Browsing by Author "Anuj Kumar Pandey"

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Effectiveness of 13-valent pneumococcal conjugate vaccine on radiological primary end-point pneumonia among cases of severe community acquired pneumonia in children: A prospective multi-site hospital-based test-negative study in Northern India
(Public Library of Science, 2022) Shally Awasthi; Neera Kohli; Monika Agarwal; Chandra Mani Pandey; Tuhina Rastogi; Anuj Kumar Pandey; Chittaranjan Roy; Kripanath Mishra; Neelam Verma; Chandra Bhushan Kumar; Pankaj Kumar Jain; Rajesh Yadav; Puneet Dhasmana; Abhishek Chauhan; Namita Mohindra; Ram Chandra Shukla
Introduction Community acquired pneumonia (CAP) is a leading cause of under-five mortality in India and Streptococcus pneumoniae is the main bacterial pathogen for it. Pneumococcal Conjugate Vaccine 13 (PCV13) has been introduced in a phased manner, in the national immunization program of India since 2017/2018. The primary objective of this study was to evaluate the effectiveness of PCV13 on chest radiograph (CXR)-confirmed pneumonia, in children hospitalized with WHO-defined severe CAP. Methods This prospective, multi-site test-negative study was conducted in a hospital-network situated in three districts of Northern India where PCV13 had been introduced. Children aged 2–23 months, hospitalized with severe CAP and with interpretable CXR were included after parental consent. Clinical data was extracted from hospital records. CXRs were interpreted by a panel of three independent blinded trained radiologists. Exposure to PCV13 was defined as >2 doses of PCV13 in children aged < 12 months and > 1 dose(s) in children > 12 months of age. Our outcome measures were CXR finding of primary endpoint pneumonia with or without other infiltrates (PEP±OI); vaccine effectiveness (VE) and hospital mortality. Results From 1st June 2017-30th April 2021, among 2711 children included, 678 (25.0%) were exposed to PCV1. CXR positive for PEP±OI on CXR was found in 579 (21.4%), of which 103 (17.8%) were exposed to PCV. Adjusted odds ratio (AOR) for PEP±OI among the exposed group was 0.69 (95% CI, 0.54–0.89, p = 0.004). Adjusted VE was 31.0% (95% CI: 11.0–44.0) for PEP±OI. AOR for hospital mortality with PEP±OI was 2.65 (95% CI: 1.27–5.53, p = 0.01). Conclusion In severe CAP, children exposed to PCV13 had significantly reduced odds of having PEP ±OI. Since PEP±OI had increased odds of hospital mortality due to CAP, countrywide coverage with PCV13 is an essential priority. © 2022 Public Library of Science. All rights reserved.
Epidemiology of Hypoxic Community-Acquired Pneumonia in Children Under 5 Years of Age: An Observational Study in Northern India
(Frontiers Media S.A., 2022) Shally Awasthi; Tuhina Rastogi; Anuj Kumar Pandey; Chittaranjan Roy; Kripanath Mishra; Neelam Verma; Chandra Bhushan Kumar; Pankaj Kumar Jain; Rajesh Yadav; Abhishek Chauhan; Namita Mohindra; Ram Chandra Shukla; Monika Agarwal; Chandra Mani Pandey; Neera Kohli
Background: Community-acquired pneumonia (CAP) is the leading cause of under-five mortality in India. An increased risk of mortality has been reported in cases of hypoxic pneumonia. Methods: The primary objective of this study was to assess the proportion of children aged 2–59 months, hospitalized with hypoxic CAP, as well as socio-demographic, clinical, and radiological features associated with it. The secondary objective was to determine the risk of mortality among hospitalized cases of hypoxic CAP. This prospective, observational study was conducted in four districts of Northern