Indian Journal of Medical Research最新文献

{"title":"Essential programme on immunization in WHO South-East Asia: A five-decade journey of saving millions of lives & ending diseases.","authors":"Vinod Kumar Bura, Rahul Srivastava, Anil Kumar Chawla, Tondo Opute Emmanuel Njambe, Sudhir Khanal, Lucky Sangal, Shreya Jha, Sunil Bahl","doi":"10.25259/IJMR_1527_2024","DOIUrl":"10.25259/IJMR_1527_2024","url":null,"abstract":"<p><p>Vaccination is one of the most successful and cost-effective interventions designed by science which has helped in preventing millions of deaths, especially in children. The Expanded Programme on Immunization (EPI) was established by World Health Organization (WHO) in 1974 to develop immunization programmes throughout the world with polio, measles, diphtheria, tetanus, tuberculosis and whooping cough. The WHO South-East Asia Region (SEAR) has a disproportionately high burden of infectious diseases and has greatly benefitted from the EPI as compared to other regions with more than 90 per cent of the population having access to vaccines. The story of vaccines in South-East Asia is a testament to scientific progress, global collaboration, and unwavering commitment to public health. This article aims to discuss the journey of EPI in the WHO SEAR.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"267-278"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult vaccination in India: A rapid review of current status & implementation challenges.","authors":"Arunaloke Bhattacharyya, Sheikh Mohammed Shahabuddin","doi":"10.25259/IJMR_1521_2024","DOIUrl":"10.25259/IJMR_1521_2024","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Background & objectives The expanded programme on immunization launched in India in 1978, with its focus on preventing six diseases in children (tetanus, diphtheria, pertussis, poliomyelitis, typhoid, and childhood tuberculosis), was widened in its scope in 1985-86. This new avtaar, the Universal Immunization Programme (UIP), incorporated measles vaccine for children and rubella and adult diphtheria vaccines for pregnant women. We conducted this rapid review on adult immunization relevant for India, as recent COVID-19 experience revealed how newly emergent or re-emergent pathogens could have their onslaughts on the elderly and adults with comorbidities. Methods Three different bibliographic databases, namely PubMed, Scopus and Ovid were searched electronically to access the articles published in peer-reviewed journals. Relevant consensus guidelines by in-country professional groups were also collated. We conducted deduplication and screening of the outputs of these searches (1242 bibliographical records). Finally, 250 articles were found eligible for inclusion. As trials on the reduction of morbidities, mortalities and hospitalizations in adults due to proposed vaccines under Indian consensus guidelines were not available, no meta-analysis was conducted. Results Evidence from articles finally included in this synthesis were grouped under (i) preventing viral and bacterial infections in adults; (ii) adult vaccination and awareness tools; (iii) vaccine hesitancy/acceptance; and (iv) adult vaccination guidelines. In-country research revealed the need for introducing the Human Papilloma Virus (HPV) vaccine in adolescence or early-adulthood to prevent ano-genital cancers in elderly and later life. Importantly HPV prevalence among cervical cancer patients varied between 88 to 98 per cent in Andhra Pradesh, Odisha and Delhi. The importance of conducting regular surveillance of pneumococcal diseases and influenza, as well as tweaking the vaccines accordingly, was revealed in other articles. A poor uptake of influenza vaccine (≤2%) in adults (≥45 yr) was documented. The uptake of hepatitis B vaccine in Health Care Workers (HCWs) in Delhi and Mumbai was of concern and ranged from 55 to 64 per cent. The vulnerability of HCWs to rubella was investigated in a paediatric ophthalmic hospital in Madurai: a tenth of the selected HCWs were rubella seronegative and mounted good protective immunity following RA 27/3 vaccine administration. An outbreak of measles in college students in Pune emphasized the phenomenon of waning immunity. Similarly, a study in the infectious disease hospital in Kolkata and in-patients in Delhi revealed a lack of protective immunity against diphtheria and tetanus in adults. The researchers estimated the economic benefits of providing a typhoid vaccine to a household to be US$ 23 in a middle-income neighbourhood and US$ 14 in slum settings. The authors