Prevalence and causes of blindness and visual impairment and their associated risk factors, in three tribal areas of Andhra Pradesh, India.
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SUBMITTER: Singh N
PROVIDER: S-EPMC4090120 | biostudies-other | 2014
REPOSITORIES: biostudies-other
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Project description:PurposeTo report visual outcomes and risk factors for poor outcomes of cataract surgery in three Integrated Tribal Development Agency (ITDA) areas of Andhra Pradesh, India.Methods and resultsUsing validated Rapid Assessment of Avoidable Blindness (RAAB) methodology, a population based cross-sectional study, was conducted in three ITDA areas. A two-stage sampling procedure was used to select 7281 participants aged 50 years and above. Vision assessment using a tumbling E chart and standard ocular examinations were completed. Visual outcomes and risk factors for poor outcomes were assessed among subjects undergoing cataract surgery (1548 eyes of 1124 subjects). Mean age at surgery was 67±8 years; Among the operated eyes, presenting visual acuity (PVA) and best corrected visual acuity (BCVA) worse than 6/18 was seen in 492 (31.8%; 95% CI, 29.5-34.2%) and 298 eyes (19.3%; 95% CI, 17.3-21.3%), respectively. Similarly, PVA and BCVA worse than 6/60 was seen in 219 (14.1%; 95% CI, 12.4-16%) and 147 eyes (9.5%; 95% CI, 8.1-11.1%), respectively. When either eye was taken into consideration, the PVA and BCVA worse than 6/18 was seen in 323 (20.1%; 95% CI, 18.9-23%) and 144 subjects (9.3%; 95% CI, 7.9-10.9%), respectively. PVA and BCVA worse than 6/60 was seen in 74 (4.8%; 95% CI, 3.8-6%) and 49 subjects (3.2%; 95% CI, 2.4-4.2%), respectively. Posterior capsular opacification was seen in 51 of 1316 pseudophakic eyes (3.9%; 95% CI, 2.9-5.1%). In multivariable analysis among pseudophakic subjects with PVA worse than 6/18, increasing age (p?=?0.002) and undergoing free surgery (p?=?0.05) were independent risk factors. Undergoing surgery before 2005 (p?=?0.05) and being illiterate (p?=?0.05) were independent risk factors for BCVA worse than 6/18.ConclusionsThere are changing trends with improved outcomes in cataract surgery among these tribal populations of India. However, post-operative refractive error correction remains an issue, especially for those undergoing free surgeries.
| S-EPMC3342298 | biostudies-literature
Project description:IntroductionAvoidable blindness is a significant public health problem in India. Nationally representative RAAB surveys (Rapid Assessment of Avoidable Blindness) are being conducted periodically in the country to know the current status of blindness in the country. The current study describes the findings from the RAAB survey conducted during 2015-19 in India.MethodologyA cross-sectional, population-based survey was conducted across the entire country among persons aged 50 years and above using RAAB version 6 methodology. Presenting and pinhole visual acuity was recorded followed by lens examination using a torchlight. In order to estimate the prevalence of blindness and visual impairment in overall population in India, district weights were assigned to each of the 31 surveyed districts and the prevalence was standardized using the RAAB software.ResultsThe overall weighted, age-gender standardized, prevalence of blindness (presenting visual acuity <3/60 in better eye) in population aged ≥50 years was 1.99% (95% CI 1.94%, 2.13%) and of visual impairment (VI) (presenting visual acuity <6/12 in better eye) was 26.68% (95% CI 26.57-27.17%). On multivariate analysis, adjusted odds ratio showed that blindness was associated with age ≥ 80 years (OR = 20.3, 95% CI: 15.6-26.4) and being illiterate (OR = 5.6, 95% CI: 3.6-8.9). Blindness was not found to be significantly associated with either gender or locality.ConclusionThe results of the survey demonstrate that currently more than one fourth of persons aged 50 years and above are visually impaired (PVA<6/12 in better eye) in India. The prevalence of blindness among them is 1.99%, and older age and illiteracy are significantly associated with blindness. Major causes of blindness included cataract (66.2%), corneal opacity (CO) (8.2%), cataract surgical complications (7.2%), posterior segment disorders (5.9%) and glaucoma (5.5%). The proportion of blindness and visual impairment that is due to avoidable causes include 92.9% and 97.4% respectively.
