Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-12 (of 12 Records) |
Query Trace: Naik R [original query] |
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Clinical characteristics and factors associated with long COVID among post-acute COVID-19 clinic patients in Zambia, August 2020 to January 2023: A cross-sectional and longitudinal study design
Malambo W , Chanda D , Besa L , Engamba D , Mwiinga L , Mwitumwa M , Matibula P , Naik N , Sivile S , Agolory S , Auld A , Mulenga L , Hines JZ , Fwoloshi S . PLoS One 2024 19 (7) e0306131 INTRODUCTION: A number of seroprevalence studies in Zambia document the extent of spread of acute SARS-CoV-2 infection, yet knowledge gaps still exist on symptoms and conditions that continue or develop after acute COVID-19 (long COVID). This is an important gap given the estimated prevalence of long COVID in other African countries. We assessed factors associated with long COVID at the initial visit to a post-acute COVID-19 (PAC-19) clinic and longitudinally among a cohort of patients with ≥2 review visits. METHODS: We implemented a cross-sectional and longitudinal analysis of PAC-19 clinic patients from Aug-2020 to Jan-2023. The study outcome was long COVID; defined as the presence of new, relapsing, or persistent COVID-19 symptoms that interfere with the ability to function at home or work. Explanatory variables were demographic and clinical characteristics of patients which included sex, age group, presence of new onset medical conditions, presence of pre-existing comorbidities, vaccination status and acute COVID-19 episode details. We fitted logistic and mixed effects regression models to assess for associated factors and considered statistical significance at p<0.05. RESULTS: Out of a total 1,359 PAC-19 clinic patients in the cross-sectional analysis, 548 (40.3%) patients with ≥2 PAC-19 clinic visits were in the longitudinal analysis. Patients' median age was 53 (interquartile range [IQR]: 41-63) years, 919 (67.6%) were hospitalized for acute COVID-19, and of whom 686 (74.6%) had severe acute COVID-19. Overall, 377 (27.7%) PAC-19 clinic patients had long COVID. Patients with hospital length of stay ≥15 days (adjusted odds ratio [aOR]: 5.37; 95% confidence interval [95% CI]: 2.99-10.0), severe acute COVID-19 (aOR: 3.22; 95% CI: 1.68-6.73), and comorbidities (aOR:1.50; 95% CI: 1.02-2.21) had significantly higher chance of long COVID. Longitudinally, long COVID prevalence significantly (p<0.001) declined from 75.4% at the initial PAC-19 visit to 26.0% by the final visit. The median follow-up time was 7 (IQR: 4-12) weeks. CONCLUSION: Factors associated with long COVID in Zambia were consistent both cross-sectionally at the initial visit to PAC-19 clinics and longitudinally across subsequent review visits. This highlights the importance of ongoing monitoring and tailored interventions for patients with comorbidities and severe COVID-19 to mitigate the long-term impacts of COVID-19. |
Public health emergency preparedness: Qualitative analysis of after-action reports
Naik R , Maxwell N , Jones T , Dopson SA . Disaster Med Public Health Prep 2023 17 e523 After-Action Reports (AARs) are retrospective summaries that capture key information and lessons learned from emergency response exercises and real incidents. The AAR is a commonly used evaluation tool used by the Centers for Disease Control and Prevention as part of the Public Health Emergency Preparedness (PHEP) program. It is used as a metric of accountability and awardee performance. The objectives of this study were to qualitatively analyze AARs of public health preparedness programs and develop a coding scheme for standardizing future review and analysis of AARs. We evaluated 14 AARs (4 exercises and 10 real incidents) generated between 2012 and 2018. We applied inductive qualitative analyses using ATLAS.Ti software. While, previous exercises focused on medical countermeasure responses, real-world incidents focused on natural disasters and infectious disease outbreaks. Six overarching themes emerged: Communications, Coordination, Resource Distribution, Unified Planning, Surveillance, and Knowledge Sharing. A standardized analysis format is proposed for future use. |
