Browsing by Author "Arvind Pandey"

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A stochastic model for the study of last closed birth interval with some biosocial components
(Taylor and Francis Ltd., 1998) Arvind Pandey; S.N. Dwivedi; R.N. Mishra
We present a stochastic model to describe variation in last closed birth interval for women of a given marriage duration by parity as well as regardless of parity. The model is derived under some simplified assumptions relating to human reproduction process accounting for the non-exposure period in the beginning of the reproductive life caused by such biosocial components as adolescent sterility and temporary separation between the partners called as an inoperative period. We illustrate the model regardless of parity on an observed set of data taken from a rural area of northern India and estimate the risk of conception before and after the first birth. © 1998 OPA (Overseas Publishers Association) Amsterdam B.V. Published under license under the Gordon and Breach Publishers imprint.
A study on initiation of postpartum family planning in India based on NFHS-4: does urban poor differ significantly from rural?
(BioMed Central Ltd, 2022) Ujjaval Srivastava; Arvind Pandey; Pragya Singh; Kaushalendra Kumar Singh
Objective: To explore the differentials of postpartum contraceptive adoption between rural and urban poor after adjusting for utilization of MCH services and other selected socioeconomic and demographic covariates. Methods: The data for this study is taken from the 4th round of NFHS survey conducted in India during 2015–16. The analysis is limited to 125,340 currently married women whose menses had returned at the time of survey. Discrete time complementary log–log multilevel model was applied. Results: The results clearly indicate that women from rural areas had a lower chance of early initiation of modern spacing methods after having recent birth as compare to that of Urban Poor and Urban non-poor areas. The contributions of several socioeconomic and demographic characteristics that were important for family planning practice were also highlighted in this study. Conclusion: There is an urgent need of designing an intervention that will result in effective delivery of services to achieve the greatest impact. Policy planners must focus on targeted interventions for family planning use in the postpartum period than simply focusing on family planning. © 2022, The Author(s).
Alcohol Use and STI among men in India: Evidences from a national household survey
(2012) Arvind Pandey; Ram Manohar Mishra; Dandu C.S. Reddy; Mariamma Thomas; Damodar Sahu; Deepak Bharadwaj
Background: Alcohol use has been found to correlate with risky sexual behavior as well as with sexually transmitted infections (STI) among populations with high-risk behavior in India. Objective: To examine the correlates of alcohol use and its association with STI among adult men in India. Materials and Methods: Data from a national representative large-scale household sample survey in the country were used. It included information on sociodemographic characteristics and alcohol use as a part of substance use. Clinical as well laboratory testing was done to ascertain the STI. Results: The overall STI prevalence among adult males was found to be 2.5% (95% confidence interval (CI): 1.9-3.1). Over 26% adult men were found to have been using alcohol in the study population. It was higher among men who were illiterate and unskilled industrial workers/drivers. The men who consumed alcohol had higher prevalence of STI (3.6%; 95% CI: 2.9-5.1) than those who did not consume alcohol (2.1%; 95% CI: 1.5-2.6). The degree of association between alcoholism and STI was slightly reduced after adjusting for various sociodemographic characteristics (adjusted odds ratio: 1.5; 95% CI: 0.9-2.3; P=0.06). Conclusions: The findings of present study suggest integrating alcohol risk reduction into STI/HIV prevention programmes.
