PubMed Health⌕ Search

Biomedical subjects

J Chakraborty

Publications and source records attributed to J Chakraborty.

At least 37 records · Page 2Linked to original sources
PubMed1998

Maternal measles antibody decay in rural Bangladeshi infants--implications for vaccination schedules.

Considerable numbers of measles cases occur below the target age for vaccination in the Indian sub-continent. The immunogenicity of measles vaccine in infancy is dependent on the rate of decay in maternal antibody since this antibody interferes with vaccine induced seroconversion. This study investigated maternal antibody decay in a rural population in Bangladesh and evaluated possible risk factors for early decay. Measles antibodies were assessed using both ELISA and Plaque Reduction Neutralization (PRN) test in 330 infant-mother pairs in a cross-sectional survey. PRN was more sensitive method than ELISA for determining antibody levels. Antibody levels decreased rapidly in infants with increasing age. By the age of 5 months, 67% (28/42) infants had practically no protective antibody left (30 mIU ml-1 or below). Only 12% infants at 5 months of age, and 5% at 8 months, had levels greater than 120 mIU ml-1--stated to 'protect' children. Multiple regression showed that maternal age was the only variable associated with the level of antibody (maternal weight, height and MUAC were not associated), decreasing by 1.06 mIU ml-1 for each year of age (P = 0.002). Infant's antibody concentration decreased with age by an average 2 mIU mL-1 for every month of life (P < 0.0001), and was determined by the maternal antibody concentration (P < 0.0001) (child's length, weight, MUAC, mother's gestational age and parity were not associated). The relatively rapid antibody decay suggests that the target age for measles vaccination might be reduced. Further, as the cohort of vaccinated mothers enters reproductive age in Bangladesh, a more rapid decay of antibody may be expected in future generations of Bangladeshi children. The information presented here suggests that a formal trial of standard measles vaccine at younger ages is justified in this population as it could confer considerable benefit in reducing infant measles.

Adult↗
PubMed1998

Adherence to cotrimoxazole treatment for acute lower respiratory tract infections in rural Bangladeshi children.

This study evaluates compliance with taking oral cotrimoxazole in an ALRI control programme in rural Bangladesh. Health workers administered the first dose to children with moderate disease and entrusted relatives to give the remaining doses. A team of medical assistants visited the families of cases 3 to 5 days after initiating treatment and counted the remaining tablets. Medical assistants undertook 367 visits to families of children under treatment at a mean (SD) of 4.4 (0.99) days after treatment began. All children appeared to have been given the antibiotic, but one-quarter were being under-dosed on the day of the visit. Under-dosing did not correlate with any of the socio-demographic variables studied, and seemed to be homogeneously distributed in the community. Under-dosed children did not seem to have a higher risk of subsequent ALRI episodes during the study period. There was no indication of progression to severe disease or death in home-managed cases of moderate pneumonia in this study. These findings raise a question about the need for 5 days of oral antibiotic in the management of moderate pneumonia. Careful studies of the effect on subsequent morbidity, mortality and antibiotic resistance of providing briefer treatment for moderate episodes of ALRI are required. If a briefer course proves effective, this would have important implications for funding programmes of control of ALRI in the community.

Anti-Infective Agents, Local↗
PubMed1998

A comparison of three verbal autopsy methods to ascertain levels and causes of maternal deaths in Matlab, Bangladesh.

