State In Central India Research Articles

First comprehensive study on neonatal septicaemia at secondary-level public health-care facilities in Central India: An eye opener

Background: In India secondary-level public health-care facilities (HCF)-District Hospitals, are not equipped either with a microbiological laboratory or a robust Infection control program. The present study was initiated to investigate the epidemiology of neonatal septicaemia in SNCUs (Special new-born care units) situated at various District Hospitals of Chhattisgarh (a state in Central India) in terms of Blood Stream Infection (BSI) rates, pathogen profile and their antimicrobial sensitivity patterns. Methods & Materials: The study was conducted from October 2017 through June 2019 at the Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Raipur, a tertiary level healthcare teaching institute in collaboration with 23 SNCUs. Paired blood samples (0.5–1.0 ml) were collected in paediatric aerobic blood culture bottles (BacT/ALERT PF Plus, BioMerieux Inc. Durham, NC, USA) and transported to the laboratory, where culture and identification was performed by automated ID and AST system (Vitek 2 ID/AST system, BioMerieux Inc. Durham, USA) and by manual methods using standard laboratory protocol. Results: Paired blood cultures were received from 2843 neonates; out of which 1645 (58%) were sterile, 388 (13.6%) grew contaminants and 810 grew pathogens, indicating BSI rate of 28.4%. Gram negative bacilli were the most commonly encountered pathogens (382/810, 47.2%), with more than half being multi drug resistant (211/382, 55.2%). Klebsiella pneumoniae was the commonest isolate (n = 253). Amongst the gram- positive cocci (253/810, 31.2%) coagulase negative staphylococcus (CoNS) was commonest. Only 17 (6.7%) Methicillin Resistant Staphylococcus aureus and one Streptococcus agalactiae were isolated. Candida spp. accounted for 21.6% (175/810) pathogen, predominated by non-albicans candida (161/175). 18% of the Candida spp. were resistant to Fluconazole, while 1.2% were MDR. A fall in NMR (neonatal mortality rate) and antibiotic usage rate was observed in almost all the units after the microbiology laboratory support was initiated. Conclusion: The secondary-level public health-care facilities have a very high rate of laboratory proven neonatal septicemia with an alarmingly high AMR (Antimicrobial resistance) rate, both among bacterial and fungal isolates. This warrants urgent intervention for reducing neonatal septicaemia by microbiology laboratory support, optimising infection control practices and implementing AMSP (antimicrobial stewardship program).

Universal Salt Iodinization is not that Universal - A study among school age children in Mandla District, Madhya Pradesh.

Background: Iodine deficiency is a preventable cause of brain damage. Aims &Objectives: The present study was conducted to determine the prevalence of goiter in school going children clinically, to assess the iodine status (urinary iodine excretion) of school children, and to assess the iodine content of the salt consumed by the population. Materials and Methods: It is school based cross-sectional study, conducted in Mandla district of Madhya Pradesh state in central India in 2016. The study participants were school children in 6-12 years of age. Probability-proportional-to-size cluster sampling was used. Palpation method was used to identify the presence of goiter. Urine samples were collected and median urinary iodine excretion was found. The salt samples were also collected from the households and local market to determine the iodinization status. Results: A total of 2700 school children were studied. The total goitre rate was 0.74%. Among those clinically palpable goiter 15(75%) were girls. The prevalence of goitre higher among girls was statically significant with p=0.025. All the cases of clinically palpable goiter belonged to caste other than general with p<0.001. The median urinary iodine excretion of 270 urine samples of school children was 184 µg/l. The prevalence of iodine deficiency disorders using urinary iodine excretion as indicator in the present study was 22.9% Seven percent of the samples had median urinary iodine The normal iodine content i.e more than the 15 ppm iodine was present in 84% of samples collected from households. Conclusion: The children of Mandla district of Madhya Pradesh had low prevalence of goiter. However, there is significant burden of goiter among backward classes.

