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Phthalic acid esters are pivotal plasticizers in various applications, including cosmetics, packaging materials, and medical devices. They have garnered significant attention from the scientific community due to their persistence in ecosystems. The multifaceted aspects of PAEs, encompassing leaching, transformation, and toxicity, underscore their prominence as primary components of anthropogenic waste. In this study, we conducted an extensive investigation to isolate and evaluate bacterial strains with the potential to degrade plasticizers from soil samples collected at JUHU Beach, Mumbai. The degradation capabilities of the isolates were meticulously assessed, and their characterization was performed using established microbiological protocols followed by Sanger dideoxy 16S rRNA sequencing. Four isolates demonstrating notable plasticizer degradation proficiency were subjected to in-depth examinations of their growth dynamics and tolerance thresholds. The biodegradation capabilities of these isolates were evaluated under varying pH, temperature, and plasticizer concentrations. Optimization of degradation rates was achieved through a central composite design experiment. Phenotypic characterization of the isolates was conducted through phylogenetic analysis. The isolates were identified as novel strains belonging to Brevibacillus brevis, Acinetobacter baumannii, Moraxella sp., and Halomonas sp. respectively. The novel isolates were submitted to GenBank with accession numbers OP984197, OQ690115, PP174910, and PP177540 respectively., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Visceral leishmaniasis (VL), known as Kala-azar on the Indian subcontinent, is a parasitic disease caused by the flagellated protozoa Leishmania donovani and can be fatal if left untreated. The sand fly Phlebotomus argentipes is the only proven vector of VL in the Southeast Asia region, and VL control in this region has relied on the use of synthetic insecticides for indoor residual spraying (IRS). The use of DDT in VL control programmes has led to the development of resistance to this insecticide in sand flies, resulting in DDT being replaced with the insecticide alpha-cypermethrin. However, alpha-cypermethrin has a similar mode of action as DDT and, therefore, the risk of resistance development in sand flies increases under the pressure of regular exposure to this insecticide. In the present study we assessed the susceptibility status of wild-caught sand flies and F1 progeny using the CDC bottle bioassay., Methods: Sand flies were collected from 10 villages in Muzaffarpur District, Bihar, India. Eight of these villages are receiving continuous IRS with alpha-cypermethrin, one village had discontinued IRS with alpha-cypermethrin and one village had never received IRS with alpha-cypermethrin. The collected sand flies were exposed to a pre-determined diagnostic dose for a specific time duration (3 µg/ml for 40 min), and knockdown and mortality at 24 h post-exposure were recorded., Results: Knockdown ranged from 91.19% to 99.47% for wild-caught sand flies and from 91.70% to 98.89% for their F1 progeny. At 24 h post-exposure, mortality ranged from 89.34% to 98.93% for wild-caught sand flies and from 90.16% to 98.33% for F1 progeny., Conclusions: The results of this study showed that P. argentipes is potentially developing resistance, signalling the need for continuous monitoring and vigilance to sustain the validation of elimination once achieved., Competing Interests: Declarations. Ethical approval and consent to participant: This work was conducted with ethical approval (Letter No. CAEC/DEAN/2014/CAEC/615) obtained from Institutional Review Committees of Banaras Hindu University, Varanasi, India. Informed verbal consent was obtained from the household and cattle shed owners before the installation of light traps for sand fly collection. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Visceral leishmaniasis derived from Leishmania donovani is transmitted by sand flies (Phlebotomus argentipes) throughout the Indian subcontinent. Although considered anthroponotic, L. donovani infects other mammals susceptible to sand fly bites, including dogs. Aggressive strategies to reduce sand fly populations in India have led to flies seeking nonhuman hosts, so understanding the role of dogs in L. donovani transmission has become critical. Our study investigated L. donovani infection in dogs and the potential for such infections to be transmitted back to sand flies. We performed xenodiagnosis by using P. argentipes on dogs (n = 73) with quantitative PCR-detectible parasitemia in both endemic and outbreak villages. We found that 12% (9/73) of dogs were infectious to sand flies during winter and rainy seasons. Patients with visceral leishmaniasis remain primary sources of L. donovani transmission, but our findings suggest a possible link between canine infection and human exposure.

Understanding the nutritional diversity in Perilla (Perilla frutescens L.) is essential for selecting and developing superior varieties with enhanced nutritional profiles in the North Eastern Himalayan (NEH) region of India. In this study, we assessed the nutritional composition of 45 diverse perilla germplasm collected from five NEH states using standard protocols and advanced analytical techniques. Significant variability was observed in moisture (0.39-11.67%), ash (2.59-7.13%), oil (28.65-74.20%), protein (11.05-23.15%), total soluble sugars (0.34-3.67%), starch (0.01-0.55%), phenols (0.03-0.87%), ferric reducing antioxidant power (0.45-1.36%), palmitic acid (7.06-10.75%), stearic acid (1.96-2.29%), oleic acid (8.11-13.31%), linoleic acid (15.18-22.74%), and linolenic acid (55.47-67.07%). Similarly, significant variability in mineral content (ppm) was also observed for aluminium, calcium, cobalt, chromium, copper, iron, potassium, magnesium, manganese, molybdenum, sodium, nickel, phosphorus, and zinc. Multivariate analyses, including hierarchical clustering analysis (HCA) and principal component analysis (PCA), revealed the enriched nutritional diversity within the germplasm. Correlation analysis indicated significant positive and negative relationships between nutritional parameters, indicating potential biochemical and metabolic interactions present in the perilla seeds. TOPSIS-based ranking identified promising genotypes for functional foods, pharmaceuticals, and nutritional applications. This study provides a first in-depth report of the nutritional composition and diversity of perilla germplasm in the NEH region, thus aiding in the identification of superior varieties for food and nutritional diversification and security., Competing Interests: Declarations Ethical Approval Not applicable. Competing Interests The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

An assessment of the treatment outcomes of single-dose liposomal amphotericin B, implemented in 2010, had not been conducted until this study. This prospective cross-sectional study encompassed 527 cases, comprising 470 (89%) cases of visceral leishmaniasis (VL) and 57 (11%) cases of post-kala-azar dermal leishmaniasis (PKDL). The male proportion was higher (55% for VL), and the mean (±SD) age was 39.2 (±33.9) years. Among VL cases (426) treated with single-dose liposomal amphotericin B, 402 cases were cured at the 6-month follow-up, resulting in a cure rate of 95%, whereas fewer than 1% (0.9%) experienced unsuccessful outcomes and 4.1% faced relapse. A statistically highly significant difference in treatment outcomes (successful versus unsuccessful) was observed between males and females (P = 0.0005). Males had higher odds of successful outcomes compared with females, with an odds ratio of 5.03 (95% CI: 1.84-13.74). Those aged ≤23 years had higher odds of successful outcomes than unsuccessful outcomes, with an odds ratio of 6.82 (95% CI: 2.29-20.33). Patients with PKDL had a mean (±SD) age of 28.5 (±10.6) years, with 63% being male. Among the 57 PKDL cases, 21 (37%) had been treated with single-dose liposomal amphotericin B, whereas others had received alternative drugs. The median duration of PKDL development for single-dose liposomal amphotericin B was significantly shorter (14.5 months), with a statistically significant difference (P <0.001) compared with other drugs. The current treatment strategy necessitates continuous close monitoring and reviews to ensure consistent and improved outcomes.

The consumption pattern of alcohol varies between cultures and different communities. Moreover, alcohol consumption pattern depends on age, religion, education, type of drink, and other socio-economic parameters. Alcohol use has reportedly declined in most developed counties, but developing countries still witnessed an increasing trend. The study investigated socio-economic drivers, nature, and patterns of alcohol use among adult men in India. We have also investigated the state-level alcohol prevalence in India better to understand the impact of state-level alcohol prohibition policies. We have retrieved the data from the National Family Health survey's fourth and fifth-round, which was conducted in 2015-2016 and 2020-2021, respectively. We used the bi-variate technique to estimate that percentage of men who consume alcohol. Furthermore, a multivariate logistic regression model was applied to assess the association of each background characteristic with alcohol consumption. It is observed that 19 percent of men aged 15 and above currently drink alcohol, including 20 percent in rural and 17 percent in urban areas. The consumption of tadi/madi/country liquor/homemade liquor was high in rural areas than in urban areas in both rounds of the survey. Additionally, beer or wine consumption is higher in urban areas than in rural areas in NFHS-4 and NFHS-5. Among the 35-49 years of age group, around 6 and 8 times more likely to consume alcohol in NFHS-4 and NFHS-5, respectively. Rural men were 18 and one percent less likely to consume alcohol in NFHS-4 & 5 compared to urban (OR: 0.82 and 0.99 in NFHS-4 & 5 respectively). Despite an overall reduction in alcohol consumption among men, lowering alcohol consumption remains the main priority of policymakers. There is a need to target the most vulnerable socio-economic segments where alcohol consumption is still a problem, one of the primary reasons for violence against women.

