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Title: Delivering services and influencing policy: health care professionals join forces to improve maternal, newborn, and child health.
Author: Health Care Professional Association Writing Group
Source: International Journal of Gynaecology and Obstetrics. 2009 Jun;105(3):271-4.
Abstract: This article reviews the major activities of health care professional organizations (HCPAs), and emphasizes the role they can play in advocating for women and children and influencing maternal, newborn, and child health (MNCH) programs and policies. The ICM/FIGO joint effort to prevent postpartum hemorrhage and the 40-year partnership between the American Academy of Pediatrics (AAP) and the Indian Health Service (IHS) are highlighted as examples of how and why HCPAs should assume a leadership role in advocacy work. The action-oriented multicountry HCPA workshops organized by the Partnership for Maternal, Newborn, and Child Health (PMNCH) and the international HCPAs are also described. These capacity building workshops are aimed at strengthening the ability of HCPAs to organize, coordinate activities, and become more involved in program and policy development.
Language: English
Keywords:
INDIA | RESEARCH REPORT | HEALTH PERSONNEL | CAPACITY BUILDING | MATERNAL HEALTH | CHILD HEALTH | ANTENATAL CARE | HEALTH POLICY | Asia, Southern | Asia | Developing Countries | Delivery of Health Care | Health | Program Sustainability | Programs | Organization and Administration | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Policy | Political Factors | Sociocultural Factors
Document Number: 341372

Peer Reviewed

Title: Evaluation of mifepristone as a once a month contraceptive pill.
Author: Agarwal M; Das V; Agarwal A; Pandey A; Srivastava D
Source: American Journal of Obstetrics and Gynecology. 2009 May;200(5):e27-9.
Abstract: OBJECTIVE: The purpose of this study was to assess the efficacy and safety of mifepristone as a contraceptive pill. STUDY DESIGN: A prospective case-control study was conducted in a tertiary care center of North India. The study group (n = 86) was given 200-mg mifepristone tablets on the 16th day of the menstrual cycle. The control group (n = 92) received combined oral contraceptive (COC) as per protocol. Subjects were followed for drug compliance, satisfaction, side effects, and failure. RESULTS: Acceptability of mifepristone was significantly higher in educated population (P < .001), with fewer side effects (P = .001), good satisfaction (P < .001), and higher compliance rate (P = .05). The oral contraceptive pill group had higher adverse biochemical parameters. CONCLUSION: Mifepristone can be used as a monthly contraceptive pill effectively.
Language: English
Keywords:
INDIA | RESEARCH REPORT | ORAL CONTRACEPTIVES | RU-486 | TIME FACTORS | ADMINISTRATION AND DOSAGE | Asia, Southern | Asia | Developing Countries | Contraceptive Methods | Contraception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341243

Title: Spontaneous vesicovaginal fistula caused by genitourinary aspergillosis.
Author: Agarwal N; Seth A; Kulshrestha V; Kochar S; Kriplani A
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):63-4.
Abstract: Genitourinary aspergillosis is rare in patients who are not immunocompromised. A 39-year-old woman presented with vaginal urinary leakage with no history of previous trauma, procedure, or fever. The patient's last delivery had been by cesarean 12 years previously and she had no history of difficult labor. Six months prior to presenting, the patient had been scheduled to undergo abdominal hysterectomy for menorrhagia along with repair of a surgical hernia; only the hernia was repaired at that time as dense adhesions prevented the hysterectomy. The patient had been amenorrheic since that surgery and her incontinence began 6 days prior to presentation. (excerpt)
Language: English
Keywords:
INDIA | SUMMARY REPORT | CASE HISTORIES | CLIENTS | FISTULA | AMENORRHEA | VAGINAL ABNORMALITIES | SURGERY | BACTERIAL AND FUNGAL DISEASES | UROGENITAL EFFECTS | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Diseases | Menstruation Disorders | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Urogenital System | Physiology | Biology
Document Number: 341383

Title: Prevalence of Candida species and potential risk factors for vulvovaginal candidiasis in Aligarh, India.
Author: Ahmad A; Khan AU
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2009 May;144(1):68-71.
Abstract: OBJECTIVES: The objectives were to determine the frequency of Candida species in women of different age groups as well as to suggest the criteria for the diagnosis of vulvovaginal candidiasis (VVC). STUDY DESIGN: A prospective study of vulvovaginal candidiasis was carried out using laboratory diagnosis, with the estimation of vaginal pH and the direct microscopic and biochemical examination of vaginal discharge/secretions. Vaginal cultures for Candida species were collected from 1050 women with vulvovaginal symptoms. RESULTS: Out of 1050 women, 215 (20.47%) were positive for Candida species. Of 215 women, 172 (80%) had pH within the normal range and 167 (77.67%) were showing yeast cells and mycelia on direct microscopic examination. Candida albicans accounted for 46.9% of cases, Candida glabrata 36.7%, Candida parapsilosis 10.2%, Candida tropicalis 2.8%, Candida krusei 1.4%, and Candida kiefer 1.9%. The frequency of culture positivity was related to pregnancy (P<0.001), an increase in parity (P<0.001), and use of oral contraceptives (P<0.001) and antibiotics (P<0.001). The most common signs and symptoms in 215 women with positive cultures were pruritus with or without vaginal discharge and vaginal erythema. CONCLUSION: Our study suggests that vulvovaginal candidiasis can only be diagnosed by using clinical criteria in correlation with vulvovaginal symptoms and Candida cultures.
Language: English
Keywords:
INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | CANDIDIASIS | RISK FACTORS | PREVALENCE | LABORATORY EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | PRURITUS | VAGINITIS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Bacterial and Fungal Diseases | Infections | Diseases | Health | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Dermatitis | Vaginal Abnormalities
Document Number: 342002

6.
Title: Counsellors are human [letter]
Author: Anand V
Source: Indian Journal of Medical Ethics. 2009 Jul-Sep;6(3):169-70.
Abstract: This letter touches on the subject of the medical knowledge of physicians in India. It first discusses male circumcision and then moves on to India not having an established system for sharing medical information and updates. It asks that better systems of regularly updating the medical knowledge of Indian physicians be developed.
Language: English
Keywords:
INDIA | CRITIQUE | PROVIDERS WITH CLIENTS | MALE CIRCUMCISION | KNOWLEDGE | INFORMED CONSENT | FEES | INFORMATION DISTRIBUTION | Asia, Southern | Asia | Developing Countries | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Sociocultural Factors | Financial Activities | Economic Factors | Communication
Document Number: 342876

