South Indian Community Research Articles

South Asian tissue economies

This introduction surveys existing literature on South Asian tissue economies and reflects on engagements with diverse modes of biological exchange in the subcontinent. It elaborates the aims and themes of this special issue, which presents essays on caste, gender, and blood donation in Pakistan (Mumtaz and Levay), DNA testing amongst a former Untouchable community in south India (Egorova) and amongst diasporic Indians in Houston, Texas (Reddy), body (cadaveric) donation in India (De Looze), the use of fake blood in Bangladeshi cinema (Hoek), the mobilisation of blood, hearts, and ketones to protest the Indian government's failure to provide redress or care to victims of the 1984 Bhopal industrial disaster (Banerjee), and blood-based political portraits in south India (Copeman). Extending the parameters of classic accounts of the role of substance transactions in the production of South Asian personhood into investigations of contemporary tissue economies, it examines the foundational work of Lawrence Cohen in this area and proposes a set of relations between the double-ness of substance (its promise, as a locus of hope, emerging precisely from its capacity to debase) and its productivity within discourses of civil society and ‘modernisation’.

Metabolic syndrome among schizophrenia patients: Study from a rural community of south India

Though metabolic syndrome (MS) is a major concern in schizophrenia, there is no data among rural community dwelling patients in India. This study describes prevalence and correlates of MS in a cohort of schizophrenia patients from a rural community of south India. 171 patients with schizophrenia were screened for the presence of MS using the International Diabetes Federation (IDF) criteria. 94.8% were receiving atypical antipsychotics for a mean (SD) duration of 13.04 (9.51) months. Fifty-four of the 171 (31.6%) patients screened met criterion for central obesity. Of these, laboratory results (fasting blood sugar, triglycerides and HDL cholesterol) were available for 47 patients. The rest 7 were deemed to have met the criteria for MS in order to avoid under-estimation of the syndrome. Only 22 (12.86%) patients met the criteria for MS thus defined. Females were significantly likely to have both central obesity and MS than males. No other predictors of metabolic adverse effects could be identified. Biological and the prevailing socio-cultural factors may contribute to such considerably low prevalence of metabolic abnormalities. Lack of data from a control group forms the most important limitation of this study.

PCV6 - Assessment of drug related problems (DRP) in prescriptions received by patients suffering from chronic diseases dwelling in a south indian rural community

PCV6 - Assessment of drug related problems (DRP) in prescriptions received by patients suffering from chronic diseases dwelling in a south indian rural community

Molecular Detection of Human Metapneumovirus and Human Bocavirus on Oropharyngeal Swabs Collected from Young Children with Acute Respiratory Tract Infections from Rural and Peri-Urban Communities in South India

BackgroundAcute respiratory tract infections (ARTIs) are one of the major causes of morbidity and mortality among young children in developing countries. Information on the incidence of human metapneumovirus (hMPV) and human bocavirus (HBoV) infections in developing countries, especially among rural children, is very limited.ObjectivesThis study was conducted to identify whether these viruses were associated with ARTI among children ≤5 years of age in rural and peri-urban populations in South India.MethodsThe study was cross-sectional with prospective sample collection. Oropharyngeal swabs were collected from children ≤5 years of age presenting with ARTI. None of the children in this study were known to have any immunosuppressive conditions. The two viruses, hMPV and HBoV, were identified using semi-nested polymerase chain reaction (PCR) assays and one-step PCR assays, respectively. The lower limits of detection of hMPV and HBoV were 6.69 × 105 plasmid copies and 5.77 × 103 plasmid copies, respectively, per 5 μL PCR reaction input.ResultsThe frequency of hMPV infection in children was higher than that of HBoV infection. The different frequencies of hMPV in patients in various age groups with upper and lower respiratory tract infections were compared, and the variance was found to be insignificant. In the 38 children who were hMPV positive, the majority (73.7 %) were from rural communities. The overall hMPV-positive rate was higher in the rural population than in the peri-urban population, but the difference was statistically insignificant. The youngest age at which hMPV-positive status was recorded was 5 months.ConclusionThis study demonstrated that hMPV was associated with a significant number (i.e. >10 %) of ARTIs in children in South India, whereas a relatively smaller number of HBoV infections was observed.

