Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “INDIA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources

Impact of migration on coronary heart disease risk factors: comparison of Gujaratis in Britain and their contemporaries in villages of origin in India.

The causes of the excess coronary heart disease (CHD) risk in South Asian migrants from the Indian subcontinent remain unclear. Comparisons of CHD risk factors amongst South Asian migrants living in Britain with those of the general UK population provide only a partial explanation. We compared Gujaratis in Britain with similar, non-migrant Gujaratis in India, to test the hypothesis that differences in CHD risk factors associated with migration would be more informative. Randomly sampled Gujaratis aged 25-79 years living in Sandwell (n = 242) were compared with age-, gender- and caste-matched contemporaries remaining in their villages of origin in Navsari, India (n = 295). Lifestyle indices, food intake and physical activity, were assessed with standardised questionnaires and energy expenditure and metabolic parameters measured. British Gujaratis had higher, mean body mass indices by 6 (4.5-7.4) kg/m(2) mean (95% CI), and greater dietary energy intake, fat intake, blood pressure, fasting serum cholesterol, apolipoprotein B, triglycerides, non-esterified fatty acid (NEFA) and C-reative protein concentrations than Gujaratis in India. Dietary folate and serum folate and Vitamin B(12) were lower and plasma homocysteine was higher in India. Smoking was less prevalent and high-density lipoprotein cholesterol tended to be higher in Britain. Diabetes prevalence was high in both populations and impaired fasting or 2 h post-glucose challenge plasma glucose was even more prevalent in Gujarat. In India, however, where insulin secretion and NEFA were lower diabetes and impaired glucose tolerance were less frequently accompanied by excess metabolic CVD risk factors. In conclusion, exposure to increased fat intake and obesity related to migration is likely to explain the disproportionate combination of established and emerging CHD risk factors prevalent in Gujaratis in Britain. Strategies to improve nutrition and to identify and treat cardiovascular risk factors such as dyslipidaemia and hypertension are urgently required.

Adult↗

Investigator and site selection and performing GCP clinical studies in India.

The optimum site and investigator selection process remains a closely guarded confidential matter and an essential part of development expertise of big pharmaceutical companies and CROs. The right and careful selection and evaluation of investigators and site is critical for successful completion of the trial within budget, timelines and generation of high quality data. The criteria for site and investigator selection in India for Good Clinical Practices (GCP) clinical trials are described for a start up company/CRO and can be applied to any country in Asia and Africa. Foreign sponsors doing clinical studies in India should pay close attention to site and investigator selection. The first GCP study in India was done only in 1995. At the dawn of 21st century, India is at the take off stage in clinical trials now. GCP studies can be done in India, as the quality of data is good, costs are lower and patient enrolment is much faster resulting in early completion of studies.

Choice Behavior↗

Do tribal communities show an inverse relationship between sickle cell disorders and glucose-6-phosphate dehydrogenase deficiency in malaria endemic areas of Central-Eastern India?

Tribal communities in India constitute the largest tribal population in the world. There are about 635 biological isolates (tribes and subtribes), which constituted 8.08% (about 84.3 million) of the total population of India as per the 2001 census. Out of 635 scheduled tribes (aborigines), 62 live in the state of Orissa alone forming about 10.8% of the tribal population of India. Orissa state occupies an important place, being the 3rd in rank for the highest concentration of tribal population in the country. In India, tribal communities are highly vulnerable to hereditary diseases and have a high degree of malnutrition, morbidity and mortality. The sickle cell haemoglobinopathy and glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency are important genetic and public health problems in Central-Eastern part of India. In order to map out these genetic disorders among the tribal people, a cross-section of 15 major tribal communities from different parts of Orissa was randomly screened for haemoglobin variants and G6PD deficiency. The high frequency of sickle cell haemoglobinopathy (0-22.4%) and G6PD deficiency (4.3-17.4%), with beta-thalassemia trait (0-8.5%) taking almost an intermediate position, was observed. For G6PD deficiency, hemizygous males as well as female heterozygotes and female homozygotes were detected. Twelve cases showed compound heterozygosity for sickle cell haemoglobinopathy and G6PD deficiency. There seems to be a trend towards an inverse relationship between the sickle cell allele and G6PD deficiency, and sickle cell and beta-thalassemia allele in a cross-section of malaria endemic (Plasmodium falciparum) tribal communities in Orissa. When the frequency of sickle cell allele decreases in a cross-section of malaria endemic tribal population, the frequency of G6PD enzyme deficiency and beta-thalassemia allele increases and vice versa. Natural selection had played a major role in favour of sickle cell, beta-thalassemia and G6PD mutation alleles so that they had probably evolved as a protective mechanism against the lethal effects of malaria in this part of the country. However, the calculated values of 0.074, 0.218 and 0.337, respectively, of Pearson's correlation co-efficient (r), showed no correlation between sickle cell disorders and G6PD deficiency, sickle cell disorders and beta-thalassemia, and G6PD deficiency and beta-thalassemia.

