17-Dec-2021: Update on National Tuberculosis Elimination Programme
The Ministry of Health and Family Welfare is implementing a National Strategic Plan for Ending TB by 2025. As per the Global TB Report, 2021, the country has reduced the incidence of TB from 217/lakh population in 2015 to 188/lakh population in 2020 (a 13% decline). The death rate has declined from 36/lakh population in 2015 to 33/lakh population in 2019.
During the COVID pandemic, proactive initiatives were taken to provide uninterrupted diagnostic and treatment services. Special outreach activities were also undertaken to identify presumptive TB cases.
During the year 2020 (Jan - Dec), a total of 18.12 lakh TB cases were notified under the programme which was 25% less than the total cases notified in 2019 (which was 24.00 lakhs). In 2021, in spite of a larger wave of COVID-19, the programme has been able to notify 17.6 lakh TB cases (till Oct,2021), which is 18% higher compared to 2020.
To mitigate the impact of COVID and to ensure that all TB patients including pregnant women have uninterrupted access to drugs and diagnostics, the Ministry has taken several steps including:
Active TB case finding campaign in key vulnerable and co-morbid population
- Integration with Ayushman Bharat- Health & Wellness Centres to decentralize screening and treatment services closer to the community
- Provision of free TB drugs of extended duration and door-step delivery during COVID times
- Implementation of bi-directional TB-COVID screening and TB screening / testing for all presumptive cases with influenza like illness (ILI) and Severe Acute Respiratory Infections (SARI)
- Scale up of molecular diagnostic laboratories to sub-district levels
- Sample collection and transportation system from Sub Centre to PHC, PHC to CHC and from CHC to District / State level laboratories
- Intensified IEC campaigns to raise community awareness
20-Aug-2020: First synthesis path for tuberculosis & chikungunya inhibiting flavonoid molecules deciphered
Flavonoid molecules, like rugosaflavonoids, podocarflavone, and isoflavone found to inhibit tuberculosis and chikungunya, have so far been isolated from plants. For the first time, scientists have unearthed the route to synthesize the molecules in the lab, paving the path for ensuring their availability at all seasons without overexploiting the medicinal plants that contain them.
Scientists from Agharkar Research Institute (ARI), Pune, an autonomous institute of the Department of Science and Technology (DST), Govt. of India, have come up with the first synthetic route for producing flavonoids molecules related to the treatment of tuberculosis and chikungunya. Preliminary indications have been witnessed regarding probable treatment response to COVID 19.
According to the recent work published in the peer-reviewed scientific journal, ‘ACS Omega’ by Dr. Pratibha Srivastava and her team from ARI have developed the first total synthesis of flavonoids such as rugosaflavonoids, podocarflavone, and isoflavone. 'Rugosaflavonoid A' is reported from a Chinese medicinal plant Rosa rugosa. 'Podocarflavone A' is isolated from the plant Podocarpus macrophyllus.
“Most ayurvedic products are rich in flavonoids. Flavonoids are mostly present in tomato, onion, lettuce, grape, apple, strawberry, peach, and other vegetables. A diet rich in flavonoids protects us from diseases related to heart, liver, kidney, brain, and other infectious diseases. Right now, the world is facing a traumatic situation due to COVID-19. Since flavonoids boost-up immunity, a flavonoid-rich diet is recommended,” explains Dr. Srivastava.
Flavonoids are normally isolated from plants. However, inconsistency in natural products can occur in different seasons, places, and species. Along with these hurdles, over-exploitation of medicinal plants puts an extra burden on the environment.
To overcome these problems, such products can be developed by synthetic protocols in the laboratory by simple and cost-effective methods. The synthetic natural products possess a structure and medicinal properties similar to the natural product.
The chemical structure of flavonoids is similar to the female hormone 17-beta-estradiol (estrogen). Therefore, flavonoids can ease the life of women who face problems in the premenopausal stage.
“While synthesizing rugosaflavonoids, my team has obtained dihydro rugosa flavonoids, which are found to be more potent in inhibiting highly infectious diseases like chikungunya and tuberculosis. Computational analysis of these molecules to inhibit COVID-19 by targeting spike protein, proteases and RdRp is also obtained, and the results are exciting,” says an exuberant Dr. Srivastava.
