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Background: Gonorrhea is a significant cause of morbidity among sexually active population. Young adults and adolescents have a high risk of contracting sexually transmitted infections (STIs) due to behavioral, biological, and cultural factors fuelling the epidemic among them. The Centers for Disease Control recommends annual STI screening for sexually active individuals under twenty‑five and those at higher risk. The present study aims at determining the risk factors linked to the rising prevalence of gonorrhea among Indian adolescents and antimicrobial susceptibility profiles of Neisseria gonorrhoeae. Materials and Methods: Clinical samples from adolescents attending the STI clinics were collected over 10 years. The isolates were confirmed as N. gonorrhoeae and antimicrobial susceptibility tests were performed to various drugs using the minimum inhibitory concentration strip method. Results: A total of 7308 genital discharge specimens were collected from STI clinic attendees, of which 417 samples were positive for gonorrhea (25 among male adolescents). Seventy six percent of positive adolescents had multiple sex partners, with only 4% using condoms. Nearly 20% practiced exchange of drugs for sex. Antimicrobial susceptibility rates were 96% sensitive for azithromycin, cefixime, and ceftriaxone. Gentamicin and spectinomycin reported 100% sensitivity rates. High resistance rates were reported to penicillin, ciprofloxacin, and tetracycline at 80%, 88%, and 68%, respectively. Conclusion: Regular screening for STIs helps understand the trends and transmission of gonorrhea, which helps initiate appropriate control measures. The resistance to recommended treatment regimens such as azithromycin and cefixime seems to be escalating gradually, probably due to irrational use of antibiotics for non‑STI cases and empirical treatment, which needs close monitoring. [ABSTRACT FROM AUTHOR]

Background: Neisseria gonorrhoeae (Gonococcus-GC) is a fastidious, autolytic Gram-negative diplococcus with stringent growth requirements, and cannot be cultivated in a routine microbiology laboratory, without well-equipped incubators, reagents, and special media. Hence, many clinics and laboratories prefer to ship the specimens or isolates to a dedicated referral laboratory for confirmation of isolates and antimicrobial susceptibility testing. Thus, transportation conditions for gonococcal isolates, become crucial for its recovery and successful isolation in the laboratory. This retrospective study was conducted at a national referral laboratory for gonococcus, in India, over 3 years. Aim: In this study, an attempt was made to determine the factors affecting the revival of isolates of gonococci, that were despatched, from across India, to the referral laboratory for confirmation of species and antimicrobial susceptibility patterns. Method: Over 3 years, the culture plates, test tubes, or vials used for transporting gonococcal isolates, and their modes of transport to the referral laboratory, were studied in detail. The isolates were revived (whenever possible), subcultured, and identified by standard methods in the referral laboratory. Results: A total of 77 samples were processed for revival and 83.12% of isolates were recovered, with failure of recovery in 16.88% of specimens. Conclusion: Several factors play a role in the successful revival of N. gonorrhoeae from culture isolates transported across the Indian subcontinent. These include purity of growth, culture media used for transport, sending of isolates in duplicates, temperature, time, distance, and season of transport. All these factors must be kept in mind when transporting gonococcal isolates, for successful revival. Finally, the skills of the laboratory technician are of immense importance too. [ABSTRACT FROM AUTHOR]

A growing number of organisations, including medical associations, recommend that research subjects should be given the option of being informed about the general outcome and results of the study. We recently completed a study involving nine serosurveys from 2018 to 2020 in five districts of India among three age groups (children 9 months to < 5 years; 5 to < 15 years of age, and women 15 to < 50 years of age before and after the measles and rubella (MR) vaccination campaigns). In Palghar district of Maharashtra all individuals in 30 selected clusters were enumerated, and 13 individuals per age group were randomly sampled. We established the procedures to return the results to the respondents for each stage of the survey. Of the 1,166 individuals selected for the measles and rubella serosurvey, 971 (83%) agreed to participate and were enrolled. Participants were