Completed projects

Principal Investigator: Mr. Elangovan A. / Scientist - G

Funding Agency: NACO

Period:Yearly

Conducting HIV sentinel surveillance in 7 southern states of India. The surveillance is being carried out since 2006. The HIV estimate derived from the surveillance used to calculate the disease burden as well as impacts of intervention in different population groups (ANC and other High-Risk Groups).

  The surveillance is mainly focused on High Risk Groups especially on FSW, MSM, IDU and Migrants. Since India is classified as concentrated nature of epidemic,         control strategies on HRGs will bring down the HIV prevalence.

Principal Investigator: Mr. Elangovan A. / Scientist - G

Funding Agency: Intramural

Period: 2014-2015

This study is aimed to determine the effects of the quarry works in the general population living around the quarry. The prevalence of TB observed among quarry workers is 1208 per lakh and in the community it is only 101 per lakh. The proportion of symptoms (shortness of breath, cough and respiratory infection/cold) related to lung function is relatively higher in quarry workers.

Principal Investigator: Dr. Tarun Bhatnagar / Scientist - E

Funding Agency: National AIDS Control Organization, Government of India

Period: 2018-20

The first national-level ART impact evaluation (ART-IE) of the Government of India’s free ART program under the NACP. This NACO-commissioned ART-IE study evaluated the impact of NACP’s ART program on various parameters at 396 ART centres (ARTCs) across the country for the 2012-2017 period. It was planned and conducted by ICMR-NARI and its collaborative partners, including ICMR-NIE. Through this study, the research team aimed to evaluate the impact of ART at the national level to understand whether the objectives of comprehensive, equitable, stigma-free, quality care, support and treatment services to all PLHIV in India under NACP have been met.

Principal Investigator: Dr. Tarun Bhatnagar / Scientist - E

Funding Agency: UNICEF

Period: 2018-19

The National AIDS Control Organization has proposed to conduct an assessment of progress towards elimination of mother to child transmission (EMTCT) of HIV and syphilis in India in 19 States/Union Territories (UT) as per WHO 2017 guidelines. The States/UT included are Andhra Pradesh, Karnataka, Maharashtra, Mizoram, Tamil Nadu, Telangana Assam, Bihar, Chandigarh, Delhi, Gujarat, Jharkhand, Madhya Pradesh, Manipur, Odisha, Punjab, Rajasthan, Uttar Pradesh and West Bengal. The specific objectives are to 1. review the data quality for global EMTCT process indicators reported to NACO at state and district levels, 2. review the process of data generation and compilation for reporting to NACO at the district facility level, 3. review the PPTCT programmatic service components at the district facility, state and national levels, 4. review the PPTCT-related laboratory services and data at the district facility, state and national levels, 5. review the human rights, gender equality and community engagement components of PPTCT at the state and national levels, and 6. prepare the EMTCT National Work Plan. Methods for the assessment include desk review of NACO and NHM data, reports, facility reviews, and interviews of key stakeholders at national, state, district and facility level.

Principal Investigator: Dr. Tarun Bhatnagar / Scientist - E

Funding Agency: UNICEF

Period: 2017

To garner national level momentum—and in the run-up towards achieving EMTCT of HIV and congenital Syphilis in India—NACO’s Technical Resource Group (TRG) on PPTCT, during December 2016, recommended launch of the sub-national pre-verification exercise in a phased approach. It was recommended to launch the data-verification exercise under a phased approach with a focus on the following six states: Andhra Pradesh, Karnataka, Maharashtra, Tamil Nadu, Telangana and Mizoram. The study design included both desk review of the programme data, and field work that focused on specific EMTCT process indicators for ANC, HIV and Syphilis. The reference period for the desk review was 2015-16 and 2016-17 while for the field work, the DITs reviewed reports and records for two months (June 2015 and December 2016) in selected facilities in each district. The following data quality aspects were reviewed and analysed through the data verification exercise: reporting status of the unit, completeness of reporting for the above-mentioned indicators, consistency of reporting over time with no outliers, the correctness of reporting and recording, and duplication of the number of pregnant women tested for HIV. The recommend strategies and mechanisms would help to inform the further strengthening of information systems and overall data quality at the state and district levels. This is imperative to progress towards achieving EMTCT of HIV and Syphilis in India.

Principal Investigator: Dr. Tarun Bhatnagar / Scientist - E

Funding Agency: The Global Fund

Period: 2016-17

Structural and individual level factors in prisons create challenges towards detection and management of HIV/tuberculosis. WHO and India’s HIV/tuberculosis control programs recommend intensified case finding in prisons. Low HIV and tuberculosis detection rates suggest poor implementation of existing surveillance strategies within the prison healthcare system in Mizoram’s capital city of Aizawl. We explored the operational feasibility of implementing the intensified case finding strategy in Aizawl central prison. We implemented the intensified screening through entry screening of new inmates, mass screening of resident inmates and exit screening at release. We set up digital chest radiography, sputum smear microscopy and HIV testing facilities within the prison and referral to external facility for Cartridge Based Nucleic Acid Amplification Test (CBNAAT). We screened 738 inmates (Male: 626; Female: 112). Of 53% inmates having presumptive tuberculosis symptoms, 37% underwent sputum microscopy. We detected 14 new tuberculosis cases; overall tuberculosis positivity 1.9%. We tested 65% of 657 inmates for HIV, of which 41 new cases were detected; overall HIV positivity 16.5%. Three male inmates had HIV-tuberculosis co-infection. It is feasible to implement intensified case detection for tuberculosis/HIV in the prison with inter-departmental coordination, albeit with certain challenges