Adolescent suicide: characterizing the need and identifying the predictive factors for preventive consultation or hospitalization in a rural community setting

Studies from India consistently document the highest suicide rates in the world, and the majority of completed suicides had been within adolescents. To characterize the need and identify the predictive factors for preventive consultation or hospitalization for adolescent suicide in a community setting. We prospectively collected data from 500 adolescents in a rural South Indian community with independent, trained raters. The need for suicide prevention was measured with the SAD PERSONS scale, socio-economic status with the Modified Kuppusamy Scale, depression and anxiety disorders with the Beck Depression Inventory and the Screen for Child Anxiety Related Emotional Disorders, respectively. The relationship between predictors and the need for preventive action was analyzed with univariate and multivariate regression analyses and a predictive model was built. Of those investigated, 2% and 0.6% required emergency consultation and hospitalization, respectively. Males needed more preventive action (p=0.04). Age (OR=3.40, p=0.07), gender (OR=3.13, p=0.05), presence of anxiety (OR=16.35, p=0.001), or depressive (OR=42.59, p=0.001) disorder independently predicted a need for protective action and, together, contributed to a parsimonious predictive model. The majority of adolescents in the community do not require preventive steps to address suicide risk. These predictors could identify the high-risk adolescents for suicide prevention and reduce the burden of care in the community.

Surveillance of lymphatic filariasis after stopping ten years of mass drug administration in rural communities in south India

While various studies provided insight into the impact of mass drug administration (MDA), information on the dynamics of the post-MDA threshold level lymphatic filariasis (LF) infection facilitates understanding its disappearance pattern and determining the duration of post-MDA monitoring and evaluation. The changes in microfilaraemia (Mf) prevalence and vector infection rates were monitored for four (2005-2008) and six years (2005-2010) respectively after stopping ten rounds of annual mass diethylcarbamazine (DEC) administration in a group of five villages located in South India. Four years after stopping MDA, circulating filarial antigenaemia (Ag) status among children and adults was also assessed in two villages. Overall Mf prevalence (n = 700) and vector infection rates (n=803-3520) showed a declining trend. Two villages maintained zero Mf status in each of the four years, vector infection rate was zero from the third year onwards and Ag prevalence in adults was 0.4% (n = 226). In two other villages despite persistence of Mf and vector infection there was zero vector infectivity rate during the third to sixth year and Ag prevalence among children (n = 50) was nil. In the fifth village Mf prevailed at <1.0% and Ag prevalence among 1-7 year old children was 4.6% (n = 44) and vector infectivity rate during the sixth year was 0.1% (n = 852). The incidence of sporadic new infections is evident in highly endemic communities such as the fifth village. However, there is uncertainty on the potential of the Ag positive children to reestablish infection. Six years of post-MDA monitoring and evaluation appears to be adequate to discern the status of transmission interruption and appropriate decision making.

The Reformed Church in Africa’s Laudium Declaration. A gift to the ecumenical community

The author provides a brief overview of the history of the Reformed Church in Africa (RCA), a church that is rooted in the South African Indian community, from its birth in 1968 till the present day. He then proceeds to discuss the content and the impact of the Laudium Declaration, which was adopted at the synod of the RCA in 1990. The declaration was widely welcomed in the RCA, defining the evangelical character of the church. The reaction of other churches in the Dutch Reformed Church Family to the Laudium Declaration is discussed, together with an appraisal of the role that the declaration may play in the current unification process in the Dutch Reformed Family in South Africa. The article ends with a heartfelt prayer that the declaration will be accepted as a gift from God not only by the Reformed churches in South Africa, but by the wider ecumenical community.

PDB25 Evaluation of Health Care Cost of Diabetes Before and After Counseling in South Indian Community Setup

PDB25 Evaluation of Health Care Cost of Diabetes Before and After Counseling in South Indian Community Setup

Decoupling Religion and Ethnicity: Second-Generation Indian American Christians

Classic assimilation theory was based on the assumption of individualistic adaptation, with immigrants and their children expected to shed their ethnic identities to become Americans. In the sphere of religion, however, they could maintain their communitarian traditions through American denominations. In contemporary society, multiculturalism, spiritual seeking, and postdenominationalism have reversed this paradigm. First- and second-generation immigrants integrate by remaining ethnic and group-identified, but religion is viewed as a personal quest. This paper examines how this paradigm shift affects the ethnic and religious behavior of second-generation Americans. It is based on research among Malankara Syrian Christians belonging to an ancient South Indian community.

