Odisha tribal family health survey: methods, tools, and protocols for a comprehensive health assessment survey.

Tribal or indigenous communities have unique health behaviors, challenges, and inequities that nationally representative surveys cannot document. Odisha has one of India's largest and most diverse tribal populations, constituting more than a fifth of the state. State and tribe-specific health data generation is recommended in India's national roadmap of tribal health. The Odisha tribal family health survey (OTFHS) aims to describe and compare the health status of tribal communities in the state of Odisha and to estimate the prevalence of key maternal-child health indicators and chronic diseases. This paper summarizes the methodology, protocols, and tools used in this survey. This is a population-based cross-sectional survey with a multistage random sampling design in 13 (tribal sub-plan areas) districts of Odisha, India. We will include participants of all age groups and gender who belong to tribal communities. The sample size was calculated for each tribe and aggregated to 40,921, which will be collected from 10,230 households spread over 341 clusters. The survey data will be collected electronically in modules consisting of Village, Household, and Individual level questionnaires. The age-group-specific questionnaires were adapted from other national family health surveys with added constructs related to specific health issues of tribal communities, including-critical indicators related to infectious and non-communicable diseases, multimorbidity, nutrition, healthcare-seeking behavior, self-rated health, psycho-social status, maternal and child health and geriatric health. A battery of laboratory investigations will be conducted at the household level and the central laboratory. The tests include liver function tests, kidney function tests, lipid profile, iron profile, and seroprevalence of scrub typhus and hepatitis infections. The datasets from household questionnaires, field measurements and tests and laboratory reports will be connected using a common unique ID in the database management system (DBMS) built for this survey. Robust quality control measures have been built into each step of the survey. The study examines the data focused on different aspects of family health, including reproductive health, adolescent and child health, gender issues in the family, ageing, mental health, and other social problems in a family. Multistage random sampling has been used in the study to enable comparison between tribes. The anthropometric measurements and biochemical tests would help to identify the indicators of chronic diseases among various age groups of the population.

Hepatitis B virus infection among the tribal and particularly vulnerable tribal population from an eastern state of India: Findings from the serosurvey in seven tribal dominated districts, 2021-2022.

The Global Health Sector Strategy on viral hepatitis (2016-2021) endorsed by the World Health Assembly in 2016, called for the elimination of viral hepatitis as a public health threat by 2030. Odisha, an eastern state of India, has the third-highest percentage of tribal population in the country and limited information is available regarding the prevalence of HBsAg among them. The present study was undertaken to estimate the seroprevalence of hepatitis B surface antigen as well as HBV DNA almost after 12 years of the first prevalence study of HBsAg among the tribal community of Odisha. The present study attempted to estimate the prevalence of HBsAg among the 35 Scheduled tribal (ST) communities and 5 Particularly Vulnerable Tribal Group (PVTG) using the 2,737 number of sera collected as part of a statewide COVID-19 serosurvey, among the tribal populations of Odisha (residing in 7 districts) aged 6-75 years. HBsAg positivity ranged between 1.79 and 2.94% across various age groups. 42.9% of HBsAg positive individuals showed the presence of HBV DNA and the high viral load was 0.10 × 102-6.84 × 108 IU/mL, indicating a high potential to transmit the virus. The HBsAg positivity was 14.18 and 6.06% among the PVTGs, Kutia Khond and Paudi Bhuyan, who were first time surveyed for HBsAg prevalence. The present study documents the prevalence of HBsAg among the major tribal population residing in the eastern state of the country and highlights the need for a statewide survey of Hepatitis B infection and risk factors, coverage and impact of the Hepatitis B vaccination program introduced in 2010-2011 in Odisha among the ST and PVTG population of the state.

Antimicrobial activity of root canal irrigants against biofilm forming pathogens- An in vitro study.