Publication – Citation VancouverBhatnagar T, Ralte M, Ralte L, Chawnglungmuana, Sundaramoorthy L, Chhakchhuak L. Intensified tuberculosis and HIV surveillance in a prison in Northeast India: Implementation research. PLoS ONE 2019;14(7): e0219988. https://doi.org/10.1371/journal.pone.0219988

Principal Investigator: Dr. Tarun Bhatnagar / Scientist - E

Funding Agency: TEPHINET, USA

Period: 2016

NIE received a grant to initiate field epidemiology training program for veterinarians in India. A series of workshops leading to longer-term training programs were planned with the aim of strengthening the capacity of veterinarians in the country to prevent, detect and respond infectious disease threats using a One Health approach. The first workshop on "Basic Epidemiology for Veterinarians” was held from 22 to 26 August 2016 in Chennai. The following topics were covered: Basic epidemiological concepts; Descriptive epidemiology; Epidemiological study designs; Analytical epidemiology; Sampling of animal population; and Interpretation of diagnostic tests. The 2nd workshop on “Surveillance and Outbreak Investigations for Veterinarians” was held from 7-11 Nov, 2016 in partnership with Maharashtra Animal & Fishery Sciences University, Nagpur. The topics included principles of disease surveillance, surveillance for zoonotic diseases, surveillance for avian influenza, NADRES, filed and herd sampling, EpiInfo, principles of outbreak investigation, KFD case study, descriptive and analytical analysis, risk assessment, and risk communication. 31 scientific/technical/programmatic staff from the following institutions participated: Indian Veterinary Research Institute (IVRI), Izzatnagar, Bareilly; National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru; National Institute of High Security Animal Diseases (NIHSHAD), Bhopal; Tamil Nadu Veterinary and Animal Sciences University (TANUVAS), Chennai; Department of Animal Husbandry, Govt. of Tamil Nadu.

Principal Investigator: Dr. Tarun Bhatnagar / Scientist - E

Funding Agency: Internatioanl AIDS Vaccine Initiative

Period: 2012-14

The Goals Model is designed to provide evidence for strategic program planning by examining the impact of different interventions on projected HIV incidence. We present the methodological concerns related to use of Goals Model to fit the epidemic curves and assess its feasibility to assess impact of newer interventions in Andhra Pradesh, Maharashtra and Tamil Nadu states of India where HIV epidemic is considered to have matured and in a declining phase. We collated the data from the three states for demographic, epidemiological, transmission-related and risk group wise behavioral input parameters in Goals Model. Model fitting was analyzed by comparing the HIV prevalence simulated by the Goals model with the epidemic curve generated by the Estimation and Projection Package (EPP) for each risk group in each state. In all the three states, the HIV prevalence trends for high-risk populations simulated by the Goals Model matched reasonably well with the trends derived from curve fitting to surveillance data with the EPP. However, trends for the remaining populations differed between the two approaches. More representative and robust data coupled with structural changes in the modeling equation and parameters in Goals Model are needed in order to effectively use it to assess the impact of future strategies of HIV control in India, more so at the sub-national level.

Publication – Citation VancouverBhatnagar T, Dutta T, Stover J, Godbole S, Sahu D, Boopathi K, et al. Fitting HIV Prevalence 1981 Onwards for Three Indian States Using the Goals Model and the Estimation and Projection Package. PLoS ONE 2016;11(10): e0164001. doi:10.1371/journal.pone.0164001.

Principal Investigator: Dr. Tarun Bhatnagar / Scientist - E

Funding Agency: National Institutes of Health, USA

Period: 2008-11

Our aim was to assess the nutritional status of a treatment-naïve population of past and current drug users in order to examine the role of nutrition in the natural history of HIV infection and to use this data to develop appropriate nutritional interventions that will help improve quality of life in this vulnerable population. Another important goal of this study was to establish and monitor baseline nutrition and metabolic status among HIV-infected patients prior to widespread access to ART. This data will allow us to document the natural history of metabolic and nutritional complications of ART in this population once they gain access to these medications. In 2007, a total of 300 (107 HIV-positive and 193 HIV-negative) clients were recruited from a drug treatment center in Chennai, India run by a non-governmental organization. 100 HIV-positive and negative participants were then followed six monthly for 3 years to determine the effect of HIV, co-morbidities, ART use and drug use on the prevalence and incidence of nutritional and metabolic abnormalities; to determine the consequences of co-morbidities and nutritional and metabolic status on clinical outcomes, by HIV status and/or ART use; and to examine the contributions of adherence to HIV medications, psychosocial factors, and socioeconomic factors to the development or persistence of nutritional and metabolic abnormalities. This study was led by Tufts University, Boston, USA.