A fundamental necessity in advancing sustainable crop production lies in the establishment of a reliable technique for assessing soil health. Soil health assessment is a challenge considering multiple interactions among dynamic indicators within various management strategies and agroecological contexts. Hence a study was conducted to determine the soil health variables, quantify the soil health index (SHI), and validate them with the productivity of rice (Oryza sativa L.)-wheat (Triticum aestivum L.) system for the Indo Gangetic basin of Bihar, India, under four contrasting agro-climatic zones (ACZ-I, II, IIIA & IIIB). For this study, 100 soil samples (0-15 cm) from each ACZ with a total of 400 soil samples were obtained for analyzing 20 soil health variables (soil physical, chemical, and biological properties). To identify SHI and important soil health variables, principal component analysis (PCA) was employed. Apart from specific variables, soil pH, soil organic carbon (SOC), available Zn and available water capacity (AWC) were identified as common indicators for the four ACZs. Results revealed that under the rice-wheat cropping system, ACZ-IIIB soils had a higher SHI (0.19-0.70) than other ACZs. SHI of ACZ-IIIB was significantly influenced by SOC (19.32 %), available P (10.52 %), clay (10.43 %), pH (10.80 %), and soil respiration (9.8 %). The strong relationship between SHI and system productivity of the rice-wheat (R 2  = 0.79) system indicates that the selected soil health variables are representative of good soil health. It is concluded that ACZ-specific SHIs are a promising strategy for evaluating and monitoring soil health to achieve the United Nations' Sustainable Development Goal of 'zero hunger' by 2030., Competing Interests: Declaration of competing interest The authors declare that there are no known competing financial interests or personal relationships that could have influenced this paper's findings., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background and Objectives: Candidaemia is a potentially life-threatening emergency in the intensive care units (ICUs). Surveillance using common protocols in a large network of hospitals would give meaningful estimates of the burden of candidaemia and central line associated candidaemia in low resource settings. We undertook this study to understand the burden and epidemiology of candidaemia in multiple ICUs of India, leveraging the previously established healthcare-associated infections (HAI) surveillance network. Our aim was also to assess the impact that the pandemic of COVID-19 had on the rates and associated mortality of candidaemia., Methods: This study included adult patients from 67 Indian ICUs in the AIIMS-HAI surveillance network that conducted BSI surveillance in COVID-19 and non-COVID-19 ICUs during and before the COVID-19 pandemic periods. Hospitals identified healthcare-associated candidaemia and central line associated candidaemia and reported clinical and microbiological data to the network as per established and previously published protocols., Results: A total of 401,601 patient days and 126,051 central line days were reported during the study period. A total of 377 events of candidaemia were recorded. The overall rate of candidaemia in our network was 0.93/1000 patient days. The rate of candidaemia in COVID-19 ICUs (2.52/1000 patient days) was significantly higher than in non-COVID-19 ICUs (1.05/patient days) during the pandemic period. The rate of central line associated candidaemia in COVID-19 ICUs (4.53/1000 central line days) was also significantly higher than in non-COVID-19 ICUs (1.73/1000 central line days) during the pandemic period. Mortality in COVID-19 ICUs associated with candidaemia (61%) was higher than that in non-COVID-19 ICUs (41%). A total of 435 Candida spp. were isolated. C. tropicalis (26.7%) was the most common species. C. auris accounted for 17.5% of all isolates and had a high mortality., Conclusion: Patients in ICUs with COVID-19 infections have a much higher risk of candidaemia, CLAC and its associated mortality. Network level data helps in understanding the true burden of candidaemia and will help in framing infection control policies for the country., (© 2024 Wiley‐VCH GmbH. Published by John Wiley & Sons Ltd.)

Quality of life (QoL) is a vital aspect of postdonation amongst donors, especially elderly donors. There is a limited study from India assessing the QoL amongst young live donors (YLD), and no study has been done on the elderly sub-group. This study was undertaken to determine the donors' sociodemographic and essential clinical characteristics, as well as to study the QoL of the live kidney donors and compare the QoL of elderly and young donors. Baseline demographic characters taken from the RTR registration register and SF-36 questionnaire were used to assess the QoL at baseline, discharge post-transplant, 1 month, 3 months, 6 months, and 12 months through an interview. We found that the QoL of the elderly donors in postkidney donation returns to baseline at the end of 6 months in all dimensions of the QoL amongst the North Indian population. The physical function is better amongst elderly donors at the end of 3 and 6 months than among young donors. The study's findings must be propagated to increase the donation of kidneys to older people. This is the first of its kind from India, necessitating further multicentric study., Competing Interests: Declaration of competing interest 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 Elsevier Inc. All rights reserved.)

The aim of this research was to simulate the future water balance of the Silwani watershed, Jharkhand, India, under the combined effect of land use and climate change based on the Soil and Water Assessment Tool (SWAT) and Cellular Automata (CA)-Markov Chain model. The future climate prediction was done based on daily bias-corrected datasets of the INMCM5 climate model with Shared Socioeconomic Pathway 585 (SSP585), which represent the fossil fuel development of the world. After a successful model run, water balance components like surface runoff, groundwater contribution to stream flow, and ET were simulated. The anticipated change in land use/land cover (LULC) between 2020 and 2030 reflects a slight increase (3.9 mm) in groundwater contribution to stream flow while slight decrease in surface runoff (4.8 mm). The result of this research work helps the planners to plan any similar watershed for future conservation., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Groundwater is an essential source of drinking as well as irrigation water. It has recently become a significant challenge to maintain good and safe drinking water for all living beings. The continuous supply of arsenic detected in groundwater poses a severe health problem and has adverse effects on humans and the ecosystem. Researchers also identified arsenic contamination globally across various regions. However, a few studies also identified that the groundwater of Patna, Saran, and Vaishali districts of Bihar is intoxicated by arsenic. To assess the toxic level of arsenic in groundwater, samples from various GPS-based pointed locations were collected from the study area using a GARMIN GPS device. The total concentration of arsenic in drinking water (mostly traces of arsenic, level of μg L -1 or less) can be detected only by sophisticated analytical techniques such as ICP-MS, GF-AAS, and HG-AAS. The standard procedures were followed to determine quality attributes in groundwater. Arsenic contamination persists in most areas and exceeds the permissible limits prescribed by the World Health Organization (WHO), negatively impacting the health of more than 10 million people in the state. The 90.47% and 85.71% groundwater samples of the study area exceeded the permissible limit of the WHO (0.01 mg L -1 ) and Bureau of Indian Standards (BIS (0.05 mg L -1 ), respectively. The analyzed data was obtained, and variability was noticed in total arsenic concentrations ranging from 0.002 to 7.801 mg L -1 , with a mean value of 0.87 mg L -1 . Similarly, the water quality attribute like total dissolved solids were identified in 14.28% of samples, which crossed 201 to 1026 mg L -1 , with a mean value of 375.33 mg L -1 ., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The increasing air pollution in the urban atmosphere is adversely impacts the environment, climate and human health. The alarming degradation of air quality, atmospheric conditions, economy and human life due to air pollution needs significant in-depth studies to ascertain causes, contributions and impacts for developing and implementing an effective policy to combat these issues. This work lies in its multifaceted approach towards comprehensive understanding and mitigating severe pollution episodes in Delhi and its surrounding areas. We investigated the aerosol dynamics in the post-monsoon season (PMS) from 2019 to 2022 under the influence of both crop residue burning and meteorological conditions. The study involves a broad spectrum of factors, including PM2.5 concentrations, active fire events, and meteorological parameters, shedding light on previously unexplored studies. The average AOD550 (0.79) and PM2.5 concentration (140.12 μg/m³) were the highest in 2019. PM2.5 was higher from mid-October to mid-November each year, exceeding the WHO guideline of 15 μg/m³ (24 h) by 27-34 times, signifying a public health emergency. A moderate to strong correlation between PM2.5 and AOD was found (r = 0.65) in 2021. The hotspot region accounts for almost 50% (2019), 47.51% (2020), 57.91% (2021) and 36.61% (2022) of the total fire events. A statistically significant negative non-linear correlation (r) was observed between wind speed (WS) and both AOD and PM2.5 concentration, influencing air quality over the region. HYSPLIT model and Windrose result show the movement of air masses predominated from the North and North-West direction during PMS. This study suggest to promotes strategies such as alternative waste management, encouraging modern agricultural practices in hot-spot regions, and enforcing strict emission norms for industries and vehicles to reducing air pollution and its detrimental effects on public health in the region and also highlights the need for future possibilities of research to attract the global attention., Competing Interests: Declaration of competing interest 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 Elsevier Inc. All rights reserved.)

