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C S Pandav

Publications and source records attributed to C S Pandav.

60 records · Page 4Linked to original sources
PubMedDate not supplied

Economic consequences of HIV/AIDS in India.

BACKGROUND: HIV/AIDS is one of the pressing public health problems in India. Available information indicates a rising trend of infection. The impact of HIV/AIDS on the economic front is important as it affects mainly the young, who are in the reproductive age group. We estimated the cost of productivity losses in a lifetime attributable to HIV-related mortality in India in the population of the year 1991 at current HIV infection rates. METHODS: The analysis was done from the societal viewpoint, adopting a discount rate of 5%. To estimate the loss in person-years due to HIV/AIDS, two scenarios were considered. Firstly, the population without HIV/AIDS, and secondly, the population with HIV/AIDS. The difference in person-years lived by the cohort in both populations would provide the person-years lost due to HIV/AIDS. To calculate the person-years lived in each, the life table approach was used. The demographic data from the 1991 Census were used. The population was divided into 15 five-year cohorts and the current age-specific death rates were used. Assumptions regarding HIV incidence rates in urban and rural areas in different age groups were made based on the available data and consensus of experts. The estimate was first done for a cohort of 100,000 population for rural and urban areas and then extrapolated to the population in the different age groups. To convert the person-years lost into monetary terms, minimum wages were estimated to be Rs 14,460 per annum. RESULTS: The total undiscounted life-years lost due to HIV/ AIDS by the present population of India will be 238.4 million years-123.7 million years for urban and 114.7 million years for rural areas. On an average this is 0.4 years lost per person. The life-years lost per case of HIV was 44.4 years. Assuming minimum wages of Rs 14460 as the value of one year, the total economic loss is Rs 3447 billion. The productivity loss per case is Rs 642,024 (US$ 20,710). For an estimated national per capita income of Rs 4252.4 the total economic loss is Rs 1014 billion. If a discount rate of 5% is applied for future losses then the total potential years of life lost will be 23 million-11.3 million for urban and 11.7 million for rural areas. In monetary terms this will be Rs 332.6 billion by minimum wages assumption, and 97.8 billion if the national per capita income is assumed to be the cost of one year. CONCLUSION: HIV/AIDS imposes a significant burden on the economic front. The productivity losses are likely to be an underestimate as the costs of treatment of HIV/AIDS patients, prevention programmes and labour costs have not been taken into account. To decide whether HIV/AIDS needs a high priority int he Indian context, it is necessary to have similar estimates for other important diseases such as tuberculosis and cancer.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Prevalence of iodine deficiency disorders among school children of Delhi.

BACKGROUND: Iodine deficiency disorders (IDDs) are an important cause of mental handicap and poor educability of children. Though Delhi does not lie in the classical Himalayan goitre belt, it has been shown that IDD was endemic in Delhi. Studies of school children in Delhi reported a total goitre rate of 55% which indicates severe endemicity. The sale of uniodized salt has been banned in Delhi since July 1989. This study was done five years later to assess the impact of this measure on IDD prevalence in Delhi. METHODS: A cross-sectional study was done among class VI students studying in government schools of Delhi. A complete list of government middle schools in Delhi was obtained and 30 were selected on the basis of 'probability proportion to size'. A sample size of 1200 was decided based on an expected prevalence of 50% with 5% error and design effect of three. All children in class VI of each school were clinically examined by a trained doctor for the presence of goitre and casual urine samples were collected in capped plastic tubes. The urinary iodine estimation was done by the wet ashing method. RESULTS: The total goitre rate was 20.5%. If the results were limited to children in the age group of 10-12 years it was 19.7%. The urinary iodine was less than the recommended 100 micrograms/L of urine in 23.6% of the children; 7.6% had no iodine in the urine. It is possible that some children could have substituted water in place of urine. The median urinary iodine level was 198 micrograms/L of urine. CONCLUSION: The study showed that IDD continues to be prevalent in mild endemic proportions. Compared to the results of previous surveys, the IDD rates have declined in the last few years. However, it continues to be an important public health problem in Delhi. It is essential to monitor the iodine content of salt on a regular basis. IDD control activities should be strengthened in Delhi and repeat surveys should be done every 3-5 years to monitor the progress achieved in eliminating IDD.

Child↗
PubMedDate not supplied

Relevance and importance of universal salt iodization in India.

It is well known that iodine and thyroid hormone are essential for normal development of the human brain and body. Lack of iodine in the diet leads to 'visible' and 'invisible' spectrum of iodine deficiency disorders. The prevalence of iodine deficiency can be assessed by estimating the total goitre rate in the population. A large section of the Indian population suffers from iodine deficiency disorders. These are easily preventable as was shown more than 40 years ago in the study conducted in Kangra Valley. Salt is the best medium of iodine supplementation in India. The potential risks of iodine supplementation, including the risk of iodine-induced thyrotoxicosis, are discussed. Finally, we attempt to formulate policy guidelines on iodine supplementation on the basis of presumed risk:benefit ratio for carrying out an iodine supplementation programme. Taking into consideration medical, social, economic and political aspects of universal salt iodization, the benefits far outweigh the potential low risk due to iodine excess in a small segment of the population.

Deficiency Diseases↗
PubMedDate not supplied

Iodine deficiency disorders in Car Nicobar (Andaman and Nicobar Islands).

BACKGROUND: The term 'Iodine deficiency disorders' (IDDs) reflects the spectrum of health effects due to iodine deficiency at all ages. So far, no survey for IDD has been carried out in the Andaman and Nicobar Islands (A&N). Therefore, we aimed to determine the status of IDDs at Car Nicobar Island and to assess the iodine content of salt available for consumption on the island. METHODS: The study population comprised tribal school children between 7 and 18 years of age in government schools of Car Nicobar, A&N. Children were selected from each school by the simple random sampling method using the random number table. The same sampling method was used for each school till completion of the desired sample size for that school. Casual urine samples (in screw-capped plastic bottles for iodine estimation) and blood samples (on No. 3 Whatman filter paper for TSH estimation) were collected from a randomly selected sub-sample of students. Salt samples for iodine estimation were collected from 'captains' (village headman) of each village and the headmasters of the schools and 'canteens' in government retail outlets in the villages. RESULTS: Of the 969 children surveyed, 160 (16.5%) had goitre. The prevalence was significantly more among females (23.6%) than males (9.7%). Analysis of 105 urine samples showed that the median urinary iodine excretion level was 7.0 micrograms/dl. The median TSH values in subjects was 5.7 mU/L. Fifty (82.5%) of the 54 salt samples had adequate iodine (> or = 15 parts per million). CONCLUSIONS: IDDs pose a mild-to-moderate public health problem in Car Nicobar Island. The supply of iodized salt and its iodine content was found to be satisfactory at the time of the study.

Adolescent↗