HIV Seroprevalence among Tuberculosis Patients in India, 2006–2007

BACKGROUND: Little information exists regarding the burden of HIV among tuberculosis patients in India, and no population-based surveys have been previously reported. A community-based HIV prevalence survey was conducted among tuberculosis patients treated by the national tuberculosis control programme to evaluate the HIV prevalence among tuberculosis patients in India. METHODOLOGY/PRINCIPAL FINDINGS: Fifteen districts (total population: 40.2 million) across 8 states were stratified by HIV prevalence in antenatal clinic HIV surveillance sites and randomly selected. From December 2006 to May 2007, remnant serum was collected from patients' clinical specimens taken after 2 months of anti-tuberculosis treatment and subjected to anonymous, unlinked HIV testing. Specimens were obtained and successfully tested for 5,995 (73%) of 8,217 tuberculosis patients eligible for the survey. HIV prevalence ranged widely among the 15 surveyed districts, from 1% in Koch Bihar, West Bengal, to 13.8% in Guntur, Andhra Pradesh. HIV infection was 1.3 times more likely among male TB patients than among female patients. Relative to smear-positive tuberculosis, HIV infection was 1.4 times more likely among smear-negative patients and 1.3 times more likely among extrapulmonary patients. In 4 higher-HIV prevalence districts, which had been previously surveyed in 2005-2006, no significant change in HIV prevalence was detected. CONCLUSIONS: The burden of HIV among tuberculosis patients varies widely in India. Programme efforts to implement comprehensive TB-HIV services should be targeted to areas with the highest HIV burden. Surveillance through routine reporting or special surveys is necessary to detect areas requiring intensification of TB-HIV collaborative activities

Progress Of Poliomyelitis Control Selected States And Union Territories

Goa, Haryana, Himachal Pradesh, Karnataka, Kerala, Maharashtra, Punjab, Tamil Nadu, Chandigarh and Pondicherry have recorded sustained high levels of coverage with the third dose of oral polio vaccine (OPV) over the last few years. An incidence rate of poliomyelitis of 1.1/100,000 populations was recorded in these states in 1990, a decline of more than 80% as compared to the reported incidence of 5.7/100,000 populations in 1980. The efficacy of OPV in the control of poliomyelitis is convincingly documented by the decline in cases despite several measures taken to strengthen the surveillance system. The impact has been recorded in widely diverse; areas such as the hitty terrain in Himachal Pradesh to high-density areas in Bombay and Madras were large proportion of the population live under poor sanitary conditions. The data shows that the strategy of progressively increasing coverage through regular immunization services, as part of primary health care, is effective

Diethylene glycol poisoning in Gurgaon, India, 1998

OBJECTIVE: To discover the cause of acute renal failure in 36 children aged 2 months to 6 years who were admitted to two hospitals in Delhi between 1 April and 9 June 1998. METHODS: Data were collected from hospital records, parents and doctors of the patients, and district health officials. Further information was obtained from house visits and community surveys; blood and stool samples were collected from other ill children, healthy family members and community contacts. Samples of drinking-water and water from a tube-well were tested for coliform organisms. FINDINGS: Most of the children (26/36) were from the Gurgaon district in Haryana or had visited Gurgaon town for treatment of a minor illness. Acute renal failure developed after an episode of acute febrile illness with or without watery diarrhoea or mild respiratory symptoms for which the children had been treated with unknown medicines by private medical practitioners. On admission to hospital the children were not dehydrated. Median blood urea concentration was 150 mg/dl (range 79-311 mg/dl) and median serum creatinine concentration was 5.6 mg/dl (range 2.6-10.8 mg/dl). Kidney biopsy showed acute tubular necrosis. Thirty-three children were known to have died despite being treated with peritoneal dialysis and supportive therapy. CONCLUSION: Cough expectorant manufactured by a company in Gurgaon was found to be contaminated with diethylene glycol (17.5%v/v), but a sample of acetaminophen manufactured by the same company tested negative for contamination when gas-liquid chromatography was used. Thus, poisoning with diethylene glycol seems to be the cause of acute renal failure in these children

Diethylene glycol poisoning in Gurgaon, India, 1998

OBJECTIVE: To discover the cause of acute renal failure in 36 children aged 2 months to 6 years who were admitted to two hospitals in Delhi between 1 April and 9 June 1998. METHODS: Data were collected from hospital records, parents and doctors of the patients, and district health officials. Further information was obtained from house visits and community surveys; blood and stool samples were collected from other ill children, healthy family members and community contacts. Samples of drinking-water and water from a tube-well were tested for coliform organisms. FINDINGS: Most of the children (26/36) were from the Gurgaon district in Haryana or had visited Gurgaon town for treatment of a minor illness. Acute renal failure developed after an episode of acute febrile illness with or without watery diarrhoea or mild respiratory symptoms for which the children had been treated with unknown medicines by private medical practitioners. On admission to hospital the children were not dehydrated. Median blood urea concentration was 150 mg/dl (range 79-311 mg/dl) and median serum creatinine concentration was 5.6 mg/dl (range 2.6-10.8 mg/dl). Kidney biopsy showed acute tubular necrosis. Thirty-three children were known to have died despite being treated with peritoneal dialysis and supportive therapy. CONCLUSION: Cough expectorant manufactured by a company in Gurgaon was found to be contaminated with diethylene glycol (17.5%v/v), but a sample of acetaminophen manufactured by the same company tested negative for contamination when gas-liquid chromatography was used. Thus, poisoning with diethylene glycol seems to be the cause of acute renal failure in these children

Trends in HIV seroprevalence among tuberculosis patients in 4 districts, 2005–6 survey and 2006–7 surveys.

<p>Trends in HIV seroprevalence among tuberculosis patients in 4 districts, 2005–6 survey and 2006–7 surveys.</p

Districts selected for the survey.

<p>District selection stratified by mean HIV seroprevalence in antenatal clinic (ANC) surveillance sites, 2003–2005. Districts shaded blue had mean 2003–2005 ANC HIV seroprevalence 0–0.5%, yellow districts had ANC HIV seroprevalence 0.51–1.0%, and red districts had ANC HIV seroprevalence >1.0%. The districts of Davangere, Guntur, Nasik, and Tiruvanamalai were selected in the previous years' survey, and were purposively selected again for trend analysis.</p

Survey enrollment and inclusion, with reasons for non-eligibility and non-enrollment into survey.

<p>Survey enrollment and inclusion, with reasons for non-eligibility and non-enrollment into survey.</p

HIV seroprevalence among tuberculosis patients in 15 districts in India, 2006–2007.

a<p>Districts stratified by mean HIV seroprevalence in antenatal clinic (ANC) surveillance sites, 2003–2005. Low <0.5%, Medium = 0.51–1.0%, High >1.0%.</p