TB diagnostic cascade among patients registered under the Revised National TB Control Programme in Chennai, South India.

OBJECTIVE: To discern and quantify the TB diagnostic cascade among patients registered under the Revised National TB Control Programme, Chennai city, Tamil Nadu, South India. METHODS: This cross-sectional study was conducted in metropolitan Chennai from February 2017 to March 2018. We interviewed TB patients retrospectively on their diagnostic attempt in different health facilities. RESULTS: Of 455 TB patients, only 4.4% received their diagnosis at their first health facility. Of 1250 visits to health facilities, the vast majority (79.4 vs. 20.6%) was in the public rather than the private sector. 56% of patients went to a public facility as the first point of care, of whom 1.6% shifted to private facilities subsequently. The remaining 54.4% shifted between up to five government health facilities. Male patients and those with a higher family income were more likely to shift from private to public. CONCLUSION: Most shifts between diagnostic facilities occurred in the public sector. This necessitates interventions at public health facilities for strengthening and extending services to TB patients at their first point of care.

OBJECTIF: Discerner et quantifier la cascade de diagnostic de la TB chez les patients enregistrés dans le Programme National Révisé de lutte contre la TB, dans la ville de Chennai, dans le Tamil Nadu, dans le sud de l'Inde. MÉTHODES: Cette étude transversale a été menée dans la région métropolitaine de Chennai de février 2017 à mars 2018. Nous avons interviewé rétrospectivement des patients TB sur leur tentative de diagnostic dans différents établissements de santé. RÉSULTATS: Sur 455 patients TB, seuls 4,4% ont reçu leur diagnostic dans le premier établissement de santé visité. Parmi 1250 visites dans les établissements de santé, la grande majorité (79,4 vs 20,6%) était dans le secteur public plutôt que le privé. Parmi les 56% des patients qui sont allés dans un établissement public comme premier point de soins, dont 1,6% sont ensuite passés dans des établissements privés. Les 54.4 restants se sont déplacés entre cinq établissements différents de santé publics. Les patients de sexe masculin et ceux dont le revenu familial était plus élevé étaient plus susceptibles de passer du privé au public. CONCLUSION: La plupart des changements entre les établissements de diagnostic se sont produits dans le secteur public. Cela nécessite des interventions dans les établissements de santé publique pour renforcer et étendre les services aux patients TB à leur premier point de soins.

Host-feeding pattern of Aedes aegypti and Aedes albopictus (Diptera: Culicidae) in heterogeneous landscapes of South Andaman, Andaman and Nicobar Islands, India.

Mosquito foraging behavior is a determinant of host-vector contact and has an impact on the risk of arboviral epidemics. Therefore, blood-feeding patterns is a useful tool for assessing the role in pathogen transmission by vector mosquitoes. Competent vectors of dengue and chikungunya viz. Aedes aegypti and Aedes albopictus are widely prevalent in the Andaman and Nicobar archipelago. Considering the vector potential, medical importance of both these mosquito species and lack of information on host-feeding patterns, blood meal analysis of both these vector mosquitoes was undertaken. Biogents Sentinel traps were used for sampling blooded mosquitoes, for identifying the source of blood meal by agar gel-precipitin test. We identified vertebrate source of 147 and 104 blood meals in Ae. aegypti and Ae. albopictus from heterogeneous landscapes in South Andaman district. Results revealed that Ae. aegypti (88 %) and Ae. albopictus (49 %) fed on human and a small proportion on mammals and fowls, indicative of predominance of anthropophilism. Ae. aegypti predominantly fed on human blood (94.2 %-densely built urban, 89.8 %-low vegetation coverage, and 78.3 %-medium vegetation coverage). Anthropophilism in Ae. albopictus was maximal in densely built urban (90.5 %) and progressively decreased from low vegetation-vegetation/forested continuum (66.7, 36.4, and 8.7 %), indicating plasticity in feeding across these landscapes. Epidemiological significance of the findings is discussed.

Studies on insecticide susceptibility of Aedes aegypti (Linn) and Aedes albopictus (Skuse) vectors of dengue and chikungunya in Andaman and Nicobar Islands, India.

Dengue and chikungunya are important arboviral infections in the Andaman Islands. Competent vectors viz. Aedes aegypti and Aedes albopictus are widely prevalent. The most effective proven method for interrupting the transmission of these arboviruses is vector control, mediated through insecticides. Currently, DDT and temephos are the insecticides used for vector control in these islands. Lack of information on susceptibility necessitated assessing the susceptibility profile of A. aegypti and A. albopictus. F1 generation of adult and larvae were assayed, and LT50 and LT90 values were interpreted following the World Health Organization (WHO) protocol. Adults were found resistant to DDT-4 % while susceptible to dieldrin-0.4 %. Against organophosphates, both showed resistance to fenitrothion but susceptible to malathion-5 %. Both species showed resistance to carbamate and bendiocarb-0.1 % while susceptible to propoxur-0.1 %. Of the four synthetic pyrethroids, both were susceptible to deltamethrin-0.05 %, while resistant to permethrin-0.75 %, lambdacyhalothrin-0.05 % and cyfluthrin-0.15 %. Larvae of both species showed resistance to temephos at 0.02 mg/L but susceptible to malathion at 1 mg/L and fenthion at 0.05 mg/L. Currently, there is no prescribed WHO dose for adult-insecticide susceptibility testing. The emergence of resistance to DDT and temephos in the vector population poses a challenge to the on-going vector control measures. The results highlight the need for monitoring resistance to insecticides in the vector population. Impetus for source reduction and alternative choices of control measures are discussed for tackling future threat of arboviral infections in these islands.

Prevalence and diagnostic significance of p16, p53 expression in lichen planus as a potential premalignant lesion in oral squamous cell carcinoma.

Background: Oral squamous cell carcinoma (OSCC) is a prevalent malignancy with significant morbidity and mortality. Identifying potential premalignant lesions is crucial for early detection and effective management. Lichen planus (LP), a chronic inflammatory disorder has been associated with an increased risk of developing OSCC. This study aimed to assess the diagnostic importance of p16 and p53 expression in identifying LP as a potential premalignant lesion for OSCC. Materials and Methods: A retrospective analysis was conducted on archived tissue samples from patients diagnosed with LP (n = 80) and OSCC (n = 60) between 2017 and 2022. Immunohistochemistry was performed to evaluate p16 and p53 protein expression levels in both LP and OSCC tissues. Clinical data, including patient demographics and lesion characteristics, were collected and correlated with the immunohistochemical findings. Results and Discussion: The results revealed a significantly higher prevalence of p16 and p53 expression in LP tissues compared to normal oral mucosa (P < 0.001). Notably, p16 expression was observed in 70% of LP cases, while p53 was detected in 55% of LP cases. Furthermore, a significant association was established between p53 expression and the presence of dysplasia within LP lesions (P = 0.003). This indicates the potential of p53 as a predictive biomarker for malignant transformation in LP. The correlation between p16 and p53 expression levels in LP and OSCC tissues suggests a potential mechanistic link between LP and OSCC development. Conclusion: This study underscores the diagnostic importance of p16 and p53 expression as potential markers for identifying LP as a premalignant lesion in the context of OSCC. The elevated prevalence of these markers in LP tissues suggests a potential role in predicting malignant transformation. The findings contribute to a deeper understanding of the molecular pathways underlying OSCC development from LP and emphasize the need for regular monitoring and early intervention in patients diagnosed with LP. Further prospective studies are warranted to validate these findings and to explore the clinical utility of p16 and p53 as biomarkers for predicting OSCC risk in LP patients.