8.
Title: Quality-of-life assessment of family adopters through user perspectives in the District of Karimnagar.
Author: Avasarala K
Source: Indian Journal of Community Medicine. 2009 Jan;34(1):24-28.
Abstract: Background: Small families adopting family planning are usually considered happy families. They are expected to lead a better qualitative life. Quality-of-life (QOL) is routinely assessed for knowing patients' health status. Recently, the QOL concept has become increasingly popular for evaluating the impact of public health interventions. Hitherto, QOL is usually assessed by means of program achievements or indicators, which may sometimes be misleading. Hence, the new culture of QOL assessment by means of user perspectives is now becoming popular. Research Questions: 1) Is the quality-of-life of family planning (FP) adopters better than that of non-FP adopters? 2) Are the user perspectives helpful in QOL assessment? Materials and Methods: A cross-sectional descriptive study was carried out among 50 FP adopting families and 50 non-FP adopting families from the village of Vutoor and the city of Karimnagar in Andhra Pradesh. Sampling Methods: Random sampling, Proportions and Chi square test. Results: Program perspectives revealed a better standard of living for FP adopters because they have amenities like housing, television, and vehicles and less mortality and morbidity (P < 0.001). However, they lack positive feelings towards life, general adaptation, personal relationships, and leisure opportunities. Finally, self-assessment by FP adopters themselves revealed no significant increase in their qualitative life after family planning (P = 0.05). Conclusions: While assessing the impact of a health program on quality-of-life, multiple methods of assessments including user perspectives are better than program indicators alone.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLIENTS | FAMILY PLANNING | QUALITY OF LIFE | LIFE STYLE | SOCIOECONOMIC FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Social Welfare | Economic Factors | Behavior
Document Number: 328705

Peer Reviewed

Title: Domestic violence against women in eastern India: a population-based study on prevalence and related issues.
Author: Babu BV; Kar SK
Source: BMC Public Health. 2009;9:129.
Abstract: BACKGROUND: Violence against women is now widely recognised as an important public health problem, owing to its health consequences. Violence against women among many Indian communities on a regularly basis goes unreported. The objective of this study is to report the prevalence and other related issues of various forms of domestic violence against women from the eastern zone of India. METHODS: It is a population-based study covering both married women (n = 1718) and men (n = 1715) from three of the four states of Eastern India selected through a systematic multistage sampling strategy. Interviews were conducted using separate pre-piloted structured questionnaires for women (victimization) and men (perpetration). Women were asked whether their husband or any other family members committed violent acts against them. And men were asked whether they had ever perpetrated violent acts against their wives. Three principle domestic violence outcome variables (physical, psychological and sexual violence) were determined by response to a set of questions for each variable. In addition, data on socio-economic characteristics were collected. Descriptive statistics, bi- and multivariate analyses were done. RESULTS: The overall prevalence of physical, psychological, sexual and any form of violence among women of Eastern India were 16%, 52%, 25% and 56% respectively. These rates reported by men were 22%, 59%, 17% and 59.5% respectively. Men reported higher prevalence of all forms of violence apart from sexual violence. Husbands were mostly responsible for violence in majority of cases and some women reported the involvement of husbands' parents. It is found that various acts of violence were continuing among majority of women who reported violence. Some socio-economic characteristics of women have significant association with the occurrence of domestic violence. Urban residence, older age, lower education and lower family income are associated with occurrence of domestic violence. Multivariate logistic regressions revealed that the physical violence has significant association with state, residence (rural or urban), age and occupation of women, and monthly family income. Similar associations are found for psychological violence (with residence, age, education and occupation of the women and monthly family income) and sexual violence (with residence, age and educational level of women). CONCLUSION: The prevalence of domestic violence in Eastern India is relatively high compared to majority of information available from India and confirms that domestic violence is a universal phenomenon. The primary healthcare institutions in India should institutionalise the routine screening and treatment for violence related injuries and trauma. Also, these results provide vital information to assess the situation to develop public health interventions, and to sensitise the concerned agencies to implement the laws related to violence against women.
Language: English
Keywords:
INDIA | RESEARCH REPORT | SAMPLING STUDIES | HOUSEHOLDS | DOMESTIC VIOLENCE | PREVALENCE | PHYSICAL ABUSE | PSYCHOLOGICAL ABUSE | SEXUAL ABUSE | SOCIOECONOMIC STATUS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Family and Household | Sociocultural Factors | Crime | Social Problems | Measurement | Violence | Behavior | Aggression | Socioeconomic Factors | Economic Factors
Document Number: 341406

10.
Title: Role of the calcium channel in blastocyst implantation: a novel contraceptive target.
Author: Banerjee A; Padh H; Nivsarkar M
Source: Journal of Basic and Clinical Physiology and Pharmacology. 2009;20(1):43-53.
Abstract: The proinflammatory blastocyst implantation cascade involves important mediators like prostaglandins (PG). The influx of calcium via the calcium channel acts as a trigger for the activation of the PG synthesis pathway. Hence, it was hypothesized that calcium channel blockers that are known to possess anti-inflammatory activity may interfere with normal implantation. Pregnant Swiss albino mice (Mus musculus) were treated with diltiazem (1) 4 mg/kg, po on days 1-6 of pregnancy, n=6/day) or (2) at the implantation site (25 microg/animal) via intrauterine injection in the right horn at 5:00 pm on day 4. The intact uterus was used to assay lipid peroxidation and superoxide dismutase activity as markers of membrane fluidity or to observe the day 15 fetus. Oral diltiazem treatment in therapeutic dosage before and during the implantation period did not cause any change in normal uterine milieu during the window of implantation. When injected into the uterine lumen 12-14 h before the average implantation time, however, a complete failure in implantation was observed. Thus, the site specific action of diltiazem may be blocking prostaglandin synthesis, hence causing implantation failure. Oral diltiazem treatment did not mimic this action, indicating that although orally safe in pregnancy in therapeutic dosage, calcium channel blockers may provide a new and yet unknown target in female contraceptive research.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | LABORATORY PROCEDURES | LABORATORY ANIMALS | LIPID METABOLIC EFFECTS | CONTRACEPTION RESEARCH | Asia, Southern | Asia | Developing Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Lipids | Physiology | Biology | Contraception | Family Planning
Document Number: 342045

11.