Sex Hormone-Binding Globulin and The Risk for Metabolic Syndrome in Children of South Asian Indian Origin

To determine whether the plasma level of sex hormone-binding globulin (SHBG) identifies South Asian Indian children at risk for metabolic syndrome. Adults and their children aged 5 to 9 years were recruited at the annual health fair at the Hindu temple serving the South Asian Indian community in Louisville, Kentucky. Anthropometric data were collected in adults and children, and blood pressure, lipid, and glucose levels were measured in adults. SHBG levels were measured in children using a fingerstick blood sample. In adults, metabolic syndrome was diagnosed according to the International Diabetes Federation criteria. Twelve months later, follow-up anthropometric data were obtained for a portion of the children. The study included 30 sets of parents and 30 children. The prevalence of metabolic syndrome among 310 adults attending the health fair was 42% in men and 39% in women. Children with 1 parent with metabolic syndrome had 24% lower SHBG levels that increased to 55% if both parents had metabolic syndrome. SHBG levels were inversely related to waist circumference and to body mass index percentile. Both SHBG and waist circumference predicted weight gain over 1 year in children. CONCLUSIONS Low SHBG levels were found in South Asian Indian children whose parents had attributes of metabolic syndrome. The dose dependency of SHBG is consistent with inheritance of a genetic trait, and if the results are applicable to other racial/ethnic groups, SHBG may be a useful marker to identify at-risk children for early intervention.

Changes in knowledge and practices related to taeniasis/cysticercosis after health education in a south Indian community

A health education programme for taeniasis/cysticercosis was implemented and evaluated among schoolchildren and the general community in a rural block in southern India, an area that is endemic for cysticercosis. The baseline survey among 831 participants from three randomly selected villages showed poor knowledge regarding the spread of taeniasis and neurocysticercosis. There was also a lack of adequate hygiene and sanitation practices. Health education was given in these villages and in the schools located in these villages regarding the lifecycle of the pork tapeworm, spread of taeniasis and cysticercosis, and prevention of these conditions. The post-intervention test conducted 6 months later among 1060 participants revealed a 46% increase in the overall score of knowledge and practices. Awareness about the mode of spread of taeniasis and cysticercosis improved by almost 3 times and the reported practice of washing hands with soap and water before eating improved by 4.8 times and after using the toilet by 3.6 times. One person who reported the passage of tapeworm segments was confirmed to be a carrier of Taenia solium and was treated. The health education given on prevention of taeniasis and cysticercosis was useful in improving the knowledge and practices of the community and also in diagnosing taeniasis through self-reporting.

Desires under reform: Contemporary reconfigurations of family, marriage, love and gendering in a transnational south Indian matrilineal Muslim community

I trace here some connections between contemporary reconfigurations of gendering, family and marriage in a matrilineal Muslim south Indian community (Kerala Koyas). I argue that shifts from joint matrifocal households to small neo-patriarchal households are underscored by market reforms, migration processes, Islamic reformism and by modernist processes which work towards purging queer forms of affect and gender in favour of impeccably gendered heterosexual subjectivities. I also note considerable ambivalence and tension within these moves, and argue against any teleological mappings of such moves that would – first – take for granted and – then – celebrate a shift from Indian ‘arranged marriage’ towards a ‘pure relationship’, founded on romantic and passionate love. In thus article, I present recent academic discussions of Western marriage, Indian middle-class and Indian subaltern marriages, and conclude that many commonly drawn oppositions (‘love’ versus ‘arranged’, ‘companionate’ versus ‘ economic-pragmatic’, ‘till death do us part’ versus ‘easy divorce’) are representational fictions requiring sharp critique. I also address the question of moral panic around female-centred households and proffer feminist and queer critiques. Finally, I build upon work by Saba Mahmood and others who are urging Western academics to examine their own production as liberal subjects.

PCV45 Evaluation of Health Care Cost of Diabetes in South Indian Community Setup

USD$2679 and major bleeding was USD$5564. Similar estimations were found for knee replacement events. CONCLUSIONS: The occurrence of VTE events related to orthopedic surgery can significantly impact the costs of surgery, particularly given that in Argentina the cost of hip replacement was estimated as USD $1959 and the cost of knee replacement as USD $1193. One must therefore consider treatments given for VTE prevention, as these therapies not only impact survival and quality of life but can also substantially impact the efficient use of health care resources.