AIMS: The aim of the study was to check the antimicrobial activity of the 5% Sodium hypochlorite, 2% Chlorhexidine, 0.10% Octenidine (OCT), and 2% Silver Zeolite (SZ) at different time intervals against a single species biofilm of Enterococcus faecalis, Staphylococcus aureus, and Candida albicans model prepared on a nitrocellulose membrane. SETTINGS AND DESIGN: In vitro nitrocellulose biofilm model was used to check antibacterial efficacy of root canal irrigants. MATERIALS AND METHODS: The in vitro nitrocellulose biofilm model was used to check the antibacterial activity of root canal irrigants. Single species biofilms were suspended into 96-well microtiter plate and treated with root canal irrigants for 1, 5, 10, 15, 30, and 60 s, respectively. The remaining microbial load in the form of colony-forming unit/ml after antimicrobial treatment was tabulated and data were statistically analyzed. STATISTICAL ANALYSIS: SPSS version 17, Kruskal-Wallis ANOVA, Mann-Whitney U-test, and Wilcoxon matched pair test (P < 0.05) were used. RESULTS: All tested microorganisms were eliminated within 30 s by all the antimicrobial substances tested except normal saline. 2% chlorhexidine and 0.10% OCT were equally effective against C. albicans at 30 s. CONCLUSION: The newly tested irrigants have shown considerable antibacterial activity against selected single species biofilm. OCT (0.10%) can be used as an alternative endodontic irrigant.

Bystander Attitudes to Prevent Sexual Assault: A Study of College Students in the United States, Japan, India, Vietnam, and China.

College women are at a high risk of sexual assault. Although programs that aim to change bystander behaviors have been shown to be potentially effective in preventing sexual assault on campuses in the United States, little is known about bystander behaviors outside of the United States. The purpose of this study was to explore and compare factors affecting bystander behaviors regarding sexual assault intervention and prevention among undergraduate students in the United States, Japan, India, Vietnam, and China. A total of 1,136 students participated in a self-reported survey. Results demonstrate substantial variations across countries. Bystander behaviors are associated with multilevel factors, including gender, knowledge of individuals who have experienced a sexual assault, and knowledge about campus or community organizations.

Status of hepatitis B infection - a decade after hepatitis B vaccination of susceptible Nicobarese, an indigenous tribe of Andaman & Nicobar (A&N) islands with high hepatitis B endemicity.

BACKGROUND & OBJECTIVES: Andaman and Nicobar Islands of India, home to six primitive tribes, constituting about 10 per cent of the total population of these Islands have been detected with high endemicity of hepatitis B infection. During 2000, a total of 936 individuals ≤ 45 yr, negative for hepatitis B surface antigen (HBsAg) and antibody anti-HBs were vaccinated with three doses of a recombinant DNA hepatitis B vaccine in two villages of Car Nicobar Islands. The present study was undertaken to evaluate the impact of the hepatitis B vaccination with respect to the persistence of antibodies and incidence of new infections, prevalence of surface gene mutations among the Nicobarese community in the two villages ten years after hepatitis B vaccination. METHODS: Follow up samples were collected from 211 individuals who had received three doses of vaccine ten years back and from a control group of 515 non-vaccinated individuals. The HBsAg, anti-HBs and anti-HBc assay results were compared among vaccinated and non-vaccinated groups. HBV DNA was extracted and sequenced from all the samples for detection of mutation. Genotyping and serotyping of the viruses were performed. RESULTS: The results showed that 85.3 per cent of the vaccinated persons retained protective level of antibodies and among the non-vaccinated individuals, 54.2 per cent showed presence of anti-HBs indicating an exposure to the infection. The overall HBsAg positivity among the studies Nicobarese individuals was reduced to 7.4 per cent after 10 years of vaccination. Anti-HBc was positive in 60.6 and 57 per cent among the vaccinated and non-vaccinated individuals, respectively. Overall breakthrough infection of 8.5 per cent was detected among the vaccinated individuals. The predominant genotype and serotype circulating among these tribal populations were D and ayw3, respectively. INTERPRETATION & CONCLUSIONS: The results of this study showed an overall reduction in the pool of HBsAg carriers because of the vaccination which helped in reducing the HBsAg carrier rate among the non-vaccinated also, probably due to an increase in herd immunity and reduction in the source of infection. Further studies need to be done to evaluate long term benefits of hepatitis B vaccination among these tribes.

Occult hepatitis B infection among individuals belonging to the aboriginal Nicobarese tribe of India.