Title: RISUG: a potential candidate for the entry inhibitor group of antiretroviral drugs.
Author: Banerjee S; Guha SK
Source: Medical Hypotheses. 2009 Aug;73(2):150-2.
Abstract: Entry inhibitors are a group of antiretroviral drug which prevents HIV from entering human immune cells. They include both fusion and attachment inhibitors. A hypothesis is put forward in which a new male contraceptive drug with proven antimicrobial property is proposed as a possible candidate for the entry inhibitor group of antiretroviral drugs. The proposed mechanism of action involves (i) interaction with gp120 and thereby preventing binding to CD4 and (ii) competitive binding with the viral glycoprotein and inhibit the glycoprotein - cell surface glyocosaminoglycan Heparan Sulfate (HS) interaction. A new drug RISUG (Reversible Inhibition of Sperm Under Guidance) presently undergoing Phase III clinical trials throughout India for its contraceptive effect in male has also antimicrobial actions. RISUG is a chemical complex of styrene maleic anhydride (SMA(AN)) and dimethyl sulfoxide. On injection into the vas deferens, it reacts with the components of intravas fluid, the spermatic fluid and gets converted to styrene maleic acid (SMA(AC)) and breakdown products like mandelic acid. An anti HIV activity of RISUG is likely due to its electrical charge and mandelic acid generation. For experimental validation HIV in vitro assays can be performed which will involve infectivity assays, luciferase assay and soluble gp120 assays. A positive result from the studies will validate the hypothesis.
Language: English
Keywords:
INDIA | RESEARCH PROPOSAL | DRUGS | CONTRACEPTIVE AGENTS, MALE | MICROBICIDES | ANTIRETROVIRAL DRUGS | HIV INFECTIONS | IMMUNE SYSTEM | ANTIGEN-ANTIBODY REACTIONS | Asia, Southern | Asia | Developing Countries | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents | Contraception | Family Planning | Viral Diseases | Diseases | Physiology | Biology | Antibodies | Immunologic Factors | Immunity
Document Number: 342410

12.

Peer Reviewed

Title: Sensitivity of paediatric AIDS score vs. WHO case classification in Indian children--a retrospective study.
Author: Banerjee T; Pensi T; Banerjee D
Source: Journal of Tropical Pediatrics. 2009 Apr;55(2):91-6.
Abstract: This study was conducted at the Department of Paediatrics, Dr Ram Manohar Lohia Hospital, to test the statistical significance of existing World Health Organization (WHO) clinical case definition (CCD) for diagnosis of AIDS in areas where diagnostic resources are limited. A total of 360 cases between 18 months and 12 years of age satisfying WHO case definitions of AIDS were included in study group. Our study detected 16.66% (60) of HIV incidence in children visiting the paediatrics outpatient clinic. Twenty percent of cases manifested three major and two minor signs, which had sensitivity of 73.33%; specificity, 90.66% and positive predictive value (PPV), 61.11%. Stepwise logistic analysis identified weight loss, chronic fever >1 month and total lymphocyte count <1500 cells mm(-3) as important predictors. Eighty-six cases (23.89%) showed two major and two minor signs with sensitivity and specificity of 86.66 and 88.66%, respectively. Thus a CCD based on 13 clinical signs/symptoms was proposed for paediatric AIDS with better sensitivity and PPV than the WHO case definition but with almost similar specificity.
Language: English
Keywords:
INDIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | CHILDREN | PERSONS LIVING WITH HIV/AIDS | HIV TESTING | AIDS | LABORATORY PROCEDURES | EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | STANDARDS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 331192

13.
Title: Growth and nutritional status of pre-school children in India: rural-urban and gender differences.
Author: Bharati P; Bharati S; Pal M; Chakrabarty S; Som S; Gupta R
Source: Collegium Antropologicum. 2009 Mar;33(1):7-21.
Abstract: This cross-sectional study of growth and nutritional status makes an attempt to find the gender and rural-urban differences among Indian preschool children. This study is based on the data of weight and height of children aged 0-35 months taken from 26 States (total 26,369 children; 13784 boys and 12585 girls). The children are found to be lighter and shorter compared to International standards irrespective of age and sex. Boys are heavier and taller than girls. Urban preschool children are heavier and taller compared to rural counterparts. In the urban area, higher percentages of girls are affected by underweight (37.1%) and stunting (35.0%) than boys. In rural areas, the prevalence of underweight is also higher among girls (47.9%) compared to boys (45.7%), which is found to be much significant (p < 0.01). There is a significant rural-urban as well as gender difference in growth and nutritional status of Indian preschool children.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | RURAL POPULATION | URBAN POPULATION | CHILDREN | PRIMARY SCHOOLS | GROWTH | CHILD NUTRITION | CHILD DEVELOPMENT | Asia, Southern | Asia | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Schools | Education | Biology | Nutrition | Health
Document Number: 341201

14.
Peer Reviewed

Title: Maternal healthcare financing: Gujarat's Chiranjeevi Scheme and its beneficiaries.
Author: Bhat R; Mavalankar DV; Singh PV; Singh N
Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):249-58.
Abstract: Maternal mortality is an important public-health issue in India, specifically in Gujarat. Contributing factors are the Government's inability to operationalize the First Referral Units and to provide an adequate level of skilled birth attendants, especially to the poor. In response, the Gujarat state has developed a unique public-private partnership called the Chiranjeevi Scheme. This scheme focuses on institutional delivery, specifically emergency obstetric care for the poor. The objective of the study was to explore the targeting of the scheme, its coverage, and socioeconomic profile of the beneficiaries and to assess financial protection offered by the scheme, if any, in Dahod, one of the initial pilot districts of Gujarat. A household-level survey of beneficiaries (n=262) and non-users (n=394) indicated that the scheme is well-targeted to the poor but many poor people do not use the services. The beneficiaries saved more than Rs 3000 (US$ 75) in delivery-related expenses and were generally satisfied with the scheme. The study provided insights on how to improve the scheme further. Such a financing scheme could be replicated in other states and countries to address the cost barrier, especially in areas where high numbers of private specialists are available.
Language: English
Keywords:
INDIA | RESEARCH REPORT | PILOT PROJECTS | LOW INCOME POPULATION | MATERNAL HEALTH SERVICES | FINANCIAL ACTIVITIES | OBSTETRICS | EMERGENCY SERVICES | PROGRAM EVALUATION | MATERNAL MORTALITY | QUALITY OF HEALTH CARE | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Medicine | Programs | Organization and Administration | Mortality | Population Dynamics | Demographic Factors | Population | Health Services Evaluation
Document Number: 341931

15.

