Awareness and Perception Regarding Eye Donation in Students of a Nursing College in Bangalore

Context:

Corneal diseases constitute a significant cause of visual impairment and blindness in the developing world. The number of corneal transplants done is far less than the actual requirement in India. This is largely due to the inadequate number of corneas collected. Well-informed nursing students could be expected to influence eye donation rates.

Aims:

To assess the awareness and perception of 188 first- and second-year nursing students towards eye donation in Bangalore.

Settings and Design:

Cross-sectional study design.

Materials and Methods:

A pretested, semi-structured questionnaire.

Statistical Analysis Used:

Data were analyzed using the Epi-Info software package, Version 6.04.

Results:

The majority (96.8%) of students knew that eyes can be donated after death but only 38.2% knew that the ideal time of donation was within 6 hours of death. Most participants (85.1%) were either willing or had already donated their eyes. Nobility in the act of eye donation was the main motivational force for eye donation according to 85.6% of students. Perceived reasons for not pledging eyes by the students were: the unacceptable idea of separating the eyes from the body (67.9%), lack of awareness (42.8%), objection by family members (28.5%), and unsuitability to donate because of health problem (10.7%).

Conclusion:

This study revealed that nursing students were well aware of eye donations and most of them were inclined to sign-up for eye donation. The perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community. The nursing students could be actively involved as volunteers in eye donation campaigns and they can act as counsellors for eye donors. They can also contribute by participating in creating awareness and motivating people to become eye donors.     

Estimating the Burden of Disease from Unsafe Injections in India: A Cost�Cbenefit Assessment of the Auto-disable Syringe in a Country with Low Blood-borne Virus Prevalence

Background:

Unsafe medical injections are a prevalent risk factor for viral hepatitis and HIV in India.

Objectives:

This review undertakes a cost–benefit assessment of the auto-disable syringe, now being introduced to prevent the spread of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV).

Materials and Methods:

The World Health Organization methods for modeling the global burden of disease from unsafe medical injections are reproduced, correcting for the concentrated structure of the HIV epidemic in India. A systematic review of risk factor analyses in India that investigate injection risks is used in the uncertainty analysis.

Results:

The median population attributable fraction for hepatitis B carriage associated with recent injections is 46%, the median fraction of hepatitis C infections attributed to unsafe medical injections is 38%, and the median fraction of incident HIV infections attributed to medical injections is 12% in India. The modeled incidence of blood-borne viruses suggests that introducing the auto-disable syringe will impose an incremental cost of $46–48 per disability adjusted life year (DALY) averted. The epidemiological evidence suggests that the incremental cost of introducing the auto-disable syringe for all medical injections is between $39 and $79 per DALY averted.

Conclusions:

The auto-disable syringe is a cost-effective alternative to the reuse of syringes in a country with low prevalence of blood-borne viruses.     

Prevalence of anaemia,syphilis and hepatitis B in pregnant women in Nausori,Fiji

Setting:

An antenatal clinic serving a population of 47 604 in Nausori, Fiji.

Objective:

1) To estimate the prevalence of anaemia, syphilis and hepatitis B in pregnant women attending their first antenatal visit; and 2) to estimate the uptake of treatment for syphilis and for the prevention of hepatitis B transmission in affected individuals.

Design:

Retrospective review of the clinic register and patient records for the year 2011.

Results:

The prevalence of anaemia, hepatitis B and syphilis were respectively 22%, 2% and 5%. Among women with syphilis, 78% of those for whom data were available received a complete course of three doses of penicillin during their pregnancy, and 83% of babies born to women with hepatitis B received hepatitis B immunoglobulin.

Conclusion:

The prevalence of anaemia in pregnant women has declined but remains high, and further research is required to identify the major causes of this condition in Fiji. The prevalence of syphilis has remained static, while hepatitis B has decreased over the past decade. There are some gaps in the implementation of effective interventions to manage these conditions in pregnant women.     