Introduction: Reducing childhood mortality by curtailing the incidence of vaccine preventable diseases is contingent upon a robust and high-performing routine immunization system. According to the available data, the full immunization coverage (FIC) in the state of Bihar (India) has reached ~ 71%. While the government aspires to reach 90% FIC, a systematic evidence-based investigation of the reasons behind underimmunization as well as the identification of drivers and enablers to reach and sustain 90% FIC is critical. This study aimed to review the factors leading to underimmunized children in the state of Bihar and develop a forward-looking roadmap to reach and sustain 90% FIC by adopting a system strengthening approach., Method: We conducted a desk review, followed by extensive stakeholder interviews and field visits to document and analyze the data and evidence relevant to routine immunization system performance in the state of Bihar. The stakeholders included the State Immunization Officer, District Immunization Officers, Block-level health officials, representatives from development agencies, healthcare workers, and caregivers. A total of eighty-six structured interviews were conducted, which included qualitative and quantitative parameters., Result: While positive results were observed from the assessment of Bihar's immunization system, the implementation of targeted strategies for supply, service delivery and demand can provide a means to achieve FIC of 90%. The roadmap developed by the Government of Bihar enlists 40 + interventions across key thematic areas and has been prioritized over a 5-year time horizon as short, medium, and long-term milestones to achieve 90% FIC. These interventions include strengthening the data availability and quality, improving the governance and review mechanism, augmenting the capacity of health workers involve with immunization programme, and initiatives to increase demand for immunization services., Conclusion: The Bihar's Immunization Roadmap development project work follows a methodical approach to assess and identify intervention to improve immunization coverage and can provide information and reference to other states and countries that are aiming to formulate similar action plans., (© 2024. The Author(s).)

Background: Of the 43 mpox cases reported by the WHO in South East Asia between January 2022 and March 2023, 24 (56%) were from India., Objectives: We describe the clinical and epidemiological profile of cases identified through India's hospital case-based surveillance., Materials and Methods: We identified mpox cases as a positive result for mpox virus polymerase-chain-reaction assay, reported through surveillance from July 1, 2022 to January 7, 2023. Cases and clinicians were interviewed, and data were abstracted from the medical records. We conducted contact tracing among family, close social networks, and healthcare personnel staff for the first 17 cases. We collected the data on sociodemographics, clinical findings, and behavior, and described data using summary statistics., Results: We identified 24 laboratory-confirmed cases (42% females, median age 30 years, range 22-38), including one death (case fatality rate 4.2%). We collected clinical and behavioural data from 21 of 24 cases. All had rashes with vesicles and genital lesions; 7 (33%) reported genital lesions as the first symptom; and 3 (13%) reported complications. Among the 21 cases, all were sexually active, none self-identified as men having sex with men (MSM), and 6 (29%) reported multiple sex partners. We identified 51 contacts of the first 17 reported cases, none reported symptoms suggestive of mpox., Conclusion: The clinical and behavioral characteristics of mpox cases in India are consistent with the global 2022 outbreak, with the exception that no cases in India reported MSM. Most were sexually active young adult economic migrants and developed genital lesions., (Copyright © 2024 Copyright: © 2024 Indian Journal of Public Health.)

The Integrated Child Development Services (ICDS) programme has been the central focus of the POSHAN Abhiyaan to combat maternal and child malnutrition under the national nutrition mission in India. This paper examined the linkages between utilization of ICDS and underweight among children aged 6-59 months. The study utilized data from two recent rounds of the National Family Health Survey (NFHS-4 [2015-2016] and NFHS-5 [2019-2021]). Descriptive analyses were used to assess the change in utilization of ICDS and the prevalence of underweight at the national and state levels. Multivariable logistic regressions were performed to examine factors associated with the utilization of ICDS and underweight. Linkages between utilization of ICDS and underweight were examined using the difference-in-differences (DID) approach. Utilization of ICDS increased from 58% in 2015-2016 to 71% in 2019-2021. The prevalence of underweight decreased from 37% to 32% in the same period. Changes in ICDS utilization and underweight prevalence varied considerably across states, socioeconomic and demographic characteristics. Results from decomposition of DID models suggest that improvements in ICDS explained 9%-12% of the observed reduction in underweight children between 2016 and 2021, suggesting that ICDS made a modest but meaningful contribution in addressing undernutrition among children aged 6-59 months in this period., (© 2024 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Background: Understanding chronic disease prevalence, patterns, and co-occurrence is pivotal for effective health care planning and disease prevention strategies. In this paper, we aimed to identify the clustering of major non-communicable diseases among Indian adults aged ≥50 years based on their self-reported diagnosed non-communicable disease status and to find the risk factors that heighten the risk of developing the identified disease clusters., Methods: We utilised data from the nationally representative survey Study on Global AGEing and Adult Health (SAGE Wave-2). The eligible sample size was 6298 adults aged ≥50 years. We conducted the latent class analysis to uncover latent subgroups of multimorbidity and the multinomial logistic regression to identify the factors linked to observed latent class membership., Results: The latent class analysis grouped our sample of men and women >49 years old into three groups - mild multimorbidity risk (41%), moderate multimorbidity risk (30%), and severe multimorbidity risk (29%). In the mild multimorbidity risk group, the most prevalent diseases were asthma and arthritis, and the major prevalent disease in the moderate multimorbidity risk group was low near/distance vision, followed by depression, asthma, and lung disease. Angina, diabetes, hypertension, and stroke were the major diseases in the severe multimorbidity risk category. Individuals with higher ages had an 18% and 15% higher risk of having moderate multimorbidity and severe multimorbidity compared to those in the mild multimorbidity category. Females were more likely to have a moderate risk (3.36 times) and 2.82 times more likely to have severe multimorbidity risk., Conclusions: The clustering of diseases highlights the importance of integrated disease management in primary care settings and improving the health care system to accommodate the individual's needs. Implementing preventive measures and tailored interventions, strengthening the health and wellness centres, and delivering comprehensive primary health care services for secondary and tertiary level hospitalisation may cater to the needs of multimorbid patients., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2024 by the Journal of Global Health. All rights reserved.)

Both diabetes mellitus (DM) and tuberculosis (TB) are prevalent all across in India. TB-DM comorbidity has emerged as a syndemic and needs more attention in India considering gaps in screening, clinical care, and research. This paper is intended to review published literature on TB and DM in India to understand the burden of the dual epidemic and its trajectory and to obtain perspectives on the gaps, constraints, and challenges in care and treatment of this dual epidemic. A literature search was carried out on PubMed, Scopus, and Google Scholar, using the key words 'Tuberculosis' OR 'TB' AND 'Diabetes' OR 'Diabetes Mellitus' AND 'India', focusing on the research published between the year 2000 to 2022. The prevalence of DM is high in patients with TB. Quantitative data on the epidemiological situation of TB/DM in India such as incidence, prevalence, mortality, and management are lacking. During the last 2 years convergence of TB-DM syndemic with the COVID-19 pandemic has increased cases with uncontrolled DM but also made coordinated control of TB-DM operationally difficult and of low effectiveness. Research regarding TB-DM comorbidity is required in the context of epidemiology and management. Detection and bidirectional screening are aggressively warranted. Management of DM in those with TB-DM comorbidity needs more efforts, including training and supervision of frontline workers., (© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)

Diphtheria is a re-emerging disease with a changing epidemiology. It is thus essential to recognize diphtheria's clinical profile, patterns of morbidity and mortality, and the level of immunization. This study aimed to analyze the clinical-epidemiological profile of patients with diphtheria at the Infectious Disease Hospital, New Delhi, India. The present study was a cross-sectional investigation conducted on 94 patients diagnosed with diphtheria. The data collection tool was a questionnaire that had questions eliciting details such as socio-demographic characteristics, clinical history, examination findings, and vaccination history. The case fatality rate was calculated. Means and proportions were also measured, and the significance level was set at P <0.05. The meanSD age of the participants was 94.4 years. Laryngeal involvement was found in 10 (11%) participants. Complete diphtheria vaccination doses were taken by 6 (6.4%) participants. The case fatality rate was 13%, and complications such as neuropathy were found in 21 (22%) cases, cardiac problems in 12 (13%), and respiratory problems in 13 (14%). Longer duration of the illness, delayed presentation, and complications were associated with poor clinical outcomes ( P <0.05). The majority of diphtheria cases were 6-10 years old and had a low socio-economic status. Most of them had a partial vaccination against diphtheria. Around one-third of the patients had complications related to diphtheria, and the case fatality rate was also high. Key preventive measures for controlling the deadly diphtheria disease include specialized immunization programs for areas with poor immunization coverage, as well as the early detection and treatment of suspected cases., Competing Interests: None.

Background: Psoriasis is an inflammatory skin disease associated with significant comorbidity. However, the characteristics of patients with psoriasis are not well documented in India, and a more detailed understanding is needed to delineate the epidemiologic profile at the regional level for better management of psoriasis. Herein, we reported the clinical profile and demographic pattern of psoriasis to further understand its burden in the Indian setting., Methods: We conducted a retrospective observational study of patients diagnosed with psoriasis who fulfilled the classification criteria for psoriatic arthritis (CASPAR) criteria. Patients were included from the rheumatology outpatient department of Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute in Mumbai, India. The outcomes included demographic and clinical profiles, patterns of joint involvement, and comorbidities associated with psoriasis. A p -value of <0.05 was considered significant., Results: We enrolled 60 patients, with a mean age of 50.87 years and a higher proportion of females (62%). The majority of patients with less than five joints had associated comorbidities (40 out of 60). Psoriatic arthritis (PsA) occurred in 41 patients [mean ± standard deviation (SD) age of onset-38.88 ± 13.24 years], with the highest occurrence in the 30-50 years (53.3%). The majority of patients with PsA developed it within 2 to ≥5 years of psoriasis occurrence. We did not find any significant correlation between the occurrence of PsA and comorbidities, as well as the duration of PsA and the number of joints ( p = 0.152). Pitting and enthesitis were the most common morphological changes noted in almost half of the patients., Conclusion: Our study provides an overview of the epidemiologic and clinical characteristics of psoriasis patients in India. These findings could be useful for early diagnosis of PsA and help clinicians in assessing the progression of psoriasis into PsA., (© Journal of the Association of Physicians of India 2024.)