INTRODUCTION: The long-lasting persistence of hepatitis B virus (HBV) genomes in the liver (with or without detectable HBV DNA) of individuals with negative for HBV surface antigen (HBsAg) is termed occult HBV infection (OBI). The present study is a part of the follow up on efficacy of vaccination, 10 years post inception, and was designed to understand the prevalence of Occult Hepatitis B infection (OBI) among the aboriginal Nicobarese tribal community. METHODOLOGY: A total of 612 serum samples were collected and tested for various markers including HBsAg, Anti-HBs, Anti-HBc and HBV DNA. Part of S gene of the extracted HBV DNA was amplified by nested PCR. The amplified products were then subjected to sequencing. Genotyping was performed on the basis of phylogenetic relationship along with representative reference sequences from different sub genotypes. RESULTS: The study revealed OBI in 11.1% of the people belonging to the Nicobarese tribe. Phylogenetic analysis showed only one genotype, HBV/D circulating among the Nicobarese population with ayw3 was the major serotype detected. Single or multiple amino acids substitutions were found in 5 of 34 samples (14.7%) which includes I110T, P120T, P/T127I, A128P, M133L and G159V. CONCLUSIONS: The detection of OBI among these aboriginal tribes is of great concern and stresses the need for the continuous surveillance as it may contribute to the progression of liver disease to a more advanced stage.

Prevalence of mutations in basal core promoter and precore region of hepatitis B virus in vaccinated and nonvaccinated individuals of the aboriginal Nicobarese tribe of Car Nicobar Island, India.

The aim of this study was to explore the prevalence of basal core promoter (BCP) and precore gene (PC) mutations in hepatitis B virus (HBV) isolates among the Nicobarese tribe and their relationship with genotypes and HBeAg status. A total of 726 blood samples were collected from two villages of the Car Nicobar Island where mass vaccination was performed in the year 2000. HBV DNA was isolated and the BCP and PC regions were amplified and sequenced directly. The samples positive for HBV DNA were tested for HBsAg, HBeAg and anti-HBe. Among the 211 and 515 samples collected from vaccinated and nonvaccinated persons, 16 and 82 were positive for HBV DNA, respectively. Among the vaccinated individuals, only 1 had a mutation in both the BCP and PC gene. Among the nonvaccinated subjects, 3 (4.5%) had an A1762T mutation, 8 (12.1%) had a G1764A mutation, 11 (16.7%) had a G1896A mutation and 4 (6.1%) had a G1899A mutation. The HBeAg-negative subjects had a significantly higher frequency of BCP and PC mutations than the HBeAg-positive subjects. The prevalence of a PC mutation was higher than that of a BCP mutation. The present study stresses the need for the continuous surveillance of subjects with BCP and PC mutations, as the mutations may contribute to the progression of liver disease.

Impact of hepatitis B immunization among the Nicobarese tribe--antibody titres & seroprotection five years after vaccination.

BACKGROUND & OBJECTIVES: A total of 237 Nicobarese subjects who had received hepatitis B vaccination as part of mass vaccination project during 2000-2001 were screened for anti-HBsAg titres by quantitative ELISA five years after vaccination. METHODS: Anti-HBsAg antibody was estimated using quantitative ELISA. Proportion of the subjects with protective levels of antibody and geometric mean antibody titres were calculated. RESULTS: Among the 237 study subjects, 213 had received three doses of vaccine, 17 had received two doses and seven had received one dose. The geometric mean titres of anti-HBs antibodies were 201.7, 31.9 and 23.1 mIU/ml among those who received three, two and one dose of vaccine, respectively. Among those who received three doses of vaccination, 85.9 per cent had anti-HBs antibody levels of 10 mIU/ml or more, indicating seroprotection. The difference in the seroprotection rates among those who received three doses of vaccination (85.9%) and those who received less than three doses (58.3%) was significant. Seroprotection rates one month after the first, second and third dose of vaccination were 49.1, 86.9 and 96.7 per cent, respectively. It then declined to 89 per cent by the end of the second year and to 85.5 per cent by the end of the third year, but there was no decline thereafter. INTERPRETATION & CONCLUSIONS: Seroprotection rate reached at the maximum one month after the third dose of HBV vaccine. Although about 15 per cent of the vaccinated persons lost seroprotection by the end of the third year, no further loss in seroprotection was observed between the third year and the fifth year.

Emergence of New Delhi metallo-ß-lactamase 1 (NDM-1) producing and multidrug resistant uropathogens causing urinary tract infections in Andaman Islands, India.

