South-East Asia Region (SEA Region), which accounts for 44% of the global TB burden, only 1.2 million high-risk individuals (household contacts and people living with HIV) were provided TPT (11% of the 10.8 million regional UNHLM TPT target) in 2018 and 2019. By 2020, almost all 11 countries of the SEA Region had revised their policies on TPT target groups and criteria to assess TPT eligibility, and had adopted at least one shorter TPT regimen recommended in the latest WHO TPT guidelines. The major challenges for TPT scale-up in the SEA Region are resource shortages, knowledge and service delivery/uptake gaps among providers and service recipients, and the lack of adequate quantities of rifapentine for use in shorter TPT regimens. There are several regional opportunities to address these gaps and countries of the SEA Region must make use of these opportunities to scale up TPT services rapidly to reduce the TB burden in the SEA Region.
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Affiliation(s)
- S Satyanarayana
- Tuberculosis Unit, South-East Asia Regional Office, WHO, New Delhi, India
| | - V Bhatia
- Tuberculosis Unit, South-East Asia Regional Office, WHO, New Delhi, India
| | - P P Mandal
- Tuberculosis Unit, South-East Asia Regional Office, WHO, New Delhi, India
| | - A Kanchar
- Global TB Programme, WHO, Geneva, Switzerland
| | - D Falzon
- Global TB Programme, WHO, Geneva, Switzerland
| | - M Sharma
- Tuberculosis Unit, South-East Asia Regional Office, WHO, New Delhi, India
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Harries AD, Kumar AMV, Satyanarayana S, Thekkur P, Lin Y, Dlodlo RA, Brigden G. TB and COVID-19: measuring key risk factors that affect treatment outcomes. Int J Tuberc Lung Dis 2021; 25:329-331. [PMID: 33762081 DOI: 10.5588/ijtld.21.0061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi, Yenepoya Medical College, Yenepoya (deemed University), Mangalore, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi
| | - P Thekkur
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi
| | - Y Lin
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - R A Dlodlo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - G Brigden
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
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7
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Nagamani C, Reddy PV, Reddy MR, Reddy KL, Satyanarayana S. Synthesis and Characterization of Ru(II) Polypyridyl Complexes with 2-(4-Methylbenzoate)-1H-imidazo[4,5-f][1,10]phenantroline Ligand, and Their DNA Binding, Photocleavage, Physico-Chemical Properties, and Cytotoxicity. RUSS J GEN CHEM+ 2021. [DOI: 10.1134/s1070363220120385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Shewade HD, Gupta V, Satyanarayana S, Chadha SS, Pandurangan S, Mohanty S, Kumar AMV. History of household member with tuberculosis or related death in newly diagnosed patients in India. Public Health Action 2020; 10:53-56. [PMID: 32639482 DOI: 10.5588/pha.19.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 03/07/2020] [Indexed: 11/10/2022] Open
Abstract
Among new smear-positive pulmonary tuberculosis (TB) patients aged ⩾15 years from marginalised populations in India, one in four had a history of a household member with TB and one in 10 had a TB-related death in the household. This contribution of household transmission to overall TB transmission provides evidence for a potential population-level benefit of TB preventive treatment for all household contacts (without active TB). Females with TB had a significantly higher household TB exposure than males. Targeted TB preventive treatment (if implemented in a phased manner) among female household contacts may be explored after considering other factors.
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Affiliation(s)
- H D Shewade
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia (USEA), New Delhi, India
| | - V Gupta
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - S S Chadha
- Foundation for Innovative New Diagnostics (FIND), New Delhi, India
| | | | - S Mohanty
- The Union South-East Asia (USEA), New Delhi, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia (USEA), New Delhi, India.,Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, India
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Wohlgemuth W, Fins A, Tutek J, Gonzalez A, Martinez-Garcia A, Satyanarayana S, Marchetti D, Wallace D. 0551 Longitudinal Measurement Invariance of the Insomnia Severity Index in Veterans with Sleep Apnea. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The Insomnia Severity Index is a commonly used instrument to assess the presence of insomnia symptoms as well as an outcome measure following an intervention. Longitudinal measurement invariance is a necessary property of an assessment instrument when it is repeated over time. The validity of conclusions regarding change in the construct ‘insomnia severity’ depend on scale equivalence at each measurement timepoint. Assessment of measurement invariance of the ISI in sleep apnea patients has never been performed.
Methods
Veterans with sleep apnea (n=654; AHI=36±28; 93% male; age=52±12; BMI=33±6) completed the ISI on the night of their overnight PSG and again when they picked up their PAP device. Invariance was determined by imposing a series of more restrictive equivalence constraints on a 2-factor model of the ISI. The series of constraints tested for configural, weak, strong and strict invariance. Invariance testing was modeled with exploratory structural equation modeling in Mplus (v. 7.0).
Results
The 2-factor model that emerged from the analysis showed items relating to nighttime symptoms loading on factor 1 and daytime symptoms loading on factor 2. The sleep ‘satisfaction’ item, however, had weak but similar loadings on both factors. The increasingly restrictive constraints imposed on the model revealed no decrement in model fit (RMSEA=.039 to.043; CFI=.987 to .980; TLI=.981-.977; SRMR=.027-.041).
Conclusion
The ISI met strict criteria for longitudinal measurement invariance demonstrating that it is a valid instrument to be used in repeated measures study designs of insomnia in sleep apnea patients. Change over time on the ISI is not due to the changing measurement characteristics of the ISI but to true changes in the ‘insomnia severity’ construct.
Support
None
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Affiliation(s)
| | - A Fins
- Nova Southeastern University, Ft. Lauderdale, FL
| | - J Tutek
- Miami VA Sleep Center, Miami, FL
| | - A Gonzalez
- Nova Southeastern University, Ft. Lauderdale, FL
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Kyaw NTT, Kumar AMV, Kyaw KWY, Satyanarayana S, Magee MJ, Min AC, Moe J, Aung ZZ, Aung TK, Oo MM, Soe KT, Oo HN, Aung ST, Harries AD. IPT in people living with HIV in Myanmar: a five-fold decrease in incidence of TB disease and all-cause mortality. Int J Tuberc Lung Dis 2020; 23:322-330. [PMID: 30871663 DOI: 10.5588/ijtld.18.0448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Myanmar, a country with a high human immunodeficiency virus-tuberculosis (HIV-TB) burden, where the tuberculin skin test or interferon-gamma release assays are not routinely available for the diagnosis of latent tuberculous infection. OBJECTIVE To assess the effect of isoniazid (INH) preventive therapy (IPT) on the risk of TB disease and mortality among people living with HIV (PLHIV). DESIGN A retrospective cohort study of routinely collected data on PLHIV enrolled into care between 2009 and 2014. RESULTS Of 7177 patients (median age 36 years, interquartile range 31-42; 53% male) included in the study, 1278 (18%) patients received IPT. Among patients receiving IPT, 855 (67%) completed 6 or 9 months of INH. Patients who completed IPT had a significantly lower risk of incident TB than those who never received IPT (adjusted hazard ratio [aHR] 0.21, 95%CI 0.12-0.34) after controlling for potential confounders. PLHIV who received IPT had a significantly lower risk of death than those who never received IPT (PLHIV who completed IPT, aHR 0.25, 95%CI 0.16-0.37; those who received but did not complete IPT, aHR 0.55, 95%CI 0.37-0.82). CONCLUSION Among PLHIV in Myanmar, completing a course of IPT significantly reduced the risk of TB disease, and receiving IPT significantly reduced the risk of death.
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Affiliation(s)
- N T T Kyaw
- International Union Against Tuberculosis and Lung Disease (The Union), Myanmar Office, Mandalay, Myanmar, Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | | | - K W Y Kyaw
- International Union Against Tuberculosis and Lung Disease (The Union), Myanmar Office, Mandalay, Myanmar
| | | | - M J Magee
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - A C Min
- International Union Against Tuberculosis and Lung Disease (The Union), Myanmar Office, Mandalay, Myanmar
| | - J Moe
- International Union Against Tuberculosis and Lung Disease (The Union), Myanmar Office, Mandalay, Myanmar
| | - Z Z Aung
- National HIV/AIDS Programme, Department of Public Health, Naypyidaw, Myanmar
| | - T K Aung
- International Union Against Tuberculosis and Lung Disease (The Union), Myanmar Office, Mandalay, Myanmar
| | - M M Oo
- International Union Against Tuberculosis and Lung Disease (The Union), Myanmar Office, Mandalay, Myanmar
| | - K T Soe
- Department of Medical Research, Pyin Oo Lwin Branch
| | - H N Oo
- National HIV/AIDS Programme, Department of Public Health, Naypyidaw, Myanmar
| | - S T Aung
- National Tuberculosis Programme, Department of Public Health, Naypyidaw, Myanmar
| | - A D Harries
- The Union, Paris, France, London School of Hygiene & Tropical Medicine, London, UK
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Harries AD, Schwoebel V, Monedero-Recuero I, Aung TK, Chadha S, Chiang CY, Conradie F, Dongo JP, Heldal E, Jensen P, Nyengele JPK, Koura KG, Kumar AMV, Lin Y, Mlilo N, Nakanwagi-Mukwaya A, Ncube RT, Nyinoburyo R, Oo NL, Patel LN, Piubello A, Rusen ID, Sanda T, Satyanarayana S, Syed I, Thu AS, Tonsing J, Trébucq A, Zamora V, Zishiri C, Hinderaker SG, Aït-Khaled N, Roggi A, Caminero Luna J, Graham SM, Dlodlo RA, Fujiwara PI. Challenges and opportunities to prevent tuberculosis in people living with HIV in low-income countries. Int J Tuberc Lung Dis 2020; 23:241-251. [PMID: 30808459 DOI: 10.5588/ijtld.18.0207] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
People living with the human immunodeficiency virus (HIV) (PLHIV) are at high risk for tuberculosis (TB), and TB is a major cause of death in PLHIV. Preventing TB in PLHIV is therefore a key priority. Early initiation of antiretroviral therapy (ART) in asymptomatic PLHIV has a potent TB preventive effect, with even more benefits in those with advanced immunodeficiency. Applying the most recent World Health Organization recommendations that all PLHIV initiate ART regardless of clinical stage or CD4 cell count could provide a considerable TB preventive benefit at the population level in high HIV prevalence settings. Preventive therapy can treat tuberculous infection and prevent new infections during the course of treatment. It is now established that isoniazid preventive therapy (IPT) combined with ART among PLHIV significantly reduces the risk of TB and mortality compared with ART alone, and therefore has huge potential benefits for millions of sufferers. However, despite the evidence, this intervention is not implemented in most low-income countries with high burdens of HIV-associated TB. HIV and TB programme commitment, integration of services, appropriate screening procedures for excluding active TB, reliable drug supplies, patient-centred support to ensure adherence and well-organised follow-up and monitoring that includes drug safety are needed for successful implementation of IPT, and these features would also be needed for future shorter preventive regimens. A holistic approach to TB prevention in PLHIV should also include other important preventive measures, such as the detection and treatment of active TB, particularly among contacts of PLHIV, and control measures for tuberculous infection in health facilities, the homes of index patients and congregate settings.