Peer Reviewed

Title: Contraceptive failure with Depo-Provera� [letter]
Author: Bhathena R
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):130.
Abstract: I have a concern regarding the recent case report where a 28-year-old woman was given a subsequent (second) injection of Depo-Provera� by a practice nurse when she attended after 13 weeks, and when no precautions were advised, nor documentation done. The patient subsequently again reported with a positive pregnancy test and opted for a termination of pregnancy. My personal feeling is that although by and large consultation times are often too short for practising doctors to cover all aspects of counselling at all times, when a patient is using a contraceptive method outside the terms of the product licence, to ensure that optimal service is offered and also in view of the remote possibility of litigation following failure of the method, it should be mandatory for the practising doctor to also get involved and appropriately counsel, and to adequately document such an episode. (full-text)
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN IN DEVELOPMENT | PHYSICIANS | NURSES AND NURSING | DEPO-PROVERA | CONTRACEPTION FAILURE | ABORTION | REFERRAL AND CONSULTATION | COUNSELING | TIME FACTORS | FAMILY PLANNING EDUCATION | Asia, Southern | Asia | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Health Personnel | Delivery of Health Care | Health | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Usage | Fertility Control, Postconception | Program Activities | Programs | Organization and Administration | Clinic Activities | Population Dynamics | Demographic Factors | Population | Education
Document Number: 330946 Notification

16.

Peer Reviewed

Title: Can sex workers regulate police? Learning from an HIV prevention project for sex workers in southern India.
Author: Biradavolu MR; Burris S; George A; Jena A; Blankenship KM
Source: Social Science and Medicine. 2009 Apr;68(8):1541-7.
Abstract: There is an argument that policing practices exacerbate HIV risk, particularly for female sex workers. Interventions that mobilize sex workers to seek changes in laws and law enforcement practices have been prominent in India and have received considerable scholarly attention. Yet, there are few studies on the strategies sex worker advocates use to modify police behavior or the struggles they face in challenging state institutions. This paper draws upon contemporary theories of governance and non-state regulation to analyze the evolving strategies of an HIV prevention non-governmental organization (NGO) and female sex worker community-based organizations (CBOs) to reform police practices in southern India. Using detailed ethnographic observations of NGO and CBO activities over a two year period, and key informant interviews with various actors in the sex trade, this paper shows how a powerless group of marginalized and stigmatized women were able to leverage the combined forces of community empowerment, collective action and network-based governance to regulate a powerful state actor, and considers the impact of the advocacy strategies on sex worker well-being.
Language: English
Keywords:
INDIA | RESEARCH REPORT | NONGOVERNMENTAL ORGANIZATIONS | POLICE | SEX WORKERS | HIV PREVENTION | INTERVENTIONS | ADVOCACY | POWER | INTERVIEWS | Asia, Southern | Asia | Developing Countries | Organizations | Political Factors | Sociocultural Factors | Corrections Officers | Government | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Communication | Data Collection | Research Methodology
Document Number: 341691

17.

Peer Reviewed

Title: Incidence and correlates of 'catastrophic' maternal health care expenditure in India.
Author: Bonu S; Bhushan I; Rani M; Anderson I
Source: Health Policy and Planning. 2009 Aug 17;
Abstract: Using data from the 60(th) round of the National Sample Survey of India (2004), the study investigates the incidence and correlates of 'catastrophic' maternal expenditure (ME) in India. Data on ME come from 6879 births that took place during 365 days prior to the survey. The study adapts earlier definitions and methods for catastrophic total health care expenditure to measure 'catastrophic' ME as: (i) maternal health care expenditure more than 10% of the annual normative household consumption expenditure (ME-1), and (ii) maternal health care expenditure more than 40% of the annual 'capacity to pay' (ME-2). The 'capacity to pay' was derived by subtracting state-wise poverty-line household expenditure from household consumption expenditure. The average maternal expenditure varied by place of delivery: US$9.5, US$24.7 and US$104.3 for birth at home, in a public facility and in a private facility, respectively. Sixteen per cent of households incurred ME of more than 10% of total household consumption expenditure (ME-1), while 51% households incurred ME of more than 40% of household 'capacity to pay' (ME-2). While incidence of ME-1 increased with income decile, the reverse was observed for ME-2, reflecting higher non-utilization of institutional maternal care and its non-affordability among poorer households. All the households from the poorest decile and 99% from the second poorest decile paid more than 40% of their capacity to pay. Multivariate regression results indicate that antenatal care and delivery care in private facilities increased the chances of ME-1 and ME-2 (P < 0.001). Measuring maternal expenditure against 'capacity to pay' (ME-2) may be better than measuring it as a proportion of overall household expenditure when assessing financial constraints in the use of maternal services. Improving the performance of the public sector, appropriate regulation of and partnership with the private sector, and effective direct cash transfers to pregnant women in the poorest households may increase utilization of maternal services and reduce the financial distress associated with ME.
Language: English
Keywords:
INDIA | RESEARCH REPORT | EXPENDITURES | INCIDENCE | MATERNAL HEALTH | UTILIZATION OF HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | FEES | Asia, Southern | Asia | Developing Countries | Financial Activities | Economic Factors | Measurement | Research Methodology | Health | Health Services | Delivery of Health Care | Primary Health Care
Document Number: 342553

18.

Peer Reviewed

Title: Do men and women with HIV differ in their quality of life? A study from south India.
Author: Chandra PS; Satyanarayana VA; Satishchandra P; Satish KS; Kumar M
Source: AIDS and Behavior. 2009 Feb;13(1):110-117.
Abstract: This paper examined gender differences in Quality of Life (QOL) among people living with HIV/ AIDS in South India using the locally validated version of the WHO Quality of Life Instrument for HIV (WHOQOLHIV 120). Participants (N = 109) were men and women with HIV1 Clade C infection participating in a cohort study. There was no gender difference in CD4 counts or use of antiretroviral therapy. Of the 29 facets of QOL, men reported significantly higher QOL in the following facetspositive feeling, sexual activity, financial resources and transport, while women reported significantly higher QOL on the forgiveness and blame facet. Of the six domains of QOL, men reported better quality of life in the environmental domain while women had higher scores on the spirituality/religion and personal beliefs domain. Understanding these gender differences may provide potentially useful information for tailoring interventions to enhance QOL among people infected with HIV/AIDS.
Language: English
Keywords:
INDIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | SEX FACTORS | QUALITY OF LIFE | HIV | Developing Countries | Asia, Southern | Asia | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Social Welfare | Economic Factors
Document Number: 330154

19.