| S-EPMC9302795 | biostudies-literature
Project description:Malaria is a major public health problem in tropical and subtropical countries of the World. During the year 1999, Visakhapatnam district of Andhra Pradesh, India experienced a major epidemic of malaria, and nearly 41,805 cases were reported. Hence, a retrospective malaria surveillance study was conducted from 2001 to 2016 and reported nearly a total of 149,317 malaria cases during the study period. Of which, Plasmodium vivax contributes 32%, and Plasmodium falciparum contributes 68% of the total cases. Malaria cases follow a strong seasonal variation and 70% of cases are reported during the monsoon periods. In the present study, we exploited multi step polynomial regression and seasonal autoregressive integrated moving average (SARIMA) models to forecast the malaria cases in the study area. The polynomial model predicted malaria cases with high predictive power and found that malaria cases at lag one, and population played a vital role in malaria transmission. Similarly, mean temperature, rainfall and Normalized Difference Vegetation Index build a significant impact on malaria cases. The best fit model was SARIMA (1, 1, 2) (2, 1, 1)12 which was used for forecasting monthly malaria incidence for the period of January 2015 to December 2016. The performance accuracy of both models are similar, however lowest Akaike information criterion score was observed by the polynomial model, and this approach can be helpful further for forecasting malaria incidence to implement effective control measures in advance for combating malaria in India.
| S-EPMC7410916 | biostudies-literature
Project description:ImportanceVision loss is the third most common impairment worldwide. Although cost-effective interventions are available for preventing or curing most causes of vision loss, availability of these interventions varies considerably between countries and districts. Knowledge of the association between vision loss and socioeconomic factors is informative for public health planning.ObjectivesTo explore correlations of the prevalence of visual impairment with socioeconomic factors at country levels and to model and estimate a socioeconomic-adjusted disease burden based on these data.Design, setting, and participantsIn this cross-sectional study, the following data were collected from 190 countries and territories: the age-standardized prevalence of moderate to severe visual impairment (MSVI) and blindness from January 1 to December 31, 2010, across countries, human development index (HDI), gross domestic product (GDP) per capita, total health expenditure, total health expenditure as percentage of GDP (total health expenditure/GDP), public health expenditure as percentage of total health expenditure (public/total health expenditure), and out-of-pocket expenditure as percentage of total health expenditure (out-of-pocket/total health expenditure). Countries were divided into 4 levels (low, medium, high, and very high) by HDI. Data analysis was conducted from September 1, 2016, to July 1, 2017.Main outcomes and measuresThe correlations between prevalence data and socioeconomic indices were assessed.ResultsA strong negative association between prevalence rates of MSVI and blindness and socioeconomic level of development was observed. The mean (SD) age-standardized prevalence of MSVI decreased from 4.38% (1.32%) in low-HDI regions to 1.51% (1.00%) in very-high-HDI regions (P < .001). The national HDI level was attributable to 56.3% of global variation in prevalence rates of MSVI and 67.1% of global variation in prevalence rates of blindness. Higher prevalence rates were also associated with lower total health expenditure per capita, total health expenditure/GDP (β = −0.236 [95% CI, −0.315 to −0.157] for prevalence of MSVI; β = −0.071 [95% CI, −0.100 to −0.042] for prevalence of blindness), public/total health expenditure (β = −0.041 [95% CI, −0.052 to −0.031] for prevalence of MSVI; β = −0.014 [95% CI, −0.018 to −0.010] for prevalence of blindness), and higher percentage of out-of-pocket/total health expenditure (β = 0.044 [95% CI, 0.032-0.055] for prevalence of MSVI; β = 0.013 [95% CI, 0.009-0.017] for prevalence of blindness). Countries with increased burden of visual impairment and blindness can be easily identified by the results of the linear models. Socioeconomic factors could explain 69.4% of the global variations in prevalence of MSVI and 76.3% of the global variations in prevalence of blindness.Conclusions and relevanceBurden of visual impairment and socioeconomic indicators were closely associated and may help to identify countries requiring greater attention to these issues. The regression modeling described may provide an opportunity to estimate appropriate public health targets that are consistent with a country’s level of socioeconomic development.