Maternal colonization versus nosocomial transmission as the source of drug-resistant bloodstream infection in an Indian neonatal intensive care unit: A prospective cohort study
Robinson ML , Johnson J , Naik S , Patil S , Kulkarni R , Kinikar A , Dohe V , Mudshingkar S , Kagal A , Smith RM , Westercamp M , Randive B , Kadam A , Babiker A , Kulkarni V , Karyakarte R , Mave V , Gupta A , Milstone AM , Manabe YC . Clin Infect Dis 2023 77 S38-s45 BACKGROUND: Drug-resistant gram-negative (GN) pathogens are a common cause of neonatal sepsis in low- and middle-income countries. Identifying GN transmission patterns is vital to inform preventive efforts. METHODS: We conducted a prospective cohort study, 12 October 2018 to 31 October 2019 to describe the association of maternal and environmental GN colonization with bloodstream infection (BSI) among neonates admitted to a neonatal intensive care unit (NICU) in Western India. We assessed rectal and vaginal colonization in pregnant women presenting for delivery and colonization in neonates and the environment using culture-based methods. We also collected data on BSI for all NICU patients, including neonates born to unenrolled mothers. Organism identification, antibiotic susceptibility testing, and next-generation sequencing (NGS) were performed to compare BSI and related colonization isolates. RESULTS: Among 952 enrolled women who delivered, 257 neonates required NICU admission, and 24 (9.3%) developed BSI. Among mothers of neonates with GN BSI (n = 21), 10 (47.7%) had rectal, 5 (23.8%) had vaginal, and 10 (47.7%) had no colonization with resistant GN organisms. No maternal isolates matched the species and resistance pattern of associated neonatal BSI isolates. Thirty GN BSI were observed among neonates born to unenrolled mothers. Among 37 of 51 BSI with available NGS data, 21 (57%) showed a single nucleotide polymorphism distance of ≤5 to another BSI isolate. CONCLUSIONS: Prospective assessment of maternal GN colonization did not demonstrate linkage to neonatal BSI. Organism-relatedness among neonates with BSI suggests nosocomial spread, highlighting the importance of NICU infection prevention and control practices to reduce GN BSI. |
Elimination of human rabies in Goa, India through an integrated One Health approach
Gibson AD , Yale G , Corfmat J , Appupillai M , Gigante CM , Lopes M , Betodkar U , Costa NC , Fernandes KA , Mathapati P , Suryawanshi PM , Otter N , Thomas G , Ohal P , Airikkala-Otter I , Lohr F , Rupprecht CE , King A , Sutton D , Deuzeman I , Li Y , Wallace RM , Mani RS , Gongal G , Handel IG , Bronsvoort M , Naik V , Desai S , Mazeri S , Gamble L , Mellanby RJ . Nat Commun 2022 13 (1) 2788 Dog-mediated rabies kills tens of thousands of people each year in India, representing one third of the estimated global rabies burden. Whilst the World Health Organization (WHO), World Organization for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) have set a target for global dog-mediated human rabies elimination by 2030, examples of large-scale dog vaccination programs demonstrating elimination remain limited in Africa and Asia. We describe the development of a data-driven rabies elimination program from 2013 to 2019 in Goa State, India, culminating in human rabies elimination and a 92% reduction in monthly canine rabies cases. Smartphone technology enabled systematic spatial direction of remote teams to vaccinate over 95,000 dogs at 70% vaccination coverage, and rabies education teams to reach 150,000 children annually. An estimated 2249 disability-adjusted life years (DALYs) were averted over the program period at 526 USD per DALY, making the intervention 'very cost-effective' by WHO definitions. This One Health program demonstrates that human rabies elimination is achievable at the state level in India. |
Associations between select blood VOCs and hematological measures in NHANES 2005-2010
