Ranjitha S Shetty

A randomized Phase III clinical trial to assess the efficacy of a bovine-human reassortant pentavalent rotavirus vaccine in Indian infants

Highlights • Pentavalent reassortant rotavirus vaccine was tested for efficacy in infants.• The vaccine (BRV-PV) showed excellent tolerability and a good safety profile.• Primary analysis efficacy was 36% against SRVGE and up to 60.5% against VSRVGE.• The efficacy through 2 years of age was 39.5% (SRVGE) and 54.7% (VSRVGE).• The intent to treat analyses confirmed all the per protocol analyses.

Retrospective surveillance for intussusception in children aged less than five years at two tertiary care centers in India.

BACKGROUND A rotavirus vaccine could soon become part of Indias national immunization program. However the occurrence of intussusception due to rotavirus vaccine is a potential safety concern. This surveillance aimed at the collection of baseline data on childhood intussusception which would facilitate the monitoring of intussusception cases after the introduction of rotavirus vaccines. METHODS We retrospectively reviewed medical records of confirmed intussusception cases in children under the age of five, treated during 2007-2012 at two tertiary care hospitals attached to medical schools in India. Demographic, clinical, diagnostic and treatment practices data were obtained from hospital records. RESULTS Over a five to six year observation period, we identified 187 confirmed cases of intussusception, of which 75% were males. The median age of intussusception was 8 months, and we observed a possible trend in the distribution of cases with the highest number of cases being reported in the month of April and lowest in the month of October. The most common diagnostic methods used were ultrasonography and abdominal radiography with most cases being treated surgically (71%). The median length of hospital stay was 8 days (range 1-40) and mean was 10.2 days. Records of any fatality due to intussusception were not found during the review of the records. CONCLUSIONS This analysis provides an estimate of the baseline data of childhood intussusception prior to the introduction of the rotavirus vaccination as a part of routine immunization in India. A prospective surveillance system using a standardized case definition is needed in order to better examine the incidence of intussusception in developing countries.

Are Our Women Aware of HIV/AIDS? -A cross-sectional Study

Background:HIV has reduced life expectancy by more than 20 years, slowed economic growth, and deepened household poverty, and many women in the rural areas still lack complete information on how to avoid exposure to the infection.Method A Cross sectional study was carried out among 167 married women in the age group of 15-45 years during the month of July and August 2009 in the Rural Health Training centre of the Community Medicine department. A modified National Family Health Survey-3 (NFHS-3) questionnaire was used to collect the data and was analyzed using Statistical Package for Social Sciences (SPSS) version 11.5.Results Majority of the women belonged to the age group of 21 -30 years (73.7%). About 67% of them were housewives. Over 80% of the women knew about modes of transmission of HIV. Only 30% of the women were aware that HIV infection can also be present in healthy looking persons whereas 62.5% of them were unsure regarding this matter. Approximately 87(54%) respondents were aware of the anti-retroviral drugs Only 14% of the women had positive attitudes towards HIV positive people.Conclusion Misconceptions about HIV/AIDS existed although levelof awareness about the infection was acceptable among the study population. This gap in the knowledge suggests the need for better awareness campaigns targeting rural women.

Prevalence of oral premalignant lesions and its risk factors among the adult population in Udupi taluk of Coastal Karnataka, India

Objective: Globally oral cancer is one of the ten most common cancers with prevalence being high in Central and South East Asian countries. This survey was conducted to estimate the prevalence of oral pre-malignant lesions (OPML) and to identify their risk factors. Methods: A community based cross-sectional study was carried out among 2033 individuals aged ≥18 years. A questionnaire was administered to collect socio-demographic characteristics, various risk factors for oral cancer and presence of its symptoms. Oral cavity of all the participants was examined in detail by the study investigator as per WHO guidelines for the early diagnosis of oral neoplasia. Result: The prevalence of OPML was found to be 3.73%. Among those with OPML, all were ever tobacco consumers and had poor oral hygiene. A significant association was observed between OPML and younger age group (OR=2.56, 95% CI 1.08-6.02), males (OR=26.76, 95% CI 8.40-85.19) and low socio-economic status (OR = 1.91, 95% CI 1.20-3.02). Tobacco (p<0.001), alcohol (OR= 7.92, 95% CI 4.77-13.14) and areca nut consumption (OR = 5.48, 95% CI 3.42-8.77) were strongly associated with OPML. On multivariate analysis among ever tobacco users, OPML was associated with younger individuals, males and those using smokeless forms of tobacco (p <0.05). The study showed that the participants with OPML were more likely to be never married (OR=1.6, 95% CI 0.92-2.96), to be unskilled workers (OR= 1.45, 95% CI 0.61-3.43), to have suffered from oral trauma (OR =1.30, 95% CI 0.75-2.26), to have consumed hot and spicy food frequently (OR=1.53, 95% CI 0.96-2.24), to have consumed fruits infrequently (OR=1.53, 95% CI 0.90-2.59) and to report family history of any cancer (OR = 1.29, 95% CI 0.58-2.87). However, these associations were statistically insignificant. Conclusion: The study reinforces that use of substances such as tobacco, alcohol and areca nut are the modifiable risk factors for OPML.

Road safety and the community: an awareness survey among the coastal population of Karnataka

Background: Road traffic accidents (RTAs) pose a significant burden on the health care system in India with high out of pocket medical expenditure. Awareness about this public health problem is necessary to combat it and this study was carried out to assess knowledge and practice towards road safety among the adult population in the coastal region of Udupi taluk in Karnataka. Methods: A cross-sectional survey was carried out among 381 adults aged 18 years and above residing in the region for more than one year. A semi-structured questionnaire was used to assess their knowledge and practice towards road safety measures. Results: Most of the participants were in the age bracket of 18-44 years (61.4%), were females (65.1 %) and had up to 10 years of schooling. Overall knowledge was found to be low with only 30% reporting good knowledge. As regards practice, drivers fared better with a good majority (87%) reporting desirable practice. Younger age (OR=0.57, 95% CI, 0.36-0.92), male gender (OR=0.14, 95% CI, 0.08-0.23), higher level of schooling (OR=0.32, 95% CI, 0.20 -0.50) and knowing to drive (OR=0.04, 95% CI, 0.02-0.07) were found to be significantly associated with a greater level of knowledge regarding road safety measures. Conclusions: The study showed inadequate knowledge and poor road safety practices among good number of participants. This emphasises the need for a customized community based awareness campaign on road safety measures coupled with stringent legislation measures to bring about the desired change.