Morbidity among the tribal populations of West Bengal: A study based on data collected from the Mobile Medical Clinic.

Background: Tribes are the most socially excluded group in the nation due to their restricted access to healthcare. There are little data on the real burden and distribution of illnesses among tribes. The present study determines the types and patterns of sickness among tribal populations in West Bengal. Methods: Five blocks from five districts in West Bengal were used for this cross-sectional study. Between the years 2018 and 2019, 52,189 patients visited these mobile medical clinics (MMCs), but only 36,128 were included in our study. Data were analyzed using the SPSS software (ver. 27.0). Results: Younger age groups (1-25 years) show higher primary registration compared to other age categories; older age groups (>60 years) show higher repeat registration. High prevalence in infectious diseases (44.5% of the total primary registration) and high repeated cases in NCDs (11.5% to 33.2%), which are nearly three times higher than primary cases (Cramer's V test = 0.29; P = .001) are observed. Among the studied MMCs, Binpur II and Matiali MMC have more than two times the risk of gastrointestinal problems, while Madarihat MMC has more than one time the risk. Garbeta II MMC shows more than three times the risk of NCDs (adjusted odds ratio = 3.97; 95% confidence interval: 3.05-5.17) than the other diseases. Conclusion: The present study shows high prevalence of infectious diseases, injury and pain, NCDs, gastrointestinal problems, and vertigo in tribal populations of West Bengal.

Economic evaluations of neglected tropical diseases interventions in low- and middle-income countries: a systematic review protocol.

OBJECTIVE: The objective of this systematic review is to provide an overview of economic evaluation studies of interventions for neglected tropical diseases in low- and/or middle-income countries. INTRODUCTION: The majority of people most susceptible to neglected tropical diseases reside in low- and middle-income countries and suffer significant economic impact due to these diseases. The World Health Organization suggests utilizing a systematic and cross-cutting approach with multiple interventions to lessen the neglected tropical disease burden. INCLUSION CRITERIA: Studies will be eligible for inclusion if they include economic evaluations of interventions for neglected tropical diseases and are conducted in low- and/or middle-income country settings. METHODS: A preliminary search of MEDLINE (PubMed) was undertaken using MeSH terms, such as neglected tropical disease, economic evaluation, therapeutics, low- and/or middle-income countries. Two reviewers will screen titles and abstracts independently, followed by a full-text review against the inclusion criteria. Disagreements will be resolved by discussion or with a third reviewer. To assess methodological quality, the JBI checklist for economic evaluations will be used. For economic evaluations, data will be extracted using the standardized JBI data extraction form. The Dominance Ranking Matrix will be used to summarize and compare the results of different types of economic evaluations. Cost per quality adjusted life year gained and cost per disability adjusted life year averted will be measures for economic evaluation. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to assess the certainty of economic evidence, such as resource use and costs. REVIEW REGISTRATION: PROSPERO CRD42017070386.

Cost-effectiveness of newborn screening for sickle cell disease: a systematic review protocol.

OBJECTIVE: The purpose of the systematic review is to assess the cost-effectiveness of targeted/selective newborn screening compared with universal screening for sickle cell disease across various countries and settings. INTRODUCTION: The incidence of sickle cell disease is increasing worldwide and it is a widespread and potentially fatal hematologic disorder that affects thousands of newborns worldwide. The cost of newborn screening creates a burden on households and the economy. INCLUSION CRITERIA: Studies will be eligible for inclusion in the review if they include cost-effectiveness studies of newborn screening for sickle cell disease comparing targeted/selective screening with universal screening. METHODS: A preliminary search of MEDLINE (PubMed) was undertaken using MeSH terms, such as sickle cell disease, newborn, and economic evaluations. Two reviewers will screen the titles, abstracts, and full text independently against the inclusion criteria. Disagreements will be resolved by discussion or with a third reviewer. To assess methodological quality, the JBI checklist for economic evaluation will be used. Data will be extracted by 2 reviewers using a modified JBI data extraction form. The JBI dominance ranking matrix for economic evaluations will be used to summarize and compare the results. Cost-effectiveness will be measured on the basis of cost per test/case detected, quality-adjusted life years gained, or disability-adjusted life years averted. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) assessment will be conducted to evaluate the certainty of economic evidence, such as use of resources and expenditures, and to incorporate the results into the decision-making process. REVIEW REGISTRATION: PROSPERO CRD42017057963.

Cost-effectiveness of a decentralized care model for managing multi-drug-resistant tuberculosis in low- and middle-income countries: a systematic review protocol.