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Affiliation(s)
- A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, London School of Hygiene & Tropical Medicine, London, UK
| | - V Schwoebel
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - I Monedero-Recuero
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - T K Aung
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Myanmar Office, Mandalay, Myanmar
| | - S Chadha
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi, India
| | - C-Y Chiang
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - F Conradie
- Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa, Vital Strategies, New York, New York, USA
| | - J-P Dongo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Uganda Office, Kampala, Uganda
| | - E Heldal
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - P Jensen
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - J P K Nyengele
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, DRC Office, Kinshasa, Democratic Republic of Congo
| | - K G Koura
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Mère et enfant face aux infections tropicales Institut de recherche pour le développement, Université Paris 5, Sorbonne Paris Cité, Paris, France
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi, India
| | - Y Lin
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, China Office, Beijing, China
| | - N Mlilo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Zimbabwe Office, Harare, Zimbabwe
| | - A Nakanwagi-Mukwaya
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Uganda Office, Kampala, Uganda
| | - R T Ncube
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Zimbabwe Office, Harare, Zimbabwe
| | - R Nyinoburyo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Uganda Office, Kampala, Uganda
| | - N L Oo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Myanmar Office, Mandalay, Myanmar
| | - L N Patel
- Vital Strategies, New York, New York, USA
| | - A Piubello
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Damien Foundation, Brussels, Belgium
| | - I D Rusen
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Vital Strategies, New York, New York, USA
| | - T Sanda
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, DRC Office, Kinshasa, Democratic Republic of Congo
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi, India
| | - I Syed
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - A S Thu
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Myanmar Office, Mandalay, Myanmar
| | - J Tonsing
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi, India
| | - A Trébucq
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - V Zamora
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Peru Office, Lima, Peru
| | - C Zishiri
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Zimbabwe Office, Harare, Zimbabwe
| | - S G Hinderaker
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, University of Bergen, Bergen, Norway
| | - N Aït-Khaled
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - A Roggi
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - J Caminero Luna
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Pneumology Department, Dr Negrin General Hospital of Gran Canaria, Las Palmas, Spain
| | - S M Graham
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - R A Dlodlo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Zimbabwe Office, Harare, Zimbabwe
| | - P I Fujiwara
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
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Thein SK, Satyanarayana S, Kyaw KWY, Saw S, Maung TN, Swe PP, Thu MK, Aung ST. Childhood TB in Myanmar: trends in notification, profile and treatment outcomes in the private sector. Public Health Action 2019; 9:135-141. [PMID: 32042604 PMCID: PMC6945737 DOI: 10.5588/pha.19.0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/11/2019] [Indexed: 11/10/2022] Open
Abstract
SETTING Myanmar National Tuberculosis (TB) programme (NTP). OBJECTIVE To describe 1) the trends in childhood TB (aged ⩾ 14 years) notification from 2014 to 2017 and quantify the private sector contribution to this notification; and 2) the profile and treatment outcomes of childhood TB managed in the private sector in 2016. STUDY DESIGN This was an observational study involving the review of routine records and reports of the NTP public-private mix (PPM) projects managed by the Myanmar Medical Association and Population Service International. RESULTS The total number of childhood TB notified has declined from 36 314 in 2014 to 28 723 in 2017 (average annual decline = 2607 cases per year). The private sector contribution to the notification remained between 17% and 19%. Of the 5616 childhood TB cases diagnosed and treated under the two PPM projects in 2016, 99% were clinically diagnosed and 5459 (97.7%) had successful treatment outcomes. Children aged ⩾10 years, males, those with bacteriologically confirmed TB, those treated in the regions or states of Mandalay, Chin and Shan had a higher risk of an unfavourable outcome (lost to follow-up, death, move to second-line treatment and not evaluated). CONCLUSION Childhood TB notification is showing a declining trend. One of five notified childhood TB cases was diagnosed and treated in the private sector, where the successful treatment rate was high.
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Affiliation(s)
- S K Thein
- Department of Medical Research, Yangon, Myanmar
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | | | - S Saw
- Department of Medical Research, Yangon, Myanmar
| | - T N Maung
- Myanmar Medical Association, Yangon, Myanmar
| | - P P Swe
- Population Service International, Yangon, Myanmar
| | - M K Thu
- National TB Programme, Department of Public Health, Ministry of Health and Sports, Yangon, Myanmar
| | - S T Aung
- National TB Programme, Department of Public Health, Ministry of Health and Sports, Yangon, Myanmar
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13
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Harries AD, Lin Y, Kumar AMV, Satyanarayana S, Zachariah R, Dlodlo RA. How can integrated care and research assist in achieving the SDG targets for diabetes, tuberculosis and HIV/AIDS? Int J Tuberc Lung Dis 2019; 22:1117-1126. [PMID: 30236178 DOI: 10.5588/ijtld.17.0677] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Integrating the management and care of communicable diseases, such as tuberculosis (TB) and human immunodeficiency virus/acquired immune-deficiency syndrome (HIV/AIDS), and non-communicable diseases, particularly diabetes mellitus (DM), may help to achieve the ambitious health-related targets of the Sustainable Development Goals (SDG 3.3 and 3.4) by 2030. There are five important reasons to integrate. First, we need to integrate to prevent disease. In sub-Saharan Africa, in particular, HIV infection is the main driver of the TB epidemic, and antiretroviral therapy combined with isoniazid preventive therapy (IPT) can reduce TB case notification rates. In Asia, DM is another important driver of the TB epidemic, and preventing or controlling DM can reduce the risk of TB. Second, we need to integrate to diagnose cases. Between a third to a half of those living with HIV, TB or DM do not know they have the disease, and bi-directional screening, whereby TB patients are screened for HIV and DM or people living with HIV and DM are screened for TB, can help to identify these 'missing cases'. Third, we need to integrate to better treat and manage patients who have a combination of two or more of these diseases, so that treatment success and retention on treatment can be optimised. Fourth, we should integrate to ensure better infection control practices for both TB and HIV infection in health facilities and congregate settings, such as prisons. Finally, we should integrate and learn how to monitor, record and report, particularly in relation to the cascade of events implicit in the HIV/AIDS and TB 90-90-90 targets.
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Affiliation(s)
- A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, London School of Hygiene & Tropical Medicine, London, UK
| | - Y Lin
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Beijing, China
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Regional Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Regional Office, New Delhi, India
| | - R Zachariah
- Medical Department, Operational Research Unit (LuxOR), Médecins Sans Frontières, Brussels Operational Centre, Luxembourg City, Luxembourg
| | - R A Dlodlo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Bulawayo, Zimbabwe
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14
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Khaing PS, Kyaw NTT, Satyanarayana S, Oo NL, Aung TH, Oo HM, Kyaw KWY, Soe KT, Thein S, Thwin T, Aung ST. Treatment outcome of tuberculosis patients detected using accelerated vs. passive case finding in Myanmar. Int J Tuberc Lung Dis 2019; 22:1145-1151. [PMID: 30236181 DOI: 10.5588/ijtld.18.0038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Several projects involving accelerated or active case finding (ACF) of tuberculosis (TB) cases are being implemented in Myanmar. However, there is a concern that patients detected using ACF have poorer TB treatment outcomes than those detected using passive case finding (PCF). OBJECTIVE To assess differences in the demographics, clinical profile and treatment outcomes of patients detected using ACF and PCF. DESIGN Retrospective cohort study of TB patients diagnosed and enrolled for treatment during 2014-2016. RESULTS Of 16 048 patients enrolled, 2226 (16%) were detected using ACF; the treatment success rate (cured and completed) was 88%. A higher proportion of cases detected using ACF were aged 55 years, human immunodeficiency virus (HIV) negative and sputum smear-positive pulmonary TB. After adjusting for differences in demographic and clinical characteristics, we found that treatment outcomes in patients detected using ACF and PCF were not significantly different (adjusted relative risk [aRR] 0.89, 95%CI 0.78-1.00). Male sex, age 55 years, patients with a previous history of TB and HIV positivity were independently associated with unsuccessful outcomes. CONCLUSION ACF detected a significant proportion of TB cases in study townships; treatment outcomes in cases detected using ACF and those detected using PCF were similar. More tailored interventions are needed to improve treatment outcomes in patients at a higher risk of unsuccessful treatment outcomes.
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Affiliation(s)
- P S Khaing
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - N T T Kyaw
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | | | - N L Oo
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - T H Aung
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - H M Oo
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - K W Y Kyaw
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - K T Soe
- Department of Medical Research, Yangon
| | - S Thein
- National Tuberculosis Programme, Yangon, Myanmar
| | - T Thwin
- National Tuberculosis Programme, Yangon, Myanmar
| | - S T Aung
- National Tuberculosis Programme, Yangon, Myanmar
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15
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Ravi C, Vuradi RK, Avudoddi S, Ramchander M, Satyanarayana S. Induction of Apoptosis in SKOV3 and DNA Binding by Cobalt(III) Polypyridyl Complexes. Russ J Bioorg Chem 2019. [DOI: 10.1134/s1068162019040095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Shekhar B, Vasantha P, Sathish Kumar B, Anantha Lakshmi P, Ravi Kumar V, Satyanarayana S. Chromium‐metformin ternary complexes: Thermal, DNA interaction and Docking studies. Appl Organomet Chem 2019. [DOI: 10.1002/aoc.5086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- B. Shekhar
- Department of ChemistryOsmania University Tarnaka, Hyderabad Telangana State 500007 India
| | - P. Vasantha
- Department of ChemistryUniversity College for Women, Osmania University Koti, Hyderabad Telangana State 500095 India
| | - B. Sathish Kumar
- Department of ChemistryOsmania University Tarnaka, Hyderabad Telangana State 500007 India
| | - P.V. Anantha Lakshmi
- Department of ChemistryOsmania University Tarnaka, Hyderabad Telangana State 500007 India
| | - V. Ravi Kumar
- Department of ChemistryOsmania University Tarnaka, Hyderabad Telangana State 500007 India
| | - S. Satyanarayana
- Department of ChemistryOsmania University Tarnaka, Hyderabad Telangana State 500007 India
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17
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Ravi C, Vuradi RK, Avudoddi S, Yata PK, Putta VR, Srinivas G, Merugu R, Satyanarayana S. Synthesis, spectral studies, DNA binding, photocleavage, antimicrobial and anticancer activities of isoindol Ru(II) polypyridyl complexes. Nucleosides Nucleotides Nucleic Acids 2019; 38:788-806. [PMID: 31081456 DOI: 10.1080/15257770.2019.1610890] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Three new Ru(II) polypyridyl complexes [Ru(phen)2CIIP]2+ (1) {CIIP = 2-(5-Chloro-3a H-Isoindol-3-yl)-1H-Imidazo[4,5-f][1, 10]phenantholine} (phen = 1, 10 phenanthroline), [Ru(bpy)2CIIP]2+ (2) (bpy = 2, 2' bipyridine) and [Ru(dmb)2CIIP]2+ (3) (dmb = 4, 4'-dimethyl 2, 2' bipyridine) were synthesized and characterized by different spectral methods. The DNA-binding behavior of these complexes was investigated by absorption, emission spectroscopic titration and viscosity measurements, indicating that these three complexes bind to CT-DNA in an intercalative mode, but binding affinities of these complexes were different. The DNA-binding constants Kb of complexes 1, 2 and 3 were calculated in the order of 106. All three complexes cleave pBR322 DNA in photoactivated cleavage studies and exhibit good antimicrobial activity. Anticancer activity of these Ru(II) complexes was evaluated in MCF7 cells. Cytotoxicity by MTT assay showed growth inhibition in a dose dependent manner. Cell cycle analysis by flow cytometry data showed an increase in Sub G1 population. Annexin V FITC/PI staining confirms that these complexes cause cell death by the induction of apoptosis.