A Descriptive Study on the Users and Utility of HIV/AIDS Helpline in Karnataka, India

Background:

Globally, Telephone help-lines have proved their utility in several crisis situations. They were introduced in India for helping persons in need of counseling or emergency care such as victims of suicide, cardiac arrests, etc. The utility of such help-lines in HIV/AIDS has not been established .Hence this study done in ASHA Foundation, Bangalore.

Objectives:

To determine the characteristics of persons who access the HIV/AIDS helpline. To determine the reasons for calling the helpline. To identify the gaps in the provision of this service.

Materials and Methods:

Details on all calls received on ASHA Foundation''s HIV/AIDS help line during the period January 2007 to December 2008, were entered on MS excel worksheet and analyzed using the SPSS software.

Results:

Majority of callers are male, are in the age group of 20-39 years and educated. The most common reasons for calling the helpline were for HIV testing, information about HIV/AIDS, care and support services and referrals to other services not linked to HIV/AIDS. Reasons for calling were linked to risk ( HIV testing, condom use etc) in younger persons, and to avail of care and support services in the older age-group.

Conclusions:

The main users of the HIV/AIDS helpline are urban ,young, educated males.     

Enteric Pathogens in HIV/AIDS from a Tertiary Care Hospital

Background:

Patterns of enteric infections in HIV in developing countries may differ in several important ways from developed countries, the knowledge of which can often guide therapy when resource limitations hamper the exact diagnosis of the etiological agent in HIV-associated diarrhea.

Objectives:

The primary objective of this study was to define and compare the microbial etiologies of diarrhea in HIV-1 infected and non infected patients and in HIV infected non diarrheal patients.

Materials and Methods:

This study was conducted between April 2007 and July 2007 at the Department of Microbiology, Maulana Azad Medical College, New Delhi. Stool samples from 50 HIV seropositive cases with diarrhea (study group), 50 HIV seropositive cases without diarrhea (control group I), and 50 HIV seronegative cases with diarrhea (control group II) were examined. After the diagnosis of HIV infection was made, routine parasitological and bacteriological detection was done. An ELISA was used for the detection of Clostridium difficile toxin and Cryptosporidium antigen in stool samples.

Results:

The overall prevalence of enteric parasitosis in the study group was 20% and the bacteria identified were Escherischia coli in 24% of the case, Clostridium difficile in 10% of the cases, Salmonella species and Vibrio cholerae in 4% of the cases, and Shigella species in 2% of the cases. Candida species was identified in 36% of the cases.

Conclusions:

Identification of the etiological agent of diarrhea in a patient with AIDS is very important as it can help in the institution of appropriate therapy and the reduction of morbidity and mortality in these patients.     

Seroprevalence of Hepatitis B Surface Antigen, Antibodies to the Hepatitis C Virus, and Human Immunodeficiency Virus in a Hospital-Based Population in Jaipur, Rajasthan

Background:

Hepatitis B, hepatitis C, and HIV infections are a serious global and public health problem. To assess the magnitude and dynamics of disease transmission and for its prevention and control, the study of its seroprevalence is important. A private hospital catering to the needs of a large population represents an important center for serological surveys. Available data, at Rajasthan state level, on the seroprevalence of these bloodborne pathogens is also very limited.

Objective:

A study was undertaken to estimate the seroprevalence of hepatitis B surface antigen (HBsAg) and antibodies to hepatitis C (anti-HCV Ab) and human immunodeficiency virus (anti-HIV Ab) in both the sexes and different age groups in a hospital-based population in Jaipur, Rajasthan.

Materials and Methods:

Serum samples collected over a period of 14 months from patients attending OPDs and admitted to various IPDs of Fortis Escorts Hospital, Jaipur, were subjected within the hospital-based lab for the detection of HBsAg and anti-HCV Ab and anti-HIV Ab using rapid card tests. This was followed by further confirmation of all reactive samples by a microparticle enzyme immunoassay (Abbott AxSYM) at Super Religare Laboratories (formerly SRL Ranbaxy) Reference Lab, Mumbai.