Vaughan Watson C , Naik S , Lewin M , Ragin-Wilson A , Irvin-Barnwell E . J Expo Sci Environ Epidemiol 2020 31 (2) 366-376 Exposure to VOCs is linked to health effects ranging from asthma to cancer and to negative impacts on the hematopoietic system. We examined the association between select blood VOC concentrations and hematological measures in a representative sample of the U.S. population from NHANES cycles spanning the years 2005 to 2010. We used Cox regression to assess the association between complete blood count with five-part differential (CBC) parameters and seven select blood VOCs, while addressing low detection rates among VOCs. Tobacco smoke exposure was classified using serum cotinine levels. The not-smoke-exposed group had lower VOC levels for most analytes compared with the smoke-exposed. Correlations between benzene, toluene, ethylbenzene, and xylenes (BTEX) were moderate to strong. Statistical associations were found between benzene, toluene, ethylbenzene, xylene, and styrene (BTEXS) and hematocrit, hemoglobin, and white blood cell count among the smoke-exposed. Among the not-smoke-exposed, there was an association between BTEX and platelet count. We considered benzene most likely to be associated with higher levels of CBC concentrations. Our findings suggest VOC levels currently found in the general U.S. population are associated with changes in hematological measures, and smoking could be a contributor. |
Influenza-related communication and community mitigation strategies: Results from the 2015 Pandemic Influenza Readiness Assessment
Naik RI , Vagi SJ , Uzicanin A , Dopson SA . Health Promot Pract 2019 20 (3) 1524839919826582 Emergence of a novel infectious disease, such as pandemic influenza, is the one global crisis most likely to affect the greatest number of people worldwide. Because of the potentially severe and contagious nature of influenza, a rapid multifaceted pandemic response, which includes nonpharmaceutical interventions (NPIs) and effective strategies for communication with the public are essential for a timely response and mitigating the spread of disease. A web-based questionnaire was administered via email in July 2015 to 62 Public Health Emergency Preparedness (PHEP) directors across jurisdictions that receive funding through the Centers for Disease Control and Prevention PHEP cooperative agreement. This report focuses on two modules: Public Information and Communication and Community Mitigation. Consistent and targeted communication are critical for the acceptability and success of NPIs. All 62 jurisdictions have developed or are in the process of developing a communications plan. Community-level NPIs such as home isolation, school closures, and respiratory etiquette play a critical role in mitigating the spread of disease. Effective, ongoing communication with the public is essential to ensuring wide spread compliance of NPI's, especially among non-English-speaking populations. Planning should also include reaching vulnerable populations and identifying the correct legal authorities for closing schools and canceling mass gatherings. |
Use of verbal autopsy to determine underlying cause of death during treatment of multidrug-resistant tuberculosis, India
Naik PR , Moonan PK , Nirgude AS , Shewade HD , Satyanarayana S , Raghuveer P , Parmar M , Ravichandra C , Singarajipura A . Emerg Infect Dis 2018 24 (3) 478-484 Of patients with multidrug-resistant tuberculosis (MDR TB), <50% complete treatment. Most treatment failures for patients with MDR TB are due to death during TB treatment. We sought to determine the proportion of deaths during MDR TB treatment attributable to TB itself. We used a structured verbal autopsy tool to interview family members of patients who died during MDR TB treatment in India during January-December 2016. A committee triangulated information from verbal autopsy, death certificate, or other medical records available with the family members to ascertain the underlying cause of death. For 66% of patient deaths (47/71), TB was the underlying cause of death. We assigned TB as the underlying cause of death for an additional 6 patients who died of suicide and 2 of pulmonary embolism. Deaths during TB treatment signify program failure; accurately determining the cause of death is the first step to designing appropriate, timely interventions to prevent premature deaths. |
Mortality from asbestos-associated disease in Libby, Montana 1979-2011