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Affiliation(s)
- Ch Ravi
- a Department of Chemistry, JNTU , Hyderabad , India
| | | | | | - Praveen Kumar Yata
- b Department of Chemistry, Osmania University , Hyderabad , India.,c Department of Chemistry, Osmania University PG College , Narsapur , India
| | | | - G Srinivas
- b Department of Chemistry, Osmania University , Hyderabad , India.,d Department of Chemistry, Government Degree College Manthani , Peddapalli , India
| | - Ramchander Merugu
- e Department of Biochemistry, Mahatma Gandhi University , Nalgonda , India
| | - S Satyanarayana
- b Department of Chemistry, Osmania University , Hyderabad , India
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18
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Nambagari N, Perka S, Vuradi RK, Satyanarayana S. Study of the interaction of Co(III) polypyridyl complexes with DNA: an experimental and computational approach. Nucleosides Nucleotides Nucleic Acids 2019; 38:400-417. [PMID: 30689503 DOI: 10.1080/15257770.2018.1554222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Three new cobalt(III) polypyridyl complexes, [Co(L - L)2IIP]3+ where IIP = 2-(2H-isoindol-1-yl)-2H-imidazo[4,5-f][1, 10]phenanthroline, L = 1) phen (1,10-phenanthroline), 2) bpy (2,2'bipyridyl), 3) dmb (4, 4-dimethyl 2, 2'-bipyridine) have been synthesized, characterized (UV -VIS, IR, 1HNMR and 13C NMR spectroscopy) and screened for their in vitro antibacterial activity against E.coli, Staphylococcus aureus and Bacillus subtilis. The binding of these complexes with calf-thymus DNA (CT-DNA) has been investigated by absorption and fluorescence spectroscopy, viscosity measurements. The experimental studies indicate that complexes bind to CT-DNA by means of intercalation, but with different binding affinities due to differences in the planarity of the ancillary ligand. The complexes promote photocleavage of plasmid DNA from super coiled form I to the open circular form II. The antibacterial activities suggest that the metal complexes are more active as compared to the prepared un-complexed IIP ligand. In addition, a conformational search was carried out by Molecular Dynamics Simulations, and docking revealed that complexes intercalate between base pairs of DNA. The experimental and computational approaches reveal that the length of the intercalator and the nature of ancillary ligand are highly important factors for DNA binding.
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Affiliation(s)
- Navaneetha Nambagari
- a Department of Chemistry , University College of Science, Osmania University , Hyderabad , India
| | - Shyam Perka
- a Department of Chemistry , University College of Science, Osmania University , Hyderabad , India
| | - Ravi Kumar Vuradi
- a Department of Chemistry , University College of Science, Osmania University , Hyderabad , India
| | - S Satyanarayana
- a Department of Chemistry , University College of Science, Osmania University , Hyderabad , India
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19
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Singhi L, Sagili KD, Sharath BN, Bhandari K, Dadul PK, Gautam M, Ravichandra C, Chadha S, Satyanarayana S. Non-response to first-line anti-tuberculosis treatment in Sikkim, India: a risk-factor analysis study. Public Health Action 2018; 8:162-168. [PMID: 30775275 DOI: 10.5588/pha.18.0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/06/2018] [Indexed: 02/06/2023] Open
Abstract
Setting: Sikkim, India, has the highest proportion of tuberculosis (TB) patients on first-line anti-tuberculosis regimens with the outcome 'failure' or 'shifted to regimen for multidrug-resistant TB (MDR-TB)'. Objective: To assess the factors associated with non-response to treatment, i.e., 'failure' or 'shifted to MDR-TB regimen'. Methods: We conducted a retrospective cohort study using Revised National Tuberculosis Control Programme data of all TB patients registered in 2015 for first-line TB treatment. In addition, we interviewed 42 patients who had not responded to treatment to ascertain their current status. Results: Of 1508 patients enrolled for treatment, about 9% were classified as non-response to treatment. Patient factors associated with non-response were urban setting (adjusted odds ratio [aOR] 2.39, 95%CI 1.22-4.67), ethnicity (being an Indian tribal, aOR 1.73, 95%CI 1.17-2.57, Indian [other] aOR 1.83, 95%CI 1.29-2.60 compared to patients of Nepali origin) and those on retreatment (aOR 2.40, 95%CI 1.99-2.91). Of the patients interviewed, 28 (67%) had received treatment for drug-resistant TB. Conclusion: In Sikkim, one in 11 patients had not responded to first-line anti-tuberculosis treatment. Host-pathogen genetics and socio-behavioural studies may be required to understand the reasons for the differences in non-response, particularly among ethnic groups.
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Affiliation(s)
| | - K D Sagili
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - B N Sharath
- ESIC (Employees' State Insurance Act) Medical College and Post Graduate Institute of Medical Science and Research, Bangalore, India
| | | | | | | | | | - S Chadha
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
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20
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Phyu MH, Kyaw KWY, Myint Z, Thida A, Satyanarayana S, Aung ST. Sputum smear-positive, Xpert ® MTB/RIF-negative results: magnitude and treatment outcomes of patients in Myanmar. Public Health Action 2018; 8:181-186. [PMID: 30775278 DOI: 10.5588/pha.18.0056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 10/10/2018] [Indexed: 11/10/2022] Open
Abstract
Setting: Myanmar's National Tuberculosis Programme (NTP) uses the Xpert® MTB/RIF assay to diagnose rifampicin (RMP) resistance in sputum smear-positive (Sm+) pulmonary tuberculosis (TB) patients. The Xpert test may occasionally yield negative results (Xpert-) for Mycobacterium tuberculosis complex, indicating a false-positive sputum smear result, false-negative Xpert result or infection with non-tuberculous mycobacteria (NTM). Patients with NTM may respond poorly to first-line anti-tuberculosis treatment. Objective: To assess the burden of Sm+, Xpert- results at the national level and treatment outcomes of Sm+, Xpert- patients in Yangon Region. Design: A cohort study involving a retrospective record review of routinely collected NTP data. Result: In 2015 and 2016, 4% of the 25 359 Sm+ patients who underwent Xpert testing nationally were Sm+, Xpert-. Similarly, in the Yangon Region, 5% of the 5301 Sm+ patients were also Xpert- and were treated with first-line anti-tuberculosis regimens. Smear grade (scanty/1+) and age ⩾65 years were associated with Sm+, Xpert- results. The 88% treatment success rate for this group was similar to that of Sm+, Xpert+ patients without RMP resistance. Conclusion: Approximately 4-5% of Sm+ TB patients were Xpert-. There is an urgent need to formulate guidelines on how to reassess and manage these patients.
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Affiliation(s)
- M H Phyu
- National Tuberculosis Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - K W Y Kyaw
- International Union Against Tuberculosis and Lung Disease (The Union) Myanmar Office, Mandalay, Myanmar
| | - Z Myint
- National Tuberculosis Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - A Thida
- World Health Organization TB Unit, Country Office in Myanmar
| | | | - S T Aung
- National Tuberculosis Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
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21
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Srinivas G, Ravi Kumar V, Laxma Reddy K, Praveen Kumar Y, Satyanarayana S. Comparative Studies on DNA Binding, Photocleavage, and Photophysical Properties of Ru(II) Complexes Containing TIP {TIP = 2-(Thiophen-2-yl)-1H-imidazo[4,5-f][1,10]-phenanthroline} Ligand. RUSS J GEN CHEM+ 2018. [DOI: 10.1134/s1070363218120253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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22
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Harries AD, Khogali M, Kumar AMV, Satyanarayana S, Takarinda KC, Karpati A, Olliaro P, Zachariah R. Building the capacity of public health programmes to become data rich, information rich and action rich. Public Health Action 2018; 8:34-36. [PMID: 29946518 DOI: 10.5588/pha.18.0001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/02/2018] [Indexed: 11/10/2022] Open
Abstract
Good quality, timely data are the cornerstone of health systems, but in many countries these data are not used for evidence-informed decision making and/or for improving public health. The SORT IT (Structured Operational Research and Training Initiative) model has, over 8 years, trained health workers in low- and middle-income countries to use data to answer important public health questions by taking research projects through to completion and publication in national or international journals. The D2P (data to policy) training initiative is relatively new, and it teaches health workers how to apply 'decision analysis' and develop policy briefs for policy makers: this includes description of a problem and the available evidence, quantitative comparisons of policy options that take into account predicted health and economic impacts, and political and feasibility assessments. Policies adopted from evidence-based information generated through the SORT IT and D2P approaches can be evaluated to assess their impact, and the cycle repeated to identify and resolve new public health problems. Ministries of Health could benefit from this twin-training approach to make themselves 'data rich, information rich and action rich', and thereby use routinely collected data in a synergistic manner to improve public health policy making and health care delivery.
