Browsing by Author "Pankaj Kumar Jain"

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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.
Morbidity pattern and their socio-demographic co-relates among rural primary school children in eastern Uttar Pradesh: A cross-sectional study
(Indian Association of Preventive and Social Medicine, 2014) Amit Kaushik; Akash Bansal; Pankaj Kumar Jain; Sandip Kumar; Rajesh Kumar Yadav; Sri Prakash Singh
Research question: What is the morbidity pattern among primary school children in rural area of Varanasi and what their socio-demographic co-relates are? Objective: To study the morbidity pattern among of primary school children in rural Varanasi and to find out various socio-demographic correlates associated with morbidity. Study Design: Descriptive cross sectional study. Setting: Four primary schools from Chiraigaon Community Development Block of Varanasi were selected for study purpose. Participants: Eight hundred and sixteen students from four schools were included in the study by total enumeration of the students present on the day of survey. Results: The present cross-sectional study revealed overall more prevalence of morbidity among female students (86.1%) as compared to their male counterparts (84.4%). Children belonging to scheduled caste, socio-economic status class IV, those whose parents were illiterate and those belonging to joint family had higher prevalence of any morbidity. Caste, socio-economic status, parents' education and type of family were significantly associated with morbidity among school children. Conclusion: Prevalence of morbidities was found to be 2.3 morbidities per child (prevalence) and 2.8 morbidities per sick child. Female students suffered more in comparison to their male counterparts. Nutritional deficiencies were most prevalent. Socio-economic status, caste, literacy of parents and type of family had significant association with morbidity.
Prevalence of needle stick injuries, its associated factors and awareness among nursing staff at tertiary care hospital of North India
(Indian Association of Preventive and Social Medicine, 2022) Prem Prakash Bharti; Naresh Pal Singh; Prashant Kumar Bajpai; Vidya Rani; Pankaj Kumar Jain; Ayub Khan
Background: Needle Stick Injuries (NSIs) are defined as accidental skin penetrating injuries caused by needles. It is the single greatest occupational hazard to a medical personnel. In developing countries, needle stick injury is associated with the highest global prevalence of HIV, Hepatitis B, and Hepatitis C. Ai m & Obj ect i ves: To estimate the prevalence of needle stick injuries, its associated risk factors and assess the awareness regarding needle stick injuries among nursing staff. Materi al & Methods: A cross-sectional study was conducted among nursing staff who were working at a tertiary care hospital in Northern India during June 2019 to November 2019. The study commenced after taking prior approval from institutional ethics committee. A census method was used to include the participants. Results: Around 66.7% of the nursing staff was exposed to NSIs during their working hours at the hospital. There was significant association of needle stick injuries with place of working and education of nursing staff in multivariate binary logistic regression. About 26% of the nurses were unaware that recapping should be done or not for used needle, and 35% of staff nurses recapped the needle after the use. Conclusion: Needle stick injuries can be prevented by continued education, effective training, providing better safety devices, a positive work environment. © 2022, Indian Association of Preventive and Social Medicine. All rights reserved.