Naik SL , Lewin M , Young R , Dearwent SM , Lee R . J Expo Sci Environ Epidemiol 2017 27 (2) 207-213 Research on asbestos exposure in Libby, MT, has focused on occupational exposure in vermiculite mining and processing, but less attention has been paid to asbestos-related mortality among community members without vermiculite mining occupational history. Our study reports on asbestos-related mortality in Libby over 33 years (1979-2011) while controlling for occupational exposure. We calculated sex-specific 33-year standardized mortality ratios (SMRs) for Libby residents who died from 1979 to 2011 with an asbestos-related cause of death. Decedent address at time of death was geocoded to confirm inclusion in the Libby County Division. We controlled for past W.R. Grace employment by including and then removing them from the SMR analysis. Six hundred and ninety-four decedents were identified as having at least one asbestos-related cause of death and residing in our study area boundary. Statistically significant (P<0.05) 33-year SMRs, both before and after controlling for W.R. Grace employment, were found for: male and female non-malignant respiratory diseases, female COPD, and asbestosis for both sexes combined. Eighty-five men and two women were matched to employment records. We observed elevated asbestos-related mortality rates among males and females. SMR results for asbestosis were high for both sexes, even after controlling for past W.R. Grace employment. These results suggest that the general population may be experiencing asbestos-related effects, not just former vermiculite workers. Additional research is needed to determine whether SMRs remain elevated after controlling for secondary exposure, such as living with vermiculite workers. |
Drug-induced hypothyroidism during anti-tuberculosis treatment of multidrug-resistant tuberculosis: Notes from the field
Munivenkatappa S , Anil S , Naik B , Volkmann T , Sagili KD , Akshatha JS , Buggi S , Sharada MA , Kulkarni S , Chadha VK , Moonan PK . J Tuberc Res 2016 4 (3) 105-110 We followed 188 euthyroidic persons undergoing treatment for multidrug resistant tuberculosis (MDR-TB) in the state of Karnataka, India to determine the incidence of hypothyroidism during anti-tuberculosis treatment. Overall, among MDR-TB patients with valid thyroid stimulating hormone (TSH) values, about 23% developed hypothyroidism (TSH value ≥10 mIU/ml) during anti-tuberculosis treatment; the majority (74%) occurring after 3 months of treatment. Among 133 patients who received a regimen that contained ethionamide, 42 (32%) developed hypothyroidism. Among 17 patients that received a regimen that contained para-aminosalicylate sodium, 6 (35%) developed hypothyroidism. Among 9 HIV positive patients on anti-retroviral treatment, 4 (44%) developed hypothyroidism. These results differ from previously reported 4% incidence of hypothyroidism amongst patients who passively reported thyroidal symptoms during treatment, suggesting routine serologic monitoring of TSH throughout the course of treatment for MDR-TB is warranted. |
Diversity of circulating rotavirus strains in children hospitalized with diarrhea in India, 2005-2009
Kang G , Desai R , Arora R , Chitamabar S , Naik TN , Krishnan T , Deshpande J , Gupte MD , Venkatasubramaniam S , Gentsch JR , Parashar UD . Vaccine 2013 31 (27) 2879-2883 BACKGROUND: India accounts for 22% of the 453,000 global rotavirus deaths among children <5 years annually. The Indian Rotavirus Strain Surveillance Network provides clinicians and public health partners with valuable rotavirus disease surveillance data. Our analysis offers policy-makers an update on rotavirus disease burden with emphasis on regional shifts in rotavirus strain epidemiology in India. METHODS: Children <5 years requiring hospitalization for acute gastroenteritis were selected from 10 representative hospitals in 7 cities throughout India between November 2005 through June 2009. We used a modified World Health Organization protocol for rotavirus surveillance; stool specimens were collected and tested for rotavirus using enzyme immunoassay and reverse-transcription polymerase chain reaction. RESULTS: A total of 7285 stool specimens collected were tested for rotavirus, among which 2899 (40%) were positive for rotavirus. Among the 2899 rotavirus detections, a G-type could not be determined for 662 (23%) and more than one G type was detected in 240 (8%). Of 1997 (69%) patients with only one G-type, the common types were G1 (25%), G2 (21%), G9 (13%), and G12 (10%). The proportion of rotavirus infections attributed to G12 infections rose from 8% to 39% in the Northern region and from 8% to 24% in the Western region. CONCLUSIONS: This study highlights the large, ongoing burden of rotavirus disease in India, as well as interesting regional shifts in rotavirus strain epidemiology, including an increasing detection of G12 rotavirus strains in some regions. While broad heterotypic protection from rotavirus vaccination is expected based on pre- and post-licensure data from other settings, effectiveness assessments and rotavirus strain monitoring after vaccine introduction will be important. |