20.

Title: Male perceptions on female sterilization: a community-based study in rural central India.
Author: Char A; Saavala M; Kulmala T
Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):131-138.
Abstract: CONTEXT: Use of modern contraceptive methods has increased fourfold in India since the 1970s, characterized by a predominance of female sterilization. There has been considerable investigation about women's choice of female sterilization, but little from the male perspective. METHODS: Seven focus group discussions were conducted among 58 men currently married to women aged 15-45, followed by a cross-sectional survey among 793 men currently married to same-aged women. Bivariate analysis was used for the survey data, and content analysis was used for the qualitative data. RESULTS: Men's primary source of reproductive health information was mass media, although they expressed interest in getting information through discussion with knowledgeable sources. Men understood family planning and contraception to be two separate issues: Men viewed "family planning" as synonymous with female sterilization, whereas they saw "contraception" as referring to spacing methods, knowledge of which was limited. Thirty-four percent of men reported that their wives had been sterilized; 79% of men who did not rely on any permanent method said they wanted their wives to be sterilized. In focus group discussions, most men reported themselves as their family's sole decision maker about reproductive health; however, only one-third of survey respondents did so. CONCLUSION: Men are interested in acquiring family planning information, but lack knowledge about available information sources, which hampers their ability to make informed family planning choices. Family planning service providers and program planners need to be aware of males' knowledge and perceptions pertaining to family planning, and make appropriate modifications to communication strategies.
Spanish Abstract: Contexto: El uso de m�todos anticonceptivos modernos se ha cuadruplicado en India desde los a�os setenta y se ha caracterizado por el predominio de la esterilizaci�n femenina. Ha habido considerables esfuerzos de investigaci�n sobre la elecci�n de la esterilizaci�n femenina que hacen las mujeres, pero existen pocos estudios desde la perspectiva masculina. M�todos: Siete sesiones de grupos focales se condujeron con 58 hombres actualmente casados con mujeres en edades de 15-45 a�os, seguidas por una encuesta transversal aplicada a 793 hombres actualmente casados con mujeres del mismo grupo de edad. Se us� an�lisis bivariado para los datos de la encuesta y an�lisis de contenido para los datos cualitativos. Resultados: Para los hombres, la fuente primaria de informaci�n sobre salud reproductiva fue los medios masivos, aunque ellos expresaron inter�s en obtener informaci�n a trav�s de charlas con gente informada en el tema. Los hombres encuestados entendieron la planificaci�n familiar y la anticoncepci�n como dos temas separados: los hombres percibieron la "planificaci�n familiar" como sin�nimo de esterilizaci�n femenina, mientras que se refirieron a la "anticoncepci�n" como m�todos de espaciamiento, cuyo conocimiento fue limitado. Treinta y cuatro por ciento de los hombres reportaron que sus esposas hab�an sido esterilizadas; 79% de los hombres que no depend�an de alg�n m�todo permanente dijeron que quer�an que sus esposas fueran esterilizadas. En las sesiones de grupo, la mayor�a de los hombres se identific� como el �nico tomador de decisiones en su familia respecto a la salud reproductiva; sin embargo, solamente un tercio de los hombres encuestados se identific� de esa forma. Conclusi�n: Los hombres est�n interesados en obtener informaci�n sobre planificaci�n familiar, pero desconocen las fuentes disponibles que pueden consultar, lo cual limita su capacidad para tomar decisiones informadas sobre planificaci�n familiar. Los prestadores de servicios y planificadores de programas de planificaci�n familiar deben estar conscientes del conocimiento y percepciones de los hombres en relaci�n con la planificaci�n familiar, y realizar las modificaciones apropiadas a sus estrategias de comunicaci�n.
French Abstract: Contexte: La pratique de la contraception moderne a quadrupl� en Inde depuis les ann�es 1970. Elle se caract�rise par une pr�dominance de la st�rilisation f�minine. De nombreuses �tudes ont �t� men�es sur le choix f�minin de la st�rilisation. La perspective masculine n'est en revanche gu�re connue. M�thodes: Sept r�unions de groupe ont �t� organis�es avec 58 hommes mari�s � des femmes de 15 � 45 ans. Une enqu�te transversale a ensuite �t� men�e aupr�s de 793 hommes mari�s � des femmes de la m�me tranche d'�ge. L'analyse bivari�e a �t� utilis�e pour les donn�es d'enqu�te, et l'analyse de contenu pour les donn�es qualitatives. R�sultats: Pour les hommes, les m�dias repr�sentent la principale source d'information sur la sant� g�n�sique. Ils expriment cependant un certain int�r�t � s'informer par discussion aupr�s de sources comp�tentes. Les hommes voient dans la planification familiale et la contraception deux questions distinctes: la �planification familiale� est pour eux synonyme de st�rilisation f�minine, tandis que la �contraception� d�signe les m�thodes d'espacement, au sujet desquelles ils ne sont gu�re inform�s. Trente-quatre pour cent des hommes ont d�clar� que leur femme �tait st�rilis�e; 79% de ceux qui n'avaient pas eu recours � une m�thode permanente ont indiqu� d�sirer que leur femme se fasse st�riliser. Lors des discussions de groupe, la plupart des hommes se sont d�clar�s les seuls d�cideurs de leur famille en mati�re de sant� g�n�sique, par rapport � un tiers seulement des r�pondants � l'enqu�te. Conclusion: Les hommes d�sirent s'informer sur la planification familiale mais ils ignorent les sources d'information disponibles, ce qui entrave leur aptitude � op�rer des choix �clair�s en la mati�re. Les prestataires de services et les planifi- cateurs de programmes de planification familiale doivent �tre sensibles aux connaissances et aux perceptions masculines et ajuster en cons�quence leurs strat�gies de communication.
Language: English
Keywords:
INDIA | RESEARCH REPORT | FOCUS GROUPS | CROSS SECTIONAL ANALYSIS | MEN | CURRENTLY MARRIED | REPRODUCTIVE HEALTH | PERCEPTION | FEMALE STERILIZATION | INFORMATION SOURCES | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Demographic Factors | Population | Marital Status | Nuptiality | Health | Psychological Factors | Behavior | Sterilization, Sexual | Family Planning | Information
Document Number: 343003

21.