Augmenting progress on the elimination of vertical transmissions of HIV in India: Insights from Spectrum-based HIV burden estimations
(Public Library of Science, 2023) Pradeep Kumar; Chinmoyee Das; Udayabhanu Das; Arvind Kumar; Nidhi Priyam; Varsha Ranjan; Damodar Sahu; Sanjay K. Rai; Sheela V. Godbole; Elangovan Arumugam; P.V.M. Lakshmi; Shanta Dutta; H. Sanayaima Devi; Arvind Pandey; Dandu Chandra Sekhar Reddy; Sanjay Mehendale; Shobini Rajan
The government of India has adopted the elimination of vertical transmission of HIV as one of the five high-level goals under phase V of the National AIDS and STD Control Programme (NACP). In this paper, we present the data from HIV estimations 2021 for India and select States detailing the progress as well as the attributable causes for vertical transmissions. The NACP spearheads work on mathematical modelling to estimate HIV burden based on the periodically conducted sentinel surveillance for guiding program implementation and pol-icymaking. Using the results of the latest round of HIV Estimations in 2021, we analysed the mother-to-child transmission (MTCT) during the perinatal and postnatal (breastfeeding) period. In 2021, overall, around 5,000 [3,000–7,800] vertical transmissions were estimated nationally with 58% being perinatal infections and remaining during breastfeeding. MTCT at 6 weeks was around 12.95% [9.45–16.02] with the final transmission rate at 24.25% [18.50–29.50]. Overall, 57% of vertical transmissions were among HIV-positive mothers who did not receive ART during pregnancy or breastfeeding, 19% among mothers who dropped off ART during pregnancy or delivery, and 18% among mothers who were infected during pregnancy or breastfeeding. There were significant variations between States. Depending upon the States, the programme needs to focus on the intervention domains of timely engagement in antenatal care-HIV testing-ART initiation as well as programme retention and adherence support. Equally important would be strengthening the strategic information to generate related evidence for inputting India and State-specific parameters improving the MTCT-related modelled estimates. © 2023 Kumar 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.
Cross-talk between Human Papillomavirus Oncoproteins and Hedgehog Signaling Synergistically Promotes Stemness in Cervical Cancer Cells
(Nature Publishing Group, 2016) Kanchan Vishnoi; Sutapa Mahata; Abhishek Tyagi; Arvind Pandey; Gaurav Verma; Mohit Jadli; Tejveer Singh; Sukh Mahendra Singh; Alok C. Bharti
Viral oncoproteins E6/E7 play key oncogenic role in human papillomavirus (HPV)-mediated cervical carcinogenesis in conjunction with aberrant activation of cellular signaling events. GLI-signaling has been implicated in metastasis and tumor recurrence of cervical cancer. However, the interaction of GLI-signaling with HPV oncogenes is unknown. We examined this relationship in established HPV-positive and HPV-negative cervical cancer cell lines using specific GLI inhibitor, cyclopamine and HPVE6/E7 siRNAs. Cervical cancer cell lines showed variable expression of GLI-signaling components. HPV16-positive SiHa cells, overexpressed GLI1, Smo and Patch. Inhibition by cyclopamine resulted in dose-dependent reduction of Smo and GLI1 and loss of cell viability with a higher magnitude in HPV-positive cells. Cyclopamine selectively downregulated HPVE6 expression and resulted in p53 accumulation, whereas HPVE7 and pRb level remained unaffected. siRNA-mediated silencing of HPV16E6 demonstrated reduced GLI1 transcripts in SiHa cells. Cervical cancer stem-like cells isolated by side population analysis, displayed retention of E6 and GLI1 expression. Fraction of SP cells was reduced in cyclopamine-treated cultures. When combined with E6-silencing cyclopamine resulted in loss of SP cell's sphere-forming ability. Co-inhibition of GLI1 and E6 in cervical cancer cells showed additive anti-cancer effects. Overall, our data show existence of a cooperative interaction between GLI signaling and HPVE6. © The Author(s) 2016.
Distribution of closed birth intervals with some biosocial components: A stochastic model and its application
(1990) Arvind Pandey; Sada Nand Dwivedi; Ravindra Nath Mishra
Here we propound a stochastic model to describe the variation in the length of closed birth intervals by birth order for women of a given marriage duration. The model accounts for two biosocial components: adolescent sterility and temporary separation between the partners (called an inoperative period at the beginning of the reproductive process). Applying the model on an observed set of data, we estimate the risk of conception and the extent of adolescent sterility among women with varying ages at consummation of marriage. © 1990, Taylor & Francis Group, LLC. All rights reserved.
