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Featured researches published by Ravi Shankar.


PLOS Neglected Tropical Diseases | 2014

Strong association between serological status and probability of progression to clinical visceral leishmaniasis in prospective cohort studies in India and Nepal.

Epco Hasker; Paritosh Malaviya; Kamlesh Gidwani; Albert Picado; Bart Ostyn; Sangeeta Kansal; Rudra Pratap Singh; Om Prakash Singh; Ankita Chourasia; Abhishek Singh; Ravi Shankar; Mary E. Wilson; Basudha Khanal; Suman Rijal; Marleen Boelaert; Shyam Sundar

Introduction Asymptomatic persons infected with the parasites causing visceral leishmaniasis (VL) usually outnumber clinically apparent cases by a ratio of 4–10 to 1. We assessed the risk of progression from infection to disease as a function of DAT and rK39 serological titers. Methods We used available data on four cohorts from villages in India and Nepal that are highly endemic for Leishmania donovani. In each cohort two serosurveys had been conducted. Based on results of initial surveys, subjects were classified as seronegative, moderately seropositive or strongly seropositive using both DAT and rK39. Based on the combination of first and second survey results we identified seroconvertors for both markers. Seroconvertors were subdivided in high and low titer convertors. Subjects were followed up for at least one year following the second survey. Incident VL cases were recorded and verified. Results We assessed a total of 32,529 enrolled subjects, for a total follow-up time of 72,169 person years. Altogether 235 incident VL cases were documented. The probability of progression to disease was strongly associated with initial serostatus and with seroconversion; this was particularly the case for those with high titers and most prominently among seroconvertors. For high titer DAT convertors the hazard ratio reached as high as 97.4 when compared to non-convertors. The strengths of the associations varied between cohorts and between markers but similar trends were observed between the four cohorts and the two markers. Discussion There is a strongly increased risk of progressing to disease among DAT and/or rK39 seropositives with high titers. The options for prophylactic treatment for this group merit further investigation, as it could be of clinical benefit if it prevents progression to disease. Prophylactic treatment might also have a public health benefit if it can be corroborated that these asymptomatically infected individuals are infectious for sand flies.


Tropical Medicine & International Health | 2010

Management of visceral leishmaniasis in rural primary health care services in Bihar, India.

Epco Hasker; Shri Prakash Singh; Paritosh Malaviya; Rudra Pratap Singh; Ravi Shankar; Marleen Boelaert; Shyam Sundar

Objective  In 2005 a visceral leishmaniasis (VL) elimination initiative was launched on the Indian subcontinent, with early diagnosis based on a rapid diagnostic test and treatment with the oral drug miltefosine as its main strategy. Several recent studies have signaled underreporting of VL cases in the region. Information on treatment outcomes is scanty. Our aim was to document VL case management by the primary health care services in India.


Tropical Medicine & International Health | 2011

Monitoring drug effectiveness in kala-azar in Bihar, India: cost and feasibility of periodic random surveys vs. a health service-based reporting system.

Paritosh Malaviya; Rudra Pratap Singh; Sanjay Singh; Epco Hasker; Bart Ostyn; Ravi Shankar; Marleen Boelaert; Shyam Sundar

Objective  In 2009, a random survey was conducted in Muzaffarpur district to document the clinical outcomes of visceral leishmaniasis patients (VL) treated by the public health care system in 2008, to assess the effectiveness of miltefosine against VL. We analysed the operational feasibility and cost of such periodic random surveys as compared with health facility‐based routine monitoring.


International Journal of Epidemiology | 2014

Health & Demographic Surveillance System Profile: The Muzaffarpur-TMRC Health and Demographic Surveillance System

Paritosh Malaviya; Albert Picado; Epco Hasker; Bart Ostyn; Sangeeta Kansal; Rudra Pratap Singh; Ravi Shankar; Marleen Boelaert; Shyam Sundar