| S-EPMC6583541 | biostudies-literature
Project description:Traditionally, the distribution of the Mycobacterium tuberculosis genotypes in India has been characterized by widespread prevalence of ancestral lineages (TbD1+ strains and variants) in the south and the modern forms (TbD1(-) CAS and variants) predominating in the north of India. The pattern was, however, not clearly known in the south-central region such as Hyderabad and the rest of the state of Andhra Pradesh where the prevalence of both tuberculosis (TB) and human immunodeficiency virus (HIV) infection is one of the highest in the country; this area has been the hotspot of TB vaccine trials. Spoligotyping of 101 clinical isolates obtained from Hyderabad and rural Andhra Pradesh confirmed the occurrence of major genogroups such as the ancestral (or the TbD1+ type or the East African Indian (EAI) type), the Central Asian (CAS) or Delhi type and the Beijing lineage in Andhra Pradesh. Sixty five different spoligotype patterns were observed for the isolates included in this study; these were further analyzed based on specific genetic signatures/mutations. It was found that the major genogroups, CAS and "ancestral," were almost equally prevalent in our collection but followed a north-south compartmentalization as was also reported previously. However, we observed a significant presence of MANU lineage in south Andhra Pradesh, which was earlier reported to be overwhelmingly present in Mumbai. This study portrays genotypic diversity of M. tuberculosis from the Indian state of Andhra Pradesh and provides a much needed snapshot of the strain diversity that will be helpful in devising effective TB control programs in this part of the world.
| S-EPMC3219672 | biostudies-literature
Project description:BackgroundInformation on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India.MethodsBased on data from a representative sample of 128 public-funded HIV prevention programs of 14 types in Andhra Pradesh, we have recently reported the number of HIV infections averted by each type of HIV prevention intervention and their cost. Using estimates of the age of onset of HIV infection, we used standard methods to calculate the cost per Disability Adjusted Life Year (DALY) saved as a measure of cost-effectiveness of each type of HIV prevention intervention.ResultsThe point estimates of the cost per DALY saved were less than US $50 for blood banks, men who have sex with men programmes, voluntary counselling and testing centres, prevention of parent to child transmission clinics, sexually transmitted infection clinics, and women sex worker programmes; between US $50 and 100 for truckers and migrant labourer programmes; more than US $100 and up to US $410 for composite, street children, condom promotion, prisoners and workplace programmes and mass media campaign for the general public. The uncertainty range around these estimates was very wide for several interventions, with the ratio of the high to the low estimates infinite for five interventions.ConclusionsThe point estimates for the cost per DALY saved from the averted HIV infections for all interventions was much lower than the per capita gross domestic product in this Indian state. While these indicative cost-effectiveness estimates can inform HIV control planning currently, the wide uncertainty range around estimates for several interventions suggest the need for more firm data for estimating cost-effectiveness of HIV prevention interventions in India.
| S-EPMC2874552 | biostudies-literature
Project description:Excess fluoride in drinking water has been one of the leading problem faced by the arid and semi-arid regions of the world. Significantly in India the people suffer from fluorosis comparing to other toxic elements like Arsenic etc., in drinking water. Approximately, in India the excessive fluoride in groundwater is noticed in 177 districts covering 21 states, affecting 66 million people, including 6 million children and Moreover, the latest estimation gives nearly 200 million people, from among 25 nations the world over, are affected by the deadly disease of fluorosis [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14]. The fluoride of the groundwater varies from 0.4 to 5.8 mg/L with a mean of 1.98 mg/L (Table 1 & 2), which indicates that the concentration of fluoride is not uniform in the study area. In general intake of small quantities of fluoride in the permissible limit of 0.5 to 1 mg/L is known to be beneficial for human health in production and maintenance of proper health. However, in India safe limit of fluoride in potable water is considered to be between 0.6 to 1.2 mg/L, less than 0.6 mg/L can cause dental caries, while higher than 1.2 mg/L leads to fluorosis [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16].
