Browsing by Author "Damodar Sahu"

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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.
Clinical profile of hospitalized COVID-19 patients in first & second wave of the pandemic: Insights from an Indian registry based observational study
(Wolters Kluwer Medknow Publications, 2021) Gunjan Kumar; Aparna Mukherjee; Ravendra K. Sharma; Geetha R. Menon; Damodar Sahu; Naveet Wig; Samiran Panda; Vishnu Vardhan Rao; Sujeet Singh; Randeep Guleria; Balram Bhargava; Abhijit Pakhare; Rajnish Joshi; Sourin Bhuniya; Manoj Kumar Panigrahi; Pankaj Bhardwaj; Sanjeev Misra; Manoj Gupta; Akhil D. Goel; Netto George Mundadan; Adil Rashid Khan; Manish Soneja; Tridip Dutta Baruah; Pankaj Kumar Kannauje; Ajit Kumar; Kala M.L. Yadhav; Manoj Kumar; Mary John; Sangeetha Mohan; Amit Patel; Surabhi Madan; Subhasis Mukherjee; Amitava Pal; Saikat Banerjee; Arti D. Shah; Yash Rana; Arun Madharia; Ankit Madharia; Rajiv Kumar Bandaru; Archana Mavoori; Simmi Dube; Nitin Nahar; Thrilok Chander Bingi; Rajarao Mesipogu; Vinaya Sekhar Aedula; Manisha Panchal; Mansuri Amirsohil Mohammedrafiq; Rashmi Upadhyay; Saurabh Srivastava; Veeresh B. Salgar; Rizwan Desai; Nyanthung Kikon; Rhondemo Kikon; Lisa Sarangi; Mahesh Rath; Anup Agarwal; Alka Turuk; Lokesh Kumar Sharma; Tanu Anand; Tarun Bhatnagar; Saumitra Ghosh; Avijit Hazra; Yogiraj Ray; Rammohan Ray; Lipilekha Patnaik; Jagdish Prasad Sahoo; Jaya Chakravarty; Sangeeta Kansal; Mohammad Shameem; Nazish Fatima; M. Pavan Kumar; Bikshapathi Rao; D. Himanshu; Amit Kumar; Naveen Dulhani; Amar Deepak Toppo; Nikita Sharma; Rajat Vohra; Sushila Kataria; Pooja Sharma; Arunansu Talukdar; Gargi Dasgupta; Anita Desai; S.N. Nityasri; Yashmin Panchal; K. Manohar; Y.S. Raju; Star Pala; Md. Jamil; V.K. Katyal; Sandeep Goyal; U.K. Ojha; Ravi Ranjan Jha; Ashish Bhalla; G.D. Puri; S. Samita; Vikas Suri; Ritin Mohindra; Ashish Pathak; Ashish Sharma; Janakkumar R. Khambholja; Nehal M. Shah; Paltial N. Palat; Kruti Rajvansh; Sudhir Bhandari; Abhishek Agrawal; Bal Kishan Gupta; Jigyasa Gupta; Ratnamala Choudhury; Mangala Rao; Soumyadip Chatterji; Sudipta Mukherjee
Background & objectives: India witnessed a massive second surge of COVID-19 cases since March 2021 after a period of decline from September 2020. Data collected under the National Clinical Registry for COVID-19 (NCRC) were analysed to describe the differences in demographic and clinical features of COVID-19 patients recruited during these two successive waves. Methods: The NCRC, launched in September 2020, is an ongoing multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized, confirmed COVID-19 patients were captured in an electronic data portal from 41 hospitals across India. Patients enrolled during September 1, 2020 to January 31, 2021 and February 1 to May 11, 2021 constituted participants of the two successive waves, respectively. Results: As on May 11, 2021, 18961 individuals were recruited in the registry, 12059 and 6903 reflecting in-patients from the first and second waves, respectively. Mean age of the patients was significantly lower in the second wave [48.7 (18.1) yr vs. 50.7 (18.0) yr, P<0.001] with higher proportion of patients in the younger age group intervals of <20, and 20-39 yr. Approximately 70 per cent of the admitted patients were ≥ 40 yr of age in both waves of the pandemic. The proportion of males were slightly lower in second wave as compared to the first [4400 (63.7%) vs. 7886 (65.4%), P=0.02]. Commonest presenting symptom was fever in both waves. In the second wave, a significantly higher proportion [2625 (48.6%) vs. 4420 (42.8%), P<0.003] complained of shortness of breath, developed ARDS [422(13%) vs. 880 (7.9%), P<0.001], required supplemental oxygen [1637 (50.3%) vs. 4771 (42.7%), P<0.001], and mechanical ventilation [260 (15.9%) vs. 530 (11.1%), P<0.001]. Mortality also significantly increased in the second wave [OR: 1.35 (95% CI: 1.19, 1.52)] in all age groups except in <20 yr. Interpretation & conclusions: The second wave of COVID-19 in India was slightly different in presentation than the first wave, with a younger demography, lesser comorbidities, and presentation with breathlessness in greater frequency. © 2021 BioMed Central Ltd.. 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.
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.
Progress and challenges towards eliminating vertical transmission of HIV in India
(Nature Research, 2025) Pradeep Vignesh Kumar; Chinmoyee Das; Vishal Singh Deo; Himanshu Kumar Chaturvedi; Subrata Biswas; Nidhi Priyam; Lalit Singh Kharayat; Sanjay Kumar Rai; Sheela V. Godbole; Elangovan Arumugam; Pinnaka Venkata Maha Lakshmi; Dr Shanta Dutta; Hanjabam Sanayaima Devi; Pankaj Bhardwaj; Arvind Kumar Singh; Rashmi G. Shinde; Damodar Sahu; Shashi Kant; Dandu Chandra Sekhar Reddy; Sanjay Madhav Mehendale; Shobini Rajan
India has intensified efforts towards elimination of vertical transmission of HIV (EVTH) as part of National AIDS and STD Control Programme-V (NACP-V). We present the progress in achieving NACP-V’s EVTH goal as of year 2023-24. We analysed the 2023 state level data using Spectrum model in 2023 to measure the coverage of anti-retroviral treatment among pregnant women, annual paediatric HIV case incidence rate and final vertical transmission rate. UNAIDS and WHO definitions for these indicators were used. In 2023, around 2350 new paediatric infections were estimated by vertical transmission. However, 44% of these transmissions resulted from incident HIV infections among pregnant and breastfeeding women. Overall, paediatric HIV incidence per 100,000 live births decreased from 25.2 (14.7–46.6) in 2019 to 10.4 (6.1–19.3) in 2023. During the same reference period, final vertical transmission rate (inclusive of breastfeeding period) decreased from 25.28% (17.06–37.99) in 2019 to 11.75% (7.93–17.66) in 2023. The 2023 India HIV estimates, using recent data and global modelling tools, highlighted progress in eliminating vertical transmission of HIV. Early identification of HIV-positive mothers and starting them on lifelong ART is crucial. Additionally, generating local evidence is needed on interventions like safe practices, repeat testing, and feeding practices to inform policy decisions. © The Author(s) 2025.
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.