The number of privately treated tuberculosis cases in India: an estimation from drug sales data

Background Understanding the amount of tuberculosis managed by the private sector in India is crucial to understanding the true burden of the disease in the country, and thus globally. In the absence of quality surveillance data on privately treated patients, commercial drug sales data offer an empirical foundation for disease burden estimation. Methods We used a large, nationally representative commercial dataset on sales of 189 anti-tuberculosis products available in India to calculate the amount of anti-tuberculosis treatment in the private sector in 2013–14. We corrected estimates using validation studies that audited prescriptions against tuberculosis diagnosis, and estimated uncertainty using Monte Carlo simulation. To address implications for numbers of patients with tuberculosis, we explored varying assumptions for average duration of tuberculosis treatment and accuracy of private diagnosis. Findings There were 17·793 million patient-months (95% credible interval 16·709 million to 19·841 million) of anti-tuberculosis treatment in the private sector in 2014, twice as many as the public sector. If 40–60% of private-sector tuberculosis diagnoses are correct, and if private-sector tuberculosis treatment lasts on average 2–6 months, this implies that 1·19–5·34 million tuberculosis cases were treated in the private sector in 2014 alone. The midpoint of these ranges yields an estimate of 2·2 million cases, two to three times higher than currently assumed. Interpretation India's private sector is treating an enormous number of patients for tuberculosis, appreciably higher than has been previously recognised. Accordingly, there is a re-doubled need to address this burden and to strengthen surveillance. Tuberculosis burden estimates in India and worldwide require revision

Bottom-up or top-down: unit cost estimation of tuberculosis diagnostic tests in India.

SETTING: Of 18 sites that participated in an implementation study of the Xpert® MTB/RIF assay in India, we selected five microscopy centres and two reference laboratories. OBJECTIVE: To obtain unit costs of diagnostic tests for tuberculosis (TB) and drug-resistant TB. DESIGN: Laboratories were purposely selected to capture regional variations and different laboratory types. Both bottom-up and the top-down methods were used to estimate unit costs. RESULTS: At the microscopy centres, mean bottom-up unit costs were respectively US$0.83 (range US$0.60-US$1.10) and US$12.29 (US$11.61-US$12.89) for sputum smear microscopy and Xpert. At the reference laboratories, mean unit costs were US$1.69 for the decontamination procedure, US$9.83 for a solid culture, US$11.06 for a liquid culture, US$29.88 for a drug susceptibility test, and US$18.18 for a line-probe assay. Top-down mean unit cost estimates were higher for all tests, and for sputum smear microscopy and Xpert these increased to respectively US$1.51 and US$13.58. The difference between bottom-up and top-down estimates was greatest for tests performed at the reference laboratories. CONCLUSION: These unit costs for TB diagnostics can be used to estimate resource requirements and cost-effectiveness in India, taking into account geographical location, laboratory type and capacity utilisation

Infrastructure for sustainable development using renewable energy technologies in India

The renewable energy sources are going to become the long-term solution for future energy. Adequate infrastructure development is of crucial importance to harness power from them. This paper accumulates state-of-the-art issues and feasible solutions associated with large scale deployment of the renewable energy technologies. Various alternatives presented here are likely to change the look of the future power system. The role of existing technologies, automation, and communication for sustainable development is explained here. A case study of biomass power generation is presented to show efforts of India in sustainable energy development.© IEE

Power sector reforms and restructuring in India

The need for restructuring the power sector was felt due to the scarcity of financial resources available with Central and State Governments, and necessity of improving the technical and commercial efficiency. Electricity Act 2003 has come into force from June 2003. As the act allows third party sales, it introduces the concept of trading bulk electricity. The act also provides open access to transmission as well as distribution of electricity. Some of the important issues addressed by this Act and their impact on power system restructuring are discussed in this paper.© IEE

Infrastructure for sustainable development using renewable energy technologies in India

The renewable energy sources are going to become the long-term solution for future energy. Adequate infrastructure development is of crucial importance to harness power from them. This paper accumulates state-of-the-art issues and feasible solutions associated with large scale deployment of the renewable energy technologies. Various alternatives presented here are likely to change the look of the future power system. The role of existing technologies, automation, and communication for sustainable development is explained here. A case study of biomass power generation is presented to show efforts of India in sustainable energy development.© IEE

Les ruines de Aparicio, Veracruz .

L. H. Les ruines de Aparicio, Veracruz .. In: Journal de la Société des Américanistes. Tome 37, 1948. p. 351

Object-oriented network topology processor

Modern power systems have grown both in size and complexity. Various constraints, such as security, economy and environmental regulations, are forcing power systems to operate closer to their design capabilities and security margins. Here, the authors describe a system where a network topology processor groups physical buses at the substation into electrical buses, builds connectivity from electrical buses to the network branches, and analyzes electrical network connectivity for islands.IEE

Stray loss evaluation in power transformers-a review

Survey of current research papers reveals the continued interest in application of advanced techniques for accurate estimation and control of stray losses in transformers. This paper gives an overview of research, development and application of various computational tools for stray loss analysis, based on over 50 published papers. All landmark papers are systematically classified. Practicality of application of methods by transformer designers is discussed. The report concludes with critical comments on efficacy of all approaches and directions for pursuing further research.© IEE

Optimization approach to real power tracing: an application to transmission fixed cost allocation

Megawatt (MW) power flow tracing can assess the extent of network usage by the participants that can be effectively used for multiple objectives like transmission pricing, loss allocation, etc. MW power tracing, a post-facto analysis of power flow solution, is amenable to multiple solutions. This implies multiplicity of solution space of transmission cost and loss allocation problems. The conventional tracing methods enforce a "proportionate sharing rule" to calculate the shares. These shares are sensitive to quantity and distance as against the postage stamp method, which is immune to distance. Any of these methods will result in penalizing a set of constituents, which raises a fairness issue. This is evident from the experiences of developing countries like India. In this paper, a new paradigm is suggested that attempts to capture the best of the two methodologies by exploring multiplicity of the solution space of the tracing problem, within the given constraints. We show that the tracing problem can be formulated as a linear constrained optimization problem. We propose a tracing compliant modified postage stamp allocation method that computes a traceable solution that minimizes overall deviation from the postage stamp allocation. Results on actual data of central transmission utility of Western Regional Grid of India demonstrate the claims.IEE

New paradigm of tracing algorithms: application to fair loss allocation in Indian system

MW power flow tracing was invented to assess the extent of network usage by the participants so as to allocate the transmission charges and losses. MW power tracing, a post-facto analysis of power flow solution, is amenable to multiple solutions. This implies multiplicity of solution space of cost and loss allocation problem. Existing tracing methods enforce a 'proportionate sharing rule' to arrive at a solution. Case studies indicate that with such a sharing rule, extent of network usage predicted for large and distant loads can be much higher than the postage stamp or pro-rata allocation. To alleviate this problem, we suggest a new paradigm or MW power tracing algorithms wherein, we exploit the multiplicity of solution space so as to achieve a fair and equitable distribution of losses among the participants. We show that real power tracing represents a generic class of multi-commodity network flow problems and can be formulated as a linear constrained optimization problem. We propose a tracing compliant modified postage stamp allocation method which computes a traceable solution that minimizes deviation from the postage stamp allocation of losses. Results on practical data of central transmission utility of Western Regional Grid of India demonstrate the claims