highlighted the importance of preventive strategies, finding that the cost of sev","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"279-292"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccine, vaccination & personal decision making.","authors":"Samiran Panda","doi":"10.25259/IJMR_1734_2024","DOIUrl":"10.25259/IJMR_1734_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"255-258"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Typhoid & paratyphoid vaccine development in the laboratory: a review & in-country experience.","authors":"Suparna Chakraborty, Santasabuj Das","doi":"10.25259/IJMR_1382_2024","DOIUrl":"10.25259/IJMR_1382_2024","url":null,"abstract":"<p><p>Enteric fever is caused by the infection of Gram-negative bacteria, Salmonella enterica serovar Typhi and Salmonella enterica serovar Paratyphi (S. Paratyphi) A, B and C, through contaminated food and water. The disease almost exclusively affects the populations living in low- and middle-income countries, with the World Health Organization Southeast Asian Region (WHO SEAR) having the highest endemicity. Despite humans being the sole reservoir of infection and antibiotics and vaccines are made available, the disease was not taken up for elimination until recently due to several biological and technical reasons, including the lack of accurate and region-specific disease surveillance data in the real-time diagnostic inaccuracy of acute infections, difficulty in identifying the chronic asymptomatic carriers who are the major reservoirs of infection and the absence of a political will. However, there is now a renewed interest and effort to control the disease in the endemic areas with the help of better surveillance tools to monitor disease burden, wider availability of more accurate blood culture methods for diagnosis, and above all, cost-effective typhoid conjugate vaccines (TCVs) that can provide a high level of durable protection, particularly against the multidrug-resistant strains and to the age group most commonly affected by the disease. However, despite the commercial availability of a few TCVs, they are still in the development stage. Several questions need to be answered before they are taken up for routine immunization in countries like India. Furthermore, typhoid vaccines with a wider coverage, including additional efficacy against Salmonella Paratyphi A and B and preferably the non-typhoidal Salmonella (NTS) serovars, for which no vaccines are currently available would be more desirable. We have developed several subunit vaccine candidates containing the glycoconjugates of the surface polysaccharides of typhoidal and non-typhoidal Salmonellae and an intrinsic Salmonella protein that functions as both antigen and adjuvant. We also developed a novel mouse model of oral Salmonella Typhi infection to test the candidate vaccines, which demonstrated broad protective efficacy against Salmonella spp. through the induction of humoral and cell-mediated immunity as well as memory response.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"379-390"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the COVID-19 vaccination on feto-maternal outcomes: A prospective cohort study among Indian pregnant women.","authors":"Aravind P Gandhi, J S Thakur, Madhu Gupta, Kathirvel Soundappan, Kapil Goel, Gopal Singh, Tarundeep Singh","doi":"10.25259/IJMR_1014_2024","DOIUrl":"10.25259/IJMR_1014_2024","url":null,"abstract":"<p><p>Background & objectives Studies on the effects of COVID-19 vaccination among pregnant women in Asian settings, more specifically in India, are scarce. The present study evaluated the feto-maternal outcomes among Indian pregnant women who received the COVID-19 vaccine. Methods A prospective cohort study was undertaken among 430 pregnant women from two primary health centres (PHC) in Chandigarh, India during 2021-2022. The feto-maternal outcomes evaluated in the study included abortions, live birth/stillbirth, term/pre-term/post-term delivery, mode of delivery (normal vaginal/caesarean section/forceps), birth weight and intrauterine growth retardation. Results Of the 430 study participants, 295 pregnant women received COVID-19 vaccines, with an uptake rate of 68.6 per cent. Majority of vaccinated women (280- who completed the study) were in their second trimester (133, 47.5%), while 92 (32.9%) were in their third, and 55 (19.6%) were in their first trimester when they were enrolled in the study. Neonatal intensive care unit (NICU) admission was significantly lower among the vaccinated pregnant women, while other feto-maternal and neonatal outcomes were similar between vaccinated and unvaccinated pregnant women. Interpretation & conclusions The findings of this study suggest COVID-19 vaccination in pregnant women in India might be safe, in terms of feto-maternal outcomes.