informed that they will only be contacted if they test seronegative for measles and/or rubella antibodies. Overall, 140 individuals enrolled in the survey tested seronegative for IgG antibodies to measles and/or rubella viruses; were provided the reports and informed to seek medical advice. Upon follow up by phone, 10% (14) of the 140 participants reported to have been vaccinated. In this paper we discuss the procedures, experiences and considerations in returning results to participants in a community-based measles and rubella serosurvey. Although the lessons learned are specific to post measles-rubella vaccine campaign serosurvey in India, they might be helpful to those contemplating sharing results to participants of large scale survey settings. [ABSTRACT FROM AUTHOR]

Background: Hypertensive disorders of pregnancy (HDP) pose significant risks to maternal and fetal health, with substantial mortality and morbidity rates globally, particularly in developing countries. Pre-eclampsia (PE) accounts for a notable portion of maternal morbidity and mortality, with varied prevalence across regions within countries like India. Despite advancements, disparities in healthcare access persist, influencing outcomes. PE not only affects maternal health during pregnancy but also predisposes women to long-term cardiovascular complications, emphasizing the need for early screening and preventive measures., Methods: This prospective randomized double-blind clinical trial aims to compare the efficacy and safety of 75 mg versus 150 mg aspirin for preventing preterm pre-eclampsia in high-risk women. Screen-positive women aged 18-45 years with singleton pregnancies between 12 and 16 weeks of gestational age will be enrolled. They will be randomized in a 1:1 ratio to receive either 75 mg or 150 mg of aspirin nightly until 37 weeks of pregnancy or earlier if preterm pre-eclampsia develops. Feto-maternal outcomes, including preterm pre-eclampsia incidence and neonatal and maternal complications, will be assessed. The sample size calculation based on expected proportions of preterm pre-eclampsia in both groups indicates a total of 370 participants (185 per group) accounting for 20% attrition., Discussion: This prospective randomized double-blind clinical trial aims to compare the effectiveness and safety of two doses of aspirin (75 mg vs 150 mg) in preventing preterm pre-eclampsia in high-risk women. The potential implications of this study are significant, including the optimization of aspirin prophylaxis, the development of evidence-based guidelines, and comprehensive assessment of maternal and fetal outcomes. In conclusion, the results of this study have the potential to significantly impact clinical practice by enhancing maternal and perinatal health outcomes and contributing to evidence-based obstetric care., Trial Registration: Clinical Trials Registry-India CTRI/2023/12/060983. Trial was registered prospectively on 29 December 2023. Acknowledgement Number REF/2023/12/076358. https://acrobat.adobe.com/id/urn:aaid:sc:AP:15870322-f1f4-4460-900c-6e056ab83a44 ., (© 2024. The Author(s).)

Background: In alignment with the Measles and Rubella (MR) Strategic Elimination plan, India conducted a mass measles and rubella vaccination campaign across the country between 2017 and 2020 to provide a dose of MR containing vaccine to all children aged 9 months to 15 years. We estimated campaign vaccination coverage in five districts in India and assessed campaign awareness and factors associated with vaccination during the campaign to better understand reasons for not receiving the dose., Methods and Findings: Community-based cross-sectional serosurveys were conducted in five districts of India among children aged 9 months to 15 years after the vaccination campaign. Campaign coverage was estimated based on home-based immunization record or caregiver recall. Campaign coverage was stratified by child- and household-level risk factors and descriptive analyses were performed to assess reasons for not receiving the campaign dose. Three thousand three hundred and fifty-seven children aged 9 months to 15 years at the time of the campaign were enrolled. Campaign coverage among children aged 9 months to 5 years documented or by recall ranged from 74.2% in Kanpur Nagar District to 90.4% in Dibrugarh District, Assam. Similar coverage was observed for older children. Caregiver awareness of the campaign varied from 88.3% in Hoshiarpur District, Punjab to 97.6% in Dibrugarh District, Assam, although 8% of children whose caregivers were aware of the campaign were not vaccinated during the campaign. Failure to receive the campaign dose was associated with urban settings, low maternal education, and lack of school