District-level HIV estimates using the spectrum model in five states of India, 2017
(Lippincott Williams and Wilkins, 2021) Pradeep Kumar; Damodar Sahu; Shobini Rajan; Vishnu Vardhana Rao Mendu; Chinmoyee Das; Arvind Kumar; Nalini Chandra; Bilali Camara; Sanjay Rai; Elangovan Arumugam; Sheela Virendra Godbole; Shri Kant Singh; Shashi Kant; Arvind Pandey; Dandu Chandra Sekhar Reddy; Sanjay Mehendale
AbstractDecentralized response has been the hallmark of the National AIDS Control Programme in India. District-level HIV burden estimates quantifying the distribution of the epidemics are needed to enhance this decentralized response further to monitor the progress on prevention, testing, and treatment interventions. In this paper, we describe the methodology and results of district-level estimates using the Spectrum model piloted in 5 states of India under National AIDS Control Programme.Using state spectrum model for HIV estimations 2017, we disaggregated state results by the district in pilot states. Each district was considered a subepidemic and HIV epidemic configuration was carried out in its general population as well as in key population. We used HIV surveillance data from antenatal clinics and routine pregnant women testing to model the general population's epidemic curve. We used HIV prevalence data available from HIV sentinel surveillance and integrated biological and behavioral surveys to inform the epidemic curve for key population. Estimation and projection packgage classic platform was used for the curve fitting. District-wide estimates extracted from subpopulation summary in Spectrum results section were used to calculate relative burden for each district and applied to approved State HIV Estimations 2017 estimates.No district in Tamil Nadu had an adult HIV prevalence of higher than 0.5% except for one, and the epidemic seems to be declining. In Maharashtra, the epidemic has shown a decline, with all except 5 districts showing an adult prevalence of less than 0.50%. In Gujarat and Uttar Pradesh, few districts showed rising HIV prevalence. However, none had an adult prevalence of higher than 0.50%. In Mizoram, 6 of 8 districts showed a rising HIV trend with an adult prevalence of 1% or more in 5 districts.Disaggregation of state-level estimates by districts provided insights on epidemic diversity within the analyzed states. It also provided baseline evidence to measure the progress toward the goal of end of AIDS by 2030. © 2021 Authors. All rights reserved.
Diversity in HIV epidemic transitions in India: An application of HIV epidemiological metrices and benchmarks
(Public Library of Science, 2022) Pradeep Kumar; Chinmoyee Das; Arvind Kumar; Damodar Sahu; Sanjay K. Rai; Sheela Godbole; Elangovan Arumugam; P.V.M. Lakshmi; Shanta Dutta; H. Sanayaima Devi; Vishnu Vardhana Rao Mendu; Shashi Kant; Arvind Pandey; Dandu Chandra Sekhar Reddy; Sanjay Mehendale; Shobini Rajan
Background The Joint United Nations Programme on AIDS (UNAIDS) has emphasized on the incidence-prevalence ratio (IPR) and incidence-mortality ratio (IMR) to measure the progress in HIV epidemic control. In this paper, we describe the status of epidemic control in India and in various states in terms of UNAIDS’s recommended metrices. Method The National AIDS Control Programme (NACP) of India spearheads work on mathematical modelling to estimate HIV burden based on periodically conducted sentinel surveillance for providing guidance to program implementation and policymaking. Using the results of the latest round of HIV Estimations in 2019, IPR and IMR were calculated. Results National level IPR was 0.029 [0.022–0.037] in 2019 and ranged from 0.01 to 0.15 in various States and Union Territories (UTs). Corresponding Incidence-Mortality Ratio was at 0.881 [0.754–1.014] nationally and ranged between 0.20 and 12.90 across the States/UTs. Conclusions Based on UNAIDS recommended indicators for HIV epidemic control, namely IPR and IMR; national AIDS response in India appears on track. However, the program success is not uniform and significant heterogeneity as well as expanding epidemic was observed at the level of States or UTs. Reinforcing States/UTs specific and focused HIV prevention, testing and treatment initiatives may help in the attainment of 2030 Sustainable Development Goals of ending AIDS as a public health threat by 2030. © 2022 Kumar 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.