BACKGROUND: Verbal autopsies have been widely used to determine the levels and causes of maternal death but few studies have assessed the reliability of various methods. METHODS: We compared the levels and causes of maternal mortality in three data sources from Matlab, Bangladesh: (1) maternal deaths identified through a unique demographic surveillance system (DSS); (2) maternal deaths identified as a result of a previous detailed investigation into the levels and causes of maternal mortality; and (3) maternal deaths identified in the current special study. All studies used lay reporting, but differed in terms of the nature of the study, the sex of the interviewer, the format of the questionnaire and the procedure to derive the diagnosis. RESULTS: There were substantial disagreements between the routine reporting and the special studies. The DSS identified 67.2% of all deaths occurring during pregnancy or within 42 days postpartum (82.3% of direct obstetric deaths, 70.0% of deaths due to induced abortions and 42.4% of indirect obstetric deaths). Extending the definition of maternal deaths to 90 days postpartum increased the numbers of maternal deaths between 1987 and 1993 from 174 to 196. The two special studies also disagreed in the ascertainment of the causes of maternal deaths and yielded different cause of death distributions; the proportion of direct obstetric deaths (excluding abortion) was 50.4% in the current system compared to 44.5% previously (P = 0.001). CONCLUSIONS: This study confirms the known difficulties in the ascertainment of the levels and causes of maternal mortality. The large disparities in the levels and causes of maternal mortality using three different methods of lay reporting in a population with an almost complete vital registration system add to the growing concern about the inaccuracies in the measurement of maternal mortality.

Bangladesh↗
PubMed1997

Spatial distribution of watery diarrhoea in children: identification of "risk areas" in a rural community in Bangladesh.

To assess the geographic variation of acute watery diarrhoea in children 0 to 5 years old in rural Bangladesh, all cases of "cholera-like" diarrhoea were plotted on the map. A clustering pattern was noticed, and validated by a nonparametric clustering test for in-homogeneous population. Several risk areas for the disease were identified. In these areas, the point prevalence (8.7/1000) was notably higher than outside the areas (0.41/1000), (95% confidence interval, 15.55-29.30). Parents' education, population density and use of sanitary latrines were significantly related to the risk areas (p < or = 0.001). The results of this study indicate that computer-assisted mapping may be useful in defining and monitoring risk areas for watery diarrhoea in children.

Bangladesh↗
PubMed1997

Breastfeeding and the risk of life-threatening enterotoxigenic Escherichia coli diarrhea in Bangladeshi infants and children.

OBJECTIVE: To assess the relationship between breastfeeding and the risk of life-threatening enterotoxigenic Escherichia coli (ETEC) diarrhea among Bangladeshi infants and young children <36 months of age. DESIGN: Case-control study. SETTING: A rural Bangladesh community. PARTICIPANTS: A total of 168 cases with clinically severe ETEC diarrhea detected in a treatment center-based surveillance system during 1985 to 1986 and 3679 controls selected in three surveys of the same community during the same calendar interval. OUTCOMES: Cases and controls were compared for the frequency of antecedent breastfeeding patterns. RESULTS: Compared with other feeding modes, exclusive breastfeeding of infants was associated with significant protection against severe ETEC diarrhea (relative risk [RR] = 0.51; 95% confidence interval [CI]: 0.28,0.96). However, during the second and third years of life, the risk of this outcome was similar in both breastfed and nonbreastfed children (RR = 0.98; 95% CI: 0.45,2.12), and no significant overall protective association between breastfeeding and severe ETEC diarrhea was evident during the first 3 years of life (RR = 0.86; 95% CI: 0.43,1. 74). CONCLUSIONS: Exclusive breastfeeding appeared to protect infants against severe ETEC diarrhea, but breastfeeding was not associated with protection after infancy, nor was it associated with a major overall reduction of severe ETEC disease during the first 3 years of life. Although not diminishing the importance of breastfeeding, our findings suggest that other interventions, such as immunization and education about proper food hygiene, may also be required in efforts to prevent this major pediatric disease.

Bangladesh↗
PubMed1997

Acute lower respiratory infections in rural Bangladeshi children: patterns of treatment and identification of barriers.