Assessing the water spread area available for fish culture and fish production potential in inland lentic waterbodies using remote sensing: A case study from Chhattisgarh State, India

Inland lentic waterbodies have a major role in contributing to nutritional and livelihood security of the rural poor in India. Generating a spatio-temporal resource inventory of the small waterbodies has immense potential in evidence-based fisheries development planning, so as to enhance the fish production (quantity) and productivity (quantity per unit area). The present study provides a framework for mapping these waterbodies using high resolution Cartosat 1 PAN and IRS ResourceSAT LISS IV merged imagery, determining the spatio-temporal water spread area and effective water spread area available for fish culture using Sentinel 2 Multi Spectral Imagery, for the years 2016–18. It provides an approach for determining the number of fingerlings required and estimating the production potential under standard production parameters, based on the extent of water available for fish culture in the waterbodies. The framework was piloted in Chhattisgarh, a landlocked State in Central India, which has a large number of inland waterbodies. A total of 121,529 waterbodies, with an area of 202,016 ha were mapped, of which 97% had an extent less than 5 ha. The total extent of waterbodies was 37% higher than the most recent estimate by Government of India. Availability of water in the waterbodies of the state, for a duration of at least 8 and 11 months in a year, was found to be 74% (149,484 ha) and 50% (102,167 ha) respectively, which indicates the vast scope for promotion of intensive aquaculture in the state. Minimum number of fingerlings required for stocking the available water was estimated as 403 million. This framework can be replicated across the country and other regions with poor in-situ data, for effective management of inland waterbodies through location-specific data-driven intervention planning.

The impact of drought on human capital in rural India

AbstractWe study the impact of a severe drought on children's educational outcomes in rural Maharashtra, a state in central India. Using pooled cross section data on children's test scores, we employ a difference-in-differences methodology to estimate the impact. We find that the drought caused a decline of 4.14 per cent in math scores and 2.67 per cent in reading scores of affected children. We also study heterogeneity in the impact by gender, age, parents' schooling, and household wealth, finding evidence in support of an income effect whereby households with limited means to smooth consumption disinvest in their children in response to the drought.

Trend analysis of rainfall pattern over the Central India during 1901–2010

In the present study, trends of rainfall of the Central India were evaluated in monthly, seasonal, and annual time scales using the Revised Mann-Kendall (RMK) test, Sen’s slope estimator, and innovative trend method (ITM). For this purpose, the monthly rainfall data for 20 stations in Madhya Pradesh (MP) and Chhattisgarh (CG) states in Central India during 1901–2010 was used. The Sen’s slope estimator was utilized for calculating the slope of rainfall trend line. Based on the obtained results of RMK test, there is no significant trend in the stations for the January and October months. The results also showed that for MP, two out of 15 considered stations indicate significant annual trend, while the CG has four out of five stations with significant trend. The results of applying ITM test indicated that most of the stations have decreasing trends in annual (16 stations), summer (16 stations), and monsoon (11 stations) seasons, while the winter (12 stations) and post monsoon (11 stations) seasons generally show increasing trend. Unlike the RMK, the ITM shows significant increasing trend in rainfall of November and December months. The finding of current study can be used for irrigation and water resource management purpose over the Central India.

In the Realm of the Diamond King: Myth, Magic, and Modernity in the Diamond Tracts of Central India

From being “the cradle” of raw diamonds in the world in the eighteenth century, India has turned into an insignificant producer of rough diamonds today. Yet, even now, the indigenous Gonds mine diamonds artisanally in a remote location in central India, largely hidden away from public vision. This article presents an exposition of artisanal diamond mining in central India from the humanistic tradition in geography to illuminate the “realm” of the Gonds, where magic and social relations rule imaginaries of the diamonds in the particular place. It argues that the imaginations of diamonds and their mining by indigenous miners in Panna are shaped through the prism of their particular regional history, myth, geography, and culture. Without faith in the restrictive authority of science, capital, and state, and refusing domestication, the miners dig, smuggle, and spend for the savoir vivre. They remain dynamic and rely on traditional ideas of luck, masculinity, and success. They bind themselves to work and to each other in ways that preclude the possibility of amassing wealth and direct wealth in ways that reaffirm their dependence on the miner's life. The argument is illustrated through the story of protagonist Ramu, who proudly spends the earnings from his big diamond find. Based on ethnographic fieldwork in Panna, Madhya Pradesh State in central India, this article explores the magic of artisanal diamond mining, shows how place shapes such mining, and shows how informal mining shapes the context.