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Affiliation(s)
- A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,London School of Hygiene & Tropical Medicine, London, UK
| | - M Khogali
- Vital Strategies, New York, New York, USA
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia Office, New Delhi, India
| | - K C Takarinda
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,AIDS & TB Department, Ministry of Health and Child Care, Harare, Zimbabwe
| | - A Karpati
- Vital Strategies, New York, New York, USA
| | - P Olliaro
- Special Programme for Research and Training in Tropical Disease, World Health Organization, Geneva, Switzerland
| | - R Zachariah
- Special Programme for Research and Training in Tropical Disease, World Health Organization, Geneva, Switzerland.,Operations Research Unit (LuxOR), Médecins sans Frontières, Luxembourg
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Nagaraja SB, Satyanarayana S, Bansal AK. Can ventilation oust tuberculosis bacilli? Dare to plug the unpluggable. Public Health Action 2018; 8:28. [PMID: 29581941 DOI: 10.5588/pha.17.0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 12/19/2017] [Indexed: 11/10/2022] Open
Affiliation(s)
- S B Nagaraja
- Employees State Insurance Corporation Medical College, Post Graduate Institute of Medical Science and Research (PGIMSR), Bangalore, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease South East Asia Office, New Delhi, India
| | - A K Bansal
- National Jalma Institute for Leprosy and Other Mycobacterial Diseases, Agra, India
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24
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Aye S, Majumdar SS, Oo MM, Tripathy JP, Satyanarayana S, Kyaw NTT, Kyaw KWY, Oo NL, Thein S, Thu MK, Soe KT, Aung ST. Evaluation of a tuberculosis active case finding project in peri-urban areas, Myanmar: 2014-2016. Int J Infect Dis 2018; 70:93-100. [PMID: 29476901 DOI: 10.1016/j.ijid.2018.02.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 02/03/2018] [Accepted: 02/13/2018] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES We assessed the effect of an active case finding (ACF) project on tuberculosis (TB) case notification and the yields from a household and neigbourhood intervention (screening contacts of historical index TB patients diagnosed >24months ago) and a community intervention (screening attendants of health education sessions/mobile clinics). DESIGN Cross-sectional analysis of project records, township TB registers and annual TB reports. RESULTS In the household and neigbourhood intervention, of 56,709 people screened, 1,076 were presumptive TB and 74 patients were treated for active TB with a screening yield of 0.1% and a yield from presumptive cases of 6.9%. In the community intervention, of 162,881 people screened, 4,497 were presumptive TB and 984 were treated for active TB with a screening yield of 0.6% and yield from presumptive cases of 21.9%. Of active TB cases, 94% were new, 89% were pulmonary, 44% were bacteriologically-confirmed and 5% had HIV. Case notification rates per 100,000 in project townships increased from 142 during baseline (2011-2013) to 148 during intervention (2014-2016) periods. CONCLUSIONS The yield from household and neigbourhood intervention was lower than community intervention. This finding highlights reconsidering the strategy of screening of contacts from historical index cases. Strategies to reach high-risk groups should be explored for future ACF interventions to increase yield of TB.
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Affiliation(s)
- Sandar Aye
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar.
| | | | - Myo Minn Oo
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Jaya Prasad Tripathy
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - Nang Thu Thu Kyaw
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Khine Wut Yee Kyaw
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Nay Lynn Oo
- International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Saw Thein
- National Tuberculosis Program, Department of Public Health, Ministry of Health and Sports, Myanmar
| | - Myat Kyaw Thu
- National Tuberculosis Program, Department of Public Health, Ministry of Health and Sports, Myanmar
| | - Kyaw Thu Soe
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Si Thu Aung
- National Tuberculosis Program, Department of Public Health, Ministry of Health and Sports, Myanmar
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25
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Ravi Kumar V, Nagababu P, Srinivas G, Rajender Reddy M, Vinoda Rani M, Ravi M, Satyanarayana S. Investigation of DNA/BSA binding of three Ru(II) complexes by various spectroscopic methods, molecular docking and their antimicrobial activity. J COORD CHEM 2017. [DOI: 10.1080/00958972.2017.1407410] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Penumaka Nagababu
- CSIR-National Environmental Engineering Research Institute (NEERI) Kolkata Zonal Centre, Kolkata, India
- Inorganic & Physical Chemistry Division, CSIR-Indian Institute of Chemical Technology, Hyderabad, India
| | - G. Srinivas
- Department of Chemistry, Osmania University, Hyderabad, India
| | | | - M. Vinoda Rani
- Department of Physics, Osmania University, Hyderabad, India
| | - Mudavath Ravi
- Department of Chemistry, Osmania University, Hyderabad, India
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Devi CS, Thulasiram B, Satyanarayana S, Nagababu P. Analytical Techniques Used to Detect DNA Binding Modes of Ruthenium(II) Complexes with Extended Phenanthroline Ring. J Fluoresc 2017; 27:2119-2130. [PMID: 28831648 DOI: 10.1007/s10895-017-2151-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/31/2017] [Indexed: 10/19/2022]
Abstract
This review describes the analytical techniques used to detect DNA-probes such as Ru(II) complexes with hetero cyclic imidazo phenanthroline (IP) ligands. Studies on drug-DNA interactions are useful biochemical techniques for visualization of DNA both in vitro and in vivo. The interactions of small molecules that binds to DNA are mainly classified into two major classes, one involving covalent binding and another non-covalent binding. Covalent binding in DNA can be irreversible and may leads to inhibition of all DNA processes which subsequently leads to cell death. Usually, covalent interactions leads to permanent changes in the structure of nucleic acids. The non-covalent interaction of molecules with DNA can be due to electrostatic interaction, intercalation and groove binding. These interactions of DNA probes can be explored by various spectroscopic techniques viz. UV-visible, emission, emission quenching spectroscopy, viscosity and thermal denaturation measurements.
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Affiliation(s)
- C Shobha Devi
- Department of Chemistry, RGUKT, Basar, Telangana State, India
| | - B Thulasiram
- Inorganic & Physical Chemistry Division, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad, 500007, Telangana State, India
| | - S Satyanarayana
- Department of Chemistry, Osmania University, Tarnaka, Hyderabad, Telangana State, India
| | - Penumaka Nagababu
- Inorganic & Physical Chemistry Division, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad, 500007, Telangana State, India. .,CSIR-NEERI Zonal Laboratory, I-8, Sector C, East Kolkata, Area Development Project, P.O. East Kolkata, Township, Kolkata, 700 107, India.
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Shewade HD, Chadha SS, Gupta V, Tripathy JP, Satyanarayana S, Sagili K, Mohanty S, Bera OP, Pandey P, Rajeswaran P, Jayaraman G, Santhappan A, Bajpai UN, Mamatha AM, Maiser R, Naqvi AJ, Pandurangan S, Nath S, Ghule VH, Das A, Prasad BM, Biswas M, Singh G, Mallick G, Jeyakumar Jaisingh AJ, Rao R, Kumar AMV. Data collection using open access technology in multicentre operational research involving patient interviews. Public Health Action 2017; 7:74-77. [PMID: 28744430 DOI: 10.5588/pha.15.0079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 11/19/2016] [Indexed: 11/10/2022] Open
Abstract
Conducting multicentre operational research is challenging due to issues related to the logistics of travel, training, supervision, monitoring and troubleshooting support. This is even more burdensome in resource-constrained settings and if the research includes patient interviews. In this article, we describe an innovative model that uses open access tools such as Dropbox, TeamViewer and CamScanner for efficient, quality-assured data collection in an ongoing multicentre operational research study involving record review and patient interviews. The tools used for data collection have been shared for adaptation and use by other researchers.
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Affiliation(s)
| | - H D Shewade
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S S Chadha
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - V Gupta
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India.,All India Institute of Medical Sciences, New Delhi, India
| | - J P Tripathy
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - K Sagili
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Mohanty
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - O P Bera
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - P Pandey
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - P Rajeswaran
- Resource Group for Education and Advocacy for Community Health, Chennai, India
| | - G Jayaraman
- Resource Group for Education and Advocacy for Community Health, Chennai, India
| | - A Santhappan
- Catholic Health Association of India, Secunderabad, India
| | - U N Bajpai
- Voluntary Health Association of India, New Delhi, India
| | - A M Mamatha
- Catholic Health Association of India, Secunderabad, India
| | - R Maiser
- Catholic Health Association of India, Secunderabad, India
| | - A J Naqvi
- MAMTA Health Institute for Mother and Child, New Delhi, India
| | - S Pandurangan
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Nath
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - V H Ghule
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - A Das
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - B M Prasad
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - M Biswas
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - G Singh
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - G Mallick
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | | | - R Rao
- Central TB Division, Revised National Tuberculosis Control Programme, Ministry of Health and Family Welfare, New Delhi, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India.,The Union, Paris, France
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28
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Maheshwari P, Chauhan K, Kadam R, Pujani A, Kaur M, Chitalia M, Dabas H, Perkins MD, Boehme CC, Denkinger CM, Raizada N, Ginnard J, Jefferson C, Pantoja A, Rupert S, Kik SV, Cohen C, Chedore P, Satyanarayana S, Pai M. Market assessment of tuberculosis diagnostics in India in 2013. Int J Tuberc Lung Dis 2017; 20:304-13. [PMID: 27046709 DOI: 10.5588/ijtld.15.0571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND India represents a significant potential market for new tests. We assessed India's market for tuberculosis (TB) diagnostics in 2013. METHODS Test volumes and unit costs were assessed for tuberculin tests, interferon-gamma release assays, sputum smear microscopy, serology, culture, speciation testing, nucleic-acid amplification tests (i.e., in-house polymerase chain reaction, Xpert(®) MTB/RIF, line-probe assays) and drug susceptibility testing. Data from the public sector were collected from the Revised National TB Control Programme reports. Private sector data were collected through a survey of private laboratories and practitioners. Data were also collected from manufacturers. RESULTS In 2013, India's public sector performed 19.2 million tests, with a market value of US$22.9 million. The private sector performed 13.6 million tests, with a market value of US$60.4 million when prices charged to the patient were applied. The overall market was US$70.8 million when unit costs from the ingredient approach were used for the 32.8 million TB tests performed in the entire country. Smear microscopy was the most common test performed, accounting for 25% of the overall market value. CONCLUSION India's estimated market value for TB diagnostics in 2013 was US$70.8 million. These data should be of relevance to test developers, donors and implementers.
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Affiliation(s)
- P Maheshwari
- Clinton Health Access Initiative [CHAI], New Delhi, India
| | - K Chauhan
- Clinton Health Access Initiative [CHAI], New Delhi, India
| | - R Kadam
- Clinton Health Access Initiative [CHAI], New Delhi, India
| | - A Pujani
- Clinton Health Access Initiative [CHAI], New Delhi, India
| | - M Kaur
- Clinton Health Access Initiative [CHAI], New Delhi, India
| | - M Chitalia
- Clinton Health Access Initiative [CHAI], New Delhi, India
| | - H Dabas
- Clinton Health Access Initiative [CHAI], New Delhi, India
| | - M D Perkins
- Foundation for Innovative New Diagnostics [FIND], Geneva, Switzerland
| | - C C Boehme
- Foundation for Innovative New Diagnostics [FIND], Geneva, Switzerland
| | - C M Denkinger
- Foundation for Innovative New Diagnostics [FIND], Geneva, Switzerland
| | - N Raizada
- Foundation for Innovative New Diagnostics [FIND], Geneva, Switzerland
| | | | - C Jefferson
- Independent consultant, currently consulting for FIND and UNITAID, Philadelphia, Pennsylvania, USA
| | - A Pantoja
- Independent consultant, Zurich, Switzerland
| | - S Rupert
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - S V Kik
- McGill International TB Centre, Montreal, Quebec, Canada
| | - C Cohen
- McGill International TB Centre, Montreal, Quebec, Canada
| | - P Chedore
- McGill International TB Centre, Montreal, Quebec, Canada
| | | | - M Pai
- McGill Global Health Programs, Department of Epidemiology & Biostatistics, McGill International TB Centre, 1020 Pine Ave West, Montreal, QC, Canada H3A 1A2.