India, between January 2015 and April 2021. A hospital-based surveillance network was established. Inclusion criteria were as follows: (a) child between 2 and 59 months, (b) hospitalization with symptoms of WHO-defined CAP, (c) resident of project district, (d) illness of <14 days, and (e) child had neither been hospitalized for this illness nor recruited previously. Children whose chest x-rays (CXRs) were either unavailable/un-interpretable and those that received any dose of pneumococcal conjugate vaccine-13 were excluded. Hypoxic pneumonia was defined as oxygen saturation <90% on pulse oximetry or requiring oxygen supplementation during hospital stay. Results: During the study period, 71.9% (7,196/10,006) children of severe pneumonia were eligible for inclusion, of whom 35.9% (2,580/7,196) were having hypoxic pneumonia. Female gender and use of biomass fuel for cooking increased the odds of hypoxic CAP. Clinical factors like wheezing, pallor, tachypnea, low pulse volume, presence of comorbidity, general danger signs, severe malnutrition, and radiological finding of primary end-point pneumonia ± other infiltrates (PEP±OI) also increased the odds of hypoxic CAP in a conditional logistic regression model. Adjusted odds ratio for mortality with hypoxia was 2.36 (95% CI: 1.42–3.92). Conclusion: Almost one-third of cases hospitalized with severe CAP had hypoxia, which increased chances of mortality. Besides known danger signs, certain newer clinical signs such as pallor and wheezing as well as PEP+OI were associated with hypoxic CAP. Therefore, objective assessment of oxygen saturation must be done by pulse oximetry in all cases of CAP at the time of diagnosis. Copyright © 2022 Awasthi, Rastogi, Pandey, Roy, Mishra, Verma, Kumar, Jain, Yadav, Chauhan, Mohindra, Shukla, Agarwal, Pandey and Kohli.
PRAYAS: individual patient data meta-analysis database for Pooled Research and Analysis for Yielding Anemia-free Solutions in India
(Frontiers Media SA, 2025) Anuj Kumar Pandey; Anju Pradhan Sinha; Ramu Rawat; Ranadip Chowdhury; Shivaprasad S. Goudar; Jitender Nagpal; Shrey A. Desai; Avula Laxmaiah; Basany Kalpana; Sadhana Ramchandra Joshi; Chittaranjan Sakerlal Yajnik; Aparna Mukherjee; Pratibha K. Dwarkanath; Priyanka Gupta Bansal; Molly Jacob; Shinjini Bhatnagar; Komal H. Shah; Debarati Mukherjee; Amlin Shukla; Raghu Pullakhandam; Varsha S. Dhurde; Aditi A. Apte; Rajeev Kumar Singh; Aakriti Gupta; Yamini Priyanka; Usha Dhingra; Ravi Prakash Upadhyay; Sutapa Bandyopadhyay B Neogi; Manjunath Somappa Somannavar; Anirban N. Mandal; Gayatri Desai; Shantanu Sengupta; Shailendra Dandge; Girija Narendrakumar Wagh; Urmila S. Deshmukh; Gunjan Kumar; Anura Vishwanath Kurpad; Gurudayal Singh Toteja; Nikhitha Mariya John; Shailaja Sopory; Somen Saha; Giridhar R. Babu; Anandika Suryavanshi; Ravindranadh Palika; Archana Behram Patel; Radhika K. Nimkar; Gaurav Raj Dwivedi; Umesh S. Kapil; Dilip Raja; Arup Dutta; Sunita Taneja; Diksha Gautam; Avinash Kavi; Swapnil Rawat; Kapil Dave; Rajiva Raman; Catherine L. Haggerty; Sanjay Kewalchand Lalwani; Prachi Ravindra Phadke; Alka Turuk; Tinku S. Thomas; Neena Bhatia; Manisha Madai Beck; Lovejeet Kaur; Aakansha Shukla; Ravi Deepa; Lindsey Mina Locks; Dhiraj M. Agarwal; Raja Sriswan Mamidi; Harshpal Singh Sachdev; Rounik Talukdar; Sayan Das; Nita Bhandari; Ranjana A. Singh; S. Yogeshkumar; Ramasheesh Yadav; Purushotham Sudhakar Reddy; Sanjay A. Gupte; S. Rasika Ladkat; Zaozianlungliu Gonmei; Swati Rathore; Dharmendra Sharma; Apurva Kumar Pandya; Yamuna Ana; Patricia L. Hibberd; Himangi Govind Lubree; Anwar Basha Dudekula; Priti Rishi Lal; Pearlin Amaan Khan; Aruna Verma; Umesh S. Charantimath; Indrapal Ishwarji Meshram; Karuna N. Randhir; Onkar Deshmukh; Ashok Kumar Roy; Obed John; Nolita Dolcy Saldanha; Ashish R. Bavdekar; Raj Kumar; Shyam Prakash