In the present study, an attempt has been made to assess the impact of vehicular noise upon the 3-wheeler tempo drivers and to know whether there is any relationship between hearing loss and cumulative noise exposure. For this purpose, 3-wheeler tempo drivers (Exposed group) and non-commercial light motor vehicle car drivers (Unexposed group) were chosen as study subjects. Three traffic routes were selected to assess the noise level during waiting and running time in the exposed and unexposed groups. Among all three routes, the highest mean noise level (L eq ) was observed on the Chowk to Dubagga route for waiting and en-route noise measurement. It was measured as 84.13 dB(A) and 86.36 dB(A) for waiting and en-route periods of 7.68 ± 3.46 and 31.05 ± 6.6 min, respectively. Cumulative noise exposure was found to be significantly different (p < 0.001) in all age groups of exposed and unexposed drivers. Audiometric tests have been performed over both exposed and unexposed groups. The regression analysis has been done keeping hearing loss among tempo drivers as the dependent variable and age (years) and Energy (Pa 2 Hrs) as the independent variable using three different criteria of hearing loss definitions, i.e., World Health Organization, National Institute for Occupational Safety and Health (NIOSH), Occupational Safety and Health Administration criteria. Among these three criteria, the NIOSH criterion of hearing loss best explained the independent variables. It could explain the total variation in dependent variable by independent variable quite well, i.e., 68.1%. The finding showed a linear relationship between cumulative noise exposures (Pa 2 Hrs) and the exposed group's hearing loss (dB), i.e., hearing loss increases with increasing noise dose. Based on the findings, two model equations were developed to identify the safe and unsafe noise levels with exposure time., (© 2024. The Author(s).)

Municipal Solid Waste (MSW) management is a pressing global concern, with increasing interest in Waste-to-Energy Technologies (WTE-T) to divert waste from landfills. However, WTE-T adoption is hindered by financial uncertainties. The economic benefits of MSW treatment and energy generation must be balanced against environmental impact. Integrating cutting-edge technologies like Artificial Intelligence (AI) can enhance MSW management strategies and facilitate WTE-T adoption. This review paper explores waste classification, generation, and disposal methods, emphasizing public awareness to reduce waste. It discusses AI's role in waste management, including route optimization, waste composition forecasting, and process parameter optimization for energy generation. Various energy production techniques from MSW, such as high-solids anaerobic digestion, torrefaction, plasma pyrolysis, incineration, gasification, biodegradation, and hydrothermal carbonization, are examined for their advantages and challenges. The paper emphasizes risk assessment in MSW management, covering chemical, mechanical, biological, and health-related risks, aiming to identify and mitigate potential adverse effects. Electronic waste (E-waste) impact on human health and the environment is thoroughly discussed, highlighting the release of hazardous substances and their contribution to air, soil, and water pollution. The paper advocates for circular economy (CE) principles and waste-to-energy solutions to achieve sustainable waste management. It also addresses complexities and constraints faced by developing nations and proposes strategies to overcome them. In conclusion, this comprehensive review underscores the importance of risk assessment, the potential of AI and waste-to-energy solutions, and the need for sustainable waste management to safeguard public health and the environment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The discharge of industrial effluents has a significant impact on the Water Quality Index (WQI) of the water bodies and is a major source of contamination of groundwater. The present study investigated the physicochemical characteristics and scrutinized the pollution potential of the tannery, textile, and electroplating effluents uploading into the Kala Sanghian drain, located in Jalandhar, Punjab, India. In this study, 12 samples were collected from the four sites (leather complex drain (LD), leather complex outlet (LO), focal point drain (FD), and Bulandpur drain (BD)) of Kala Sanghian drain in the dry season. The result showed that the drain under consideration is very much contaminated and the water is not suitable for irrigation and agricultural purposes. Rather it has a bad impact on the health of local people, the physiology of aquatic organisms, and the soil quality of agricultural land nearby. The present study confirmed the water quality index was more than 100, indicating a highly contaminated drain and water is unfit for any use. The correlation analysis shows that there exists a positive correlation between TDS and temperature (r = 0.994), DO and pH (r = 0.808), BOD and temperature (r = 0.987), BOD and TDS (r = 0.978), EC and temperature (r = 0.963), EC and TDS (r = 0.954), and EC and BOD (r = 0.956). The principal component analysis (PCA) confirms that PC1 alone has more than 89% of the variance with high positive loading for TDS, temperature, EC, and BOD. The hierarchical cluster analysis (HCA) reflected two clusters where cluster 1 consists of pH, DO, temperature, and BOD of water while cluster 2 consists of TDS and EC of water. The PCA and HCA study of the data set confirms the high degree contribution of anthropogenic activities through the application of chemicals in agriculture, disposal of municipal waste, and industrial effluents in the deterioration of water quality. The results of the study will help to enhance the sustainable action plan for the management of industrial effluents in the studied area., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose: According to the 4th and 5th rounds of National Family Health Survey (NFHS), there is high prevalence of hysterectomies in the three states of Andhra Pradesh Telangana and Bihar. The three said states have more than double the number of hysterectomies taking place than the national average. Our purpose is to analyse whether these rates are increasing, decreasing or have stabilized and their reasons thereof. Such an analyses will help the policy makers in recommending good clinical practices within their states., Material and Methods: We used data from NFHS-4 (2015-16) and NFHS-5 (2019-2021) rounds. We calculated the differences in predicted probabilities for various factors, performed a Fairlie Decomposition analyses to quantify the positive and negative contributors in the prevalence of hysterectomy across the three states over two time points, and assessed the association of various socio-demographic characteristics to hysterectomy through a multilevel logistic regression model., Results and Conclusion: The results show that out of a total of 80,976 eligible respondents from the states under study, 5826 respondents self-reported that they had a hysterectomy done. It was found that older age, living in rural areas, belonging to other backward classes and higher wealth quintile, and higher parity positively contributed to the increased prevalence of hysterectomies in the three states. Higher educational attainment and previous use of family planning methods acted as protective factors. Characteristics at the household level had the highest intra-class correlation value in the prevalence of hysterectomy among women, followed by the Primary Sampling Unit and District levels, indicating high clustering in the prevalence of hysterectomy at the household level in all three states. Heavy menstrual bleeding/pain was the leading cause of hysterectomies in all three states, followed by fibroids/cysts in Andhra Pradesh and Telangana and Uterine disorder/ prolapse in Bihar. Over 80% of hysterectomies took place in the private hospitals., Recommendations: The study recommends better, more efficient and accountable hysterectomy surveillance to ensure more sustainable woman's reproductive health services in India. Government should adopt and implement standard regulatory guidelines to prevent provider-driven avoidable hysterectomies. Moreover, we recommend informing primary care professionals about the long-term health effects of hysterectomy and promoting alternate therapies for treating uterine fibroids and heavy bleeding., (© 2024. The Author(s).)

Frequent floods are a severe threat to the well-being of people the world over. This is particularly severe in developing countries like India where tropical monsoon climate prevails. Recently, flood hazard susceptibility mapping has become a popular tool to mitigate the effects of this threat. Therefore, the present study utilized four distinctive Machine Learning algorithms i.e., K-Nearest Neighbor, Decision Tree, Naive Bayes, and Random Forest to estimate flood susceptibility zones in the Agartala Urban Watershed of Tripura, India. The latter experiences debilitating floods during the monsoon season. A multicollinearity test was conducted to examine the collinearity of the chosen flood conditioning factors, and it was seen that none of the factors were compromised by multicollinearity. Results showed that around three-fourths of the AUW area was classified as moderate to very high flood-prone zones, while over 20 percent was between low and very low flood-prone zones. The models applied performed well with ROC-AUC scores greater than 70 percent and MAE, MSE, and RMSE scores less than 30 percent. DT and RF algorithms were suggested for places with similar physical characteristics based on their outstanding performance and the training datasets. The study provides valuable insights to policymakers, administrative authorities, and local stakeholders to cope with floods and enhance flood prevention measures as a climate change adaptation strategy in the AUW., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Tuberculosis is a common cause of morbidity and mortality especially in low-income and middle-income countries like India. BCG vaccination is recommended for all neonates after birth in areas with a high tuberculosis disease burden. Here, we describe a case where a neonate received two doses of the BCG (Chennai strain) vaccine within a span of 4 days after birth due to a vaccination error. Parents were informed about the event. The infant was managed conservatively and followed up till 12 months of life for any possible complication. There were no serious adverse effects apart from the localised reaction and a double scar on the left arm. Measures to avoid any such error in the future and the need for reporting medication error has been highlighted. Parental concerns are frequent in such scenarios and should be actively addressed., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

We read with great interest the article "the deadly duo of hypertension and diabetes in India: further affirmation from a new epidemiological study" by Metri et al. 1 They rightly pointed out that the prevalence of hypertension in Indian patients with type 2 diabetes patients is high and therefore early screening and management of hypertension should be included in the treatment of patients with type 2 diabetes. We wish to share our study findings on the prevalence of hypertension in newly onset diabetes mellitus (DM). We find that the prevalence of hypertension in all males and females with DM was 44.59, 44.34, and 45.16%, respectively. 2 ., (© Journal of the Association of Physicians of India 2023.)