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Thulasiram B, Devi CS, Kumar YP, Aerva RR, Satyanarayana S, Nagababu P. Correlation Between Molecular Modelling and Spectroscopic Techniques in Investigation With DNA Binding Interaction of Ruthenium(II) Complexes. J Fluoresc 2016; 27:587-594. [PMID: 27924438 DOI: 10.1007/s10895-016-1986-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 11/09/2016] [Indexed: 01/16/2023]
Abstract
The DNA binding studies of rutheniumu(II) polypyridyl complexes {[Ru(phen)2Mipc]2+, [Ru(bpy)2Mipc]2+, [Ru(dmb)2Mipc]2+, [Ru(phen)2BrIPC]2+, [Ru(bpy)2BrIPC]2+, [Ru(dmb)2BrIPC]2+, [Ru(phen)2PIP-Cl]2+, [Ru(bpy)2PIP-Cl]2+, [Ru(dmb)2PIP-Cl]2+, [Ru(phen)2IPPBA]2+, [Ru(bpy)2IPPBA]2+, [Ru(dmb)2IPPBA]2+} with DNA investigated by electronic absorption titration, emission and molecular modelling studies to identify the binding interactions. All these complexes are showing good binding constant values ~104 to 105. The intercalative ligands makes the binding of the ruthenium(II) complex with DNA as intercalation mode. The ancillary ligands 1,10-phenanthroline (phen), 4,4'-Dimethyl-2,2'-dipyridyl (dmb) and 2,2'-dipyridine (bpy) having been discovered found to be involved in bond formation with the phosphate backbone of nucleotide base pairs in ruthenium(II) complex-DNA docked complex. The molecular docking results are good agreement with experimental results. The molecular modelling technic should help to extend knowledge about the nature (or) mode of binding of these ruthenium(II) complexes with (calf thymus) CT-DNA.
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Affiliation(s)
- B Thulasiram
- Inorganic & Physical Chemistry Division, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad, 500007, Telangana State, India
| | - C Shobha Devi
- Department of Chemistry, RGUKT, Basar, Telangana State, India
| | - Yata Praveen Kumar
- Department of Chemistry, Osmania University, Tarnaka, Hyderabad, Telangana State, India
| | - Rajeshwar Rao Aerva
- Department of Chemical Engineering, Eritrea Institute of Technology, Asmara, Eritrea
| | - S Satyanarayana
- Department of Chemistry, Osmania University, Tarnaka, Hyderabad, Telangana State, India
| | - Penumaka Nagababu
- Inorganic & Physical Chemistry Division, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad, 500007, Telangana State, India.
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30
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Parija D, Patra TK, Kumar AMV, Swain BK, Satyanarayana S, Sreenivas A, Chadha VK, Moonan PK, Oeltmann JE. Impact of awareness drives and community-based active tuberculosis case finding in Odisha, India. Int J Tuberc Lung Dis 2016; 18:1105-7. [PMID: 25189560 DOI: 10.5588/ijtld.13.0918] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
India's Revised National Tuberculosis Control programme employs passive case detection. The new sputum smear-positive case detection rate is less than 70% in Odisha State. During April-June 2012, active case finding (ACF) was conducted through awareness drives and field-based tuberculosis (TB) screening in select communities with the lowest case detection rates. During the campaign, 240 sputum smear-positive TB cases were detected. The number of smear-positive cases detected increased by 11% relative to April-June 2011 in intervention communities compared to an 0.8% increase in non-intervention communities. ACF brought TB services closer to the community and increased TB case detection.
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Affiliation(s)
- D Parija
- World Health Organization Country Office for India, New Delhi, India
| | - T K Patra
- Department of Health, Government of Odisha, Bhubaneswar, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - B K Swain
- Department of Health, Government of Odisha, Bhubaneswar, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - A Sreenivas
- World Health Organization Country Office for India, New Delhi, India
| | - V K Chadha
- National Tuberculosis Institute, Bangalore, India
| | - P K Moonan
- Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - J E Oeltmann
- Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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31
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Harries AD, Kumar AMV, Satyanarayana S, Lin Y, Zachariah R, Lönnroth K, Kapur A. Diabetes mellitus and tuberculosis: programmatic management issues. Int J Tuberc Lung Dis 2016; 19:879-86. [PMID: 26162352 PMCID: PMC4497633 DOI: 10.5588/ijtld.15.0069] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In August 2011, the World Health Organization and the International Union Against Tuberculosis and Lung Disease launched the Collaborative Framework for Care and Control of Tuberculosis (TB) and diabetes mellitus (DM) to guide policy makers and implementers in combatting the epidemics of both diseases. Progress has been made, and includes identifying how best to undertake bidirectional screening for both diseases, how to provide optimal treatment and care for patients with dual disease and the most suitable framework for monitoring and evaluation. Key programmatic challenges include the following: whether screening should be directed at all patients or targeted at those with high-risk characteristics; the most suitable technologies for diagnosing TB and diabetes in routine settings; the best time to screen TB patients for DM; how to provide an integrated, coordinated approach to case management; and finally, how to persuade non-communicable disease programmes to adopt a cohort analysis approach, preferably using electronic medical records, for monitoring and evaluation. The link between DM and TB and the implementation of the collaborative framework for care and control have the potential to stimulate and strengthen the scale-up of non-communicable disease care and prevention programmes, which may help in reducing not only the global burden of DM but also the global burden of TB.
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Affiliation(s)
- A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; London School of Hygiene & Tropical Medicine, London, UK
| | - A M V Kumar
- The Union South-East Asia Regional Office, New Delhi, India
| | | | - Y Lin
- The Union China Office, Beijing, China
| | - R Zachariah
- Medical Department, Operational Research Unit, Médecins Sans Frontières, Brussels Operational Centre, Luxembourg, Luxembourg
| | - K Lönnroth
- Global TB Programme, World Health Organization, Geneva, Switzerland, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - A Kapur
- World Diabetes Foundation, Gentofte, Denmark
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32
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Satyanarayana S, Subbaraman R, Shete P, Gore G, Das J, Cattamanchi A, Mayer K, Menzies D, Harries AD, Hopewell P, Pai M. Quality of tuberculosis care in India: a systematic review. Int J Tuberc Lung Dis 2016; 19:751-63. [PMID: 26056098 DOI: 10.5588/ijtld.15.0186] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While Indian studies have assessed care providers' knowledge and practices, there is no systematic review on the quality of tuberculosis (TB) care. METHODS We searched multiple sources to identify studies (2000-2014) on providers' knowledge and practices. We used the International Standards for TB Care to benchmark quality of care. RESULTS Of the 47 studies included, 35 were questionnaire surveys and 12 used chart abstraction. None assessed actual practice using standardised patients. Heterogeneity in the findings precluded meta-analysis. Of 22 studies evaluating provider knowledge about using sputum smears for diagnosis, 10 found that less than half of providers had correct knowledge; 3 of 4 studies assessing self-reported practices by providers found that less than a quarter reported ordering smears for patients with chest symptoms. In 11 of 14 studies that assessed treatment, less than one third of providers knew the standard regimen for drug-susceptible TB. Adherence to standards in practice was generally lower than correct knowledge of those standards. Eleven studies with both public and private providers found higher levels of appropriate knowledge/practice in the public sector. CONCLUSIONS Available evidence suggests suboptimal quality of TB care, particularly in the private sector. Improvement of quality of care should be a priority for India.
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Affiliation(s)
- S Satyanarayana
- Department of Epidemiology, Biostatistics and Occupational Health, and McGill International TB Centre, McGill University, Montreal, Canada; Center for Operations Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - R Subbaraman
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA; Partners for Urban Knowledge, Action and Research, Mumbai, India
| | - P Shete
- Curry International Tuberculosis Center, University of California San Francisco, San Francisco, California, USA; Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, California, USA
| | - G Gore
- Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, California, USA
| | - J Das
- Life Sciences Library, McGill University, Montreal, Canada
| | - A Cattamanchi
- Curry International Tuberculosis Center, University of California San Francisco, San Francisco, California, USA; Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, California, USA
| | - K Mayer
- Development Economics Research Group, World Bank, Washington DC, USA
| | - D Menzies
- The Fenway Institute and Beth Israel Deaconess Medical Center, Boston Massachusetts, USA
| | - A D Harries
- Center for Operations Research, International Union Against Tuberculosis and Lung Disease, Paris, France; Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Canada
| | - P Hopewell
- Curry International Tuberculosis Center, University of California San Francisco, San Francisco, California, USA; Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, California, USA
| | - M Pai
- Department of Epidemiology, Biostatistics and Occupational Health, and McGill International TB Centre, McGill University, Montreal, Canada
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Kelly V, Sagili KD, Satyanarayana S, Reza LW, Chadha SS, Wilson NC. Cost-utility analysis of LED fluorescence microscopy in the diagnosis of pulmonary tuberculosis in Indian settings. Int J Tuberc Lung Dis 2016; 19:696-701. [PMID: 25946362 DOI: 10.5588/ijtld.14.0203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With support from the Stop TB Partnership's TB REACH Wave 2 Grant, diagnostic microscopy services for tuberculosis (TB) were upgraded from conventional Ziehl-Neelsen (ZN) based sputum microscopy to light emitting diode technology-based fluorescence microscopy (LED FM) in 200 high-workload microscopy centres in India as a pilot intervention. OBJECTIVE To evaluate the cost-effectiveness of LED-FM over conventional ZN microscopy to inform further scale-up. METHODS A decision-tree model was constructed to assess the cost utility of LED FM over ZN microscopy. The results were summarised using incremental cost-effectiveness ratio (ICER); one-way and probabilistic sensitivity analyses were also conducted to address uncertainty within the model. Data were analysed from 200 medical colleges in 2011 and 2012, before and after the introduction of LED microscopes. A full costing analysis was carried out from the perspective of a national TB programme. RESULTS The ICER was calculated at US$14.64 per disability-adjusted life-year, with an 82% probability of being cost-effective at a willingness-to-pay threshold equivalent to Indian gross domestic product per capita. CONCLUSIONS LED FM is a cost-effective intervention for detecting TB cases in India at high-workload medical college settings.
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Affiliation(s)
- V Kelly
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India
| | - K D Sagili
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India
| | - L W Reza
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India
| | - S S Chadha
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India
| | - N C Wilson
- Independent Public Health Consultant, Cherambadi, Tamil Nadu, India
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Prasad BM, Satyanarayana S, Chadha SS, Das A, Thapa B, Mohanty S, Pandurangan S, Babu ER, Tonsing J, Sachdeva KS. Experience of active tuberculosis case finding in nearly 5 million households in India. Public Health Action 2016; 6:15-8. [PMID: 27051605 DOI: 10.5588/pha.15.0035] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/26/2015] [Indexed: 11/10/2022] Open
Abstract
In India, to increase tuberculosis (TB) case detection under the National Tuberculosis Programme, active case finding (ACF) was implemented by the Global Fund-supported Project Axshya, among high-risk groups in 300 districts. Between April 2013 and December 2014, 4.9 million households covering ~20 million people were visited. Of 350 047 presumptive pulmonary TB cases (cough of ⩾2 weeks) identified, 187 586 (54%) underwent sputum smear examination and 14 447 (8%) were found to be smear-positive. ACF resulted in the detection of a large number of persons with presumptive pulmonary TB and smear-positive TB. Ensuring sputum examination of all those with presumptive TB was a major challenge.