Anemia, Sickle Cell↗

An overview of an indoor radon study carried out in dwellings in India and Bangladesh during the last decade using solid state nuclear track detectors.

This paper reports on radon concentrations in dwellings from fifty different locations of India. The incorporated data were obtained using the passive solid state nuclear track detector technique. The estimated geometric mean value for India is 67.1 Bq m(-3). Chuadanga in Bangladesh had the lowest observed indoor radon concentration of 27.3 Bq m(-3) and Una in the northern part of India had the highest concentration of 281.5 Bq m(-3). This paper discusses the national geometrical mean value in terms of the national geometric mean values of other countries and also in terms of the geological influence. The estimated indoor radon levels are compared with the indoor radon levels as recommended by the International Commission on Radiation Protection (ICRP). It was observed that there are several locations in India where dwellings have higher indoor radon levels than the ICRP recommended value and requires some sort of intervention from regulating authorities. The mean value for indoor radon level given in the report of UNSCEAR 2000 for India needs to be revised.

Air Pollution, Indoor↗

Spoligotyping of Mycobacterium tuberculosis isolates from patients with pulmonary tuberculosis in Mumbai, India.

Tuberculosis remains a major health problem in India, with 2 million new cases and 421,000 deaths each year. In this paper, we describe the spoligotyping results of 216 Mycobacterium tuberculosis culture isolates from patients with pulmonary tuberculosis in Mumbai, India. As spoligotyping data from India have rarely been described until now, and as there is limited information on the major circulating clades of M. tuberculosis, the data obtained were also compared to an international spoligotype database (SpolDB4) that contained patterns from 22,546 isolates from more than 100 countries. Eighty-four (39%) of the isolates were definitively marked as orphan strains, indicating the paucity of such data from India. The remaining 132 isolates clustered among 59 shared types; among these, 42 shared types were already present in the database, 17 were newly created, and 5 of them were specifically reported from Mumbai. A total of 9 major types in this study clustered 32% of the isolates. At the phylogenetic level, 30% of the isolates belonged to the Central Asian families CAS1 and CAS2, of the major genetic group (MGG) 1, 29% to MGG 2 and 3 families (spacers 33-36 missing) and 17% to the ancestral East African Indian (EAI) family. Finally, nearly 10% of the isolates belonged to the W-Beijing family in a broad sense, also in the MGG 1 group. In conclusion, historic clones of the MGG 1 group of M. tuberculosis are responsible for roughly 60% of all tuberculosis cases in Mumbai. Together with the fact that organisms presumably of European descent (such as the Haarlem family) were only rarely found, our observations suggest that tuberculosis in Mumbai, India is essentially caused by historical clones of tubercle bacilli undergoing active circulation due to uncontrolled demography, high prevalence of the disease, and a paucity of resources.

Adult↗

Pseudoexfoliation in a rural population of southern India: the Aravind Comprehensive Eye Survey.