Background: Recently, a wide range variety of manifestations, including a self‑limiting to severe illness, has been increasingly reported in dengue. Few studies attract attention to severe dengue, mainly observed in secondary infection. With this background, this study aims to provide a comprehensive overview to differentiate primary from secondary dengue using serology (IgG) and the possible association of severity of illness in secondary dengue., Methods: Present retrospective cross-sectional study was conducted at a North Indian tertiary care center from September 2021 to January 2022. Clinical data of confirmed dengue patients from the medicine department were collected and assigned as primary and secondary dengue., Results: Of the 220 dengue patients, 22 (10 %) had secondary dengue infection. Hemorrhagic manifestations were reported in 58/220 (26.4 %) cases while 7/22 (31.8 %) in secondary dengue. Prevalent hemorrhagic manifestations in secondary dengue include purpura (27.3 %), vaginal bleeding (4.5 %), melaena (9.1 %), and epistaxis (4.5 %). In addition, 42 (19.1 %) patients had pancytopenia, and 8 (36.6 %) cases were of secondary dengue. Hepatic dysfunction was noted in 164 (74.5 %) cases. Notably, all secondary dengue cases (22;100 %) had hepatic dysfunction and severe in 9 (40.9 %) cases. In addition, in secondary dengue patients, evidence of plasma leakages such as hypoproteinemia 7 (31.8 %) and ascites (35 %) were statistically more frequent. Overall, two deaths (0.9 %) were reported, and were one in each group., Conclusions: Many parameters, including hemorrhagic manifestation (melaena), hematological characteristic (pancytopenia), evidence of plasma leakage (hypoproteinemia and ascites), gastrointestinal (GB wall thickening and hepatic dysfunction) and reduction in mean hemoglobin and platelet count were found to be statistically significant in secondary dengue infection. Additionally, early classification of secondary dengue may help to anticipate its severity and allow for early strategic intervention/management to lower morbidity and mortality., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Unmet needs for contraception in India have declined over time but the rate has not been uniform among women across geographies and socio-economic strata. Identifying the characteristics of women in communities where unmet need is still high is important to devise appropriate strategies to ensure access and uptake of modern contraceptive methods. The current study examined whether there was a national decline in unmet need over time and if regional disparities exist in unmet need. Demographic variations in unmet need based on factors such as maternal age, education, religion, caste, wealth index quintile, family size, and access to antenatal care (ANC) were also documented. Our approach was to document the prevalence of total unmet need for family planning and unmet need for spacing among married Indian women and quantify variability based on socio-economic and demographic drivers within a hierarchal framework, thus providing both macro and micro perspectives. We used data from the fourth and fifth rounds of the National Family Health Survey (NFHS) collected from all the States and Union Territories (UTs) in India. Quantile regression analysis and multilevel regression techniques were used to understand the predictors for the total unmet need for family planning and the unmet need for spacing. Results show a considerable decline in the prevalence of unmet need for family planning in India from NFHS-4 to 5 (from 12.9 to 9.3%) in the last six6 years. The north-eastern states show a significant reduction in unmet need for family planning in Manipur (17.8%), Nagaland (13.5%), and followed by Sikkim (9.1%). The predictors such as years of schooling, place of residence, caste, religion, wealth quintile, number of antenatal care (ANC) visits, and children ever born have a significant association with unmet needs for family planning and spacing among married women in India. There is a significant association between years of schooling with the total unmet needs for family planning at (q25) quantiles and the unmet need for spacing at (q25, q50) quantiles. Results reveal that the demand for unmet need for spacing and limiting was the highest among the women in the age categories 15-19 (17.8%) and 20-24 (17.3%). The demand for limiting was the highest (6.8%) among Muslim women. Across wealth quantile categories, the overall unmet demand (11.4%) for spacing and limiting was the highest among the women in the lowest socioeconomic groups. We conclude that greater access to frontline health workers among young wives, and significant investment in education in general, will continue to reduce the unmet needs for family planning in India., (© 2023. The Author(s).)

Purpose: Owing to the reproductive health needs of the budding adolescent and young population, the present study aims to determine the factors associated with and decomposing the gap in contraceptive use among adolescents and young women in India., Design: Cross sectional design.SettingThe present study is based in India using the appended datasets (IV and V rounds) of the Indian Demographic Health Survey (DHS), also known as National Family Health Survey (NFHS) conducted in 2015-16 and 2019-21., Sample: The adequate sample size was 475,294 adolescents and young women in NFHS-4 and 229,705 in NFHS-5, totaling 704,999 adolescents (appended for NFHS-4 and 5) for the present study., Measures: Sociodemographic, sexual and reproductive history and contraceptive measures., Analysis: Descriptive statistics, chi-square tests, and a binary logistic regression model were executed. Additionally, a decomposition technique called Fairlie decomposition was employed to identify the primary causes of the difference in the prevalence of contraceptive use between the two survey periods., Results: Almost 96% of young women aged 15-24 knew about contraception, but only 12% used it. Regression analysis revealed that contraceptive use was associated with higher age (AOR 1.09), higher education (AOR 1.28), married adolescents (AOR 4.08), richest wealth quantile (AOR 2.95), joint decision making (AOR 4.40), knowledge of ovulatory cycle (AOR 1.47), interaction with a health worker about any methods of family planning (AOR 3.29) and three and above children ever born (AOR 18.54). Decomposition analysis showed that factors like decision-making of contraception, age, interaction with family planning worker, the intention of last pregnancy, place of residence and age at first sex contributed to increasing the probability of contraceptive use from NFHS-4 to 5., Conclusion: A target-based approach dedicated to understanding the mindset of adolescents and keeping up with their unique needs is the need of the hour., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The rice weevil, Sitophilus oryzae (Linnaeus, Coleoptera: Curculionidae), is a serious cosmopolitan pest that affects grain in storage and has developed high levels of resistance toward phosphine. In this study, RNA-seq data was used to study the phosphine resistance mechanisms in S. oryzae. Resistant and susceptible populations of S. oryzae were identified based on phosphine bioassays conducted in 32 populations collected across Tamil Nadu, India. Differential expression of mitochondrial (COX1, COX2, COX3, ND2, ND3, ATP6, and ATP8) and detoxification genes (Cyps, Gsts, and Cbe) were observed in the resistant and susceptible populations of S. oryzae. The previously characterized phosphine resistant gene, dld (dihydrolipoamide dehydrogenase) linked to the rph2 locus, was found to be up-regulated in resistant S. oryzae population (ISO-TNAU-RT) treated with phosphine. Also, the genes involved in Tricarboxylic acid (TCA) cycle were significantly down-regulated. In addition, a significant up-regulation in the expression of the antioxidant enzymes superoxide dismutase (2.5×) and catalase (2.1×) in ISO-TNAU-RT populations was recorded. Furthermore, a distinct amino acid substitution, Lysine > Glutamic acid (K141E) was identified in resistant phenotypes. In silico docking studies of both resistant and susceptible DLD protein with phosphine molecule revealed that the amino acid residues involved in the interaction were different. This suggested that the amino acid substitution might lead to structural modifications which reduces the affinity of the target (phosphine). This study provides insight on the various genes, pathways, and functional mechanisms having a significant role in phosphine resistance in S. oryzae., (© The Author(s) 2023. Published by Oxford University Press on behalf of Entomological Society of America.)