Prevalence of Transfusion Transmitted Infections among Blood Donors in Madhya Pradesh, a Central State of India

Prevalence of Transfusion Transmitted Infections among Blood Donors in Madhya Pradesh, a Central State of India

Voluntary Blood Donation in a Central State of India; Madhya Pradesh

Voluntary Blood Donation in a Central State of India; Madhya Pradesh

A Diagnosis of Biophysical and Socio-Economic Factors Influencing Farmers' Choice to Adopt Organic or Conventional Farming Systems for Cotton Production.

Organic agriculture is one of the most widely known alternative production systems advocated for its benefits to soil, environment, health and economic well-being of farming communities. Rapid increase in the market demand for organic products presents a remarkable opportunity for expansion of organic agriculture. A thorough understanding of the context specific motivations of farmers for adoption of organic farming systems is important so that appropriate policy measures are put in place. With an aim of understanding the social and biophysical motivations of organic and conventional cotton farmers for following their respective farming practices, a detailed farm survey was conducted in Nimar valley of Madhya Pradesh state in central India. The study area was chosen for being an important region for cotton production, where established organic and conventional farms operate under comparable circumstances. We found considerable variation among organic and conventional farmers for their social and biophysical motivations. Organic farmers were motivated by the sustainability of cotton production and growing safer food without pesticides, whereas conventional farmers were sensitive about their reputation in community. Organic farmers with larger holdings were more concerned about closed nutrient cycles and reducing their dependence on external inputs, whereas medium and small holding organic farmers were clearly motivated by the premium price of organic cotton. Higher productivity was the only important motivation for conventional farmers with larger land holdings. We also found considerable yield gaps among different farms, both under conventional and organic management, that need to be addressed through extension and training. Our findings suggest that research and policy measures need to be directed toward strengthening of extension services, local capacity building, enhancing availability of suitable inputs and market access for organic farmers.

A Qualitative Study on Maternal and Child Health Practices among Baiga Tribe of Madhya Pradesh State in Central India

Introduction: Health improvement for the tribal and their delivery system cannot be the same because of cultural pattern, lifestyle and health seeking behavior of tribal population. Maternal and child health care practices observed to be poor among particularly vulnerable tribal groups (PVTGs) in India. Methods: Focus Group Discussions (FDS) were conducted among ever married women aged 15-49 years. Areas explored included disclosure of pregnancy status, access barriers, perceptions about existing maternal and child health (MCH) services and influencing factors for utilization of traditional health care facilities. Content and thematic analysis was used to identify common responses and ideas. Results: Twelve FDGs were undertaken by trained investigators one in each village. Participants were identified through the Accredited Social Health Activists (ASHAs) residing in the same village. It was observed that few women are disclosing their pregnancy status to their family members after first trimester; women have many wrong perceptions about safe delivery and abortions. Due to lack of transport facilities and poverty they felt seeking health care was difficult and costly. Conclusion: This study demonstrates that Baiga is one of the PVTGs residing in dense forest in central India have low awareness and underutilization of MCH services. Key words: Particularly Vulnerable Tribal Groups, Tribal Population, Indigenous Health System, Maternal and Child Health, Rural Practice, Forest and Interior, Remote Area

Household Catastrophic Health Expenditure Due To Tuberculosis: Analysis From Particularly Vulnerable Tribal Group, Central India

Tuberculosis (TB) is disproportionately affects the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be catastrophic health expenditure for TB affected households in particularly vulnerable tribal groups (PVTGs). A survey of pulmonary tuberculosis (PTB) was carried out in Saharia dominated Pohri block of Shivpuri district of Madhya Pradesh state in central India during the period 2013 to 2014. Of 9964 surveyed, 280 PTB cases identified formed the study population for the present study. Among 280 TB patients identified, 220 (79%) cases interviewed at their residence by trained field investigators after obtaining written informed consent. This study demonstrates the economic burden in terms of direct, indirect and total costs for both diagnosis and treatment. In our sample, majority getting treatment free of costs and those who incurred costs, they faced catastrophic TB care expenditure amounted to 10%, which is the proportion of various costs in relation to annual family income. TB is a major cause of impoverishment, as it puts a heavy burden on the family budget, which can force families to absolute poverty. Our results suggest that policies to decrease direct and indirect TB patient costs are urgently needed to prevent chances of catastrophic payments to PVTGs. Also a high priority should be given to research that focuses on economic effects in different kind, in different time, in particular, among low-income

Women's Knowledge, Attitudes, and Practices about Breast Cancer in a Rural District of Central India.