The Muzaffarpur-TMRC Health and Demographic Surveillance System (HDSS), established in 2007, was developed as an enlargement of the scope of a research collaboration on the project Visceral Leishmaniasis in Bihar, which had been ongoing since 2005. The HDSS is located in a visceral leishmaniasis (VL)-endemic area in the Muzaffarpur district of Bihar state in India. It is the only HDSS conducting research on VL, which is a vector-borne infectious disease transmitted by female phlebotomine sandflies and is fatal if left untreated. Currently the HDSS serves a population of over 105,000 in 66 villages. The HDSS collects data on vital events including pregnancies, births, deaths, migration and marriages, as well as other socio-economic indicators, at regular intervals. Incident VL cases are identified. The HDSS team is experienced in conducting both qualitative and quantitative studies, sample collection and rapid diagnostic tests in the field. In each village, volunteers connect the HDSS team with the community members. The Muzaffarpur-TMRC HDSS provides opportunities for studies on VL and other neglected tropical diseases (NTDs) and their interaction with demographic events such as migration. Queries related to research collaborations and data sharing can be sent to Dr Shyam Sundar at [[email protected]].


Journal of Neurosciences in Rural Practice | 2014

Quality of life and health of opioid-dependent subjects in India.

Om Prakash Giri; Mona Srivastava; Ravi Shankar

Background and Objectives: The quality of life (QoL) of substance abusers is known to be severely impaired. This study was carried out to assess the impact of opioid dependence on the QoL of subjects and compared it with the normal subjects. Materials and Methods: Based on specified inclusion criteria a total of 47 subjects were recruited from a tertiary care center from India. The WHOQoL-BREF scale domain scores obtained at baseline were compared to that of normal subjects. An assessment of dysfunction and reasons for continuing and other parameters were assessed. Results: WHOQoL-BREF domains (Physical, Psychological, Social relationships and Environment) showed significantly lower scores and the difference was statistically significant. Interpretation and Conclusions: The results showed that QoL is an important parameter in assessment of substance abusers and can be used for long-term prognosis of these individuals.


Journal of Clinical Neuroscience | 2010

Five years' experience at a single centre of craniocerebral injury from winnowing fan blades.

Apoorva Kumar; Ravi Shankar; Rajendra Pandey; Virendra Keshri; Kulwant Singh; Vivek Sharma

India, an agriculture-based country, relies heavily on indigenous farm machinery. In our study we present 31 patients with winnowing fan blade head injury, operated on at our centre between 2004 and 2008. The mechanism and nature of the injuries, operative methods, outcome and methods of prevention are discussed with special reference to the occurrence of this type of injury in the pediatric population.


PLOS Neglected Tropical Diseases | 2013

Latent infection with Leishmania donovani in highly endemic villages in Bihar, India.

Epco Hasker; Sangeeta Kansal; Paritosh Malaviya; Kamlesh Gidwani; Albert Picado; Rudra Pratap Singh; Ankita Chourasia; Abhishek Singh; Ravi Shankar; Joris Menten; Mary E. Wilson; Marleen Boelaert; Shyam Sundar


Archive | 2013

Quality of life and its correlates among substance dependent subjects: A study from a tertiary care centre in northeastern part of India

Om Prakash Giri; Mona Srivastava; Ravi Shankar


Journal of Psychosocial Rehabilitation and Mental Health | 2016

A Comparative Study of Quality of Life, Social Support and Dysfunction in Alcohol Dependent Men Attending a De-Addiction Clinic in India

Om Prakash Giri; Mona Srivastava; Ravi Shankar


Archive | 2014

Health & Demographic Surveillance System Profile Health & Demographic Surveillance System Profile: The Muzaffarpur-TMRC Health and Demographic Surveillance System

Paritosh Malaviya; Albert Picado; Epco Hasker; Bart Ostyn; Sangeeta Kansal; Rudra Pratap Singh; Ravi Shankar; Marleen Boelaert; Shyam Sundar

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Paritosh Malaviya

Institute of Medical Sciences

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Rudra Pratap Singh

Institute of Medical Sciences

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Shyam Sundar

Institute of Medical Sciences

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Sangeeta Kansal

Institute of Medical Sciences

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Epco Hasker

Institute of Tropical Medicine Antwerp

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Marleen Boelaert

Institute of Tropical Medicine Antwerp

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Abhishek Singh

Banaras Hindu University

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Ankita Chourasia

Institute of Medical Sciences

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