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Affiliation(s)
- B M Prasad
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | | | - S S Chadha
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - A Das
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - B Thapa
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - S Mohanty
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - S Pandurangan
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - E R Babu
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - J Tonsing
- International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India
| | - K S Sachdeva
- Central Tuberculosis Division, Ministry of Health & Family Welfare, Government of India, New Delhi, India
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35
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Binepal G, Agarwal P, Kaur N, Singh B, Bhagat V, Verma RP, Satyanarayana S, Oeltmann JE, Moonan PK. Screening difficult-to-reach populations for tuberculosis using a mobile medical unit, Punjab India. Public Health Action 2016; 5:241-5. [PMID: 26767177 DOI: 10.5588/pha.15.0042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In India, the National Health Mission has provided one mobile medical unit (MMU) per district in the state of Punjab to provide primary health care services for difficult-to-reach populations. OBJECTIVES To determine the number of patients with presumptive tuberculosis (TB) and the number of TB cases detected and treated among patients who used the MMU services from May to December 2012 in Mohali district, Punjab, India. METHODS A cross-sectional study was conducted and registers of the out-patient, laboratory, radiology, and TB departments of the MMU were reviewed to determine the number of persons presumed to have TB and the number of persons diagnosed with TB. RESULTS Of 8346 patients who attended the MMUs, 663 (8%) had symptoms suggestive of TB. Among those with TB symptoms, 540 (81%) were evaluated for pulmonary TB using sputum examination or chest X-ray. In total, 58 (11%) patients had clinical or laboratory evidence of pulmonary TB, of whom 21 (36%) started anti-tuberculosis treatment. CONCLUSION As MMUs are an integral part of the general public health system, these units have the potential to detect TB cases among difficult-to-reach populations. Additional research is required to optimise the diagnosis of TB at MMUs and to increase rates of TB treatment initiation.
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Affiliation(s)
- G Binepal
- District Tuberculosis Centre, Mohali District, Punjab, India
| | - P Agarwal
- Department of Tuberculosis, World Health Organization Country Office for India, New Delhi, India
| | - N Kaur
- Civil Hospital Mohali District, Punjab, India
| | - B Singh
- Directorate of Health Services, Punjab, India
| | - V Bhagat
- Civil Hospital Mohali District, Punjab, India
| | - R P Verma
- Civil Hospital Mohali District, Punjab, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease South-East Asia Regional Office, New Delhi, India
| | - J E Oeltmann
- Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - P K Moonan
- Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Chang YP, Duo L, Kumar AMV, Achanta S, Xue HM, Satyanarayana S, Ananthakrishnan R, Srivastava S, Qi W, Hu SY. Retention and HIV seroconversion among drug users on methadone maintenance treatment in Yunnan, China. Public Health Action 2015; 4:28-34. [PMID: 26423758 DOI: 10.5588/pha.13.0101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 01/17/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING Thirteen methadone maintenance treatment (MMT) clinics across Yunnan, the province with the highest human immunodeficiency virus (HIV) burden in China. OBJECTIVES To determine, among HIV-negative participants on MMT, the proportion lost to follow-up (defined as those who missed the 6-monthly follow-up examination), factors associated with loss to follow-up (LFU), HIV seroconversion rate and factors associated with seroconversion. DESIGN Prospective cohort study from October 2008 to April 2011. All participants were administered a pre-tested structured questionnaire to capture associated factors and offered HIV testing every 6 months. χ(2) test and log-binomial regression were used for data analysis. RESULTS Of 1146 participants, 541 (47%) were lost to follow-up in 2.5 years. Factors associated with higher LFU proportion include <6 months of previous MMT, inconvenient location of the MMT clinic and average methadone dose ⩽60 mg/day, with adjusted relative risks (RRs) of respectively 1.4 (95%CI 1.2-1.5), 1.2 (95%CI 1.0-1.4) and 1.1 (95%CI 1.0-1.3). The overall HIV seroconversion rate was 6.6 (95%CI 3.7-11.0) per 1000 person-years. Not living with a partner contributed to higher HIV rates, with an adjusted RR of 3.6 (95%CI 1.0-12.8). CONCLUSION The retention rate of MMT participants in Yunnan was not satisfactory. Decentralising service delivery in the community and making directly observed treatment more convenient has the potential to improve retention.
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Affiliation(s)
- Y-P Chang
- The Red Cross Hospital of Yunnan Province, Kunming, China
| | - L Duo
- The Red Cross Hospital of Yunnan Province, Kunming, China ; HIV/AIDS Asia Regional Programme, Kunming, China
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - S Achanta
- World Health Organization India Country Office, New Delhi, India
| | - H-M Xue
- HIV/AIDS Asia Regional Programme, Kunming, China
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | | | - S Srivastava
- Public Health Foundation of India, New Delhi, India
| | - W Qi
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - S-Y Hu
- School of Public Health, Fudan University, Shanghai, China
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Khandu L, Zachariah R, Van den Bergh R, Wangchuk D, Tshering N, Wangmo D, Ananthakrishnan R, Dorji T, Satyanarayana S. Providing a gateway to prevention and care for the most at-risk populations in Bhutan: is this being achieved? Public Health Action 2015; 4:22-7. [PMID: 26423757 DOI: 10.5588/pha.13.0109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 02/20/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING Two free-standing urban human immunodeficiency virus (HIV) testing and counselling (HCT) centres in Bhutan offering services to the general population and targeting the most at-risk populations (MARPs). OBJECTIVES To assess the trend in testing for HIV, hepatitis B and syphilis in both the general population and MARPs, and to determine if sociodemographic and risk behaviour characteristics are associated with HIV, hepatitis B and syphilis seropositivity. DESIGN Cross-sectional study using client records, 2009 - 2012. RESULTS Of 7894 clients, 3009 (38%) were from the general population, while 4885 (62%) were from MARPs. Over the 4-year period, testing declined progressively among the general population, while it increased or remained static for MARPs. Of 4885 MARPs, seropositivity was respectively 0.7%, 1.3% and 1.2% for HIV, hepatitis B and syphilis. Female sex workers (FSWs) (relative risk [RR] 4.4, P = 0.03) and partners of person living with HIV (RR 25.9, P < 0.001) had a higher risk of being HIV-positive. FSWs had also a greater risk of being syphilis-positive (RR 9.1, P < 0.001). CONCLUSION The increase in uptake of HCT services by MARPs is a welcome finding; however, the relatively static trends call for the introduction of community outreach approaches. The critical gateway being provided to MARPs is an 'opportunity' for the expansion of the current service package.
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Affiliation(s)
- L Khandu
- National HIV/AIDS & STIs Control Programme, Department of Public Health, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan
| | - R Zachariah
- Operational Research Unit (LuxOR), Operational Centre Brussels, Médecins Sans Frontières, Luxembourg, Luxembourg
| | - R Van den Bergh
- LuxOR, Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - D Wangchuk
- Department of Public Health, Ministry of Health, Royal Government of Bhutan, Thimphu
| | - N Tshering
- National HIV/AIDS & STIs Control Programme, Department of Public Health, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan
| | - D Wangmo
- National HIV/AIDS Consultant (Pvt), PIE Solution, Thimphu, Bhutan
| | | | - T Dorji
- Communicable Disease Division, Department of Public Health, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease, South-East Regional Office, New Delhi, India
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Shankar D, Kumar AMV, Rewari B, Kumar S, Shastri S, Satyanarayana S, Ananthakrishnan R, Nagaraja SB, Devi M, Bhargava N, Das M, Zachariah R. Retention in pre-antiretroviral treatment care in a district of Karnataka, India: how well are we doing? Public Health Action 2015; 4:210-5. [PMID: 26400698 DOI: 10.5588/pha.14.0073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 08/28/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING Antiretroviral treatment (ART) Centre in Tumkur district of Karnataka State, India. There is no published information about pre-ART loss to follow-up from India. OBJECTIVE To assess the proportion lost to follow-up (defined as not visiting the ART Centre within 1 year of registration) and associated socio-demographic and immunological variables. DESIGN Retrospective cohort study involving a review of medical records of adult HIV-infected persons (aged ⩾15 years) registered in pre-ART care during January 2010-June 2012. RESULTS Of 3238 patients registered, 2519 (78%) were eligible for ART, while 719 (22%) were not. Four of the latter were transferred out; the remaining 715 individuals were enrolled in pre-ART care, of whom 290 (41%) were lost to follow-up. Factors associated with loss to follow-up on multivariate analysis included age group ⩾45 years, low educational level, not being married, World Health Organization Stage III or IV and rural residence. CONCLUSION About four in 10 individuals in pre-ART care were lost to follow-up within 1 year of registration. This needs urgent attention. Routine cohort analysis in the national programme should include those in pre-ART care to enable improved review, monitoring and supervision. Further qualitative research to ascertain reasons for loss to follow-up is required to design future interventions.
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Affiliation(s)
- D Shankar
- Antiretroviral Treatment Centre (ART), District Hospital, Tumkur, Karnataka, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - B Rewari
- National AIDS Control Organization, New Delhi, India
| | - S Kumar
- National AIDS Control Organization, New Delhi, India ; Karnataka State AIDS Prevention Society, Bengaluru, India
| | - S Shastri
- Lady Willingdon State TB Centre, Bengaluru, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - R Ananthakrishnan
- Resource Group for Education and Advocacy for Community Health (REACH), Chennai, India
| | - S B Nagaraja
- Employees' State Insurance Corporation (ESIC) Medical College and Post Graduate Institute of Medical Sciences & Research (PGIMSR), Bengaluru, India
| | - M Devi
- Antiretroviral Treatment Centre (ART), District Hospital, Tumkur, Karnataka, India
| | - N Bhargava
- Antiretroviral Treatment Centre (ART), District Hospital, Tumkur, Karnataka, India
| | - M Das
- Médecins Sans Frontières, Operational Centre Brussels, Luxembourg
| | - R Zachariah
- Médecins Sans Frontières, Operational Centre Brussels, Luxembourg
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Satyanarayana S, Sagili K, Chadha SS, Pai M. Use of rapid point-of-care tests by primary health care providers in India: findings from a community-based survey. Public Health Action 2015; 4:249-51. [PMID: 26400704 DOI: 10.5588/pha.14.0061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/23/2014] [Indexed: 11/10/2022] Open
Abstract
In a cross-sectional survey conducted in 45 districts of India, we assessed 1) use of any rapid point-of-care (POC) tests by primary health care providers, and 2) their willingness to use POC tests for tuberculosis (TB) in future. A total of 767 primary health care providers, including private and public sector practitioners, health workers and chemists, were interviewed. A quarter of the primary health care providers reported using POC tests, with pregnancy tests being the most common. Nearly half of the respondents expressed willingness to use POC tests for TB, provided the test was available free or at low cost (<US$ 2.00).