China, India, and the USA are the countries with the highest energy consumption and CO 2 emissions globally. As per the report of datacommons.org , CO 2 emission in India is 1.80 metric tons per capita, which is harmful to living beings, so this paper presents India's detrimental CO 2 emission effect with the prediction of CO 2 emission for the next 10 years based on univariate time-series data from 1980 to 2019. We have used three statistical models; autoregressive-integrated moving average (ARIMA) model, seasonal autoregressive-integrated moving average with exogenous factors (SARIMAX) model, and the Holt-Winters model, two machine learning models, i.e., linear regression and random forest model and a deep learning-based long short-term memory (LSTM) model. This paper brings together a variety of models and allows us to work on data prediction. The performance analysis shows that LSTM, SARIMAX, and Holt-Winters are the three most accurate models among the six models based on nine performance metrics. Results conclude that LSTM is the best model for CO 2 emission prediction with the 3.101% MAPE value, 60.635 RMSE value, 28.898 MedAE value, and along with other performance metrics. A comparative study also concludes the same. Therefore, the deep learning-based LSTM model is suggested as one of the most appropriate models for CO 2 emission prediction., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Satellite remote sensing and geographic information system (GIS) have revolutionalized the mapping, quantifying, and assessing the land surface processes, particularly analyzing the past and future land use-land cover (LULC) change patterns. Worldwide river basins have observed enormous changes in the land system dynamics as a result of anthropogenic factors such as population, urbanization, development, and agriculture. As is the scenario of various other river basins, the Brahmaputra basin, which falls in China, Bhutan, India, and Bangladesh, is also witnessing the same environmental issues. The present study has been conducted on the Brahmaputra Valley in Assam, India (a sub-basin of the larger Brahmaputra basin) and assessed its LULC changes using a maximum likelihood classification algorithm. The study also simulated the changing LULC pattern for the years 2030, 2040, and 2050 using the GIS-based cellular automata Markov model (CA-Markov) to understand the implications of the ongoing trends in the LULC change for future land system dynamics. The current rate of change of the LULC in the region was assessed using the 48 years of earth observation satellite data from 1973 to 2021. It was observed that from 1973 to 2021, the area under vegetation cover and water body decreased by 19.48 and 47.13%, respectively. In contrast, cultivated land, barren land, and built-up area increased by 7.60, 20.28, and 384.99%, respectively. It was found that the area covered by vegetation and water body has largely been transitioned to cultivated land and built-up classes. The research predicted that, by the end of 2050, the area covered by vegetation, cultivated land, and water would remain at 39.75, 32.31, and 4.91%, respectively, while the area covered by built-up areas will increase by up to 18.09%. Using the kappa index (ki) as an accuracy indicator of the simulated future LULCs, the predicted LULC of 2021 was validated against the observed LULC of 2021, and the very high ki observed validated the generated simulation LULC products. The research concludes that significant LULC changes are taking place in the study area with a decrease in vegetation cover and water body and an increase of area under built-up. Such trends will continue in the future and shall have disastrous environmental consequences unless necessary land resource management strategies are not implemented. The main factors responsible for the changing dynamics of LULC in the study area are urbanization, population growth, climate change, river bank erosion and sedimentation, and intensive agriculture. This study is aimed at providing the policy and decision-makers of the region with the necessary what-if scenarios for better decision-making. It shall also be useful in other countries of the Brahmaputra basin for transboundary integrated river basin management of the whole region., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study investigates the socio-demographic correlates of HIV discrimination among individuals aged 15-49 years. This study also aims to assess the change in discriminatory attitudes towards PLHIV in high HIV prevalence states from 2016 to 2021 using data from the national Demographic Health Survey (4th and 5th). To identify factors associated with discriminatory attitudes, a multivariable logistic regression analysis was performed. Further, predicted probabilities and average marginal effects were computed, and the difference in discriminatory attitudes across both rounds was examined using a non-linear Fairlie decomposition. Mass media exposure, improved wealth index, and comprehensive knowledge significantly reduced the discriminatory attitudes towards PLHIV. Fairlie decomposition indicated that comprehensive knowledge, knowledge of mother-to-child transmission, and mass media exposure was significant contributor to the differences observed in the discriminatory attitude towards PLHIV across survey rounds. This study emphasizes the importance of spreading accurate information about HIV transmission modes and reinforces existing programmes and policies aimed at reducing stigma and discrimination against PLHIV. These programmes' efficiency and effectiveness can be ensured by linking them with community-level programmes and activities organized by Self Help Groups (SHGs), which have resulted in a paradigm shift in empowering women in India., (© 2023. Springer Nature Limited.)

Aim: Recent National Family Health Survey results portray striking improvements in most population and health indicators, including fertility, family planning, maternal and child health, gender treatment, household environments, and health insurance coverage of the Pradhan Mantri Jan Arogya Yojana (PM-JAY), with all India resonance. However, the prevalence of any anaemia (< 11 g/dl) among children under age five has exhibited a reversed trajectory in recent years. Therefore, the present study explores key drivers of the reversal of the trend in the prevalence of childhood anaemia between 2015 and2021., Methods: Data of four rounds of the National Family Health Survey (NFHS) were used to show the overall trend of anaemia among children. However, for the analysis of key drivers of the reversal trend of childhood anaemia, only the recent two rounds (NFHS-4 & NFHS-5) were used. Descriptive, bivariate multivariable analysis and Fairlie decomposition model were used to explore the drivers of the reversal of the trend in childhood anaemia., Results: During the past two decades, India has seen a decline in the prevalence of childhood anaemia (NFHS-2 to NFHS-4). However, a reversal of trend was observed recently. The prevalence of anaemia among children aged 6-59 months increased from 59 percent in NFHS-4 to 67 percent in NFHS-5. In addition, the prevalence of mild anaemia increased from 23.3 percent in NFHS-2 to 28.7 percent in NFHS-5. However, the prevalence of moderate and severe anaemia declined considerably from NFHS-2 (40 percent and 4.1 percent) to NFHS-4 (28.7 percent and 1.6 percent), but showed an increase in the prevalence in NFHS-5 (36.3 percent and 2.2 percent). Among others, mothers' educational attainment, anaemia status and socio-economic status emerge as the key drivers of the change in the prevalence of childhood anaemia., Conclusion: These findings may have vital implications for the ongoing Anaemia Mukt Bharat Programme, one of the government's dream projects in India., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Metabolic syndrome is on the rise in India and is primarily linked to obesogenic dietary habits. The synergy of both is a prominent risk factor for cardiovascular diseases (CVDs). Hence, the present study aims to unveil clusters at high risk of metabolic syndrome and ascertain cluster characteristics based on dietary patterns among adolescents aged 10-19 years., Data and Methods: The study utilizes secondary data, i.e., Comprehensive National Nutrition Survey conducted in 2016-18. The study sample includes children and adolescents aged 10-19 years. An unsupervised learning algorithm was used to ascertain possible clusters in the data based on individuals' dietary patterns. The k-means were used to cluster the data according to their dietary patterns. To determine the number of clusters elbow method was used, and appropriate validation indices were also obtained for the final k. Further, to ascertain the distribution of the obesogenic dietary patterns and metabolic conditions in each cluster was analysed. Bivariate descriptive analysis was used to draw further inferences., Results: The k-means clusters identified five optimum clusters based on 12,318 adolescents (6333 males (mean age:14.2 ± 2.8) and 5985 females (mean age:14.3 ± 2.8)) 17 dietary patterns. Clusters were named based on how prudent these were in terms of consuming a healthy diet. Cluster phenotypic characteristics were defined as follows: a cluster of obesogenic diets (24%) constituted the highest proportion of the total sample and was significantly suffering from obesity (p < 0.001), and greater proportions of lipid anomalies (p = 0.51) and hypertension (p = 0.44) but not statistically significant. In contrast, 21% of the sample comprised a plant-based diet cluster and suffered from all deficiencies but folate (p = 0.625), zinc (p = 0.132), and greater proportion from obesity (p = 0.19; not significant), and diabetes (p < 0.001). A cluster of "convenient" (20%) mainly suffered from lipid anomalies (p = 0.00), diabetes (p = 0.03), and a greater proportion from hypertension (p = 0.56) with deficiencies of all the essential vitamins and minerals but significantly from vitamin A (p < 0.001), folate (p < 0.001), and iron (p = 0.017). Lastly, the cluster of those who follow a "Western diet" (17%) was found to have lipid anomalies (p = 0.003), diabetes (p = 0.016), greater proportion of vitamin B12 (p = 0.136), D (p = 0.002), folate (p < 0.001), and iron deficiencies (p = 0.013)., Conclusions and Relevance: Adolescents in India show a strong association between obesogenic diet and metabolic syndrome. Therefore, the burden of metabolic syndrome at early ages can be prevented by controlling obesogenic dietary practices and addressing micronutrient deficiencies. This may be done by targeted health promotional campaigns in schools and college-going populations in India., (© 2023. BioMed Central Ltd., part of Springer Nature.)

This study examines malnutrition's triple burden, including anaemia, overweight, and stunting, among children aged 6-59 months. Using data from the National Family Health Survey-5 (2019-2021), the study identifies risk factors and assesses their contribution at different levels to existing malnutrition burden. A random intercept multilevel logistic regression model and spatial analysis are employed to identify child, maternal, and household level risk factors for stunting, overweight, and anaemia. The study finds that 34% of children were stunted, 4% were overweight, and 66% were anaemic. Stunting and anaemia prevalence were higher in central and eastern regions, while overweight was more prevalent in the north-eastern and northern regions. At the macro-level, the coexistence of stunting, overweight, and anaemia circumstantiates the triple burden of childhood malnutrition with substantial spatial variation (Moran's I : stunting-0.53, overweight-0.41, and anaemia-0.53). Multilevel analysis reveals that child, maternal, and household variables play a substantial role in determining malnutrition burden in India. The nutritional health is significantly influenced by a wide range of determinants, necessitating multilevel treatments targeting households to address this diverse group of coexisting factors. Given the intra-country spatial heterogeneity, the treatment also needs to be tailor-made for various disaggregated levels.