A study conducted in rural Bangladesh examined the patterns of health seeking behavior, mothers' recognition of symptoms, the perceived causes and barriers to timely treatment of acute lower respiratory infections (ALRI). A total of 194 children under 5 years of age suffering from ALRI in an intensive maternal child health and family planning area was prospectively followed. About 62% of the mothers sought allopathic treatment for their children within 24 hours of case detection. No treatment of any kind was sought in 45 (23.2%) cases. Most of the mothers could recognize the different symptoms of ALRI. Cold was reported as the most common cause of ALRI. No significant difference was observed in the reported symptoms or perceived cause of the disease between those who sought no treatment and those who sought allopathic, homeopathic, spiritual or combined treatments. Failure to recognize severity followed by work loss were the most common reasons identified for not seeking any medical care. Whether or not a mother sought allopathic treatment was not associated with the child's age, sex, mother's age, mother's education, duration of illness, birth order, housing type or distance from the health center. The study indicates the potential value of giving parents clear guidelines on recognition of severity of symptoms of ALRI and motivating them to seek treatment quickly when these symptoms present. Health service providers should be aware of the heavy work loads which rural women have and the severe time constraints which deter them from seeking timely treatment from the appropriate sources.

Bangladesh↗
PubMed1997

Flood control embankments contribute to the improvement of the health status of children in rural Bangladesh.

Every year, Bangladesh experiences major floods that inundate about one-third of the country. Therefore, flood control projects that comprise earthen dikes and irrigation/drainage systems are built along the major rivers to protect the people living in low-lying areas, stabilize the river banks and improve agricultural productivity. However, the adverse effects of these projects are regularly emphasized, such as environmental degradation and reduction of fishing supplies. The Demographic Surveillance System of the International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B) was used to assess the effect of a flood control programme on the mortality of 0-4-year-old children residing in the Matlab study area. Adjusted mortality rates were used in comparing four adjacent child populations residing either inside or outside a flood-control embankment and according to the type of health services provided in this area. Between the periods 1983-86 and 1989-92, the crude child mortality in the total study area decreased by 37%, from 185.9 per 1000 live births to 117.9 per 1000 live births. Following the construction of the embankment, death rates outside were up to 29% higher in 1-4-year-old children and 9% higher for 0-4-year age group compared to the flood-protected area (P < 0.001). Simultaneously, in the same study area, health interventions contributed to a 40% reduction in mortality among children less than 5 years of age in all causes of deaths (P < 0.001). Migration patterns and the effect of distances to the hospital are discussed.

Bangladesh↗
PubMed1996

Urinary microalbumin measurement using a homogeneous liposomal immunoassay.

A homogeneous colorimetric immunoassay which has been developed for urinary microalbumin utilizes complement-mediated immunolysis of liposomes containing the dye, sulphorhodamine B. Unlike a previously described model complement-mediated liposomal assay for serum albumin (Frost et al., 1994) which was competitive, this assay uses a sandwich-type format and Fab' (antialbumin)-coated liposomes to increase the assay sensitivity. The liposomal assay, performed using a Cobas Bio analyser (Roche, Welwyn Garden City, UK), gave an acceptable correlation with a radioimmunoassay (NETRIA, London, UK): r = 0.94; y (liposomal assay) = 1.09 x (radioimmunoassay) - 1.54 mg/1. The imprecisions of the assays were similar and matrix effects due to the use of urine samples were determined to be acceptably small. The assay demonstrates the advantage of using Fab'-coated liposomes in sandwich-type liposomal immunoassays over liposomes coated with intact antibody, which failed to elicit complement-mediated immunolysis.

Albumins↗
PubMed1996

Field trial of inactivated oral cholera vaccines in Bangladesh: results from 5 years of follow-up.

To determine the protective efficacy (PE) of three doses of oral B subunit-killed whole cell (BS-WC) or killed whole cell-only (WC) vaccines against cholera, a clinical trial was conducted among 62285 children over 2 years and adult women in rural Bangladesh. During 5 years of follow-up, there were 144 cases of cholera in the BS-WC group (PE = 49%; P < 0.001), 150 in the WC group (PE = 47%; P < 0.001), and 283 in the K12 group. Protection by each vaccine was evident only during the first three years of follow-up; long-term protection of young children was observed only against classical but not El Tor cholera; 3-year protection against both cholera biotypes occurred among older persons, but at a higher level against classical cholera.