Dr. Srivastava also expressed confidence in the compounds synthesized by her Ph.D. student Ninad Puranik, for problems associated with women during the perimenopausal phase.
“In synthetic chemistry, the analogs of natural products can be prepared by the same route. At times the analogs show better medicinal properties than the natural products,” said Dr. Srivastava.
15-Jul-2019: Molecular mechanism behind latent TB.
Tuberculosis infection results in approximately nine million new cases worldwide every year. TB-causing bacterium can remain dormant in human body for a long time, even for several decades before it becomes infectious. The bacterium remains ensconced within a type of white blood cells called macrophages, when it is in its latent form.
A team of researchers from Kolkata-based CSIR-Indian Institute of Chemical Biology, Bose Institute and Jadavpur University have figured out how tuberculosis bacterium is released from its reservoir inside the human body.
A macrophage is an important part of the immune system. The word 'macrophage' literally means a 'big eater’. It is an amoeba-like organism and its job is to clean the body of microscopic debris and invaders. It has an innate ability to locate and consume invaders such as bacteria, viruses, fungi, and parasites.
However, the story is different with TB bacterium. Instead of killing it, the macrophage creates a sac-like formation called granuloma around it. Granuloma keeps the bacillus contained and under control. The equilibrium can last for even several decades until it gets broken leading to release of infectious bacteria into the human body. This can happen due to several reasons such as lowered immunity because of physical weakness or infections such as HIV.
Scientists globally have been trying to figure out the molecular mechanism of the release of infectious TB bacteria from the granuloma. The new study by Kolkata researchers could fill this knowledge gap.
The team has discovered that a protein molecule called MPT63 secreted by the bacteria may be playing a role in the release process. Synthetically produced MPT63 protein molecule was subjected to different levels of acidity and it was found that when the acidity value is high its structure changed dramatically. It started as what is called a beta sheet and it turned into a helical form in the acidic condition, which prevails in matured granuloma.
The protein, which was found to have no apparent function in the folded beta sheet, suddenly became toxic on assuming the helical form, and got into the cell membrane, leading to formation of pores and consequently death of the host cells and release of the bacteria.
3-Dec-2021: Dengue Epidemic
Government of India has developed National guidelines on Dengue case treatment/management, in consultation with experts and shared with all States/UTs for implementation. The guidelines emphasize on the preparedness of hospitals for case treatment/management. In addition, total 15 advisories issued from time to time to States/UTs during 2021 for prevention and control of dengue including case management.
During 2021 (till 21.11.21), a total number of 1,64,103 cases have been reported due to Dengue in the country, as against 2,05,243 in 2019. The Case Fatality Rate has been sustained at <1% since 2008. It has further come down below 0.2% in 2018 and 0.1% in 2019, which has been maintained at this level since then. Accordingly, it cannot be said that the Dengue cases are rising in the Country.
The National Center for Vector Borne Diseases Control (NCVBDC) administers the National Vector Borne Diseases Control Programme (NVBDCP) for prevention and control of six vector borne diseases i.e., Malaria, Kala-azar, Lymphatic Filariasis, Dengue, Chikungunya & Japanese Encephalitis. The programme guidelines / action plans for Dengue & other Vector Borne Diseases have been developed in consultation with Public Health Experts and States/UTs.
Government of India has taken the following measures for prevention and control of dengue in the country:
- Provided Technical Guidelines for prevention and control, case management & effective community participation to the States for implementation. 15 advisories were issued from time to time to States/UTs for prevention and control of dengue in2021.
- Free diagnostic facilities through 713 Sentinel Surveillance Hospitals and 17 Apex Referral laboratories identified across the country are fully functional. 7.26 Lakh IgM tests have been provided by Government of India. Additional funds have been provided to states for procurement of NS1 kits for early diagnosis.
- Under National Health Mission, necessary and sufficient budgetary support is provided to states/UTs for dengue control activities i.e., dengue case management, vector control activities (provision of domestic breeding checkers, insecticide, fogging machines etc.), training support, awareness activities, etc.