Results:

The seroprevalence of HBsAg was found to be 0.87%, of anti-HCV Ab as 0.28%, and of anti-HIV Ab as 0.35%.

Conclusion:

The study throws light on the magnitude of viral transmission in the community in the state of Rajasthan and provides a reference for future studies.     

Profiles of Attendees in Voluntary Counseling and Testing Centers of a Medical College Hospital in Coastal Karnataka

Research Question:

What are the socio-demographic profile and risk behavior pattern of seropositive attendees in the voluntary counseling and testing center (VCTC)?

Study Design:

Retrospective study.

Setting:

VCTC in the outpatient complex of Kasturba Medical College Hospital, Mangalore, Karnataka.

Subjects:

Records pertaining to all the 539 and 330 seropositive attendees during the years 2005 and 2006, respectively, were included in the study besides data from 2001 onwards in order to assess the time trend of human immunodeficiency virus (HIV).

Study Variables:

Age, sex, marital status, religion, educational status, occupation, place of residence and pattern of risk behavior in relation to HIV/AIDS.

Statistical Analysis:

Analysis was done with SPSS version 11. Statistical test and Chi-square was done, and P < 0.05 was considered statistically significant.

Results:

The time trend of VCTC attendees reveals a gradual increase except in 2006 showing a sharp decline. Seropositives were around 20% between 2001 and April 2007 with a sharp increase in 2006, i.e., 33.64%. Male seropositivity constituted 60-63%; 81-91% of seropositive attendees belonged to the age group of 15-50 years; 58-70% were married. Only about 3% were illiterates and 20-25% constituted 6^th-12^th pass-outs. With regard to occupational profile, about 17-27% were housewives, 19-21% were laborers/hotel workers and 7% were entrepreneurs. About 45% were from urban area and nearly one-third hailing from other districts in the border of Karnataka. About 25% were exposed to commercial sex workers; another 21-23% were involved in premarital sex and nearly 38% were indulging in heterosexual activities.     

Asymptomatic Malaria among Blood Donors in Benin City Nigeria

Background

This study aimed at determining the prevalence and associated risk factors for asymptomatic malaria parasitaemia and anemia among blood donors in a private medical laboratory in Benin City, Nigeria.

Methods

Venous blood was collected from a total of 247 blood donors. Malaria status, ABO, Rhesus blood groups and hemoglobin concentration of all participants were determined using standard methods.

Results

The prevalence of asymptomatic malaria infection was higher among commercial blood donors than volunteer group (commercial vs volunteer donor: 27.5 %vs. 13.8%; OR = 2.373, 95% CI = 0.793, 7.107, P = 0.174). Asymptomatic malaria was not significantly affected by gender (P = 0.733), age (P = 0.581), ABO (P = 0.433) and rhesus blood groups (P = 0.806) of blood donors. Age was observed to significantly (P = 0.015) affect malaria parasite density with donors within the age group of 21-26 years having the highest risk. The prevalence of anemia was significantly higher among commercial donors (commercial vs volunteer donors: 23.4% vs 3.4%: OR = 8.551, 95% CI = 1.135, 64.437, P = 0.013) and donors of blood group O type (P = < 0.0001).

Conclusions

Asymptomatic malaria parasitaemia and anemia was higher among commercial donors than voluntary donors. Mandatory screening of blood donors for malaria parasite is advocated to curb transfusion transmitted malaria and associated sequelae.     

Evaluation of the Prevention of Parent to Child Transmission Program in a Rural Tertiary Care Hospital of West Bengal, India

Background:

In India, 67,500 infants acquire HIV infection yearly due to mother to child transmission.

Objective:

The objective was to assess the operational aspect of the Prevention of Parent to Child Transmission (PPTCT) program in a tertiary care hospital and explore its bottleneck.

Materials and Methods:

A 5-year (2004-2008) prospective evaluation study was conducted among the pregnant women attending Obstetrics Department of a rural tertiary care hospital, since the year of implementation. Indicators were used according to UNAIDS/WHO guideline.