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Affiliation(s)
- S Satyanarayana
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, and McGill International TB Centre, Montreal, Quebec, Canada ; Centre for Operations Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - K Sagili
- The Union, South-East Asia Regional Office, New Delhi, India
| | - S S Chadha
- The Union, South-East Asia Regional Office, New Delhi, India
| | - M Pai
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, and McGill International TB Centre, Montreal, Quebec, Canada
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Ramsay A, Harries AD, Zachariah R, Bissell K, Hinderaker SG, Edginton M, Enarson DA, Satyanarayana S, Kumar AMV, Hoa NB, Tweya H, Reid AJ, Van den Bergh R, Tayler-Smith K, Manzi M, Khogali M, Kizito W, Ali E, Delaunois P, Reeder JC. The Structured Operational Research and Training Initiative for public health programmes. Public Health Action 2015; 4:79-84. [PMID: 26399203 DOI: 10.5588/pha.14.0011] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In 2009, the International Union Against Tuberculosis and Lung Disease (The Union) and Médecins sans Frontières Brussels-Luxembourg (MSF) began developing an outcome-oriented model for operational research training. In January 2013, The Union and MSF joined with the Special Programme for Research and Training in Tropical Diseases (TDR) at the World Health Organization (WHO) to form an initiative called the Structured Operational Research and Training Initiative (SORT IT). This integrates the training of public health programme staff with the conduct of operational research prioritised by their programme. SORT IT programmes consist of three one-week workshops over 9 months, with clearly-defined milestones and expected output. This paper describes the vision, objectives and structure of SORT IT programmes, including selection criteria for applicants, the research projects that can be undertaken within the time frame, the programme structure and milestones, mentorship, the monitoring and evaluation of the programmes and what happens beyond the programme in terms of further research, publications and the setting up of additional training programmes. There is a growing national and international need for operational research and related capacity building in public health. SORT IT aims to meet this need by advocating for the output-based model of operational research training for public health programme staff described here. It also aims to secure sustainable funding to expand training at a global and national level. Finally, it could act as an observatory to monitor and evaluate operational research in public health. Criteria for prospective partners wishing to join SORT IT have been drawn up.
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Affiliation(s)
- A Ramsay
- Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland ; Bute Medical School, University of St Andrews, Fife, Scotland, UK
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - R Zachariah
- Médecins Sans Frontières - Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), MSF-Luxembourg Luxembourg
| | - K Bissell
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; School of Population Health, The University of Auckland, New Zealand
| | - S G Hinderaker
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; Center for International Health, University of Bergen, Bergen, Norway
| | - M Edginton
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - D A Enarson
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; The Union South-East Asia Regional Office, New Delhi, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; The Union South-East Asia Regional Office, New Delhi, India
| | - N B Hoa
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - H Tweya
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - A J Reid
- Médecins Sans Frontières - Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), MSF-Luxembourg Luxembourg
| | - R Van den Bergh
- Médecins Sans Frontières - Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), MSF-Luxembourg Luxembourg
| | - K Tayler-Smith
- Médecins Sans Frontières - Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), MSF-Luxembourg Luxembourg
| | - M Manzi
- Médecins Sans Frontières - Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), MSF-Luxembourg Luxembourg
| | - M Khogali
- Médecins Sans Frontières - Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), MSF-Luxembourg Luxembourg
| | - W Kizito
- Médecins Sans Frontières - Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), MSF-Luxembourg Luxembourg
| | - E Ali
- Médecins Sans Frontières - Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), MSF-Luxembourg Luxembourg
| | - P Delaunois
- Médecins Sans Frontières - Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), MSF-Luxembourg Luxembourg
| | - J C Reeder
- Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland
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Kumar AMV, Satyanarayana S, Wilson NC, Chadha SS, Gupta D, Nair S, Zachariah R, Kapur A, Harries AD. Operational research leading to rapid national policy change: tuberculosis-diabetes collaboration in India. Public Health Action 2015; 4:85-8. [PMID: 26399204 DOI: 10.5588/pha.14.0012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 03/10/2014] [Indexed: 11/10/2022] Open
Abstract
In 2011, bi-directional screening for tuberculosis (TB) and diabetes mellitus (DM) was recommended by the World Health Organization (WHO), although how best to implement the activity was not clear. In India, with early engagement of national programme managers and all important stakeholders, a countrywide, multicentre operational research (OR) project was designed in October 2011 and completed in 2012. The results led to a rapid national policy decision to routinely screen all TB patients for DM in September 2012. The process, experience and enablers of implementing this unique and successful collaborative model of operational research are presented.
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Affiliation(s)
- A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - N C Wilson
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S S Chadha
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - D Gupta
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - S Nair
- Office of the World Health Organization Representative in India, New Delhi, India
| | - R Zachariah
- Medical Department, Médecins Sans Frontières, Operational Centre Brussels, MSF-Luxembourg, Luxembourg
| | - A Kapur
- World Diabetes Foundation, Gentofte, Denmark
| | - A D Harries
- The Union, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK
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Bajis S, Van den Bergh R, De Bruycker M, Mahama G, Van Overloop C, Satyanarayana S, Bernardo RS, Esmati S, Reid AJ. Antibiotic use in a district hospital in Kabul, Afghanistan: are we overprescribing? Public Health Action 2015; 4:259-64. [PMID: 26400706 DOI: 10.5588/pha.14.0068] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 10/15/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING A district hospital in Kabul, Afghanistan, supported by Médecins Sans Frontières (MSF). OBJECTIVES To assess antibiotic prescribing practices in the out-patient department in summer (August 2013) and winter (January 2014). DESIGN Cross-sectional study, using routinely collected hospital data and using World Health Organization (WHO) defined daily dose (DDD) methodology. RESULTS An analysis of 4857 prescriptions (summer) and 4821 prescriptions (winter) showed that respectively 62% and 50% of all out-patients were prescribed at least one antibiotic. Prescriptions without a recorded diagnosis represented a sizeable proportion of all antibiotics prescribed. For upper respiratory tract infections (URTI), dental indications, urinary tract infections (UTI) and diarrhoea, good adherence to dosages recommended in the MSF standard treatment guidelines was observed when measured by DDD. However, certain drugs not indicated in the guidelines were prescribed, such as amoxicillin and metronidazole for UTI and azithromycin for URTI. CONCLUSION Rates of antibiotic prescriptions for out-patients in a district hospital in Afghanistan were high, double the WHO recommendation of 30%. While systematic non-adherence to recommended dosages was not observed, inappropriate prescriptions for specific conditions may have occurred. This study suggests that knowledge about context-specific determinants of antibiotic prescribing is a first step towards promoting rational prescribing practices in such settings.
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Affiliation(s)
- S Bajis
- Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - R Van den Bergh
- Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - M De Bruycker
- Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - G Mahama
- Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - C Van Overloop
- Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - S Satyanarayana
- Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - R S Bernardo
- Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - S Esmati
- Ministry of Public Health, Kabul, Afghanistan
| | - A J Reid
- Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
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Harries AD, Kumar AMV, Satyanarayana S, Lin Y, Takarinda KC, Tweya H, Reid AJ, Zachariah R. Communicable and non-communicable diseases: connections, synergies and benefits of integrating care. Public Health Action 2015; 5:156-7. [PMID: 26393110 DOI: 10.5588/pha.15.0030] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 07/16/2015] [Indexed: 12/14/2022] Open
Affiliation(s)
- A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | - A M V Kumar
- The Union South-East Asia Regional Office, New Delhi, India
| | | | - Y Lin
- The Union China Office, Beijing, China
| | - K C Takarinda
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; AIDS and TB Department, Zimbabwe Ministry of Health and Child Care, Harare, Zimbabwe
| | - H Tweya
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; Lighthouse Trust, Lilongwe, Malawi
| | - A J Reid
- Médecins Sans Frontières, Operational Research Unit, Brussels Operational Centre, Luxembourg
| | - R Zachariah
- Médecins Sans Frontières, Operational Research Unit, Brussels Operational Centre, Luxembourg
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Naik B, Kumar AMV, Satyanarayana S, Suryakant MD, Swamy NMV, Nair S, Isaakidis P, Harries AD. Is screening for diabetes among tuberculosis patients feasible at the field level? Public Health Action 2015; 3:S34-7. [PMID: 26393067 DOI: 10.5588/pha.13.0022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 05/28/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING Seventeen peripheral health institutions (PHI) in Kolar district (population: 0.5 million), South India. OBJECTIVE To assess the feasibility and results of screening patients with tuberculosis (TB) for diabetes mellitus (DM) at peripheral level. DESIGN From January to September 2012, all TB patients were assessed for DM. Those with unknown DM status were screened for the disease (free of charge) by trained laboratory technicians at each PHI, using a glucometer supplied by the national programme on a capillary blood sample. Those with fasting blood glucose (FBG) ≥ 126 mg/dl (≥7 mM) were diagnosed as DM-positive. RESULTS Of 362 TB patients, 358 (99%) were assessed for DM and 62 (17.1%) had the diseases-53 (14.6%) had a previous history of DM and 9 (2.9%) were newly diagnosed. All new DM patients were enrolled into DM care. Higher DM prevalence was found among TB patients aged ≥40 years, smokers and those with smear-positive pulmonary TB. To detect a new case of DM, the number needed to screen (NNS) among TB patients was 40. CONCLUSION Screening of TB patients for DM was feasible and effective in a peripheral setting. The availability of trained laboratory technicians and free services at every PHI made the intervention feasible. The study has contributed towards a national policy decision in this regard.
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Affiliation(s)
- B Naik
- World Health Organization Country Office for India, New Delhi, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - M D Suryakant
- State Tuberculosis Centre, Ministry of Health and Family Welfare, Government of Karnataka, Bangalore, India
| | - N M V Swamy
- District Tuberculosis Centre, Ministry of Health and Family Welfare, Government of Karnataka, Kolar, India
| | - S Nair
- World Health Organization Country Office for India, New Delhi, India
| | | | - A D Harries
- The Union, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK
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Lim LKY, Enarson DA, Reid AJ, Satyanarayana S, Cutter J, Kyi Win KM, Chee CBE, Wang YT. Notified tuberculosis among Singapore residents by ethnicity, 2002-2011. Public Health Action 2015; 3:311-6. [PMID: 26393053 DOI: 10.5588/pha.13.0055] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Accepted: 09/17/2013] [Indexed: 01/17/2023] Open
Abstract
SETTING The National Tuberculosis Programme in Singapore where, among resident cases, higher tuberculosis (TB) rates have been reported in ethnic Malays. OBJECTIVE To describe the socio-demographic and clinical characteristics of resident TB cases by ethnicity, and to assess whether Malays differ from other groups in terms of the above parameters. DESIGN Cross-sectional review of records from the tuberculosis registry's electronic database. RESULTS Among 15 622 resident cases notified, 72.2% were Chinese, 18.7% Malay, 5.8% Indian and 2.9% were from other minorities. Compared to other ethnicities, Malays were more likely to be incarcerated at the time of notification (odds ratio [OR] 3.70, 95%CI 3.03-4.52) and clustered at the same residential address (OR 1.65, 95%CI 1.44-1.89), but were less likely to be aged ≥65 years (OR 0.61, 95%CI 0.54-0.70) or to reside in high-cost housing (OR 0.11, 95%CI 0.07-0.17). In terms of disease characteristics, more Malays had diabetes mellitus (OR 1.54, 1.37-1.73), a highly-positive acid-fast bacilli smear (OR 1.64, 95%CI 1.47-1.83) and cavitary disease on chest X-ray (OR 1.41, 95%CI 1.28-1.55). CONCLUSION Compared to other ethnicities, reported TB cases among Malays were more severe and were likely to be more infectious. Increased vigilance in case management and contact investigations, as well as an improvement in the socio-economic conditions of this community, are required to reduce TB rates in this ethnic group.