Breast cancer accounted for almost 25% of all cancers in women globally in 2012. Although breast cancer is the most prevalent cancer in India, there is no organised national breast cancer screening programme. Local studies on the burden of breast cancer are essential to develop effective context-specific strategies for an early detection breast cancer programme, considering the cultural and ethnic heterogeneity in India. This study examined the knowledge, attitudes, and practices about breast cancer in rural women in Central India. This community-based cross sectional study was conducted in Wardha district, located in Maharashtra state in Central India in 2013. The sample included 1000 women (609 rural, 391 urban) aged 13-50 years, selected as representative from each of the eight development blocks in the district, using stratified cluster sampling. Trained social workers interviewed women and collected demographic and socio-economic data. The instrument also assessed respondents' knowledge about breast cancer and its symptoms, risks, methods of screening, diagnosis and treatment, as well as their attitudes towards breast cancer and self- reported practices of breast cancer screening. Chi-square and t-test were applied to assess differences in the levels of knowledge, attitude, and practice (the outcome variables) between urban and rural respondents. Multivariable linear regression was conducted to analyse the relationship between socio-demographic factors and the outcome variables. While about two-thirds of rural and urban women were aware of breast cancer, less than 7% in rural and urban areas had heard about breast self-examination. Knowledge about breast cancer, its symptoms, risk factors, diagnostic modalities, and treatment was similarly poor in both rural and urban women. Urban women demonstrated more positive attitudes towards breast cancer screening practices than their rural counterparts. Better knowledge of breast cancer symptoms, risk factors, diagnosis, and treatment correlated significantly with older age, higher levels of education, and being office workers or in business. Women in rural Central India have poor knowledge about breast cancer, its symptoms and risk factors. Breast self-examination is hardly practiced, though the willingness to learn is high. Positive attitudes towards screening provide an opportunity to promote breast self-examination.

Assessment of heavy metal concentrations in surface water sources in an industrial region of central India

Rapid industrialisation and resulting industrial solid waste from power plants and integrated iron and steel industries, have imposed an enormous environmental pressure on water resources of Chhattisgarh, a state in Central India. Rural population living nearby the study area is mainly depended on the available surface water in the form of lakes or pond in their vicinity. Therefore it is necessary to look after the surface water through leachate pollution caused by dumping and disposal of industrial solid waste. In the present study, ten surface water samples each for pre monsoon and post monsoon were collected for analysis from the surrounding areas of a major industrial region of Chhattisgarh. The AAS analysis of the surface water samples shows higher concentration of certain heavy metals above the permissible limits. In the pre monsoon samples the metals Mn and Cr resulted higher concentration and at the same time metals; Cu, Fe and Pb resulted in lower concentrations. Similarly, for the post monsoon samples, Mn, Cr and Fe found with higher concentration, while Cu and Pb resulted with lower concentration. The high amount of heavy metals were found in the analyzed samples shows that there is a real risk for population living in the nearby areas of the industrial region of Chhattisgarh. Therefore a huge amount of industrial wastes produced needs a proper disposal. Unscientific and poorly-managed disposal of industrial solid wastes containing heavy metals needs remediation before discharging into the environment.