Title: Age and height predict neuropathy risk in patients with HIV prescribed stavudine.
Author: Cherry CL; Affandi JS; Imran D; Yunihastuti E; Smyth K; Vanar S; Kamarulzaman A; Price P
Source: Neurology. 2009 Jul 28;73(4):315-20.
Abstract: OBJECTIVE: Sensory neuropathy is a common problem in HIV-infected patients and is the dose-limiting toxicity of stavudine. Affordable methods of predicting neuropathy risk are needed to guide prescribing in countries where some use of stavudine remains an economic necessity. We therefore aimed to identify factors predictive of neuropathy risk before antiretroviral use. METHODS: A total of 294 patients attending clinics in Melbourne, Kuala Lumpur, and Jakarta were enrolled in a cross-sectional neuropathy screening program in 2006. Neuropathy was defined by the presence of symptoms and signs on the AIDS Clinical Trials Group Brief Peripheral Neuropathy Screen. Demographic, laboratory, and treatment details were considered as possible risk factors for neuropathy. The role of patient demographics in predicting stavudine neuropathy were then assessed in 181 patients who reported that they were free of neuropathy symptoms when first prescribed this drug. RESULTS: The prevalence of neuropathy was 42% in Melbourne (n = 100), 19% in Kuala Lumpur (n = 98), and 34% in Jakarta (n = 96). In addition to treatment exposures, increasing age (p = 0.002) and height (p = 0.001) were independently associated with neuropathy. Age and height cutoffs of > or=170 cm or > or =40 years predicted neuropathy. Among 181 patients who were asymptomatic before stavudine exposure, the risk of neuropathy following stavudine was 20% in younger, shorter patients, compared with 66% in older, taller individuals. CONCLUSIONS: Stavudine neuropathy risk increases with patient age and height. Prioritizing older and taller patients for alternative agents would be an inexpensive strategy to reduce neuropathy rates in countries where the burden of HIV disease limits treatment options.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | SCREENING | NEUROLOGIC EFFECTS | TREATMENT | PRESCRIPTIONS | ANTIRETROVIRAL DRUGS | AGE FACTORS | BODY HEIGHT | Asia, Southern | Asia | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Distributional Activities | Program Activities | Programs | Organization and Administration | Population Characteristics | Demographic Factors | Population
Document Number: 342727

22.

Title: Knowledge, beliefs, and health care practices relating to treatment of HIV in Vellore, India.
Author: Chomat AM; Wilson IB; Wanke CA; Selvakumar A; John KR; Isaac R
Source: AIDS Patient Care and STDs. 2009 Jun;23(6):477-84.
Abstract: In India, little is known about health care-seeking behavior among HIV-infected individuals. Similarly, little is known about how HIV is being treated in the community, in particular by Indian Systems of Medicine (ISM) providers. Therefore, while ART implementation programs continue to expand, it is important to determine whether the knowledge, attitudes, and treatment practices of HIV-infected individuals and their health care providers are aligned with current treatment recommendations. We conducted in-depth qualitative interviews with persons with HIV (n = 9 men and 17 women), family members of persons with HIV (n = 14 men and 3 women), and ISM providers (n = 7). Many of the patients we studied turned at some point to ISM providers because they believed that such practitioners offer a cure for HIV. ISM treatments sometimes had negative impacts including side effects, unchecked progression of an underlying illness, and financial depletion. Indian women tended to be less knowledgeable about HIV and HIV treatments, and had less access to financial and other resources, than men. Finally, most of the ISM providers reported dangerous misconceptions about HIV transmission, diagnosis, and treatment. While the existence of ART in India is potentially of great benefit to those with HIV infection, this study shows that a variety of social, cultural and governmental barriers may interfere with the effective use of these therapies. Partnerships between the allopathic and traditional/complementary health sectors in research, policy, and practice are essential in building comprehensive HIV/AIDS treatment strategies.
Language: English
Keywords:
INDIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | BEHAVIOR | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | BELIEFS | KNOWLEDGE | TRADITIONAL HEALTH PRACTICES | TREATMENT | ANTIRETROVIRAL THERAPY | Asia, Southern | Asia | Developing Countries | Viral Diseases | Diseases | Delivery of Health Care | Health | Culture | Sociocultural Factors | Medical Procedures | Medicine | HIV
Document Number: 342430

23.

Title: Comparison of intramuscular magnesium sulfate with low dose intravenous magnesium sulfate regimen for treatment of eclampsia.
Author: Chowdhury JR; Chaudhuri S; Bhattacharyya N; Biswas PK; Panpalia M
Source: Journal of Obstetrics and Gynaecology Research. 2009 Feb;35(1):119-125.
Abstract: Objectives: Our objective was to compare intramuscular (i.m.) magnesium sulfate with a low dose intravenous (i.v.) magnesium sulfate regimen in prevention of convulsion recurrence and maternal deaths in women with eclampsia. Methods: This prospective trial was conducted in Nilratan Sircar Medical College, India from January 2001 to December 2005. All women with a clinical diagnosis of eclampsia were included in the trial. Magnesium sulfate (4 gm) was given as an i.v. loading dose, followed by either i.m. injections as recommended by Pritchard or low dose i.v. infusions (0.6 gm/h). Primary measures of outcome were recurrence of convulsions and maternal death. Secondary measures of outcome were potentially life threatening events, events related to labor and delivery as well as perinatal mortality and morbidity. Results: Of the 630 women participating in the trial, 480 women received i.m. magnesium sulphate according to the Pritchard regimen and 150 women were subjected to a low dose i.v. regimen ofmagnesium sulphate. There was no significant difference in recurrence of convulsion (3.3% in the i.m. and 2% in the i.v. groups P = 0.586). Maternal deaths were not significantly lower in the i.v. group than the i.m. group (5% in the i.m. and 3.3% in the i.v. groups, P = 0.506) There were no significant differences in other measures of serious maternal morbidity, in perinatal morbidity or mortality. Conclusion: Low dose i.v. magnesium sulfate regimen is equally effective in prevention of convulsion recurrence and maternal deaths in eclamptic women when compared with an i.m. magnesium sulfate regimen.
Language: English
Keywords:
INDIA | RESEARCH REPORT | COMPARATIVE STUDIES | PREECLAMPSIA | PREGNANCY COMPLICATIONS | DRUGS | TREATMENT | CONTRACEPTIVE USE-EFFECTIVENESS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Effectiveness | Contraception | Family Planning
Document Number: 340214