PURPOSE: To determine the prevalence and risk factors for pseudoexfoliation in a rural population of southern India. DESIGN: A population-based cross-sectional study of pseudoexfoliation with and without glaucoma in rural southern India. METHOD: A total of 5,150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India. RESULTS: All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of minimal angle of resolution (logMAR) illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. Pseudoexfoliation (PXF) was diagnosed by the presence of typical white deposits on the anterior lens surface; additional sites included the cornea, iris, anterior vitreous face, posterior capsule, and intraocular lens in cataract-operated eyes and changes in the angle determined through gonioscopy, including increased pigmentation, PXF deposition, and PXF material within the angle. CONCLUSIONS: The prevalence (95% confidence interval) of PXF was 6.0% (5.3, 6.6). The prevalence increased with age (P <.001) and was greater in males (P =.01). Of subjects with PXF, 25.7% remained bilaterally blind after best correction; 89.3% of this bilateral blindness was the result of cataracts. The prevalence of glaucoma among subjects with PXF was 7.5%; exfoliation was present in 26.7% of those identified as primary open-angle glaucoma. On multivariate analysis, increasing age and male gender were significantly associated with PXF. Pseudoexfoliation appears to be a relatively common disorder in older individuals in southern India. Ophthalmologists in India may wish to focus on the detection of PXF, especially considering the relatively large burden of cataracts in this population, the risks for operative complications related to PXF, and the fact that PXF may be used as a marker to aid in the detectection of glaucoma.

Adult↗

Smoking and mortality from tuberculosis and other diseases in India: retrospective study of 43000 adult male deaths and 35000 controls.

BACKGROUND: In India most adult deaths involve vascular disease, pulmonary tuberculosis, or other respiratory disease, and men have smoked cigarettes or bidis (which resemble small cigarettes) for several decades. The study objective was to assess age-specific mortality from smoking among men (since few women smoke) in urban and in rural India. METHODS: We did a case-control study of the smoking habits of 27000 urban and 16000 rural men who had died in the state of Tamil Nadu, southern India, from medical causes (ie, any cause other than accident, homicide, or suicide), and of 20000 urban and 15000 rural male controls. The main analyses are of mortality at ages 25-69 years. FINDINGS: In the urban study area, the death rates from medical causes of ever smokers were double those of never smokers (standardised risk ratio at ages 25-69 years 2.1 [95% CI 2.0-2.2]). The risks were substantial both for cigarette smoking (the main urban habit) and for bidi smoking. Of this excess mortality among smokers, a third involved respiratory disease, chiefly tuberculosis (4.5 [4.0-5.0], smoking-attributed fraction 61%), a third involved vascular disease (1.8 [1.7-1.9], smoking-attributed fraction 24%), 11% involved cancer (2.1 [1.9-2.4], smoking-attributed fraction 32%), chiefly of the respiratory or upper digestive tracts, and 14% involved alcoholism or cirrhosis (3.3 [2.9-3.8], not attributed to smoking). Among ever smokers, the absolute excess mortality from tuberculosis was substantial throughout the age range 25-69 years. (A separate survey of 250000 men living in the urban study area found that ever smokers are three times as likely as never smokers to report a history of tuberculosis, corresponding to a higher rate of progression of chronic subclinical infection to clinical disease.) The proportional excesses of respiratory, vascular, and neoplastic mortality at ages 25-69 years among ever smokers in the urban study area were replicated, each with similarly narrow CI for the risk ratio, in the rural study area (where bidi smoking predominated), and are taken to be largely or wholly causal. For urban and for rural death from medical causes at older ages (> or =70 years), the standardised risk ratio was 1.3. INTERPRETATION: Smoking, which increases the incidence of clinical tuberculosis, is a cause of half the male tuberculosis deaths in India, and of a quarter of all male deaths in middle age (plus smaller fractions of the deaths at other ages). At current death rates, about a quarter of cigarette or bidi smokers would be killed by tobacco at ages 25-69 years, those killed at these ages losing about 20 years of life expectancy. Overall, smoking currently causes about 700000 deaths per year in India, chiefly from respiratory or vascular disease: about 550000 men aged 25-69 years, about 110000 older men, and much smaller numbers of women (since few women smoke).

Adult↗

Burden of moderate visual impairment in an urban population in southern India.