Administration, Oral↗
PubMed1996

Maternal recall of tetanus toxoid vaccination.

Difficulties of vaccination documentation in developing countries lead to a dependence on maternal recollection of vaccination to evaluate tetanus toxoid (TT) vaccination. To date, the validity of this approach has not been assessed. Recollection of TT immunization in 1477 women was compared with carefully maintained records of immunization in Matlab, rural Bangladesh. Sensitivity, specificity and predictive values for maternal recall were calculated in a highly vaccinated population of women of reproductive age. Maternal recollection of the second TT dose was good, but considerably reduced if they had received more than two doses. Recollection was also reduced if the doses were administered more than a year prior to questioning. Up to 40% of women did not remember doses received 12-23 months earlier. Logistic regression evaluated the effect of confounding variables on recalling the number of TT doses received. Younger women, with fewer children and with a good vaccination status, tended to have a better recollection of the number of doses received. Maternal education, household characteristics, religion or family planning resumption within 1 year of the last delivery had no effect on the accuracy of recall. These results suggest that maternal recall may underestimate TT doses received a year before the date of questioning. Current methods to determine TT status by asking mothers at infant vaccination contacts may result in underestimating coverage.

Adult↗
PubMed1996

The effects of health services utilization on the recovery from dysentery.

A community-based programme for the treatment of dysentery in children under five years of age was implemented in Matlab, Bangladesh. Dysentery cases, identified at home, were referred to a sub-center for standard treatment with nalidixic acid. To assess the response to this intervention, a one year survey was carried out in 1990. The incidence of dysentery in this age group was 7 per cent. Isolation of Shigella species was 27 per cent (47/177) and was strongly associated with the frequency of stools (chi2 for trend, P = 0.001). S. flexneri accounted for 81 per cent of the isolates. Only 45 per cent of the cases were actually taken to the sub-center, 27 per cent went to traditional healers and 23 per cent used private allopathic services. Less than 40 per cent of the shigellosis cases received the suggested standard treatment. The overall recovery rate at 7 days, based arbitrarily on the number and type of stools, was 62 per cent and quite homogeneous among the types of services used. Neither the presence of Shigella isolates nor the type of treatment were associated with a higher recovery rate. We concluded that a systematic treatment of dysentery patients should be more selective on shigellosis.

Anti-Infective Agents↗
PubMed1996

Explant culture, immunofluorescence and electron-microscopic study of flexor retinaculum in carpal tunnel syndrome.

Although flexor-retinaculum (FR) release provides dramatic relief from carpal tunnel syndrome (CTS), the role of this ligament in CTS is not well understood. We have adopted a unique approach to study the cellular pathogenesis of CTS by establishing a method for the culture of cells of FR from subjects with and without CTS. The cultured cells were characterized by light, immunofluorescence, electron microscopy, Western blot analysis, and growth studies. Two main differences between the CTS and control cells included a faster growth rate and an altered fine morphology that reveals the contractile nature of the CTS cells. It is possible that the presence of these contractile cells in FR is responsible for increasing the contractility of the FR, leading to a decrease in the volume of the carpal tunnel, thus exerting pressure on the median nerve and triggering CTS.

Adult↗
PubMed1996

Novel homogeneous liposomal immunoassay for colorimetric estimation of serum IgG anticardiolipin antibodies.