Results:

Out of 40,140 registered pregnant women, 23,812 were counseled of which 19,794 were agreed to undergo HIV testing and 111 were found HIV positive with a prevalence of 0.56%. Overall HIV counseling and testing rates were 59.32% and 83.13%, respectively. The nevirapine (NVP) dispensing rate of the mother and newborn were 29.72% and 85.4%, respectively. At 18 months of age, 85% babies were found HIV negative in the mother baby pair who received NVP with absolutely formula feeding but it was 42.8% without such intervention.

Conclusion:

Majority of the pregnant women who came to the labor room directly were deprived of the program (PPTCT) coverage. Although the HIV testing rate reached the WHO target which was excellent, but the NVP dispensing rate lagged far behind.     

Occupational Exposure to Blood and Body Fluids Among Health Care Workers in a Teaching Hospital in Mumbai, India

Objective:

Exposure to blood and body fluids is one of the hidden hazards faced by health care workers (HCWs). The objective of the present study was to estimate the incidence of such exposure in a teaching hospital.

Materials and Methods:

A cross-sectional study among a random sample of residents, interns, nurses and technicians (n = 830) was carried out in a teaching hospital to estimate the incidence of exposure to blood and body fluids in the preceding 12-month period. Self-reported occurrence and the circumstances of the same were recorded by face-to-face interviews using a semi-structured questionnaire.

Results:

The response rate to the study was 89.76%. Occupational exposure to blood and body fluids in the preceding 12 months was reported by 32.75% of the respondents. The self-reported incidence was the highest among the nurses. Needle-stick injury was the most common mode of such exposures (92.21% of total exposures). Index finger and thumb were the commonest sites of exposure. Only 50% of the affected individuals reported the occurrence to concerned hospital authorities. Less than a quarter of the exposed persons underwent post-exposure prophylaxis (PEP) against HIV, although the same was indicated in about 50% of the affected HCWs based on the HIV status of the source patient.

Conclusions:

Occupational exposure to blood and body fluids was a common occurrence in the study sample. There was gross under-reporting of such incidents leading to a lack of proper PEP against HIV in 50% of those in whom the same appeared to be indicated.     

Quality of Life and its Determinants in People Living with Human Immunodeficiency Virus Infection in Puducherry, India

Context:

With anti-retroviral therapy (ART) for human immunodeficiency virus infection (HIV) coming into picture, quality of life (QOL) has gained importance. Knowledge on the factors affecting QOL would be helpful in making important policy decisions and health care interventions.

Aims:

The aim of this study is to assess the quality of life of people living with HIV (PLWH) and to identify the factors influencing their QOL.

Materials and Methods:

The study was done among 200 PLWH attending a tertiary care hospital, and three Non Governmental Organizations at Puducherry, India, from November 2005 to May 2007. QOL was assessed using HIV specific World Health Organization Quality Of Life scale (WHOQOL-HIV) – BREF questionnaire which has six domains (physical, psychological, level of independence, social relationships, environment and spirituality/religiousness/personal belief). Social support and stigma were measured using “Multidimensional Scale of Perceived Social Support” and “HIV Stigma Scale,” respectively, using Likert Scale. Factors influencing QOL were identified using backward stepwise multiple linear regression with the six domain scores as the dependent variables.

Results:

Male: Female ratio was 1:1 and 58% were in early stage of the disease (stage I/II). Psychological and SRPB (Spirituality Religiousness and Personal Beliefs) domains were the most affected domains. All the regression models were statistically significant (P<0.05). The determination coefficient was highest for the social relationship domain (57%) followed by the psychological domain (51%). Disease stage and perceived social support significantly influenced all the domains of WHOQOL. Younger age, female gender, rural background, shorter duration of HIV, non-intake of ART and greater HIV related stigma were the high risk factors of poor QOL.

Conclusion:

Interventions such as ART, family, vocational and peer counseling would address these modifiable factors influencing QOL, thereby improving the QOL of PLWH.     

Awareness and Attitude of the General Public Toward HIV/AIDS in Coastal Karnataka

Objective:

To assess the awareness and attitude of the general public toward people living with HIV/AIDS (PLWHA) in Mangalore, a city in Coastal Karnataka.