OBJECTIVE: To assess the prevalence and causes of moderate visual impairment in an urban population in southern India. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 2522 (85.4% of the eligible) persons of all ages, including 1399 persons 30 years of age or older, from 24 clusters representative of the population of Hyderabad city. TESTING: The eligible subjects underwent a detailed ocular evaluation, including logarithm of the minimum angle of resolution (logMAR) visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, cataract grading, and stereoscopic dilated fundus evaluation. Automated threshold visual fields and slit-lamp and fundus photography were done when indicated by standardized criteria. MAIN OUTCOME MEASURE: Moderate visual impairment was defined as presenting distance visual acuity less than 20/40 to 20/200 or visual field loss by predefined standardized conservative criteria in the better eye. RESULTS: In addition to the 1% prevalence of blindness in this sample reported earlier, moderate visual impairment was present in 303 subjects, an age-gender-adjusted prevalence of 7.2% (95% confidence interval [CI], 4.5%-9.9%; design effect, 2.7). The major cause of moderate visual impairment was refractive error (59.4%, 95% CI, 52.3%-66.5%) followed by cataract (25.3%, 95% CI, 19%-31.6%). Multivariate analysis showed that the prevalence of moderate visual impairment was significantly higher in those 40 years of age or older (odds ratio, 10.9; 95% CI, 8-15) and females (odds ratio, 1.89; 95% CI, 1.41-2.53) and lower in those belonging to the highest socioeconomic status (odds ratio, 0.27; 95% CI, 0.14-0.51). However, because of the pyramidal age distribution of the population, 38.1% of the total moderate visual impairment was present in those younger than 40 years of age. The proportion of moderate visual impairment caused by refractive error was higher in the younger than in the older age groups (P < 0.0001). CONCLUSIONS: Projecting the results to the 26.5% urban population of India, there would be 18.4 million (95% CI, 11.5-25.2 million) persons with moderate visual impairment in urban India alone. Refractive error was the major cause of moderate visual impairment in the population studied. The absolute proportion of moderate visual impairment in those younger than 40 years of age was considerable. The eyecare policy of India, apart from dealing with blindness, should address the issue of the relatively easily treatable uncorrected refractive error as the cause of moderate visual impairment in an estimated 10.9 million persons in urban India.

Adolescent↗

Environmental impact of coal industry and thermal power plants in India.

Coal is the only natural resource and fossil fuel available in abundance in India. Consequently, it is used widely as a thermal energy source and also as fuel for thermal power plants producing electricity. India has about 90,000 MW installed capacity for electricity generation, of which more than 70% is produced by coal-based thermal power plants. Hydro-electricity contributes about 25%, and the remaining is mostly from nuclear power plants (NPPs). The problems associated with the use of coal are low calorific value and very high ash content. The ash content is as high as 55-60%, with an average value of about 35-40%. Further, most of the coal is located in the eastern parts of the country and requires transportation over long distances, mostly by trains, which run on diesel. About 70% oil is imported and is a big drain on India's hard currency. In the foreseeable future, there is no other option likely to be available, as the nuclear power programme envisages installing 20,000 MWe by the year 2020, when it will still be around 5% of the installed capacity. Hence, attempts are being made to reduce the adverse environmental and ecological impact of coal-fired power plants. The installed electricity generating capacity has to increase very rapidly (at present around 8-10% per annum), as India has one of the lowest per capita electricity consumptions. Therefore, the problems for the future are formidable from ecological, radio-ecological and pollution viewpoints. A similar situation exists in many developing countries of the region, including the People's Republic of China, where coal is used extensively. The paper highlights some of these problems with the data generated in the author's laboratory and gives a brief description of the solutions being attempted. The extent of global warming in this century will be determined by how developing countries like India manage their energy generation plans. Some of the recommendations have been implemented for new plants, and the situation in the new plants is much better. A few coal washeries have also been established. It will be quite some time before the steps to improve the environmental releases are implemented in older plants and several coal mines due to resource constraints.

Carbon↗

Burn mortality: recent trends and sociocultural determinants in rural India.