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"371-378"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccines for neglected tropical diseases: Learnings from COVID-19.","authors":"Lalit Kant","doi":"10.25259/IJMR_1548_2024","DOIUrl":"10.25259/IJMR_1548_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"319-322"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre- & post-vaccine trends in pneumococcal serotypes & antimicrobial resistance patterns.","authors":"Sreeram Chandra Murthy Peela, Sujatha Sistla, Geetha Nagaraj, Vandana Govindan, Ravi Kumar Lingegowda Kadahalli","doi":"10.25259/ijmr_1811_23","DOIUrl":"10.25259/ijmr_1811_23","url":null,"abstract":"<p><p>Background & objectives The Pneumococcal vaccines were introduced under the Universal Immunization Programme (UIP) in 2021 in India. Drawing from the collective experience of various nations, it is anticipated that there will be a substantial shift in serotype patterns following the introduction of this vaccine. The available data is limited to years until 2018 when the vaccine was introduced in only five States. The present study was carried out to estimate the changes in serotypes and antimicrobial resistance patterns pre- and post-vaccine introduction from a tertiary care centre. Methods All isolates from various clinical specimens in the pre-vaccine era (January 2015-July 2021, except for 2019) and post-vaccine era (August 2021- March 2023) were included. Antimicrobial susceptibility was tested using disc diffusion or VITEK2, and serotyping was performed using the Quellung test (post-vaccine introduction) or sequential multiplex PCR (pre-vaccine introduction). The Chi-square or Fisher exact test was used to identify associations between antimicrobial resistance and serotypes. The z-test for proportions was used to identify significant changes in serotype frequencies between the pre- and post-vaccine era; P<0.05 was considered as the level of significance. Results Overall, the resistance rates increased for most of the antibiotics in the post-vaccine era, and there was no significant increase in the non-vaccine serotypes. The proportion of serotypes 19F and 15B/C increased, and serotypes 23F and 14 reduced in the post-vaccine era. The majority of the 19F and 19A isolates (89.7% and 80%, respectively) were multidrug resistant in the post-vaccine era. Interpretation & conclusions Introducing pneumococcal vaccination reduced the burden of many vaccine serotypes, while the burden of non-vaccine serotypes slightly increased. Most of the vaccine serotypes (like 19F and 19A) that persisted in the post-vaccine era were drug resistant.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"354-361"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trend of immunization & gap in vaccine doses as observed in National Family Health Survey rounds in India.","authors":"Meenu Kalia, Megha Sharma, Ravi Rohilla, Kirtan Rana","doi":"10.25259/ijmr_1770_23","DOIUrl":"10.25259/ijmr_1770_23","url":null,"abstract":"<p><p>Background & objectives Immunization is an efficient and cost-effective way of lowering the infectious disease related morbidity and mortality in the community. The current study reviewed the trend of immunization, gaps in doses of vaccine given at the same time and gaps between the doses of same vaccine from National Family Health Survey (NFHS 1-5) rounds. Methods The current study extracted data from all five NFHS rounds conducted from 1992-93 to 2019-21. The study analyzed the State-wise and demography-wise distribution of trends of immunization from NFHS-1 to NFHS-5. State wise distribution of change in vaccination coverage between NFHS-4 and 5 was analyzed. The study also assessed the State-wise trends of fully vaccinated and unvaccinated children from NFHS 1-5. Results The northeastern States had maximum gap between the vaccination given at birth i.e., 47.3 per cent between BCG and Hepatitis B, and 32.8 per cent between BCG and birth dose of OPV in Manipur in NFHS -5. A gradual rise in the percentage of male (40.2%) and female (41.9%) childrens' vaccination was found across the NFHS rounds with reduction in gap between the male and female vaccination from NFHS-1 (2.6%) to NFHS-5 (0.9%). The percentage of vaccination decreased proportionately with birth order. The vaccination coverage has increased in both urban and rural population, but the rise was higher in rural (45.9%) areas than urban (24.8%). An increase in percentage of fully vaccinated children by 41.2 per cent and decrease in percentage of non-vaccinated children by 26.4 per cent was observed from NFHS-1 to NFHS-5. Interpretation & conclusions Our analysis clearly suggests that immunization coverage has improved over a period of time but the variability in vaccine coverage across States and gap in vaccine doses needs attention of the policy makers to cover this for achieving our national immunization goals.