Design:

Community-based cross-sectional study.

Materials and Methods:

The study population included 630 individuals aged 18 years and above. The information was collected using a semi structured pre-tested questionnaire. The questionnaire consisted of 24 questions regarding awareness of the modes of transmission of HIV/AIDS (nine questions) and questions to assess the attitude toward People Living With HIV/AIDS (PLWHA) (15 questions). Statistical package SPSS version 11.5 was used, Chi-square test was conducted and P < 0.05 was considered as statistically significant.

Results:

About one-third of the study population thought that one could get infected by merely touching an HIV positive individual. Approximately 45% stated that they would dismiss their maid on finding out her HIV positive status. About 54% were willing to undergo the HIV test. The respondents with less than secondary school education had a discriminatory attitude toward HIV positive people, with regard to them deserving to suffer, dismissing a HIV positive maid, hesitating to sit next to a HIV positive person in the bus, divorcing the infected spouse, and willingness to get tested for HIV, which was found to be statistically significant.

Conclusion:

Stigma among the general public was mostly due to fear of contracting the illness. Stigma does exist to significant degrees among the educated people, which was suggested by about 45% of the participants being willing to undergo the HIV test. There is a need for greater attempts toward making information regarding HIV/AIDS available to every individual of the society.     

Epidemiological Investigation of the Jaundice Outbreak in Lalkuan,Nainital District,Uttarakhand

Background:

In March 2013, cases of acute hepatitis were reported from Lalkuan, Nainital district. We investigated the outbreak to identify the source of infection and to facilitate control measures.

Objectives:

To study the distribution of hepatitis cases, to find the source of infection, and to initiate the control measures in the affected area.

Materials and Methods:

We defined a case of acute hepatitis as those cases that had jaundice with at least one of the following symptoms: Dark urine, fever, pain in abdomen, vomiting, and loss of appetite in the affected area between January and March 2013. Door-to-door survey was carried out. Thirteen blood samples were randomly collected from jaundice cases for immunoglobulin M (IgM) antibody for hepatitis A virus (HAV) and hepatitis E virus (HEV). Water samples were collected to test residual chlorine.

Results:

Total 2,785 individuals were surveyed; of which 240 were suffering from acute viral hepatitis (attack rate (AR) = 8.61%). Out of 13 serum samples, 10 were found positive for HEV IgM antibodies and three cases had IgM antibodies for both HAV and HEV, which confirmed a hepatitis E outbreak. The difference in attack rate of hepatitis of both the sexes was statistically significant (P < 0.001). The attack rate was significantly higher in age groups >12 years of age (P < 0.001). Environmental investigation also confirmed the sewage contamination of drinking water in the distribution system. The attack rate was much higher (29.4%) among those who were exposed to the leaking pipeline than the nonexposed (χ² = 574.26, P < 0.01).

Conclusion:

HEV was confirmed as the major etiological agent in this outbreak that was transmitted by contaminated drinking water. The recognition of early warning signals, timely investigation, and application of specific control measures can contain the outbreak.     

Cost-effectiveness of Childbirth Strategies for Prevention of Mother-to-child Transmission of HIV Among Mothers Receiving Nevirapine in India

Background:

Mother-to-child transmission of HIV is an important mode of spread of HIV in India. With strategies like caesarian section and nevirapine therapy, this spread has been reduced. However, they have costs attached. In this context, this paper attempts to compare the cost-effectiveness of alternative childbirth strategies among HIV-positive mothers receiving nevirapine.

Materials and Methods:

Using sentinel surveillance data from three districts in Tamil Nadu, a model was created to test the cost-effectiveness of vaginal delivery against elective caesarian section among mothers receiving nevirapine. Sensitivity analysis was applied to evaluate cost per HIV infection prevented.