For nearly two years, a persistent foam cover has been observed during the post-monsoon season in the Yamuna River beneath the barrage near Okhla in Delhi, India. This affair has been a matter of public concern now, after the gigantic appearance of foam in November 2021, as the visibility of foam has awakened people's environmental 'conscience' over the 'concealed' chemical pollution. The mechanisms of agents responsible for foaming in rivers, particularly surfactants and phosphates, have received wide attention in the dynamic community of river pollution. Many studies in the past, around the globe, have evidently provided different rationales behind the dense foam formation in rivers, yet the Concerned Govt. Authorities have highlighted the cause of foam formation in the river Yamuna is associated with the presence of detergents and phosphates as foaming agents. Despite this, an aperture with copious unaccounted factors or underlying agents still exists to rationalize the foam formation and persistence. In this article, we outline these unaccounted factors which might be responsible for the foam formation and stabilization and give indications for future research directives towards the emergence of studies regarding the dense foam formation in river Yamuna., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The Damoh district, which is located in the central India and characterized by limestone, shales, and sandstone compact rock. The district has been facing groundwater development challenges and problems for several decades. To facilitate groundwater management, it is crucial to monitoring and planning based on geology, slope, relief, land use, geomorphology, and the types of the basaltic aquifer in the drought-groundwater deficit area. Moreover, the majority of farmers in the area are heavily dependent on groundwater for their crops. Therefore, delineation of groundwater potential zones (GPZ) is essential, which is defined based on various thematic layers, including geology, geomorphology, slope, aspect, drainage density, lineament density, topographic wetness index (TWI), topographic ruggedness index (TRI), and land use/land cover (LULC). The processing and analysis of this information were carried out using Geographic Information System (GIS) and Analytic Hierarchy Process (AHP) methods. The validity of the results was trained and tested using Receiver Operating Characteristic (ROC) curves, which showed training and testing accuracies of 0.713 and 0.701, respectively. The GPZ map was classified into five classes such as very high, high, moderate, low, and very low. The study revealed that approximately 45% of the area falls under the moderate GPZ, while only 30% of the region is classified as having a high GPZ. The area receives high rainfall but has very high surface runoff due to no proper developed soil and lack of water conservation structures. Every summer season show a declined groundwater level. In this context, results of study area are useful to maintain the groundwater under climate change and summer season. The GPZ map plays an important role in implementing artificial recharge structures (ARS), such as percolation ponds, tube wells, bore wells, cement nala bunds (CNBs), continuous contour trenching (CCTs), and others for development of ground level. This study is significant for developing sustainable groundwater management policies in semi-arid regions, that are experiencing climate change. Proper groundwater potential mapping and watershed development policies can help mitigate the effects of drought, climate change, and water scarcity, while preserving the ecosystem in the Limestone, Shales, and Sandstone compact rock region. The results of this study are essential for farmers, regional planners, policy-makers, climate change experts, and local governments, enabling them to understand the groundwater development possibilities in the study area., Competing Interests: Declaration of competing interest 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 © 2023 Elsevier Inc. All rights reserved.)

This study characterises the quality of groundwater for the Ludhiana district of Punjab, India by analysing water samples collected from 152 locations spread across 3767 km 2 . The samples were analysed for 18 parameters consisting of pH, EC, TDS, TA, TH, major anions and cations. The parameter values have been used to calculate the drinking water quality index of the study area which suggests that 2.6, 57.9, 32.9, 4 and 2.6% of the samples fall under the excellent, good, poor, very poor and unsuitable categories, respectively. The sequence of abundance for ions (in meq/l) as revealed from the laboratory tests is Na + (37.1%) > Ca 2+ (30.8%) > Mg 2+ (29.1%) > K + (2.8%) for cations and HCO 3 - (80%) > Cl ¯ (8.9%) > CO 3 2- (6.5%) > SO 4 2- (3.9%) > NO 3 - , F - , PO 4 3- (< 1%) for anions. The spatial variability of these parameters has been depicted through the use of interpolation maps. Evaluation of different ionic ratios indicates that carbonate weathering and silicate weathering are both significantly affecting the groundwater chemistry with a slight dominance of carbonate weathering. Also, the ion exchange process is taking place in the area as confirmed by CAI index values. In terms of saturation index, the groundwater is undersaturated with respect to halite, fluorite and sylvite, whereas it is supersaturated for calcite, dolomite and aragonite minerals. The principal components in PCA explained 75.4% of the total variance with 29.1 and 28.3% contributions from PC1 and PC2. Both of these components indicate towards the geogenic and anthropogenic influence on groundwater mineralization of the area. The analysis suggests that groundwater for the study area is suitable for drinking in most of the region expect in a few places. Such a study could be used to understand the current status of groundwater quality in the area, the results of which can be used to prevent further contamination and sustain the resource for the future., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Despite the Link Worker Scheme to address the HIV risk and vulnerabilities in rural areas, reaching out to unreached men having sex with men (MSM) remains a challenge in rural India. This study explored issues around health care access and programmatic gaps among MSM in rural settings of India., Methods: We conducted eight Focused Group Discussions (FGDs), 20 Key Informant Interviews (KIIs), and 20 In-Depth Interviews (IDIs) in four rural sites in Maharashtra, Odisha, Madhya Pradesh, and Uttar Pradesh between November 2018 and September 2019. The data in the local language were audio-recorded, transcribed, and translated. Data were analyzed in NVivo version 11.0 software using the grounded theory approach., Results: Primary barriers to health care access were lack of knowledge, myths and misconceptions, not having faith in the quality of services, program invisibility in a rural setting, and anticipated stigma at government health facilities. Government-targeted intervention services did not seem to be optimally advertised in rural areas as MSM showed a lack of information about it. Those who knew reported not accessing the available government facilities due to lack of ambient services, fear of the stigma transforming into fear of breach of confidentiality. One MSM from Odisha expressed, "…they get fear to go to the hospital because they know that hospital will not maintain confidentiality because they are local people. If society will know about them, then family life will be disturbed" [OR-R-KI-04]. Participants expressed the desire for services similar to those provided by the Accredited Social Health Activists (ASHA), frontline health workers for MSM., Conclusion: Programme invisibility emerges as the most critical issue for rural and young MSM. Adolescent and panthis emerged as Hidden MSM and they need focused attention from the programme. The need for village-level workers such as ASHA specifically for the MSM population emerged. MSM-friendly health clinics would help to improve healthcare access in rural MSMs under Sexual and Reproductive Health Care., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Bangar 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.)

The study primarily focuses on analyzing married women's attitudes towards negotiating safer sex in two contexts. The first context is when a woman refuses to have sex with husband if she knows her husband has a sexually transmitted disease (STD) and the second is when she does so if she knows he has sex with other women. The study examined predictors of Indian women's attitude towards negotiating safer-sex using data on 92,306 ever married women from the state module of the 2015-16, National Family Health Survey 4. Descriptive and multilevel logistic regression was used to understand the interplay between the attitude towards negotiation of safer sexual relationships with husband and the selected background characteristics with a primary focus on controlling behaviour and power relations. About 17% of women did not believe in negotiating safer sexual relations with the husband. An approximately equal proportion of ever-married women (79% each) believed in doing so under the two specific conditions, that is, if they knew the husband had an STD and they knew he had sex with other women. Multilevel regression analysis showed that women who had household decision-making power [AOR=0.71; p<0.01] and those whose husbands displayed low control towards them [AOR=0.91; p<0.05] were more likely to believe in negotiating safer-sex. Our findings suggest that women who have controlling partners or those who live under the umbrella of the husband's authority lack the power to negotiate for safer sex. Interventions promoting sexual well-being must deal with negative male perceptions and expectations that perpetuate unhealthy sexual habits and marriage ties.