| S-EPMC5996165 | biostudies-literature
Project description:An attempt was made to identify actinobacterial strains present in the marine soil of East Coast regions viz., Chirala, Bapatla, and Peddaganjam, Andhra Pradesh; Kanyakumari, Tamil Nadu and Goa, Goa along with the study of their antimicrobial potential. Eight out of 73 actinobacterial strains isolated from these regions showed strong antimicrobial activity against Gram positive bacteria, Gram negative bacteria, and Candida albicans. Molecular identification (16S rRNA analysis) of the eight strains revealed that they belong to Dietzia sp., Kocuria sp., Nocardiopsis sp., and Streptomyces spp. ISP (International Streptomyces project) -1, ISP-2 and starch casein media supported high antimicrobial potential after 5-6 days of growth. Production of antimicrobials by the strains varied significantly with different carbon and nitrogen sources. Gas chromatography mass spectrometry (GCMS) analysis of volatile compounds produced by the strains illustrated an array of antimicrobial compounds such as 1, 2-benzene dicarboxylic acid, 2-piperidinone, pyrrolo[1,2-a]pyrazine-1,4-dion, phenyl ethyl alcohol, 3-phenyl propionic acid etc. Ours is the first report on the study and detection of above mentioned antimicrobial metabolites from Dietzia sp. (A3), Kocuria sp. (A5), and Nocardiopsis sp. (A7). By sequence based analysis for secondary metabolites, non-ribosomal peptide synthetase (NRPS) gene cluster was noticed in six strains (A2, A3, A4, A6, A7, and A8) and none of them had polyketide synthase (PKS) system. The present study intimates the biological potentiality of the actinobacterial strains isolated from East Coast of Andhra Pradesh, India which reveals further scope to investigate new bioactive compounds from them by employing both natural product chemistry and modern biotechnological aspects.
| S-EPMC5498559 | biostudies-literature
Project description:Bluetongue (BT) is an infectious, arthropod-borne viral disease of domestic and wild ruminants caused by bluetongue virus (BTV), which is a double-stranded segmented RNA virus. Of the 26 confirmed BTV serotypes, 23 were reported in India based on the detection of antibodies or virus. In order to assess the prevalence of different serotypes in Andhra Pradesh, serum samples which were positive for BTV by group-specific antibody ELISA were subjected to type-specific neutralization of BTV serotypes 1, 2, 9, 10, 21 and 23. Of the 52 samples tested, 50.0, 44.23, 21.15, 26.92, 0, and 15.38 % neutralized BTV serotypes 1, 2, 9, 10, 21 and 23, respectively. However, 32.69 % of the ELISA positive sera could not neutralize any of these serotypes, indicating that there could be other serotype viruses (e.g., BTV-3 and -16) circulating in the State. This method can be used for surveillance of the circulating serotypes as well as for assessing the level of herd immunity, and assist in determining the vaccine strains to be used in multivalent vaccines.
| S-EPMC3832695 | biostudies-literature
Project description:India has one of the largest agricultural input support programs in the world, delivered in the form of subsidies to farmers, raising concerns about its sustainability. This paper evaluates the performance of one such support, the micronutrient subsidy program in the state of Andhra Pradesh (AP) and presents a case for providing this support in the form of direct cash transfers. Under the program, key soil micronutrients- zinc, boron, and gypsum were distributed free of cost to farmers living in micronutrient-deficient areas, with identification and targeting managed entirely by the state. We survey 1621 farmers, 61 agriculture extension officers, and 78 agriculture input dealers to assess the efficacy of the program and to identify bottlenecks preventing effective targeting, with a focus on zinc. We find that use of non-subsidized zinc is high in AP, and awareness of benefits of zinc and physical access to input dealer shops are significant predictors of zinc use. We argue that the free provision of micronutrients may have created demand among farmers, but there is little justification to continue subsidizing such a program at such high rates or resorting to public distribution. We find that micronutrient procurement and distribution has become a burden on extension staff and crowds out the private sector. Our analysis shows that the subsidy can benefit more farmers if it is channeled through the network of private fertilizer dealers. We use administrative data on budgetary outlays and digital soil maps to suggest fiscal redistribution in the form of direct cash transfers that may ensure more effective targeting at a lower cost to the state.
| S-EPMC7714421 | biostudies-literature