Measurement of ambient particulate matter concentrations and particle types near agricultural burns using electron microscopy and passive samplers
Wagner J , Naik-Patel K , Wall S , Harnly M . Atmos Environ (1994) 2012 54 260-271 Computer-controlled scanning electron microscopy and energy-dispersive X-ray spectroscopy were used to obtain ambient PM mass concentrations, elemental size distributions, morphologies, and particle types during four Bermuda grass burn events in Imperial Valley, California. Passive PM samplers were deployed to three to six locations surrounding each burn for durations of 24-120 h. Average PM(2.5) and PM(10) levels were modestly but significantly higher at locations less than 3.2 km (two miles) from the nearest burn (n = 37). During one monitored burn, higher winds caused an intense ground-level plume to envelop two samplers mounted on telephone poles very close to the field. For this event, 24-h PM(2.5) exposures downwind were up to 17 times higher than that measured upwind. Particles were classified into five distinct chemical types consistent with local area sources. Burn-related particle types, primarily submicron carbonaceous particles, contributed 95% of the PM(2.5) in the location directly impacted by the ground-level plume, compared to only 12% in the upwind location. Downwind PM(10-2.5) particles were enriched in potassium, phosphorus, chlorine, calcium, silicon, and sulfur, consistent with analyses of bulk and partially-burned Bermuda grass. The accuracy and precision of passive sampler PM measurements were all within 4 mcg m(-3), though low median values caused high percent differences for PM(2.5). The use of electron microscopy and passive sampling in this study enabled detailed PM characterizations, spatial comparisons, and rapid deployment in often dynamic sampling scenarios. (2012 Elsevier Ltd.) |
Multicenter, hospital-based surveillance of rotavirus disease and strains among Indian children aged <5 years
Kang G , Arora R , Chitambar SD , Deshpande J , Gupte MD , Kulkarni M , Naik TN , Mukherji D , Venkatasubramaniam S , Gentsch JR , Glass RI , Parashar UD , Indian Rotavirus Strain Surveillance Network . J Infect Dis 2009 200 Suppl 1 S147-53 BACKGROUND: Current, nationally representative data on rotavirus disease burden and rotavirus strains in India are needed to understand the potential health benefits of rotavirus vaccination. METHODS: The Indian Rotavirus Strain Surveillance Network was established with 4 laboratories and 10 hospitals in 7 different regions of India. At each hospital, children aged <5 years who presented with acute gastroenteritis and required hospitalization with rehydration for at least 6 h were enrolled. A fecal specimen was obtained and was tested for rotavirus with use of a commercial enzyme immunoassay, and strains were characterized using reverse-transcription polymerase chain reaction. RESULTS: From December 2005 through November 2007, rotavirus was found in approximately 39% of 4243 enrolled patients. Rotavirus was markedly seasonal in northern temperate locations but was less seasonal in southern locations with a tropical climate. Rotavirus detection rates were greatest among children aged 6-23 months, and 13.3% of rotavirus infections involved children aged <6 months. The most common types of strains were G2P[4] (25.7% of strains), G1P[8] (22.1%), and G9P[8] (8.5%); G12 strains were seen in combination with types P[4], P[6], and P[8] and together comprised 6.5% of strains. CONCLUSIONS: These data highlight the need for development and implementation of effective prophylactic measures, such as vaccines, to prevent the large burden of rotavirus disease among Indian children. |
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