In 1998, India was the only country in the world where fire (burns) was classified among the 15 leading causes of death. High mortality in young married women from burns has already become an alarming and contentious medical problem in rural India. The incidences of burn mortality by age, sex, residence, marital status; manner and reasons have been reported only infrequently from the rural parts of India. From a total of 4042 medicolegal deaths reported at an Apex medical centre of a rural health district, over a period of 5 years 1997-2001, 942 deaths (23.3%) were due to burns; with mortality rate of 15.1 per year per 100,000 population. Of all burn death cases, 80.8% were females, 82.4% married ones, 71.9% belonged to the young age group of 21-40 years and 75.0% came from the rural parts of the district. Out of all burn deaths, 50.7% were accidental, 47.8% suicidal and 1.5% were homicidal in manner. In all female suicides, burns was the commonest method adopted by over 60% females. Torture by in-laws (32.1%) was the commonest reason for committing suicide by burns in married women. The present study has tried to identify the high-risk group and reasons for high burn mortality in this rural area. Religious and sociocultural reasons prevalent in the area are discussed, which play the determinant role in such a high mortality rate in burns in rural India. Further studies in India into psychodynamics of sociocultural, religious and family life are advised.

Adolescent↗

Distribution of the different genotypes of HCV among patients attending a tertiary care hospital in south India.

BACKGROUND: Genotyping of the hepatitis C virus (HCV) and assessment of viral load is important for designing therapeutic strategies and region specific diagnostic assays. OBJECTIVES: To determine the distribution of HCV genotypes among patients attending a tertiary care hospital in south India, and to correlate this with viral load. STUDY DESIGN: Ninety HCV RNA positive patients were recruited for the study. HCV genotyping was carried out using type-specific primers from the core region of the viral genome [J. Clin. Microbiol. 35 (1997) 201]. Viral load estimations were carried out using the Amplicor HCV Monitor (Versions 1.5 and 2, Roche Diagnostics, Branchburg, NJ, USA). Clinical details were elicited from patients' hospital records. RESULTS: Genotype 3 was detected most frequently (62.2%) followed by infection with HCV genotype 1 (18.8%). There was no significant difference seen in alanine aminotransferase (ALT) values between the two genotypes. Genotype 1 was associated with a significantly higher viral load as compared with genotype 3 (P=0.001). Parenteral transmission accounted for 61% of all infection caused. Infection with genotype 1 was significantly associated with a history of haemodialysis (P=0.01). Genotype 3 was detected more frequently in patients from east India, as compared with its detection in patients from south India (P=0.004). Similarly, genotype 1 was detected with greater frequency in individuals from south India as compared with patients from east India (P=0.004). The concordance between Ohno's genotyping assay and nucleotide sequencing, for genotypes 1 and 3, was 75%. CONCLUSIONS: HCV genotypes 1 and 3 accounted for 81% of HCV infections in patients from this geographical region. HCV genotype distribution showed regional differences and genotype 1 was associated with higher viral loads. Parenteral transmission was the major route for acquisition of HCV infection. Ohno's type-specific primer based genotyping assay can be used for distinguishing between HCV genotype 1 and non-1 HCV genotypes in laboratories that do not possess nucleotide sequencing facilities.

Adolescent↗

Shifting the focus of tuberculosis research in India.

India has a long and distinguished tradition of research in the field of tuberculosis (TB). Pioneering studies from India demonstrated the efficacy and safety of domiciliary treatment, the necessity of direct observation of treatment, the feasibility of case detection through sputum smear microscopy in primary health care institutions, and the effectiveness of intermittent short-course chemotherapy. These findings laid the foundation of directly observed treatment, short course (DOTS), which has been adopted by nearly 150 countries worldwide. Today, India has the second-largest and the fastest-growing DOTS programme in the world. A strong component of programme evaluation and operational research is needed to sustain and expand DOTS in the context of a suboptimal primary health care system, a large and unregulated private health care system, and the dual threats of HIV and multidrug-resistant TB (MDR-TB). Therefore, the focus of TB research in India has shifted to the following operational research areas: evaluating models to involve the private health sector; assessing the role of incentives in increasing treatment compliance; examining gender differentials in the access to TB services; assessing risk factors for delay in diagnosis; evaluating diagnosis, treatment and prevention of TB among HIV-infected persons; monitoring MDR-TB; estimating cost-effectiveness of the DOTS programme; monitoring the quality of smear microscopy services; and measuring the current burden of TB. Research for developing newer diagnostic tools, drugs and vaccines remains a long-term priority. Greater networking is needed among national researchers, programme managers and policy-makers to translate the findings of research into policies and programmes to make TB control in India more effective and efficient.