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"303-311"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An update on recombinant vaccines against leishmaniasis.","authors":"Shital Shital, Evanka Madan, Angamuthu Selvapandiyan, Nirmal Kumar Ganguly","doi":"10.25259/IJMR_1040_2024","DOIUrl":"10.25259/IJMR_1040_2024","url":null,"abstract":"<p><p>Leishmaniasis is a parasitic disease caused by various species of the Leishmania parasite, manifesting in visceral (VL), cutaneous (CL), and mucocutaneous (MCL) forms. To combat this debilitating disease, various vaccines candidates including proteins, DNA, vectors, adjuvants, and recombinant whole parasites have been developed and tested experimentally and preclinically against several Leishmania species. Some vaccines have already entered human clinical trials. These vaccines aim to induce protective immunity using specific antigens. This review examines all efforts to develop recombinant vaccines against the parasite, analyzing successes including commercially available canine vaccines and the overall challenges faced in the quest to eradicate the disease. Additionally, recent advances in vaccine delivery systems, such as viral vectors and non-pathogenic bacteria, offer promising avenues to enhance immunogenicity and improve the targeted delivery of antigens, potentially leading to more effective and long-lasting immune responses. By understanding past and current efforts, future strategies can be refined to create more effective vaccines and ultimately control or eradicate this parasitic disease.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"323-337"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of health education on acceptance of human papilloma virus vaccine among parents of adolescent girls of Bishnupur, Manipur: A quasi-experimental study.","authors":"K Dhinu, Sandra Fernandez, Avantika Gupta, Vijaya Elangbam","doi":"10.25259/IJMR_49_2024","DOIUrl":"10.25259/IJMR_49_2024","url":null,"abstract":"<p><p>Background & objectives India contributes maximum to world's cervical cancer burden. Prevention through vaccination is one of the pillars of the global strategy adopted by the World Health Organization (WHO) for the elimination of cervical cancer. Uptake of human papillomavirus (HPV) vaccine, which is about to be introduced in Universal Immunization Programme can be predicted by assessing its acceptance. Methods A quasi-experimental study was conducted among parents of adolescent girls of Bishnupur from February to May 2023 to evaluate the effect of a one-on-one health educational intervention programme on acceptance of the HPV vaccine. Data were collected by face-to-face interviews using a structured questionnaire based on the Health Belief Model from 70 participants selected through convenience sampling. Participants who responded 'definitely yes' to getting their daughters vaccinated with the HPV vaccine were considered as 'vaccine acceptant'. Health education comprised three sessions two wk apart. Descriptive statistics, Cochrane's Q and ANOVA were applied using SPSS 26. Results The median age of the participants was 38 (IQR: 34-44) yr, and 77.1 per cent were females. HPV vaccine acceptance improved significantly over time from 61.4 to 81.4 to 88.6 per cent (P=0.001), respectively. On application of repeated measure ANOVA, perceived benefits of vaccination (P<0.001) and perceived susceptibility to disease (P<0.001) improved significantly across the three time points, whereas perceived severity (P=0.051) and perceived barriers (P=0.367) did not. Interpretation & conclusions Health education intervention was effective at improving vaccine acceptance. Awareness programmes before the rollout of HPV vaccination and continuous re-enforcement would improve parents' perceived benefits and thereby potentially increase vaccine coverage.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"346-353"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}