OBJECTIVE: The purpose of this systematic review is to assess the available economic evidence of a decentralized care model compared to a centralized model for treating multi-drug-resistant tuberculosis (MDR-TB) in low- and middle-income countries (LMICs). INTRODUCTION: Diseases that affect physiological health create a burden on human livelihoods and the economy. There is a lack of studies examining the economic evaluation of MDR-TB across different countries. A preliminary search identified no published or ongoing reviews on MDR-TB in LMICs. INCLUSION CRITERIA: Studies will be eligible if they include both patients receiving centralized care (ie, care provided by specialist centers through inpatient or outpatient services) and patients receiving decentralized care (ie, care provided by grassroots community workers in peripheral facilities or in the patients' residence) for MDR-TB in LMICs. Eligible studies will report economic evaluations of treatment for MDR-TB. METHODS: A preliminary search of MEDLINE (PubMed) was undertaken using MeSH terms, such as MDR-TB, economic evaluation, therapeutics, LMICs . Two reviewers will independently screen the titles, abstracts, and full text against the inclusion criteria. Disagreements will be resolved through discussion or with a third reviewer. The JBI checklist for economic evaluations will be utilized to evaluate the methodological quality. Data will be extracted using a modified JBI data extraction form for economic evaluations. The Dominance Ranking Matrix, developed by JBI for economic evaluations, will be used to summarize and compare the results of different types of economic evaluations (cost-effectiveness, cost-benefit analysis, cost-utility analysis, or cost-minimization analysis). Cost per quality-adjusted life year gained and cost per disability-adjusted life year averted will be measures for economic evaluation. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the certainty of economic evidence. REVIEW REGISTRATION: PROSPERO CRD42022368696.

An insight into genes responsible for fosfomycin resistance among uropathogens of asymptomatic bacteriuria during pregnancy: A North Indian study.

Purpose: Asymptomatic bacteriuria (ASB) is a common finding during pregnancy. Effective antibiotic treatment could reduce its adverse effects on both mother and fetus. However, emerging antimicrobial resistance limits the treatment options. Fosfomycin might be a promising drug in this regard, as its resistance is still low. The aim of the study was to determine the antimicrobial susceptibility pattern of fosfomycin in isolates causing ASB by disc diffusion and agar dilution (in selected isolates), determine minimum inhibitory contribution (MIC) by agar dilution in isolates resistant by disc diffusion and detect the genes responsible for fosfomycin resistance. Methods: This was a 2-year study carried in the Department of Microbiology, Jawaharlal Nehru Medical College and Hospital (JNMCH), Aligarh Muslim University (AMU), Aligarh. A total of 10 252 urine samples from asymptomatic pregnant females (18-45 years) attending the antenatal care (ANC) outpatient department (OPD) were submitted. Identification of pathogen and antimicrobial susceptibility testing (AST) was carried out as per standard methods of CLSI. There was phenotypic detection of methicillin-resistant Staphylococcus aureus (MRSA) and other Staphylococcus species (MRSS), high-level aminoglycoside resistance (HLAR), vancomycin resistant Enterococci (VRE) and S. aureus (VRSA), extended spectrum ß-lactamase (ESBL) and carbapenem-resistant Enterobacterales (CRE). All the fosfomycin-resistant isolates (by disk diffusion) were tested by agar dilution. Conventional PCR was performed for murA, fosA, uhpT and glpT genes on all resistant isolates. Result: In this study, the prevalence of ASB among pregnant females was 1173(11.4 %), in which Escherichia coli 495(42 %) was the predominant organism. The overall sensitivity of fosfomycin among Gram-positive cocci (GPC) and Gram-negative bacilli (GNB) was 99 % and 97.6 %, respectively. MRSA and MRSS accounted for 50 (66.6 %) and 71 (76 %), respectively. The highest rates of MIC >2048 µg ml-1 were shown by most isolates (mainly E. coli ) on agar dilution. PCR studies revealed four E. coli strains possessed both murA (also present in one K. pneumoniae strain) and glpT genes. While only one isolate ( E. faecalis ) was positive for fosA gene. But none of the strain possessed the uhpT gene. Conclusion: According to this study, murA and glpT genes were more frequent than fosA. We cannot comment on the prevalence and regional distribution of fosfomycin-resistant genes based on this preliminary study. Therefore, more Indian studies should be carried out to create awareness about the presence of genes in a particular area.

Relationship between VITAMIN D and chronic periodontitis.

INTRODUCTION: Chronic periodontitis is a multifactorial disease primarily caused by plaque microorganisms, modified from the immune inflammatory response to chronic infection, which leads to the destruction of periodontal tissues in a susceptible host. It is very well known that vitamin D plays a vital role in bone homeostasis and immunity. There can be a biologic rationale to suspect that Vitamin D deficiency could negatively affect the periodontium. Present study was conducted to investigate any relationship between periodontitis and vitamin D. MATERIAL AND METHOD: The clinico-biochemical relationship study was carried out in 168 subjects with Chronic Periodontitis. Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL) are correlated with serum level of Vitamin D. RESULTS: Statistically significant relationship between serum 25(OH) D level and periodontal parameters namely GI, PPD and CAL were observed.No relationship between 25(OH) D levels and PI was observed.This study also revealed overall low levels of serum Vitamin D in patients with chronic periodontitis but the levels of Vitamin D did not decrease with the increase in the severity of periodontitis. CONCLUSION: A statistically significant relationship between serum 25(OH) D level and periodontal parameters namely GI, PPD and CAL were observed. No relationship between 25(OH) D levels and PI was observed.