As far as Non-Communicable Diseases are concerned, The Department of Health & Family welfare, provides technical and financial support to the States/UTs under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), as part of National Health Mission (NHM), based upon the proposals received from the States/UTs and subject to the resource envelope. The Programme focuses on strengthening infrastructure, human resource development, health promotion & awareness generation for prevention, early diagnosis, management and referral to an appropriate level of health care facility for treatment of the Non-communicable Diseases.
A population-based initiative for prevention, control and screening of common, Non– Communicable Diseases (NCDs) i.e. diabetes, hypertension and common cancers have been rolled out in the country under NHM and also as a part of Comprehensive Primary Health Care. Under the initiative, persons more than 30 years of age are targeted for their screening. Screening of these common NCDs is also an integral part of service delivery under Ayushman Bharat Health and Wellness Centres.
Preventive aspect of NCDs has been strengthened under Comprehensive Primary Health Care through Ayushman Bharat Health Wellness Centre scheme, by promotion of wellness activities and targeted communication at the community level. Other initiatives for increasing public awareness about NCDs and for promotion of healthy lifestyle includes observation of National and International Day and use of print, electronic and social media for continued community awareness. Furthermore, healthy eating is also promoted through FSSAI. Fit India movement is being implemented by Ministry of Youth Affairs and Sports, and various Yoga related activities are being carried out by Ministry of AYUSH. In addition, NPCDCS gives financial support under NHM for awareness generation (IEC) activities to be undertaken by the States/UTs as per their Programme Implementation Plans(PIPs).
National Multi-sectoral Action Plan (NMAP) for prevention and control of NCDs has been developed through series of consultations with various stakeholders including other Ministries/Departments. The action plan has identified action points for 39 Ministries/Departments.
The meetings have been conducted regularly involving public health experts from national level, United Nations Organizations and Non-Governmental Organizations.
Several committees involving public health expert from National level, medical colleges, UN organizations etc. have been constituted and regular meetings have been conducted to improve implementation of NPCDCS programme.
17-Nov-2021: Indian researchers develop better therapeutics to treat Autism Spectrum Disorder
A group of Indian researchers have developed a compound called “6BIO” that can provide a better method to treat Autism Spectrum Disorder (ASD). They have determined the potency of the compound in a pre-clinical mice model. This is the first compound that has been proved in pre-clinical evaluation to have the potential for improving daily activities like learning and recollecting new tasks in patients with ASD/ Intellectual disability (ID).
Autism Spectrum Disorder (ASD) is one of the major issues causing a tremendous burden to our society. Yet, it does not have an appropriate pharmacological or genetic method to treat ASD/ID. Current therapeutics to treat ASD aims to alleviate symptoms such as epileptic seizures or sleep issues but not to treat the multiple problems of ASD/ID. A major challenge in finding better therapeutics to treat ASD is the potency of the drug to help the patients to perform their daily activities with efficiency close to that of a healthy person. Achieving this is particularly difficult after a certain age, especially from the mid-childhood stages.
In the present work, Vijaya Verma and other authors from Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), an autonomous research institute of the Department of Science & Technology (DST), Govt. of India, have demonstrated the potential of 6BIO, to treat ASD/Intellectual disability (ID) in a pre-clinical mouse model called Syngap1+/-. Using behaviour and electrophysiology techniques, the team of scientists have shown in a research published in the Experimental Brain Research that the administration of 6BIO restores the neuronal function, learning and memory, and reduces epileptic seizures in Syngap1+/- mice.
The authors of this study Vijaya Verma, M. J. Vijay Kumar, Kavita Sharma, Sridhar Rajaram, Ravi Muddashetty, Ravi Manjithaya, Thomas Behnisch and James P. Clement, identified 6BIO synthesised in JNCASR and found that it restores neuronal function, learning and memory, sociability and reduces epileptic seizures. The other novelty of this study is that 6BIO restored the neural functions not only when administered during development (equivalent of baby (1-2 years) and childhood stages (3-6 years)) but also after mid-childhood (7-11 years) when most of the brain regions are considered to have formed properly.