Findings from the 2017 HIV estimation round & trend analysis of key indicators 2010-2017: Evidence for prioritising HIV/AIDS programme in India
(Wolters Kluwer Medknow Publications, 2020) Damodar Sahu; Pradeep Kumar; Nalini Chandra; Shobini Rajan; D. Shukla; S. Venkatesh; Saritha Nair; Anil Kumar; Jitenkumar Singh; Srikanth Reddy; Sheela Godbole; A. Elangovan; M. Saha; Sanjay Rai; P.V.M. Lakshmi; T. Gambhir; Savina Ammassari; Deepika Joshi; Amitabh Das; Poonam Bakshi; Sabyasachi Chakraborty; Amol Palkar; S. Singh; D.C.S. Reddy; Shashi Kant; Arvind Pandey; M. Vardhana Rao
Background & objectives: The National AIDS Control Organisation (NACO) and the ICMR-National Institute of Medical Statistics, the nodal agency for conducting HIV estimations in India, have been generating HIV estimates regularly since 2003. The objective of this study was to describe India's biennial HIV estimation 2017 process, data inputs, tool, methodology and epidemiological assumptions used to generate the HIV estimates and trends of key indicators for 2010-2017 at national and State/Union Territory levels. Methods: Demographic Projection (DemProj) and AIDS Impact Modules (AIM) of Spectrum 5.63 software recommended by the United Nations Programme on HIV and AIDS Global Reference Group on HIV Estimates, Modelling and Projections, were used for generating HIV estimations on key indicators. HIV sentinel surveillance, epidemiological and programme data were entered into Estimation Projection Package (EPP), and curve fitting was done using EPP classic model. Finally, calibration was done using the State HIV prevalence of two rounds of National Family Health Survey (NFHS) -3 and -4 and Integrated Biological and Behavioural Surveillance (IBBS), 2014-2015. Results: The national adult prevalence of HIV was estimated to be 0.22 per cent in 2017. Mizoram, Manipur and Nagaland had the highest prevalence over one per cent. An estimated 2.1 million people were living with HIV in 2017, with Maharashtra estimated to have the highest number. Of the 88 thousand annual new HIV infections estimated nationally in 2017, Telangana accounted for the largest share. HIV incidence was found to be higher among key population groups, especially people who inject drugs. The annual AIDS-related deaths were estimated to be 69 thousand nationally. For all indicators, geographic variation in levels and trends between States existed. Interpretation & conclusions: With a slow decline in annual new HIV infections by only 27 per cent from 2010 to 2017 against the national target of 75 per cent by 2020, the national target to end AIDS by 2030 may be missed; although at the sub-national level some States have made better progress to reduce new HIV infection. It calls for reinforcement of HIV prevention, diagnosis and treatment efforts by geographical regions and population groups. © 2020 Wolters Kluwer Medknow Publications. All rights reserved.
Human papillomavirus oncoproteins differentially modulate epithelial-mesenchymal transition in 5-FU-resistant cervical cancer cells
(Springer Science and Business Media B.V., 2016) Kanchan Vishnoi; Sutapa Mahata; Abhishek Tyagi; Arvind Pandey; Gaurav Verma; Mohit Jadli; Tejveer Singh; Sukh Mahendra Singh; Alok C. Bharti
Etiological role of viral proteins E6 and E7 of high-risk HPV in cervical carcinogenesis is well established. However, their contribution in chemoresistance and epithelial-mesenchymal transition (EMT) that leads to advanced metastatic lesions and chemoresistance is poorly defined. In the present study, contribution of viral oncoproteins in acquisition of EMT character during onset of chemoresistance was assessed. A chemoresistant cell line (SiHaCR) was developed from an established HPV16-positive cervical cancer cell line, SiHa, by escalating selection pressure of 5-fluorouracil (5-FU). Expression of Survivin, ABCG2, Snail, Slug, Twist, and Vimentin was examined in SiHa and SiHaCR cells by reverse transcriptase-PCR (RT-PCR) and immunoblotting assays. Mesenchymal phenotype in SiHaCR cells was confirmed by assessment of migration and invasion potentials. SiHaCR cells displayed elevated level of functional and molecular markers associated with chemoresistance (Survivin, ABCG2) and EMT (Snail, Slug, Twist, Vimentin) and reduced E-cadherin. SiHaCR also showed increased levels of HPV16 E6 and E7 transcripts. Specific silencing of HPV16 E6, but not E7 using corresponding siRNA, demonstrated a differential involvement of HPV oncogenes in manifestation of EMT. HPV16 E6 silencing resulted in reduction of Slug and Twist expression. However, the expression of Snail and Vimentin was only marginally affected. In contrast, there was an increase in the expression of E-cadherin. A reduced migration and invasion capabilities were observed only in E6-silenced SiHaCR cells, which further confirmed functional contribution of HPV16 E6 in manifestation of EMT. Taken together, our study demonstrated an active involvement of HPV16 E6 in regulation of EMT, which promotes chemoresistance in cervical cancer. © 2016, International Society of Oncology and BioMarkers (ISOBM).