Latent TB Detection and Isolation of MDR TB Bacteria in, MP, India

Aim: Tuberculosis which is an infectious disease caused by M. tuberculosis causing pulmonary and extra pulmonary tuberculosis in clinical suspects in Indore and region around central state of India by IGRA methods. In India, TB which is declared to be ‘notifiable disease of the nation’ by the RNTCP since 2012. We wanted to analyze present state of existence of the same in our city Indore and region around. We wanted to study the present strata of IGRA detected in population of Indore in MP correlating with the Mycobacterium isolates in our laboratory, though the protocol of DOTS have been followed in the country. Experimental design: In present study, we tested clinical suspects using microbiology biology cultivation method and ELISA method for IGRA in Indore for Mycobacterium tuberculosis in the clinical suspects in our Indore lab, MP, India. Place and duration: The study was one in Central lab-Oncquest India Ltd. in Indore between period 2012 to 2014. Methodologies: The present study included 135 patients, including 49 male, and 86 female patients. We used developed TB-TMA method (Oncquest, Ltd.) to detect infection of clinical suspects and utilized culture susceptibility test to detect drug resistance in infecting Mycobacterium causing tuberculosis, tested at Central lab-Oncquest ltd. in India using microbiological methods. The method of drug resistance in Mycobacteria was performed using microbiology methods of drug resistance as described by Songara P, 2015. Results: We found 53% samples to be positive from male group compared to 29% from female group of patients. We could isolate Mycobacterium sp from various clinical suspects using basic microbiology and cultivation methods. Were found 41.6% Mycobacterium to be sensitive to sensitive to INH 36.65 to RIF, 23.3 to PYRA, 305 to ETHM, 25% to STREPTO isolated from various samples from clinical suspects. Conclusion: We were able to detect M. tuberculosis and determine their drug resistance in Mycobacterium method by MDR sure method.

Sociobehavioral correlates of HIV risk among men who have sex with men in Chhattisgarh, India: analysis of sentinel surveillance data.

Men who have sex with men (MSM) in India are mostly hidden due to stigma and discrimination and are at a higher risk of acquiring human immunodeficiency virus (HIV). HIV Sentinel Surveillance (HSS) reported an increased HIV burden in Chhattisgarh, an important state in central India. This state has the distinction of having the highest HIV prevalence among MSM in India; therefore, it warrants special attention; hence, we focused on the role of MSM in the HIV epidemic in this state. Cross-sectional analysis of the most recent latest (2010-2011) HSS data of 227 MSM in Chhattisgarh revealed a HIV seropositivity of 14.98%. Older age, unemployment, and receiving money for sex with a man were associated with a higher HIV risk. Participants were mostly young (mean age, approximately 26 years), school-level educated (51.98%), urban residents (99.56%), in service (46.26%), not involved in heterosexual activity (97.36%), or paid sex (68.72%). None of the participants reported injection drug use, and almost all of them (98.68%) were kothis. Some of the observed associations lacked statistical power due to sparse data obtained during this initial surveillance among MSM in Chhattisgarh. Therefore, further studies involving a larger population are needed to understand the role of MSM in the dynamics of the HIV epidemic in this state to facilitate the planning of appropriate interventions, as the epidemic is likely to be concentrated among MSM in Chhattisgarh.

Pilot project in rural western Madhya Pradesh, India, to assess the feasibility of using LED and solar-powered lanterns to remove kerosene lamps and related hazards from homes

BackgroundGlobally, 300,000 deaths are estimated to occur annually and the incidence is far greater as a large majority of burns are small and go unreported. Ninety-five percent of the global burden of burns is found in low- and middle-income countries; however, there is relatively little in the literature regarding effective primary prevention in these areas. Flame is the most common cause of burn in Madhya Pradesh, the central state of India. The most common demographic among the burn unit inpatient of Choithram hospital Indore, is young women from 21 to 40 years of age, whose burns are primarily caused by kerosene lamps. A non electrical source of illumination is essential for every household in rural areas due to the infrequent and poor power supply. At the baseline, 23 kerosene lamp burns were reported by villagers in the past 5 years among the study population of this pilot project. MethodA pilot project to investigate the strategies for reducing the incidence of domestic burns in rural villages around the city of Indore was performed, by replacing kerosene lamps with safer and more sustainable alternatives, including solar-powered and light-emitting diode (LED) lamps. A total of 1042 households were randomly chosen from 18 villages within the Malwa region of Madhya Pradesh (population of 28,825) to receive the alternative light source (670 LED and 372 solar lamps). We investigated the efficacy of this strategy of reducing the incidence of burns, measured the social acceptance by villagers, and quantified the cost implications and availability of LED lamps in rural communities with a high incidence of burns. ResultsReplacing kerosene lamps with LED and solar alternatives was deemed socially acceptable by 99.34% of the participants and reduced the cost of lighting for impoverished rural villagers by 85% over 1 year. We successfully demonstrated a significant decrease in the use of kerosene lamps (p<0.01). More evidence is required to investigate the efficacy of this strategy in reducing burns. ConclusionThis pilot study highlights the viability of the approach of replacing kerosene lamps as an effective primary prevention strategy for reducing burns in rural areas. However, barriers remain to the wider adoption of these lamps, including accessibility and availability for the populations of rural India.