Previous studies have attributed disruption in optimal brain development, mainly neuronal connections, during the early stage of development (i.e., babies/childhood) as one of the causes of ASD/ID. Due to the altered brain development, information processing becomes aberrant and understanding simple tasks becomes exceptionally challenging for patients with ASD/ID. Using electrophysiology, which helps understand how neurons communicate, and behaviour experiments, which indicates the overall brain function, the JNCASR team has shown that 6BIO can restore the information processing in the pre-clinical mouse model. Thus, 6BIO has a strong potential for therapeutics to treat ASD/ID. All the behaviour and electrophysiology work was performed in Dr James Clement’s lab at JNCASR.
Patients with ASD still struggle to perform everyday activities without assistance from others as they are unable to learn and recollect new tasks. Data from the current study indicate that 6BIO can help children with ASD learn and recall, be social, and alleviate other symptoms such as seizures or sleep issues. Thus, the compound, 6BIO, can be a better therapeutics option to treat ASD.
4-Aug-2021: INSPIRE faculty fellow develops human-based models to study neurodevelopmental disorders such as autism
Dr. Yogita K Adlakha, an Inspire Faculty Fellow, has developed human-based models to study neuron development and neurodevelopmental disorder such as autism which can help design treatment strategies for such brain disorders.
Since decades, animal models have been used to understand brain-related disorders, and the drugs which function in animal models have failed in clinical trials. The dearth of human models has led to lack of knowledge of the pathophysiology of such disorders, an essential requirement for designing their treatment strategies. Therefore, Dr. Yogita K Adlakha, a recipient of INSPIRE Faculty fellowship instituted by the Department of Science and Technology (DST), filled this gap by generating human-based stem cell model to understand brain development and dysfunction at the National Brain Research Centre, Manesar, Haryana. Currently, she works as a Scientist at Translational Health Science and Technology Institute, NCR bio-cluster, Faridabad.
Along with her research group, she established a protocol from India for the first time by generating and producing induced pluripotent stem cells (iPSCs) from human peripheral blood. They have further refined the protocol of differentiation of iPSCs into the brain-specific stem cells, i.e., neural stem cells (NSCs).
Her group has contributed immensely in understanding the role of microRNA in the neural stem cell fate, which revealed how certain small non-coding RNAs called microRNA, which do not form protein but regulate expression of other genes, can enhance differentiation of neural stem cells into neurons. Her research has contributed to expanding the knowledge of neuron development and the role of small non-coding miRNA in brain-specific stem cells fate, thereby changing the face of neuroscience and stem cells.
Dr. Yogita filled this gap and developed a human-based model that could help study how brain develops, particularly the neurons, and what goes awry during brain development leading to cognitive decline, impairment in language, and social interaction. Along with her group, she derived induced pluripotent stem cells (iPSCs) from human peripheral blood and differentiated them into neural stem cells (NSCs). Since levels of microRNA-137 are less in neurodevelopmental disorders such as ASD and ID, her study demonstrates crucial roles of this miRNA during human NSC fate determination with an elaboration of underlying molecular mechanisms. This study was published in the journal “STEM CELLS”.
Her study provides the first evidence that a brain enriched miRNA-137 induces neuronal differentiation and inhibits proliferation using human neural stem cells derived from iPSCs. During the study, it was observed that miRNA-137 not only accelerates mitochondrial (powerhouse) biogenesis but also induces oxidative phosphorylation, generating ATP or energy currency of the cell. This resulted in increased mitochondrial content, which is actually necessary for the newly born neurons. Decrease in proliferative capacity of NSCs with age leads to compromised regenerative ability of the brain. The findings of her study by revealing the NSC differentiation induced by miR-137 can facilitate the design of treatments for aging-associated neurodegenerative diseases and ASD and ID.
Decrease in proliferation of brain-specific stem cells with age leads to compromised regenerative capacity of the brain. In her present work, she proposes that differentiation of brain-specific stem cells induced by a small non-coding miRNA may promote the design of treatments for aging-associated neurodegenerative diseases and autism.
“My research using DST INSPIRE fund has definitely contributed to expanding the knowledge of neuron development and neurodevelopmental disorder such as autism and the role of small non-coding miRNA in brain-specific stem cells fate,” adds Dr. Yogita.