The present study was undertaken to understand the distribution and the antimicrobial susceptibility patterns of the uropathogens in the remote islands of India. Patients' demographical data, urine culture results, and resistance rates were analyzed and multidrug resistant isolates were characterized. Significant bacteriuria was found in 16 (17.7%, 95% confidence interval [CI] 8.47-23.53%) samples, which includes Escherichia coli 9 (56.3%); Klebsiella pneumoniae 3 (18.8%); Enterobacter sp. 2 (12.5%) and Proteus mirabilis 2 (12.5%). The uropathogens showed a wide resistance involving 3-21 drugs with 15 different resistance patterns. Among the 16 isolates, 13 (81.3%, 95% CI 62.13-100.37%) and 11 (68.8%, 95% CI 46.04-91.46%) isolates were resistant to fluoroquinolones and third generation cephalosporins, respectively. Multiple mutations were detected in quinolone resistance determining region (QRDR) of the fluoroquinolone resistant isolates and all third generation cephalosporin resistant isolates producing extended-spectrum beta-lactamase. A total of 7 (44%, 95% CI 17.02-70.98%) isolates was found to harbor plasmid mediated quinolone resistance determinants The present study reports for the first time the presence of the New Delhi metallo-ß-lactamase (NDM-1) gene in two isolates of P. mirabilis in these islands. Detection of multidrug resistant and NDM-1 producing isolates from cases of urinary tract infection in these remote islands lends support to the belief that the existence of these highly resistant strains is perhaps more widespread than previously thought and underscores the need for immediate implementation of antibiotic policy integrated with a continuous surveillance system. The study strengthens the need for a continuous surveillance system of antibiotic resistance in these remote Islands.

Toxicity studies of nonylphenol on rosy barb (Puntius conchonious): a biochemical and histopathological evaluation.

Acute and subacute toxicity of the nonylphenol (NP) on fish was investigated in laboratory toxicity tests with rosy barb (Puntius conchonious). The acute toxicity of NP to rosy barb was determined in semi-static bioassays. Median lethal concentration (LC50) for 96 h was 1.72 microM. The effects of sublethal concentrations of NP (0.17, 0.34 and 0.68 microM) on the structures and biochemical parameters [alkaline phosphatase (ALP), aspartate aminotransferase (AST) and alanin aminotransferase (ALT)] in gills, liver and kidney of rosy barb were studied after 14 days. The results showed that NP caused alteration of the structure in organs, as evidenced by the hyperplasia of epithelium and the fusion of secondary lamellae in the gills, the disappearance of the cell membrane and the cell necrosis in the liver as well as haemorrhages in the kidney. In addition, the functional enzyme activities were also changed. The increase trend in ALP activity in organs of fish treated with NP was recorded. The levels of AST and ALT in gills, liver and kidney were stimulated to rise at the lower concentration and fall at the higher concentration NP treatment compared to controls. This study suggests that NP can alter of the structures and biochemical parameters within non-endocrine tissue of fish and these changes may be mediated via destroying membrane structure and inducing cell necrosis.

Exposure of Rosy Barb (Puntius conchonius) Sperm to Abamectin as an In Vitro Assay of Cytotoxicity.

The acute cytotoxicity of abamectin to the sperm of rosy barb (Puntius conchonius) was tested. It was found that 79% sperm remained motile at 30 min after activation by hypo-osmotic sodium buffer (HSB), while the motility of sperm exposed to 0.14, 0.28, and 0.42 mu M abamectin for 30 min was reduced to 60%, 35%, and 15%, respectively. Exposure to abamectin at 0.56 mu M decreased the motility of sperm to an even lower value of 5.67% after 20 min of exposure. This indicates that the toxicity of abamectin to rosy barb sperm is both dose dependent and exposure time dependent. The ultrastructural examination showed that most of the sperm exposed to 0.14 mu M abamectin for 30 min remained morphologically normal, while the midpiece and its surrounding mitochondria of the sperm treated with 0.28 mu M abamectin for 30 min were severely damaged. For the sperm treated with 0.42 mu M abamectin for 30 min, the majority of the sperm were abnormal. Sperm heads were dissolved and the midpiece broken. The mitochondria are located in the midpiece of the sperm and may be the target of abamectin toxicity in rosy barb sperm. The results also suggest that rosy barb sperm are a suitable candidate for rapid screening of the acute toxicities of bioorganic pesticides.