Liposomes entrapping the dye sulforhodamine B were used to develop an assay for anticardiolipin antibodies (ACAs). In the presence of magnesium ions, IgG ACAs induced liposomal lysis and the resulting absorbance changes were dependent on the amount of ACAs present. The liposomal assay (y) showed similar intraassay imprecision and detection limit to an ELISA for IgG ACAs (x), with a correlation coefficient of 0.90 (y = 1.05x - 1.61). No correlation with ELISA IgM ACA measurements was observed. Although ELISA remains the method of choice, particularly in examining different ACA classes, the liposomal assay offers advantages of speed and potential for processing large numbers of samples for IgG ACAs. This may facilitate study of the significance of increased IgG ACAs in the groups of conditions with which they are associated, and perhaps enable more laboratories to perform the test.

Antibodies, Anticardiolipin↗
PubMed1996

A comparative study of the awareness and attitude of HIV/AIDS among students living in India and migrants to the United States.

The goal of the current study was to collect preliminary data regarding HIV/AIDS awareness among Indian students who are residing in India and those who have migrated to the United States. A questionnaire was distributed to thirty-four college students in the United States and thirty-eight college students who are residing in India, between ages 18-26 years. 74% of the Indian group and 53% of the USA group felt that their knowledge of this disease is not adequate. 3% felt that this disease is completely curable. Only 13% of the Indian group and 23% of the USA group thought that tuberculosis is linked to HIV infection. Both groups felt that the newspapers and magazines are good sources of information. The majority of the Indian (71%) and USA (50%) groups felt that HIV/AIDS education should begin in high school. 90% of the Indian group and 79% of the USA group felt that people in India do not have adequate knowledge about AIDS. The majority felt that the high-risk population should be screened and there should be more governmental support.

Adolescent↗
PubMed1995

Impaired immune response to natural infection as a correlate of vaccine failure in a field trial of killed oral cholera vaccines.

In a field trial carried out in 1985 in Matlab, Bangladesh, the authors evaluated whether subjects who developed Vibrio cholerae 01 infections during the first year after earlier receipt of B subunit-killed whole cell (BS-WC) or killed whole cell-only (WC) oral cholera vaccines exhibited deficient serum vibriocidal immune responses to these infections. After severe V. cholerae 01 infections (n = 70) in subjects > 5 years of age, the age group in which both vaccines were efficacious, a 6.5 geometric mean-fold rise of serum vibriocidal antibodies was observed among vaccinees, compared with an 18.6 geometric mean-fold rise in placebo-recipients (p < 0.01). Depressions of serum vibriocidal responses among vaccinees were even more marked after asymptomatic infections (n = 30): a 1.1 geometric mean-fold rise in vaccinees versus a 5.9 geometric mean-fold rise in placebo-recipients (p < 0.01). The authors conclude that subjects who failed to be protected by BS-WC and WC, despite being in the age group for which these vaccines were protective, exhibited poor immune responses even to the vigorous stimulus of natural infection. These findings raise the possibility that immune hyporesponsiveness may limit the potential efficacy attainable by cholera vaccines in populations with endemic cholera.

Administration, Oral↗
PubMed1995

Methylprednisolone-hemisuccinate and its metabolites in serum, urine and bile from two patients with acute graft rejection.

Methylprednisolone-hemisuccinate (MPHS), methylprednisolone (MP), 20-alpha-hydroxy- (20 alpha HMP) and 20-beta-hydroxymethyl-prednisolone (20 beta HMP) concentrations were measured in serum, urine and bile from two liver transplant recipients who had received 1 g MPHS by a 1 h intravenous infusion for treatment of an acute rejection episode. These patients excreted similar total amounts of the dose in urine as patients with rheumatoid arthritis (historical controls) who had normal liver function. The transplant patients showed a ratio in urine of 'total metabolites'/MPHS that was one third that of patients with rheumatoid arthritis. Less than 0.2% of the administered MPHS appeared in bile as MPHS, MP, 20 alpha HMP and 20 beta HMP during the 24 h following infusion. Liver transplantation did not affect the overall elimination of drug in urine. However, the impaired liver function following transplantation resulted in reduced conversion of MPHS to its active form (MP).

Adult↗