Results:

Vaginal delivery is not only cheaper in HIV-infected mothers receiving nevirapine but also cost-effective as compared to elective caesarian section. The incremental cost for preventing an additional HIV infection through caesarian section was Rs. 76,000. Sensitivity analysis reveals that the findings are robust over a range of HIV transmission probabilities, 0.04-0.14 for vaginal delivery and 0.00-0.02 for caesarian section.

Conclusions:

From a clinical perspective, the findings suggest that pregnant HIV-infected women receiving nevirapine should consider the benefits of a cheaper and safer vaginal delivery. From an economic perspective, the findings support the strategy of vaginal delivery in mothers receiving nevirapine.     

Assessment of Quality of Life of HIV-Positive People Receiving ART: An Indian Perspective

Context:

HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole.

Aims:

The purpose of the present study is to evaluate the quality of life (QOL) of people living with HIV/AIDS (PLHIV) receiving ART and its association with Body mass index (BMI) and CD4 count.

Study Design:

An observational study was performed on PLHIV receiving ART in Orissa, India.

Materials and Methods:

Data on sociodemographic profile, BMI, and CD4 were gathered from 153 HIV-positive subjects. QOL was assessed using WHOQOL-HIV BREF scale.

Results:

The overall QOL score of the subjects was moderate; PLHIV with lower BMI also had poorer QOL (P<0.05). Employment affected only the social health domain of the subjects. Men reported poorer level of independence and physical health while women reported poorer social relationships and environment. All the six domains correlated significantly with the overall QOL indicated by the G-facet.

Conclusion:

Attention toward improving the nutritional status of PLHIV should be accorded high priority to ensure improvement in the overall QOL of PLHIV.     

Diabetes and Hypertension in Urban Bhutanese Men and Women

Background:

Bhutan is a mountainous country with 31% urban population. There is no information on prevalence of diabetes and hypertension in Bhutan yet. This was the first study of its kind conducted in the capital city.

Objective:

To determine prevalence of diabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and hypertension in urban Bhutanese population aged 25 to 74 years.

Materials and Methods:

Stratified two-stage sampling was adopted to include 2474 respondents (Males: 1132, Females: 1342) equally distributed among different age and sex groups. A questionnaire containing demographic, educational and social details and history of diabetes and hypertension was administered on the sampled population the previous evening and blood pressure measured the next morning in nearby camp where fasting blood samples were collected and an oral glucose tolerance test done.

Results:

Age and sex standardized prevalence of diabetes, IGT and IFG were 8.2.0, 21.6 and 4%, respectively. Only 66.5% of the population had normal blood sugar. Prevalence of diabetes and IGT increased progressively with increasing age. Prevalence of hypertension was 26% (Males: 28.3%, Females: 23.2%). It was observed that 54.1% of diabetes population had hypertension.

Conclusion:

The study shows that not only is prevalence of diabetes and hypertension high in the urban Bhutanese but also there is a high diagnosis and treatment gap in these disorders.     

Electronic matching of HIV/AIDS and hepatitis C surveillance registries in three states

Objectives

Both HIV and hepatitis C virus (HCV) can be transmitted through percutaneous exposure to blood in similar high-risk populations. HCV and HIV/AIDS surveillance databases were matched in Colorado, Connecticut, and Oregon to measure the frequency of co-infection and to characterize co-infected people.

Methods

We defined a case of HCV infection as a person with a reactive antibody for hepatitis C, medical diagnosis, positive viral-load test result, or positive genotype reported to any of three state health departments from the start of each state’s hepatitis C registry through June 30, 2008. We defined a case of HIV/AIDS as a person diagnosed and living with HIV/AIDS at the start of each state’s respective hepatitis C registry through June 30, 2008. HIV/AIDS and hepatitis C datasets were matched using Link King, public domain record linkage and consolidation software, and all potential matches were manually reviewed before acceptance as a match.

Results

The proportion of reported hepatitis C cases co-infected with HIV/AIDS was 1.8% in Oregon, 1.9% in Colorado, and 4.9% in Connecticut. Conversely, the proportion of HIV/AIDS cases co-infected with hepatitis C was consistently higher in the three states: 4.4% in Oregon, 9.7% in Colorado, and 23.6% in Connecticut.