Purpose: The PRAYAS Individual Patient Data Meta-analysis (IPD-MA) database aims to estimate the prevalence of anemia among children under 18 years, non-pregnant and non-lactating (NPNL) women, and pregnant women (by trimester), with further stratification by age group, year, and region of India. Beyond prevalence, it seeks to address the etiological contribution of iron and other erythropoietic micronutrient deficiencies and to evaluate the effectiveness of anemia prevention and treatment interventions, including factors associated with non-response. This will directly support India’s “test–treat–track” approach under the Anemia Mukt Bharat program. Participants: Children (0–18 years), pregnant women, and NPNL women in India. Findings to date: The database currently includes 88 datasets (1994–2023), with 319,721 participants for prevalence analysis—children (19,762), NPNL women (17,883), and pregnant women (282,076). Intervention studies comprise 59,292 participants—children (13,435), NPNL women (11,594), and pregnant women (34,263). Over half the datasets (55.7%, 49/88) are randomized controlled trials, while 35.2% (31/88) are observational. Geographically, 43.2% (38/88) are from northern India, 22.7% (20/88) from the west, and 18.2% (16/88) from the south. Most studies (67%, 59/88) are community-based. Median ages were 26 years (IQR 23–32) for NPNL and 23 years (IQR 21–25) for pregnant women, while children’s data covered 6 months to 18 years. Mean gestational age at enrollment in pregnancy was 10.24 weeks (SD 17.65). Of the total sample, 10.8% had complete blood count data, 9% ferritin, and 4.5% vitamin B12. Among interventions, pregnant women received intravenous iron sucrose, ferric carboxymaltose, iron isomaltoside, combined IV iron with vitamin B12/folic acid/niacinamide, integrated packages, and low-dose calcium supplementation. NPNL women were often part of trials comparing 60 mg daily ferrous sulfate with 120 mg on alternate days. Children’s interventions mainly included ferrous sulfate, food supplementation, and select Ayush-based approaches. Future plans: PRAYAS will generate robust, policy-relevant evidence to refine anemia prevention and treatment strategies. Findings will directly inform the Anemia Mukt Bharat program, supporting targeted, evidence-driven interventions to reduce anemia and associated health burdens across children, women, and pregnant populations in India. Clinical Trial Registration: OSF—https://doi.org/10.17605/OSF.IO/6YRXF. © © 2025 Pandey, Sinha, Rawat, Chowdhury, Goudar, Nagpal, Desai, Laxmaiah, Basany, Joshi, Yajnik, Mukherjee, Dwarkanath, Bansal, Jacob, Bhatnagar, Shah, Mukherjee, Shukla, Pullakhandam, Dhurde, Apte, Singh, Gupta, Priyanka, Dhingra, Upadhyay, Neogi, Somannavar, Mandal, Desai, Sengupta, Dandge, Wagh, Deshmukh, Kumar, Kurpad, Toteja, John, Sopory, Saha, Babu, Suryavanshi, Palika, Patel, Nimkar, Dwivedi, Kapil, Raja, Dutta, Taneja, Gautam, Kavi, Rawat, Dave, Raman, Haggerty, Lalwani, Phadke, Turuk, Thomas, Bhatia, Beck, Kaur, Shukla, Deepa, Locks, Agarwal, Mamidi, Sachdev, Talukdar, Das, Bhandari, Singh, Yogeshkumar, Yadav, Reddy, Gupte, Ladkat, Gonmei, Rathore, Sharma, Pandya, Ana, Hibberd, Lubree, Dudekula, Lal, Khan, Verma, Charantimath, Meshram, Randhir, Deshmukh, Roy, John, Saldanha, Bavdekar, Kumar, Prakash, Fawzi and Sazawal.