Alcohol consumption patterns and sexual risk behavior among female sex workers in two South Indian communities

BackgroundHIV transmission in India is primarily heterosexual and there is a concentrated HIV epidemic among female sex workers (FSWs). Earlier reports demonstrate that many FSWs consume alcohol regularly before sexual encounters. This qualitative study is part of a larger quantitative study designed to assess alcohol consumption patterns among female sex workers and their association with sexual risk taking. Here we investigate the environmental influence, reasons for and consequences of consuming alcohol in the FSW population. MethodsTrained staff from two Non-Governmental Organizations in Andhra Pradesh and Kerala conducted semi-structured interviews with 63 FSWs in Chirala, Andhra Pradesh (n=35) and Calicut, Kerala (n=28) following extensive formative research, including social mapping and key informant interviews, to assess drinking patterns and sexual risk behaviors. ResultsFSWs reported consuming alcohol in multiple contexts: sexual, social, mental health and self-medication. Alcohol consumption during sexual encounters with clients was usually forced, but some women drank voluntarily. Social drinking took place in public locations such as bars and in private locations including deserted buildings, roads and inside autorickshaws (motorcycle taxis). Consequences of alcohol consumption included failure to use condoms and to collect payments from clients, violence, legal problems, gastrointestinal side effects, economic loss and interference with family responsibilities. ConclusionFSWs consume alcohol in multilevel contexts. Alcohol consumption during transactional sex is often forced and can lead to failure to use condoms. Social drinkers consume alcohol with other trusted FSWs for entertainment and to help cope with psychosocial stressors. There are multiple reasons for and consequences of alcohol consumption in this population and future interventions should target each specific aspect of alcohol use.

Social learning across the life cycle: cultural knowledge acquisition for honey collection among the Jenu Kuruba, India

Accounting for age-dependent patterns of knowledge transmission is critical for understanding cultural evolution in age-structured populations. Cultural evolution theory predicts which social learning biases we expect people to use, but much less often when—during a person's life cycle— different social learning biases will be used. By measuring knowledge and skill variation among age cohorts, it is possible to infer how people socially acquire different types of knowledge at different ages. We use this strategy among the Jenu Kuruba, a tribal community in South India. We document the accumulation of local knowledge required for collecting wild honey among 71 children and 125 adults from five communities. Combining quantitative measurements of knowledge with measures of four honey-collecting skills and self-reported data on learning age, we infer patterns of social learning across the lifecycle. We find that (1) most knowledge related to honey collecting is acquired by the early 20s, and later social learning mainly functions to update information; (2) the eldest cohort has the highest average explicit knowledge, although the most knowledgeable or skilled individuals do not always belong to the most elderly cohort; (3) length of learning can be affected by age-dependent trade-offs of costs and benefits to learners; and (4) children tend to learn from parents, but individuals use other demonstrators later in life. These results have implications for current models of cultural evolution.

Work functioning of schizophrenia patients in a rural south Indian community: status at 4-year follow-up

This report describes the work functioning of schizophrenia patients receiving antipsychotic treatment in a rural south Indian community and examines the factors associated with it. We assessed work functioning of 201 patients who have completed a minimum of 3 years of follow-up as part of a cohort study of schizophrenia patients receiving community-based treatment. 'Work' section of the Indian disability evaluation and assessment scale (IDEAS) was used to evaluate work-related disability at the time of recruitment and after a mean (SD) 47.0 (9.6) months of follow-up. Patients with moderate to profound work-related disability were compared with those with no or mild disability across socio-demographic and clinical variables. 75 (37.3 %) were agriculturists; 58 (28.9 %) were pursuing household jobs; 28 (13.9 %) were daily wage labourers; 7 (3.5 %) were skilled labourers; 7 (3.5 %) were involved in other jobs. 26 (12.9 %) were not doing any sort of work. The proportion of patients with moderate or profound disability reduced from 137/201 (68.2 %) at baseline to 82/201 (40.8 %) at follow-up (p < 0.001). Work-related disability reduced significantly [mean (SD) work score on IDEAS was 2.2 (1.6) at baseline and 1.1 (1.2) at follow-up; t = -9.1; p < 0.001]. Logistic regression analysis showed that work-related disability was significantly associated with male gender, longer duration of illness, higher psychopathology and poor treatment adherence. Nearly two-thirds of schizophrenia patients living in this rural south Indian community had satisfactory work functioning, a rate, which is substantially higher than rates reported from high-income countries. Agrarian work atmosphere and rural sociocultural milieu may have contributed to this in our sample. However, substantial proportion of patients remains considerably disabled. This highlights the need for concerted, community-level efforts to improve their functioning.