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Affiliation(s)
- L K-Y Lim
- Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore
| | - D A Enarson
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - A J Reid
- Operational Research Unit, Médecins Sans Frontières Operational Centre, Brussels, Luxembourg
| | | | - J Cutter
- Communicable Diseases Division, Ministry of Health, Singapore
| | - K M Kyi Win
- Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore
| | - C B-E Chee
- Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore
| | - Y T Wang
- Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore
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Palanivel C, Kumar AMV, Mahalakshmi T, Govindarajan S, Claassens M, Satyanarayana S, Gurumurthy D, Vasudevan K, Purty A, Paulraj AK, Raman KV. Uptake of HIV testing and HIV positivity among presumptive tuberculosis patients at Puducherry, South India. Public Health Action 2015; 3:220-3. [PMID: 26393033 DOI: 10.5588/pha.13.0045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 07/02/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING Puducherry, a district in South India with a low prevalence of human immunodeficiency virus (HIV) infection (<1% among antenatal women). OBJECTIVES 1) To estimate the proportion of patients with known HIV status who were HIV-positive, 2) to describe the demographic and clinical characteristics of patients with unknown HIV status among presumptive TB patients, and 3) to assess the additional workload at HIV testing centres. DESIGN In this cross-sectional study, consecutive presumptive TB patients attending microscopy centres for diagnosis during March-May 2013 were asked if they knew their HIV status. Patients with unknown HIV status were offered voluntary counselling and HIV testing. RESULTS Of 1886 presumptive TB patients, HIV status was ascertained for 842 (44.6%); 28 (3.3%) were HIV-positive. The uptake of HIV testing was significantly higher in younger age groups, males, residents of Puducherry and smear-positive TB patients. The median increase in the number of clients tested for HIV per day per testing centre was 1 (range 0-6). CONCLUSION The uptake of HIV testing was low. HIV prevalence was higher among presumptive TB patients than in antenatal women, and as high as in TB patients. With minimal increase in workload at HIV testing centres, HIV testing could be implemented using existing resources.
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Affiliation(s)
- C Palanivel
- Indira Gandhi Medical College and Research Institute, Puducherry, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - T Mahalakshmi
- Indira Gandhi Medical College and Research Institute, Puducherry, India
| | - S Govindarajan
- State TB Cell, Directorate of Health Services, Puducherry, India
| | - M Claassens
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - S Satyanarayana
- State TB Cell, Directorate of Health Services, Puducherry, India
| | - D Gurumurthy
- Pondicherry State AIDS Control Society, Puducherry, India
| | - K Vasudevan
- Indira Gandhi Medical College and Research Institute, Puducherry, India
| | - A Purty
- Pondicherry Institute of Medical Sciences, Puducherry, India
| | - A K Paulraj
- World Health Organization Country Office in India, New Delhi, India
| | - K V Raman
- Department of Health and Family Welfare Services, Government of Puducherry, Puducherry, India
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Kumar AMV, Satyanarayana S, Wilson N, Zachariah R, Harries AD. Operational research capacity building in Asia: innovations, successes and challenges of a training course. Public Health Action 2015; 3:186-8. [PMID: 26393025 DOI: 10.5588/pha.13.0008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 03/11/2013] [Indexed: 11/10/2022] Open
Abstract
A structured training course on operational research (OR) based on the model created by the International Union Against Tuberculosis and Lung Disease and Médecins Sans Frontières was conducted in the South Asian region in 2012. Many innovations were introduced into the administration, structure and content of the course. Of 12 participants, 11 successfully completed all pre-defined milestones. Several challenges were identified. The main challenges included shortage of time, especially for data analysis and interpretation, and insufficient numbers of experienced facilitators. Appropriate modifications have been made to the structure and processes of the next course scheduled for 2013. We describe these modifications and the innovations, successes and challenges of this model of training.
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Affiliation(s)
- A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India
| | - N Wilson
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India
| | - R Zachariah
- Medical Department, Médecins Sans Frontières (MSF), Operational Centre Brussels, MSF-Luxembourg, Luxembourg
| | - A D Harries
- The Union, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK
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Siddiquea BN, Islam MA, Bam TS, Satyanarayana S, Enarson DA, Reid AJ, Husain MA, Ahmed SM, Ferdous S, Ishikawa N. High quit rate among smokers with tuberculosis in a modified smoking cessation programme in Dhaka, Bangladesh. Public Health Action 2015; 3:243-6. [PMID: 26393038 DOI: 10.5588/pha.13.0051] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 08/13/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING BRAC, a non-governmental organisation, implemented a modified smoking cessation programme for tuberculosis (TB) patients based on International Union Against Tuberculosis and Lung Disease (The Union) guidelines in 17 peri-urban centres of Dhaka, Bangladesh. OBJECTIVE To determine whether a modified version of The Union's smoking cessation intervention was effective in promoting cessation among TB patients and determinants associated with quitting smoking. DESIGN Cohort study of routinely collected data. RESULTS A total of 3134 TB patients were registered from May 2011 to April 2012. Of these, 615 (20%) were current smokers, with a mean age of 38 years (±13.8). On treatment completion, 562 patients were analysed, with 53 (9%) lost to follow-up or dead, while 82% of smokers had quit. Patients with extra-pulmonary TB were less likely to quit than those with pulmonary TB. Patients with high-intensity dependence were less likely to quit than those with low-intensity dependence. CONCLUSION This study suggests that a simplified smoking cessation intervention can be effective in promoting smoking cessation among TB patients in Bangladesh. This is encouraging for other low-resource settings; the Bangladesh National Tuberculosis Control Programme should consider nationwide scaling up and integration of this smoking cessation plan.
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Affiliation(s)
- B N Siddiquea
- Health, Nutrition and Population Programme, BRAC, Dhaka, Bangladesh
| | - M A Islam
- Health, Nutrition and Population Programme, BRAC, Dhaka, Bangladesh
| | - T S Bam
- International Union Against Tuberculosis and Lung Disease (The Union), Jakarta, Indonesia
| | | | | | - A J Reid
- Operational Research Unit, Médecins Sans Frontières, Operational Centre Brussels, Luxembourg
| | - Md A Husain
- National Tuberculosis Control Programme, Ministry of Health, Dhaka
| | - S M Ahmed
- BRAC Research and Evaluation Division, Dhaka, Bangladesh
| | - S Ferdous
- Health, Nutrition and Population Programme, BRAC, Dhaka, Bangladesh
| | - N Ishikawa
- Research Institute of Tuberculosis, Tokyo, Japan
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Vishnu PH, Bhat P, Bansal A, Satyanarayana S, Alavadi U, Ohri BS, Shrinivas MSR, Desikan P, Jaju J, Rao VG, Moonan PK. Is bleach-sedimented smear microscopy an alternative to direct microscopy under programme conditions in India? Public Health Action 2015; 3:23-5. [PMID: 26392991 DOI: 10.5588/pha.12.0100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 02/14/2013] [Indexed: 11/10/2022] Open
Abstract
This cross-sectional multi-centric study compared the yield of and potential benefit for detecting smear-positive pulmonary tuberculosis (PTB) by bleach sedimentation (2% sodium-hypochlorite) versus direct microscopy under programme conditions in India. Among 3168 PTB suspects, 684 (21.6%) were detected by bleach sedimentation vs. 625 (19.7%) by direct microscopy, with a proportional overall agreement of 96% (κ = 0.88). While 594 patients were smear-positive with both methods, 31 patients detected by direct microscopy were missed and an additional 90 patients were detected by bleach sedimentation. Overall, bleach sedimentation increased the yield of smear-positive TB detection; however; it also increased the time to results.
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Affiliation(s)
- P H Vishnu
- State Tuberculosis Training and Demonstration Centre, Hyderabad, Andra Pradesh, India
| | - P Bhat
- World Health Organization Revised National Tuberculosis Control Programme (RNTCP) Technical Assistance Project, New Delhi, India
| | - A Bansal
- World Health Organization Revised National Tuberculosis Control Programme (RNTCP) Technical Assistance Project, New Delhi, India
| | - S Satyanarayana
- Regional Office for South-East Asia, International Union Against Tuberculosis and Lung Disease, New Delhi, India
| | - U Alavadi
- World Health Organization Revised National Tuberculosis Control Programme (RNTCP) Technical Assistance Project, New Delhi, India
| | - B S Ohri
- RNTCP State Tuberculosis Office, Bhopal, Madhya Pradesh, India
| | | | - P Desikan
- Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India
| | - J Jaju
- World Health Organization Revised National Tuberculosis Control Programme (RNTCP) Technical Assistance Project, New Delhi, India
| | - V G Rao
- Regional Medical Research Center for Tribals, Jabalpur, Madhya Pradesh, India
| | - P K Moonan
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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50
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Harries AD, Kumar AMV, Satyanarayana S, Bissell K, Hinderaker SG, Edginton M, Reid AJ, Zachariah R. References for scientific papers: why not standardise to one global style? Public Health Action 2015; 3:255-7. [PMID: 26393041 DOI: 10.5588/pha.13.0066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 08/05/2013] [Indexed: 11/10/2022] Open
Abstract
The different reference styles demanded by journals, both for in-text citations and manuscript bibliographies, require that significant time and attention be paid to minute detail that constitute a tedious obstacle on the road to publication for all authors, but especially for those from resource-limited countries and/or writing in a second language. To illustrate this, we highlight different reference styles requested by five popular journals to which operational research papers are often submitted. We call for a simpler, standardised format for in-text and bibliography reference citations, so that researchers can concentrate on the science and its interpretation rather than fonts and punctuation.
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Affiliation(s)
- A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; The Union, South-East Asia Regional Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; The Union, South-East Asia Regional Office, New Delhi, India
| | - K Bissell
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - S G Hinderaker
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; Center for International Health, University of Bergen, Bergen, Norway
| | - M Edginton
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - A J Reid
- Médecins Sans Frontières-Operational Centre Brussels, Medical Department, Operational Research Unit, MSF-Luxembourg, Luxembourg
| | - R Zachariah
- Médecins Sans Frontières-Operational Centre Brussels, Medical Department, Operational Research Unit, MSF-Luxembourg, Luxembourg
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