Modelling and estimation of HIV prevalence and number of people living with HIV in India, 2010–2011
(SAGE Publications Ltd, 2016) Yujwal Raj; Damodar Sahu; Arvind Pandey; S. Venkatesh; D.C.S. Reddy; Taoufik Bakkali; Chinmoyee Das; Kh Jitenkumar Singh; Shashi Kant; M. Bhattacharya; John Stover; Ugra Mohan Jha; Pradeep Kumar; Ram Manohar Mishra; Nalini Chandra; B.K. Gulati; Sharad Mathur; Deepika Joshi; L. Chavan
This paper provides HIV estimation methodology used in India and key HIV estimates for 2010–2011. We used a modified version of the Spectrum tool that included an Estimation and Projection Package as part of its AIDS Impact Module. Inputs related to population size, age-specific pattern of fertility, gender-ratio at birth, age and gender-specific pattern of mortality, and volume and age–gender distribution of net migration were derived from census records, the Sample Registration System and large-scale demographic health surveys. Epidemiological and programmatic data were derived from HIV sentinel surveillance, large-scale epidemiological surveys and the programme management information system. Estimated adult HIV prevalence retained a declining trend in India, following its peak in 2002 at a level of 0.41% (within bounds 0.35–0.47%). By 2010 and 2011, it levelled at estimates of 0.28% (0.24–0.34%) and 0.27% (0.22–0.33%), respectively. The estimated number of people living with HIV (PLHIV) reduced by 8% between 2007 and 2011. While children accounted for approximately 6.3% of total HIV infections in 2007, this proportion increased to about 7% in 2011. With changing priorities and epidemic patterns, the programme has to customise its strategies to effectively address the emerging vulnerabilities and adapt them to suit the requirements of different geographical regions. © 2016, © The Author(s) 2016.
Prevalence and determinants of heterosexual anal-intercourse among female sex workers in India: Findings from nationwide cross-sectional biological and behavioural survey
(SAGE Publications Ltd, 2023) Partha Haldar; Pradeep Kumar; Sanjay Rai; Shashi Kant; Yujwal Raj; Chandrasekhar Reddy; Shobini Rajan; Arvind Pandey; S. Venkatesh; Kiran Goswami; Puneet Misra
Background: The vulnerability of female sex workers (FSWs) to HIV infection increases if unprotected heterosexual anal intercourse (HAI) is practiced. Objectives: To estimate the prevalence of HAI among FSWs, and associated factors, and prevalence of consistent condom use (CCU) during HAI and associated factors. Methods: Analysis of cross-sectional data from nationwide biological and behavioural survey, conducted at 73 randomly selected domains with sample size of 27,000 in India. Results: A total of 25,932 FSWs were included in the analysis, after excluding 1075 (3.9%) FSWs for which the data were incomplete. The prevalence of HAI was 29.9% (95% CI, 29.3, 30.4); The CCU during HAI in the last one month was 58.9%. Younger age at the start of sex work, use of mobile phone/internet for soliciting client, home as a place of sex work, consumption of alcohol/drug, and physical violence against FSWs were associated with higher odds of HAI. Frequent contact with outreach workers, awareness of sexually transmitted infection, and older age at the start of sex work was associated with CCU. Conclusion: Prevalence of HAI was high among FSW in India. The national program could target those factors that reduce the odds of HAI and/or promote CCU. © The Author(s) 2023.