Groundwater contamination studies are important to understand the risks to public health. In this study, groundwater quality, major ion chemistry, sources of contaminants, and related health risks were evaluated for North-West Delhi, India, a region with a rapidly growing urban population. Groundwater samples collected from the study area were analysed for physicochemical parameters - pH, electrical conductivity, total dissolved solids, total hardness, total alkalinity, carbonate, bicarbonate, chloride, nitrate, sulphate, fluoride, phosphate, calcium, magnesium, sodium and potassium. Investigation of hydrochemical facies revealed that bicarbonate was the dominant anion while magnesium was the dominant cation. Multivariate analysis using principal component analysis and Pearson correlation matrix indicated that major ion chemistry in the aquifer under study is primarily due to mineral dissolution, rock-water interactions and anthropogenic factors. Water quality index values showed that only 20% of the samples were acceptable for drinking. Due to high salinity, 54% of the samples were unfit for irrigation purposes. Nitrate and fluoride concentrations ranged from 0.24 to 380.19 mg/l and 0.05 to 7.90 mg/l, respectively due to fertilizer use, wastewater infiltration and geogenic processes. The health risks from high levels of nitrate and fluoride were calculated for males, females, and children. It was found that health risk from nitrate is more than fluoride in the study region. However, the spatial extent of risk from fluoride is more indicating that more people suffer from fluoride pollution in the study area. The total hazard index for children was found to be more than adults. Continuous monitoring of groundwater and application of remedial measures are recommended to improve the water quality and public health in the region., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Agriculture, meteorological, and hydrological drought is a natural hazard which affects ecosystems in the central India of Maharashtra state. Due to limited historical data for drought monitoring and forecasting available in the central India of Maharashtra state, implementing machine learning (ML) algorithms could allow for the prediction of future drought events. In this paper, we have focused on the prediction accuracy of meteorological drought in the semi-arid region based on the standardized precipitation index (SPI) using the random forest (RF), random tree (RT), and Gaussian process regression (GPR-PUK kernel) models. A different combination of machine learning models and variables has been performed for the forecasting of metrological drought based on the SPI-6 and 12 months. Models were developed using monthly rainfall data for the period of 2000-2019 at two meteorological stations, namely, Karanjali and Gangawdi, each representing a geographical region of Upper Godavari river basin area in the central India of Maharashtra state which frequently experiences droughts. Historical data from the SPI from 2000 to 2013 was processed to train the model into machine learning model, and the rest of the 2014 to 2019-year data were used for testing to forecast the SPI and metrological drought. The mean square error (MSE), root mean square error (RMSE), adjusted R 2 , Mallows' (Cp), Akaike's (AIC), Schwarz's (SBC), and Amemiya's PC were used to identify the best combination input model and best subregression analysis for both stations of SPI-6 and 12. The correlation coefficient ([Formula: see text]), mean absolute error (MAE), root mean square error (RMSE), relative absolute error (RAE), and root relative squared error (RRSE) were used to perform evaluation for SPI-6 and 12 months of both stations with RF, RT, and GPR-PUK kernel models during the training and testing scenarios. The results during testing phase revealed that the RF was found as the best model in forecasting droughts with values of [Formula: see text], MAE, RMSE, RAE (%), and RRSE (%) being 0.856, 0.551, 0.718, 74.778, and 54.019, respectively, for SPI-6 while 0.961, 0.361, 0.538, 34.926, and 28.262, respectively, for SPI-12 scales at Gangawdi station. Further, the respective values of evaluators at Karanjali station were 0.913 and 0.966, 0.541 and 0.386, 0.604 and 0.589, 52.592 and 36.959, and 42.315 and 31.394 for PUK kernel and RT models, respectively, during SPI-6 and SPI-12. Machine learning models are potential drought warning techniques because they take less time, have fewer inputs, and are less sophisticated than dynamic or scientific models., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: The North East (NE) India is rich in biodiversity and also considered as the secondary centre for origin of rice. The NE rice accessions was characterized previously using genetic markers and morphological traits. Simultaneously, genome-wide association studies (GWAS) reveal significant marker-trait associations for the drought tolerance traits., Methods and Results: The genetic diversity and population structure of 296 NE rice accessions were studied using 96,712 single nucleotide polymorphism (SNP) markers distributed across 12 chromosomes. The accessions were clustered into two major sub-groups (SG). A total of 91 accessions were assembled as SG1 and 114 accessions as SG2, while the remaining 91 were admixture genotypes. A total of 200 genotypes belonging to different groups were phenotyped for yield component traits under drought and control conditions. The GWAS was performed to identify significant marker-trait associations (MTAs). Consequently, 47 MTAs were detected under drought, exhibiting 0.02-9.95% of phenotypic variance (P.V.). Whereas 58 MTAs were discovered under control conditions, showing a 0.01-9.74% contribution to the phenotype. Through in-silico mining of QTLs, 2999 genes were identified. Among these; only 22 genes were directly associated with stress response., Conclusion: These QTLs/genes may be deployed for marker-assisted pyramiding to improve drought tolerance in popular drought susceptible rice varieties., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Chronic disease burden among women leads to various detrimental consequences, impacting women's health throughout their life course and off-springs. The present study explores the chronic disease profile among reproductive-aged women and analyzes the effects of various covariates on multimorbidity among reproductive-aged women in India. Here, multimorbidity is defined as an individual suffering from two or more chronic conditions., Methods: The present study employed the most recent National Family Health Survey round, 2019-2021. The study utilized information on 695,707 non-pregnant women aged 15-49 years. The study used descriptive, bivariate, and multivariable ordered logistic regression analysis to explore the burden of chronic non-communicable diseases and multimorbidity., Results: The mean age of women with single chronic condition-related morbidity is 30 years, whereas it was 35 years for those with multimorbidity. Approximately 28% of urban women suffered from multimorbidity. Further, significant factors that affect multimorbidity include age, educational attainment, working status, marital status, parity, menopause, religion, region, wealth index, tobacco use, alcohol consumption, and dietary patterns., Conclusions: The present study hints that women in the reproductive age group are at very high risk of developing multimorbidity in India. Most of the programs and policies are focused on the elderly population in terms of awareness and facilitating them with better health services. However, right now, one should also prioritize the emerging chronic condition related to chronic conditions other than hypertension, diabetes, and cancer among the study population, which is escalating as soon as women reach 30 years of age., (© 2023. The Author(s).)

Background: Muzaffarpur district in Bihar State of India recorded a resurgence of acute encephalopathy syndrome (AES) cases in the summer of 2019 after no reported outbreak in 3 y. Earlier studies generated evidence that litchi consumption and missing the previous evening's meal were associated with AES. We investigated the recent outbreak to understand the risk factors associated with AES., Methods: We conducted a matched case-control study by comparing AES cases with healthy controls from case-households and the neighborhood community for risk factors like missing evening meal and litchi consumption before onset of AES., Results: We recruited 61 cases and 239 controls. Compared with the community controls, case-patients were five times more likely to have reported eating litchi in the 7 d preceding the onset of illness (adjusted OR [AOR]=5.1; 95% CI 1.3 to 19) and skipping the previous evening's meal (AOR=5.2; 95% CI 1.4 to 20). Compared with household controls, case-patients were five times more likely to be children aged <5 y (AOR=5.3; 95% CI 1.3 to 22) and seven times more likely to have skipped the previous evening's meal (AOR=7.4; 95% CI 1.7 to 34)., Conclusions: Skipping the previous evening's meal and litchi consumption were significantly associated with AES among children in Muzaffarpur and adjoining districts of Bihar., (© The Author(s) 2022. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Data on Point Prevalence Surveys (PPSs) in India are limited yet. We report findings of a PPS conducted in a core "National Antimicrobial Consumption Network site" under National Centre for Disease Control - WHO project "Point prevalence survey of antimicrobial consumption at healthcare facilities." A cross-sectional survey was conducted as per the "WHO methodology for PPS on antibiotic use in hospitals" in a tertiary care hospital in India in December 2021. Data were collected using predesigned and pretested questionnaire in separate hospital, ward, and patient forms. Eight hundred two inpatients (excluding ICUs) were covered out of whom 299 (37.3%) were on antibiotics with 11.7% receiving 3 or more antibiotics. Surgical prophylaxis (SP) (42.5%) and community acquired infections (32.8%) were the most common indications for antibiotic use. Of the patients, 92.5% received SP for more than 24 hrs. Most commonly prescribed antibiotics were penicillins with beta-lactamase inhibitors (22.3%). Of the total antibiotic prescriptions, 81.5% were from WHO essential medicines list and 12% from "not recommended" WHO AWaRe classification. Of the antibiotic prescriptions, 84.6% were parenteral. Few prescriptions complied with standard treatment guidelines (1.9%), documented indication for antibiotic use (11.6%), and stop/review date (4.4%) in notes. Double anaerobic cover accounted for 6.8% of the total prescriptions. Some identified areas for improvement were: formulation of hospital antibiotic guidelines, promoting culture of sending cultures, improvement in surgical antibiotic prophylaxis, decreasing use of antibiotic combinations and double anaerobic cover, fostering IV to oral switch of antibiotics, and ensuring effective communication among health care workers by documenting adequate information in medical notes.

The radiation workers in India use extremity dosemeter in occupational areas where there is likelihood of receiving significant dose to extremities of the body. Algorithm used for the estimation of whole body dose and extremity dose of wrist are same and is based on slab phantom calibration. However, internationally, different phantoms are recommended for calibration of dosemeter used for extremity and whole body. The recommended quantity for estimation of dose to extremity is the personal dose equivalent Hp(0.07) at 0.07 mm depth. In light of this, an algorithm was developed for estimation of wrist dose in terms of Hp(0.07) based on calibration performed on ISO recommended pillar phantom. Performance of the dosemeter for the estimation of Hp(0.07) with new algorithm was carried out at different angular exposures of photon beams and mixed field of photon and beta. Comparison of results obtained for two types of ISO phantoms (slab and pillar) is also performed for photon beams to highlight the uncertainty caused due to the use of the slab phantom. In case of beta radiation, it was found that the size and shape of the phantom has very little influence in the response of the dosemeter. Performance of the dosemeter using ISO slab and ISO pillar phantoms for beta radiation using the prevalent algorithm was carried out and found to be within the uncertainty limits laid down by ISO except at angle 60°., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

The India Field Epidemiology Training Program (FETP) has played a critical role in India's response to the ongoing COVID-19 pandemic. During March 2020-June 2021, a total of 123 FETP officers from across 3 training hubs were deployed in support of India's efforts to combat COVID-19. FETP officers have successfully mitigated the effect of COVID-19 on persons in India by conducting cluster outbreak investigations, performing surveillance system evaluations, and developing infection prevention and control tools and guidelines. This report discusses the successes of select COVID-19 pandemic response activities undertaken by current India FETP officers and proposes a pathway to augmenting India's pandemic preparedness and response efforts through expansion of this network and a strengthened frontline public health workforce.