24.
Title: Mainstreaming early and exclusive breastfeeding for improving child survival.
Author: Dadhich JP; Agarwal RK
Source: Indian Pediatrics. 2009 Jan;46(1):11-7.
Abstract: India is home to maximum number of under-five deaths and underweight children in the world. In 2006, for the first time, the number of children in the world dying before their fifth birthday fell below 10 million, to 9.7 million annually. South Asia's contribution to this figure was 3.1 million out of which 2.1 million deaths occurred in India i.e., 21 percent of the global burden of under five deaths. Most of these deaths occur during the neonatal period. A reduction in the number of deaths among the under-five children reflects the country's progress on the fourth Millennium Development Goal (MDG 4). About 55 million, or one-third of the world's underweight children under the age of five years, live in India. Malnutrition has been estimated to be an underlying cause of up to 50-60 percent of under five deaths. The number of young underweight children reflects the country's progress on the first Millennium Development Goal (MDG 1), which deals with eradication of extreme poverty and hunger. In India, the average annual rate of decline in malnutrition has been around 0.9% since 1990. Considerably accelerated progress is needed for India to meet its MDG target of halving the percentage of underweight children by 2015. Despite breastfeeding's numerous recognized advantages, early and exclusive breastfeeding rates in most states of the India are low. There are many gaps in policy and programs related to infant and young child feeding in India. The big challenge is how to mainstream IYCF counseling and support interventions to help women to succeed both in early and exclusive breastfeeding. The rationale for supporting a major program to protect, promote and support breastfeeding action, backed by a budgetary support, is compelling for our country. Child health and development policies should urgently address this major concern.
Language: English
Keywords:
INDIA | RECOMMENDATIONS | HEALTH SURVEYS | MOTHERS | INFANT | BREASTFEEDING, EXCLUSIVE | CHILD SURVIVAL | MALNUTRITION | BODY WEIGHT | TIME FACTORS | POSTPARTUM PROGRAMS | LONGTERM EFFECTS | INTELLIGENCE | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | Asia, Southern | Asia | Developing Countries | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Breastfeeding | Infant Nutrition | Nutrition | Survivorship | Length of Life | Mortality | Population Dynamics | Nutrition Disorders | Diseases | Physiology | Biology | Family Planning Programs | Family Planning | Personality | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Disease Transmission Control | Prevention and Control
Document Number: 331250

25.
Peer Reviewed

Title: Economic analysis of HIV prevention interventions in Andhra Pradesh state of India to inform resource allocation.
Author: Dandona L; Kumar SG; Kumar GA; Dandona R
Source: AIDS. 2009 Jan 14;23(2):233-42.
Abstract: OBJECTIVE: To conduct composite economic analysis of HIV prevention interventions to inform efficient utilization of resources in India. METHODS: We obtained output and economic cost data for the 2005-2006 fiscal year from a representative sample of 128 public-funded HIV prevention programmes of 14 types in Andhra Pradesh state of India. Using data from various sources, we developed a model to estimate the number of HIV infections averted. We estimated the additional HIV infections that could be averted if each intervention reached optimal coverage and the associated cost. RESULTS: In a year, 9688 HIV infections were averted by public-funded HIV prevention interventions in Andhra Pradesh. Scaling-up interventions to the optimal level would require US$38.8 million annually, 2.8 times the US$13.8 million economic cost in 2005-2006. This could increase the number of HIV infections averted by 2.4-fold, if with higher resources there were many-fold increases in the proportional allocation for programmes for migrant labourers, men who have sex with men and voluntary counselling and testing, and reduction of the high proportion for mass media campaigns to one-third of the 2005-2006 proportion of resource utilization. If the proportions of resource allocation for interventions remained similar to 2005-2006, the higher resources would avert 54% of the additional avertable HIV infections. CONCLUSION: The recent four-fold increase in public funding for HIV/AIDS control in India should be adequate to scale-up HIV prevention interventions to an optimal level in Andhra Pradesh, but the prevention would be suboptimal if additional investments were not preferentially directed to some particular interventions.
Language: English
Keywords:
INDIA | RESEARCH REPORT | INTERVENTIONS | HIV INFECTIONS | COST BENEFIT ANALYSIS | ECONOMIC FACTORS | RESOURCE ALLOCATION | FUNDS | FINANCIAL ACTIVITIES | Developing Countries | Asia, Southern | Asia | Programs | Organization and Administration | Viral Diseases | Diseases | Quantitative Evaluation | Evaluation
Document Number: 330502

26.

27.
Title: Rapid progression of HIV infection in infancy.
Author: Devi NP; Shenbagavalli R; Ramesh K; Rathinam SN; Swaminathan S
Source: Indian Pediatrics. 2009 Jan;46(1):53-6.
Abstract: Transmission of HIV from mother to child can occur in utero, during labor or after delivery via breast feeding. Data on the fate of babies born with HIV in India are scarce. We present details of 25 infants with perinatally acquired HIV infection (virologically confirmed) to highlight the observed high rate of morbidity and mortality within the first 18 months of life. Our findings of rapid disease progression among perinatally infected HIV positive children underline the importance of early diagnosis and treatment.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | EPIDEMIOLOGIC METHODS | PERSONS LIVING WITH HIV/AIDS | INFANT | MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | DEATH RATE | INFANT MORTALITY | AIDS | TIME FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Studies | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Transmission | Infections | Mortality | Population Dynamics
Document Number: 331249

28.