Diversity of Endophytic Fungi in Tropical Semi-evergreen Forests Trees of Chhattisgarh

Endophytic fungi grow asymptomatically within the living plant tissues such as leaves and stem. Chhattisgarh state in central India is well recognized for maximum area of Sal forests (Shorea robusta) along with some of the members of family Combretaceae viz. Terminalia arjuna, T. chebula, and T. bellerica. The state is also known for maximum varieties of tree species most of which are of pharmaceutical importance. In the present study the above mentioned tree species were screened for the presence of endophytic fungi. The samples were collected from the Achanakmar–Amarkantak Biosphere Reserve in the winter, summer and rainy season. The seasonal occurrence and distribution of endophytic fungi were recorded. Species belonging to Aspergillus, Fusarium, Pestalotia, etc. were common for all the tree species and some species such as Acremonium, Cladosporium and Dendrophoma were specific. Despite the specificity of tree plants, the study reveals importance of the geographical and seasonal factors with respect to the presence or absence of endophytic fungi.

Sickle haemoglobin comes of age.

Sickle haemoglobin comes of age.

An interdisciplinary parallel methodological approach for the diagnosis of tuberculosis in the Central state of India

Early and accurate diagnosis of tuberculosis is extremely important for its control. The classical staining and microbiological methods lack in accuracy and speed respectively. On the other hand, the accurate and faster advanced nucleic acid amplification (NAA) methods have their own limitations and the results need to be interpreted with much caution for therapy. To balance the requirements of accuracy and speed for aiding early and correct drug prescription to the patients, we used a combined classical and molecular biological approach. Using this approach, 244 pulmonary and extra-pulmonary clinical samples from tuberculosis suspects from the Central state of India were tested for the presence of M. tuberculosis. Of these, 84 samples were finally confirmed positive for M. tuberculosis. Most positive samples were from clinical suspects in the age group of 20-24 and 35-39. Analysis of the positive samples showed that the peak at 20-24 was dominated by male while 35-39 was dominated by female gender. We also found gender based difference in the proportion of some of the different type of positive samples. We present here, the status of tuberculosis infection in Central state of India in 2012-2014 tested in our lab.

Reaching the poor with adequately iodized salt through the Supplementary Nutrition Programme and Midday Meal Scheme in Madhya Pradesh, India

In India, adequately iodized salt needs to be made accessible to the most marginalized. In an effort to provide adequately iodized salt to the most vulnerable, in 2009 Madhya Pradesh launched a state-wide initiative through two national flagship nutrition programmes: the Supplementary Nutrition Programme of the Integrated Child Development Services and the Midday Meal Scheme. Programme staff members were taught how to correctly store salt and monitor its iodine content. Field monitors assessed the iodine content of the salt in the common kitchens of participating schools and anganwadi centres monthly. Madhya Pradesh, a state in central India, is home to a substantial proportion of India's poor. In 2009, household coverage of adequately iodized salt in the state was nearly 90% among the richest but only about 50% among the poorest. Two hot meals prepared with adequately iodized salt were served daily for more than 21 days per month to approximately 89% of the 12,113,584 children aged 3 to 6 years enrolled in anganwadi centres (June 2011 to March 2012). One meal on school days was served to 78% of 5,751,979 primary-school children and to 79% of 2,704,692 secondary-school children (April 2011 to March 2012). Most of the kitchens visited in 2010 (79%) and 2011 (83%) were consistently using adequately iodized salt to prepare hot meals. India has large-scale social safety net programmes for the poorest. Both national and state policies should mainstream the use of adequately iodized salt in these programmes.