Publication – Citation VancouverTang AM, Bhatnagar T, Ramachandran R, Dong K, Skinner S, Kumar MS, Wanke CA. Malnutrition in a population of HIV-positive and HIV-negative drug users living in Chennai, South India. Drug Alcohol Depend. 2011 Oct 1;118(1):73-7. doi: 10.1016/j.drugalcdep.2011.02.020. Epub 2011 Mar 21.

Principal Investigator: Dr.Manickam P./ Scientist - E

Funding Agency: WHO-TDR

Period: 2001-2015

Uniform MDT We evaluated six-month multidrug therapy (MDT) currently recommended for multibacillary (MB) patients as uniform MDT (U-MDT) in a single-arm open trial under programme conditions. Primary objective was to determine efficacy to prevent five-year cumulative five per cent relapse. Secondary objectives were to assess acceptability, safety and compliance. We recruited 2091 PB and 1298 MB patients from six settings in India and two sites in China. We observed low relapse, minimal ADR and other adverse clinical events. Clofazimine-related pigmentation was acceptable. Evidence supports introduction of U-MDT in national leprosy programmes.

Single dose for PB We conducted randomized double-blind trial for single-dose of Rifampicin, Ofloxacin and Minocycline (ROM) compared to WHO-PB-MDT among paucibacillary (PB) leprosy patients with 2-5 skin lesions. We enrolled 1526 patients from five centres (ROM=762; WHO-PB-MDT=764) and followed them for 36 months posttreatment during 1998-2003. Single dose ROM, though less effective than the standard WHO-PB-MDT regimen conceptually offers an alternative treatment regimen for PB leprosy patients with 2-5 lesions only when careful follow-up for relapse is possible.

Principal Investigator: Dr.Manickam P./ Scientist - E

Funding Agency: ICMR

Period: 2018

We investigated outbreak of Nipah in Kozhikode, Kerala. We were part of the surveillance and response team alongwith State and Central health teams. We did descriptive and analytical epidemiological studies.

Principal Investigator: Dr.Manickam P./ Scientist - E

Funding Agency: ICMR

Period: 2012-14

We conducted a cross-sectional study in six Indian sites to clarify relevance of socio-cultural features of experience and meaning of illness and stigma between leprosy and other health problems. We interviewed leprosy and non-leprosy (Tuberculosis, Malaria and Skin) patients and providers (public and private) and community members.

Principal Investigator: Dr.Manickam P./ Scientist - E

Funding Agency: ICMR

Period: 2006

We investigated outbreak of Chikungunya in South Indian settings.

Principal Investigator: Dr.Manickam P./ Scientist - E

Funding Agency: CCRS

Period: 2016-18

Cross-sectional study: Chennai, Tamil Nadu (Central Council for Research in Siddha)

We reviewed the marketed anti-diabetic Siddha formulations for the status of label, drug information and branding through a cross-sectional study.

Principal Investigator: Dr. Ganesh B./Scientist - D

Funding Agency: ICMR-NICED, Kolkata (Intramural research grants)

Period: 2008-2013

23 PBV positives were detected (2%; n=1112) in children aged

Principal Investigator: Dr. Ganesh B./Scientist - D

Funding Agency: ICMR-CDC, USA

Period: 2008-2009

Human rotavirus strains were detected from children (aged

Principal Investigator: Dr. Ganesh B./Scientist - D

Funding Agency: ICMR-NIE Intramural research grants

Period: 2015-2018

This study was conducted in Avadi and Poonamalle Taluk Hospitals. The Clinical case reporting form was designed in EpiInfo software package (Version 7.0) for Data entry and storage.

Principal Investigator: Dr. Ganesh B./Scientist - D

Funding Agency: NACO Extramural research grants

Period: 2017-2018

Acute diarrheal disease (ADD) is the most frequent cause of childhood illness and a leading cause of death in children

Isolation of major diarrheagenic etiologies of gram negative bacteria (viz. Vibrio spp. Salmonella spp. Shigella spp. and Escherichia coli) will be carried out by direct plating of neat stool specimens or stool swabs in Cary Blair medium collected from hospitalized diarrheic patients will be transported from the sample collection site (Communicable diseases Hospital) to the ICMR-NIE laboratory on a daily basis for 5 days in a week. A minimum of 5 samples per day (weekly 25 nos.) i.e., 100 samples per month and approximately 1200 samples/year will be screened.

The isolates of the major diarrheagenic pathogens (Vibrio spp. Salmonella spp. Shigella spp. And Escherichia coli) only will be further characterized by biochemical, serotyping and antimicrobial sensitivity tests. Further molecular characterization and analyze the presence of resistance genes to tetracycline, macrolide, carbapenems, ESBL (extended-spectrum beta-lactamases), etc., and also to analyze genotype based on MLST (multi-locus sequence typing) scheme.