Directly Observed Therapy↗

Neonatal feeding practices of Anglo American mothers and Asian Indian mothers living in the United States and India.

OBJECTIVE: To compare the colostrum and prelacteal feeding practices of Anglo American mothers and Asian Indian mothers living in the United States and India. DESIGN: Data were collected by interviews in the mother's home. SETTING: Southeastern United States and India. PARTICIPANTS: Participants included 75 mother-infant pairs (n=25 per ethnic group). VARIABLES MEASURED: Demographic characteristics, length of US residence, mother's colostrum and prelacteal feeding practices, and associated reasons. ANALYSIS: Descriptive statistics. RESULTS: All Anglo American mothers initiated breast-feeding immediately after the infant's birth, and none gave prelacteal feeds. Asian Indian mothers living in the United States and India initiated breast-feeding postpartum at means of 12 and 30 hours, respectively. Six of the Asian Indian women living in the United States and 17 Asian Indian mothers living in India delayed introducing colostrum and fed prelacteal feeds. CONCLUSIONS AND IMPLICATIONS: Asian Indian women who come to live in the United States demonstrate different feeding practices than their Indian counterparts. In India, women may receive guidance regarding breast-feeding primarily from relatives and friends, whereas in the United States, breast-feeding counseling may be provided by health professionals. Nutritionists are encouraged to understand the maternal reasons for withholding colostrum and prelacteal feeding and to give compatible messages targeted at women of Asian Indian origin about breast-feeding.

Adult↗

Demographic perspectives on China and India.

This paper compares levels and trends of population growth rates, age and sex composition, mortality, and fertility including family planning practices in the world's two most populous countries, China and India. Both countries are undergoing demographic transition but China is nearer than India to achieving a stationary population. Fertility in China has declined below replacement level while in India it is nearly one and a half children per woman above replacement level. Both countries have achieved large reductions in mortality but life expectancy at birth in China is currently about 10 years longer than in India. Both countries have young populations but China will precede India in the aging of population structure during the 21st century.

Adolescent↗

Trends in hypertension epidemiology in India.

Cardiovascular diseases caused 2.3 million deaths in India in the year 1990; this is projected to double by the year 2020. Hypertension is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. Indian urban population studies in the mid-1950s used older WHO guidelines for diagnosis (BP > or =160 and/or 95 mmHg) and reported hypertension prevalence of 1.2-4.0%. Subsequent studies report steadily increasing prevalence from 5% in 1960s to 12-15% in 1990s. Hypertension prevalence is lower in the rural Indian population, although there has been a steady increase over time here as well. Recent studies using revised criteria (BP > or =140 and/or 90 mmHg) have shown a high prevalence of hypertension among urban adults: men 30%, women 33% in Jaipur (1995), men 44%, women 45% in Mumbai (1999), men 31%, women 36% in Thiruvananthapuram (2000), 14% in Chennai (2001), and men 36%, women 37% in Jaipur (2002). Among the rural populations, hypertension prevalence is men 24%, women 17% in Rajasthan (1994). Hypertension diagnosed by multiple examinations has been reported in 27% male and 28% female executives in Mumbai (2000) and 4.5% rural subjects in Haryana (1999). There is a strong correlation between changing lifestyle factors and increase in hypertension in India. The nature of genetic contribution and gene-environment interaction in accelerating the hypertension epidemic in India needs more studies. Pooling of epidemiological studies shows that hypertension is present in 25% urban and 10% rural subjects in India. At an underestimate, there are 31.5 million hypertensives in rural and 34 million in urban populations. A total of 70% of these would be Stage I hypertension (systolic BP 140-159 and/or diastolic BP 90-99 mmHg). Recent reports show that borderline hypertension (systolic BP 130-139 and/or diastolic BP 85-89 mmHg) and Stage I hypertension carry a significant cardiovascular risk and there is a need to reduce this blood pressure. Population-based cost-effective hypertension control strategies should be developed.