attendance although the associations varied by district., Conclusion: Awareness of the MR vaccination campaign was high; however, campaign coverage varied by district and did not reach the elimination target of 95% coverage in any of the districts studied. Areas with lower coverage among younger children must be prioritized by strengthening the routine immunization programme and implementing strategies to identify and reach under-vaccinated children., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright: © 2024 Thangaraj et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: This study aimed to assess the efficacy of a dengue intervention program in economically deprived urban regions of India, with a particular emphasis on housing conditions and community involvement. Given the global significance of dengue fever as a vector-borne disease, successful vector management requires effective community engagement. Study Design: A quasi-experimental study., Methods: This study was conducted with 314 participants from Delhi's Sanjay Colony, divided into control and intervention groups. The study spanned 14 months (August 2020 to September 2021). The intervention program comprised two educational sessions held one month apart, covering dengue awareness, health self-care, and environmental maintenance. Data were collected at baseline, after each intervention session, and during a final follow-up assessment three months later., Results: The primary outcome, the house index (HI), revealed statistically significant differences ( P <0.001) favoring the intervention group. The total score (TS) for mosquito-borne disease, TS of knowledge, TS of attitude, and TS of practices all exhibited significant improvements in the intervention group. Participants showed an enhanced understanding of dengue causes, symptoms, and mosquito behavior related to breeding and biting. The HI in the intervention group decreased significantly from 21.65% to 4.45% ( P <0.05)., Conclusion: This study, grounded in the health belief model (HBM), demonstrated the effectiveness of the intervention program in reducing HI and improving knowledge and preventive practices regarding dengue fever in impoverished urban neighborhoods of Delhi. The intervention program may be beneficial in such a poor urban community., (© 2023 The Author(s); Published by Hamadan University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: India did phased measles-rubella supplementary immunisation activities (MR-SIAs; ie, mass-immunisation campaigns) targeting children aged 9 months to less than 15 years. We estimated measles-rubella seroprevalence before and after the MR-SIAs to quantify the effect on population immunity and identify remaining immunity gaps., Methods: Between March 9, 2018 and March 19, 2020 we did community-based, cross-sectional serosurveys in four districts in India before and after MR-SIAs. 30 villages or wards were selected within each district, and one census enumeration block from each was selected as the survey cluster. Households were enumerated and 13 children in the younger age group (9 months to <5 years) and 13 children in the older ager group (5 to <15 years) were randomly selected by use of computer-generated random numbers. Serum samples were tested for IgG antibodies to measles and rubella viruses by enzyme immunoassay., Findings: Specimens were collected from 2570 children before the MR-SIA and from 2619 children afterwards. The weighted MR-SIA coverage ranged from 73·7% to 90·5% in younger children and from 73·6% to 93·6% in older children. Before the MR-SIA, district-level measles seroprevalence was between 80·7% and 88·5% among younger children in all districts, and between 63·4% and 84·5% among older children. After the MR-SIA, measles seroprevalence among younger children increased to more than 90% (range 91·5 to 96·0) in all districts except Kanpur Nagar, in which it remained unchanged 80·4%. Among older children, measles seroprevalence increased to more than 90·0% (range 93·7% to 96·5%) in all districts except Hoshiarpur (88·7%). A significant increase in rubella seroprevalence was observed in all districts in both age groups, with the largest effect in Dibrugarh, where rubella seroprevalence increased from 10·6% to 96·5% among younger children., Interpretation: Measles-rubella seroprevalence increased substantially after the MR-SIAs but the serosurvey also identified remaining gaps in population immunity., Funding: The Bill & Melinda Gates Foundation and Indian Council of Medical Research., Competing Interests: Declaration of interests KH has been an employee by Pfizer Vaccines from October 26, 2020. All other authors declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)