Projected impact of fast-tracking of antiretroviral treatment coverage on vertical transmission of HIV in India
(Public Library of Science, 2024) Pradeep Kumar; Chinmoyee Das; Subrata Biswas; Nidhi Priyam; Lalit Singh Kharayat; Damodar Sahu; Sanjay K. Rai; Sheela V. Godbole; Elangovan Arumugam; P.V.M. Lakshmi; Shanta Dutta; H. Sanayaima Devi; Arvind Pandey; Dandu Chandra Sekhar Reddy; Sanjay Mehendale; Shobini Rajan
One of the five high-level goals under Phase V of the National AIDS and STD Control Programme (NACP) of the Government of India is the elimination of vertical transmission of HIV. In this paper, we estimate the potential impact of maintaining and enhancing the antiretroviral treatment under the NACP in terms of averting new infections and vertical transmission rates vis-à-vis no intervention scenario. We used India’s HIV Estimates 2022 models to create treatment coverage scenarios of no interventions, status quo, business as usual, on-track and fast-track scenarios from 2023 to 2030. Our analysis indicates that fast-tracking scale-up of treatment services would avert almost 41000 child infections from 2023 to 2030 leading to a vertical transmission rate of around 7.70% in 2030 vis-a-vis no interventions scenario. Higher and sustained ART coverage would not only take the country closer to the elimination goals but would also prevent thousands of vertical transmissions, thus bringing a lot of benefits to HIV-positive pregnant women and their families. Supported by efforts for the prevention of new infections in the general population, India is on track for the attainment of elimination of vertical transmission of HIV by 2030. © 2024 Kumar 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.
Sustained progress, but no room for complacency: Results of 2015 HIV estimations in India
(Indian Council of Medical Research, 2017) Arvind Pandey; Neeraj Dhingra; Pradeep Kumar; Damodar Sahu; D.C.S. Reddy; Padum Narayan; Yujwal Raj; Bhavna Sangal; Nalini Chandra; Saritha Nair; Jitenkumar Singh; Laxmikant Chavan; Deepika Joshi Srivastava; Ugra Mohan Jha; Vinita Verma; Shashi Kant; Madhulekha Bhattacharya; Pushpanjali Swain; Partha Haldar; Lucky Singh; Taoufik Bakkali; John Stover; Savina Ammassari
Background & objectives: Evidence-based planning has been the cornerstone of India’s response to HIV/AIDS. Here we describe the process, method and tools used for generating the 2015 HIV estimates and provide a summary of the main results. Methods: Spectrum software supported by the UNAIDS was used to produce HIV estimates for India as a whole and its States/Union Territories. This tool takes into consideration the size and HIV prevalence of defined population groups and programme data to estimate HIV prevalence, incidence and mortality over time as well as treatment needs. Results: India’s national adult prevalence of HIV was 0.26 per cent in 2015. Of the 2.1 million people living with HIV/AIDS, the largest numbers were in Andhra Pradesh, Maharashtra and Karnataka. New HIV infections were an estimated 86,000 in 2015, reflecting a decline by around 32 per cent from 2007. The declining trend in incidence was mirrored in most States, though an increasing trend was detected in Assam, Chandigarh, Chhattisgarh, Gujarat, Sikkim, Tripura and Uttar Pradesh. AIDS-related deaths were estimated to be 67,600 in 2015, reflecting a 54 per cent decline from 2007. There were variations in the rate and trend of decline across India for this indicator also. Interpretation & conclusions: While key indicators measured through Spectrum modelling confirm success of the National AIDS Control Programme, there is no room for complacency as rising incidence trends in some geographical areas and population pockets remain the cause of concern. Progress achieved so far in responding to HIV/AIDS needs to be sustained to end the HIV epidemic. © 2017, Indian Council of Medical Research. All rights reserved.