Peer Reviewed

Title: Estimating the burden of malaria in pregnancy: a case study from rural Madhya Pradesh, India.
Author: Diamond-Smith N; Singh N; Gupta RK; Dash A; Thimasarn K; Campbell OM; Chandramohan D
Source: Malaria Journal. 2009;8:24.
Abstract: BACKGROUND: Malaria in pregnancy (MiP) is inadequately researched in India, and the burden is probably much higher than current estimates suggest. This paper models the burden of MiP and associated foetal losses and maternal deaths, in rural Madhya Pradesh, India. METHODS: Number of pregnancies per year was estimated from the number of births and an estimate of pregnancies that end in foetal loss. The prevalence of MiP, risk of foetal loss attributable to MiP and case fatality rate of MiP were obtained from the literature. The estimated total number of pregnancies was multiplied by the appropriate parameter to estimate the number of MiP cases, and foetal loss and maternal deaths attributable to MiP per year. A Monte Carlo simulation sensitivity analysis was done to assess plausibility of various estimates obtained from the literature. The burden of MiP in tribal women was explored by incorporating the variable prevalence of malaria in tribal and non-tribal populations and in forested and non-forested regions within Madhya Pradesh. RESULTS: Estimates of MiP cases in rural Madhya Pradesh based on the model parameter values found in the literature ranged from 183,000-1.5 million per year, with 73,000-629,000 lost foetuses and 1,500-12,600 maternal deaths attributable to MiP. The Monte Carlo simulation gave a more plausible estimate of 220,000 MiP cases per year (inter-quartile range (IQR): 136,000-305,000), 95,800 lost foetuses (IQR: 56,800-147,600) and 1,000 maternal deaths (IQR: 650-1,600). Tribal women living in forested areas bore 30% of the burden of MiP in Madhya Pradesh, while constituting 18% of the population. CONCLUSION: Although the estimates are uncertain, they suggest MiP is a significant public health problem in rural Madhya Pradesh, affecting many thousands of women and that reducing the MiP burden should be a priority.
Language: English
Keywords:
INDIA | LITERATURE REVIEW | CASE STUDIES | PREVALENCE | RURAL AREAS | PREGNANT WOMEN | MALARIA | MATERNAL MORTALITY | CAUSES OF DEATH | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Measurement | Geographic Factors | Population | Population Characteristics | Demographic Factors | Parasitic Diseases | Diseases | Mortality | Population Dynamics
Document Number: 330550

29.

Peer Reviewed

Title: Estimation of the predictive role of plasma viral load on CD4 decline in HIV-1 subtype C-infected subjects in India.
Author: Ding M; Tarwater P; Rodriguez M; Chatterjee R; Ratner D; Yamamura Y; Roy P; Mellors J; Neogi D; Chen Y; Gupta P
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Feb 1;50(2):119-25.
Abstract: BACKGROUND: Plasma viral load has been shown to be a meaningful prognostic marker for disease progression in untreated, HIV-1 subtype B-infected subjects in United States and Western Europe and therefore used as a prognostic marker for disease progression. Because of high expenses of commercially available viral load assays, the role of viral load in disease progression has not been evaluated in HIV-1 subtype C-infected patients in India. METHODS: We developed an inexpensive real-time reverse transcriptase-polymerase chain reaction assay to quantify viral load in plasma of HIV-1 subtype C-infected subjects from India and used it in a longitudinal analysis of viral load and CD4 cell number in HIV-infected subjects from Calcutta, India. RESULTS: The real-time reverse transcriptase-polymerase chain reaction assay can quantify plasma viral load with a linear range of detection from 10 to 10 HIV-1 RNA copies per input. Longitudinal analysis of viral load in a cohort of 39 subjects over an average period of approximately 3 years indicates that 1-log increase in HIV-1 RNA level was associated with a decline of 67 CD4 cell count. Furthermore, HIV-1 RNA level between 500 and 50,000 copies per milliliter would predict a 12.9% decrease in CD4 cell count per year, whereas HIV-1 RNA levels above 50,000 copies HIV-1 RNA per milliliter would predict a 25.3% decrease in CD4 cells per year. In addition, we estimated that the mean incubation period of disease development, as defined by the loss of CD4 below 200, is 8.2 years. CONCLUSION: Our report on the level of viral load on predicting CD4 decline in Indian subjects with HIV-1 provides an additional important tool to the physicians for treating and planning a therapeutic strategy to control HIV-1 infection in India.
Language: English
Keywords:
INDIA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | GENETIC TECHNIQUES | ESTIMATION TECHNIQUES | EVALUATION INDEXES | PERSONS LIVING WITH HIV/AIDS | HEALTH STATUS INDEXES | HIV INFECTIONS | COST EFFECTIVENESS | LABORATORY EXAMINATIONS AND DIAGNOSES | IMMUNITY, CELLULAR | Developing Countries | Asia, Southern | Asia | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Quantitative Evaluation | Evaluation | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Immunity | Immune System | Physiology | Biology
Document Number: 330366

30.

Title: Seroprevalence of human immunodeficiency virus and syphilis in blood donors of Delhi [letter]
Author: Ekadashi R; Langer S
Source: Indian Journal of Medical Microbiology. 2009 Apr-Jun;27(2):167-8.
Abstract: Transfusion of blood and blood products is a life saving measure that benefits numerous patients worldwide. At the same time it is an important mode of infection to the recipients. In up to 15% of the total patients infected with human immunodeficiency virus (HIV), blood transfusion has been the route of transmission. Syphilis positivity varies from 0.8% in voluntary donors to more than 15% in paid commercial donors. Although HIV infection has been reported in all groups of blood donors in Delhi, it is particularly high among replacement donors. Concealing the medical history by professional or replacement donors pose a great threat to safe blood supply. Problems are also due to the prevalence of asymptomatic carriers in the society, blood donations during the window period, genetic variability in the viral strains and laboratory errors. Only few reports are available regarding the trend of HIV seropositivity and syphilis serology, particularly in blood donors from northern India. In this study, we aimed to assess the prevalence and trend of HIV and syphilis over 4 years, 2004-2007, among blood donors of Central Delhi. A total of 13,672 blood units were collected from blood donors during the period from January 1 2004 to December 31 2007 at the blood bank of Delhi Heart and Lung Institute in New Delhi, India. This is a tertiary care level hospital super specializing in heart and lung ailments. Blood donors were either replacement or voluntary. Care was taken to exclude professional donors by taking appropriate history and examination. (excerpt)
Language: English
Keywords:
INDIA | CRITIQUE | BLOOD DONORS | HIV TRANSMISSION | SYPHILIS | HIV | LABORATORY PROCEDURES | SCREENING | SAFETY | PREVENTION AND CONTROL | Asia, Southern | Asia | Developing Countries | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Public Health
Document Number: 341204


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