Blood Pressure↗

HLA diversity among Nadars, a primitive Dravidian caste of South India.

South India is one of the oldest geophysical regions mainly occupied by Dravidian language-speaking people. Here a random panel of 61 unrelated Nadar healthy individual from Tamil Nadu State were analyzed and compared with other populations of India and the world. HLA-A, B and C alleles frequencies and their haplotype frequencies were determined by high-resolution typing of genomic DNA. The analysis revealed that the Nadar caste of South India have several characters shared with East Asian populations consistent with the demographic history of South India, as well as specific features including several unique alleles such as A*03011, A*31011, B*15011, B*3501, B*51011, Cw*02022. In addition, haplotypes such as A*31011-Cw*02022-B*3501, A*03011-Cw*04011-B*4406 and A*2402101-Cw*04011-B*51011 are of high frequency in both these populations but are rare or absent in other populations of India and the world. The study suggests that a comparatively lesser degree of genetic admixture occurred between the South Indian and North Indian racial groups than that between South Indian and East Asian groups.

Gene Frequency↗

Bilateral environmental and occupational health program with India.

In spite of considerable economic progress in recent years, India continues to face challenges dealing with poverty, unemployment, malnutrition, disease and disability. The governments of India and the United States have formed a collaborative effort to address outstanding issues in the fields of environmental and occupational health. The Joint Statement on Indo-U.S. Collaboration in Environmental and Occupational Health, which was approved by the Minister of the Indian Union of Health and Family Welfare and the Secretary of Health and Human Services of the United State in Geneva in May of 2002, formalizes the collaborative relationship and calls for the development of Implementation Guidelines. The Implementation Guidelines establish a Joint Working Group, which is responsible for identifying and implementing the collaborative projects. The collaborating organizations have identified three broad areas for collaboration: emergency preparedness and response; training, education, and technology transfer; and research. Within the three broad areas, the organizations have identified two subject areas for initiation: arsenicosis and asbestosis. Researchers and health officials in both India and the U.S. share interest in both research and interventions efforts in these subject areas. As many as 42 million people in the West Bengal area of India may be exposed to arsenic in drinking water at concentrations of health concern. Similarly, as many as 10 million industrial or mine workers in India may be exposed to asbestos or other dusts at concentrations of health concern. The first Joint Working Group meeting is scheduled for March 2003 in New Delhi and will consider these subject areas in developing collaborative projects. Other tasks being undertaken by the signatory agencies include expanding the relationship to include academic and nongovernmental organizations and obtaining funds for the various projects from governmental and nongovernmental sources.

Arsenic Poisoning↗

Mapping of lymphatic filariasis in India.

The derivation of detailed epidemiological maps, at the relevant spatial resolution, is being increasingly recognized as vital to the effective design and implementation of successful programmes for the control of parasites and their vectors. Geographical information systems (GIS) and a recently complied database on the distribution of lymphatic filariasis in India have now been used to develop the first maps at district-level (i.e. the level at which control against this parasite will be enacted in India) of filariasis endemicity in this country. The derived maps indicate both the substantial extent as well as the marked variability in the geographical distribution of this disease in India. The causative infection and/or the symptomatic disease were detected in most (257) of the 289 districts surveyed up to 1995. Currently there may be up to 27.09 million microfilaraemics, 20.83 million cases of symptomatic filariasis, and about 429.32 million individuals potentially at risk of infection in the country. Probability mapping, based on data quantiles, clearly indicates that the risk of filarial infection in India is not constant throughout the country but exhibits strong regional trends. Filariasis in general may be a particular problem of the eastern half of the country. The results indicate the potentially vital role that GIS-based mapping approaches can play in the development of filariasis-control campaigns in India and elsewhere.

Elephantiasis, Filarial↗