The suicide niche: Accounting for self-harm in a South Indian leprosy colony

This article analyses the circumstances under which attempted suicide became an increasingly common possibility of thought and action among the young, healthy generation of people who had grown up in the South Indian leprosy community where I conducted long-term fieldwork, despite suicide remaining relatively uncommon amongst their leprosy-affected, and often physically disabled, parents and grandparents. Alert to the pitfalls of analytical approaches that either privilege over-arching structural explanations—like those favoured by Durkheim—or, conversely, give too much credence to individual agency and psychology, my analysis here attempts to chart a course through these polarities. It does so by drawing both on Ian Hacking’s ‘ecological niche’ metaphor—to explore how particular configurations of events and circumstances, at different times, might render suicide related behaviour more or less likely among different groups; and on Pierre Bourdieu’s notion of the ‘habitus’—to consider how particular sets of bodily dispositions might generate certain styles of attempted suicide and self-harm.

Prevalence of uncorrected refractive errors, presbyopia and spectacle coverage in marine fishing communities in South India: Rapid Assessment of Visual Impairment (RAVI) project

To investigate the prevalence of uncorrected refractive errors, presbyopia and spectacle coverage in subjects aged 40 years or more using a novel Rapid Assessment of Visual Impairment (RAVI) methodology. A population-based cross-sectional study was conducted using cluster random sampling to enumerate 1700 subjects from 34 clusters predominantly inhabited by marine fishing communities in the Prakasam district of Andhra Pradesh, India. Unaided, aided and pinhole visual acuity (VA) was assessed using a Snellen chart at a distance of 6 m. Near vision was assessed using an N notation chart. Uncorrected refractive error was defined as presenting VA < 6/18 and improving to ≥6/18 with pinhole. Uncorrected presbyopia was defined as binocular near vision worse than N8 in subjects with binocular distance VA ≥ 6/18. 1560 subjects (response rate - 92%) were available for examination. Of these, 54.6% were female and 10.1% were ≥70 years of age. Refractive error was present in 250 individuals. It was uncorrected in 179 (unmet need) and corrected in 71 (met need) individuals. Among 1094 individuals with no distance visual impairment, presbyopia was present in 494 individuals. It was uncorrected in 439 (unmet need) and corrected in 55 individuals (met need). Spectacle coverage was 28.4% for refractive errors and 11.1% for presbyopia. There is a high unmet need for uncorrected refractive errors and presbyopia among marine fishing communities in the Prakasam district of South India. The data from this study can now be used as a baseline prior to the commencement of eye care services in this region.

Dalit Christians in India: Reflections from the ‘Broken Middle’

The focus of this article is on Dalit Christian experience in India. It strives to understand the milieu and framework of religious expression within the Dalit Christian community in South India. This article consists of three sections. Firstly, it develops a comprehensive perception of what it means to be a Dalit and a Christian simultaneously; the notion of multiple belonging in practice. Secondly, it weaves the lived reality of Dalit Christians by using Gillian Rose's socio-philosophical concept of ‘the broken middle’. Thirdly, through the paradigm of the ‘broken middle’, this article furthers certain facets of a locally relevant church. In brief, by drawing upon fieldwork from various Dalit communities in South India, this article gives a perspective and a glimpse into the wider Christian experience, in order to elucidate a contextually appropriate theological framework and the need for a locally relevant church.

A Qualitative Inquiry into the Application of Verbal Autopsy for a Mortality Surveillance System in a Rural Community of Southern India

The aim of this investigation was to identify operational and ethical issues encountered in the application of verbal autopsy (VA) in a rural community in south India. A qualitative study involving semi-structured interviews was conducted with 183 bereaved caregivers in rural Andhra Pradesh, India. Simple descriptive analysis was undertaken. Only 16% of adult deaths and 27% of child deaths occurred in healthcare settings. Healthcare utilization for the terminal illness was reported in two thirds of medical (non-injury) causes of death. Supporting medical evidence was available in <10% of cases to supplement the interpretation of verbal autopsies. About 14% of bereaved caregivers refused to give written consent but provided oral consent. Additional ethical concerns included inability to ensure privacy in 15% of interviews and unsolicited information from unauthorized neighbours in 5% of cases. Such methodological, logistical and ethical issues operate to impact on the quality of VAs. Consideration of these issues would strengthen ongoing efforts in the harmonization of VA procedures.