Conclusions

Electronic matching of registries is a potentially useful and efficient way to transfer information from one registry to another. In addition, it can provide a measure of the public health burden of HIV/AIDS and hepatitis C co-infection and provide insight into prevention and medical care needs for respective states.In the United States, an estimated 3.2 million people have chronic hepatitis C virus (HCV) infection¹ and an estimated 1.1 million people are living with human immunodeficiency virus (HIV).² Co-infection of HIV and HCV results in more rapid progression of both infections^3,4 and complicates treatment.⁵ Because both HIV and HCV viruses can be transmitted through percutaneous exposure to blood, similar at-risk populations are affected, notably injection drug users (IDUs), and estimating the number of co-infected people can help steer public health initiatives.At the local level, assessing the number and characteristics of co-infected individuals is an important public health endeavor. Prevention and care planning groups can use these data to target and evaluate their activities. The objectives of this study were to use surveillance data to measure HIV/acquired immunodeficiency syndrome (AIDS) and HCV co-infections; to characterize the co-infected populations; and to compare similarities and differences of the co-infected populations in Colorado, Connecticut, and Oregon.     

Alcohol Use and STI among Men in India: Evidences from a National Household Survey

Background:

Alcohol use has been found to correlate with risky sexual behavior as well as with sexually transmitted infections (STI) among populations with high-risk behavior in India.

Objective:

To examine the correlates of alcohol use and its association with STI among adult men in India.

Materials and Methods:

Data from a national representative large-scale household sample survey in the country were used. It included information on sociodemographic characteristics and alcohol use as a part of substance use. Clinical as well laboratory testing was done to ascertain the STI.

Results:

The overall STI prevalence among adult males was found to be 2.5% (95% confidence interval (CI): 1.9–3.1). Over 26% adult men were found to have been using alcohol in the study population. It was higher among men who were illiterate and unskilled industrial workers/drivers. The men who consumed alcohol had higher prevalence of STI (3.6%; 95% CI: 2.9–5.1) than those who did not consume alcohol (2.1%; 95% CI: 1.5–2.6). The degree of association between alcoholism and STI was slightly reduced after adjusting for various sociodemographic characteristics (adjusted odds ratio: 1.5; 95% CI: 0.9–2.3; P=0.06).

Conclusions:

The findings of present study suggest integrating alcohol risk reduction into STI/HIV prevention programmes.     

Early Infant Diagnosis: A New Tool of HIV Diagnosis in Children

Background:

Standard assay has limited utility in diagnosing HIV reactivity among infants till the age of 18 months by which time, many HIV-infected infants expire. The test for diagnosing infant and children below 18 months is DNA polymerase chain reaction (DNAPCR) either by dried blood spot (DBS) or whole blood sample (WBS). Early infant diagnosis (EID) project is implemented in 18 districts of Gujarat through 33 PPTCT centers from 1st April 2010. Present analysis is done to evaluate factors curbing mother to child HIV transmission.

Materials and Methods:

Study included all children (< 18 months) who are born to HIV-positive mothers or referred children with signs/ symptoms of HIV with unknown parent status or children already on anti-retroviral therapy whose status could not be confirmed by antibody tests. Data was compiled and analyzed according to the infant''s age at testing, type of feeding, history of Anti retero viral (ARV) prophylaxis, and type of delivery. Data compiled between April and August 2010 was used for the analysis.

Results:

Cohort of 326 infants was followed up, fewer infants (14/270) who received ARV prophylaxis tested positive than those who did not (23/56). Transmission was more in normal delivery (29/252) than cesarean (8/74). Low transmission rate was seen in replacement feeding (13/208) than breast/mixed feeding (24/94). Out of 37 samples found positive by the DBS, 17 were sent for WBS and all were found to be positive.

Conclusion:

DBS test results were found as accurate as WBS. So DBS (less cumbersome and cost effective) can be used in future exclusively. Nevirapine administration at birth as mother baby pair showed 36% decrease in MTCT.