Publications by authors named "Sanjay Juvekar"

Article Synopsis
  • Spirometry is a test used to evaluate lung function by comparing it to normal levels in healthy non-smokers, focusing on metrics like forced vital capacity (FVC) and the FEV/FVC ratio.
  • The study analyzed data from over 14,000 participants aged 40 and older across 41 sites, revealing regional differences in FVC tied to factors like age and height, categorized into four regions: Europe/richer countries, Near East, Africa, and Far East.
  • Findings showed significant regional variations in FVC values between men and women, particularly in Europe compared to the Far East, but minimal differences in the FEV/FVC ratio across regions.
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Article Synopsis
  • The study aimed to improve global surveillance of child and adolescent movement behaviors (like physical activity and screen time) by gathering expert opinions through a Delphi method involving 62 participants.
  • Experts ranked important items in categories like funding, capacity building, and methods, with a consensus on key priorities such as increased public funding and standard protocols for measures.
  • The findings highlighted common priorities across different income countries and initiatives, but there was no agreement on the use of private funding for surveillance.
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Temporary Childbirth Migration (TCM) involves women returning to their natal homes during or after pregnancy, a common but understudied practice in India and South Asia. This study examines social support practices influencing TCM decisions among Indian women. Factors such as family support, especially from husband, in-laws and parents, play a crucial role in migration decisions during the perinatal period.

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Objective: This paper explores the role of depressive symptoms (mediator/moderator) in the association between physical multimorbidity (exposure) and cognitive function (outcome) among older adults in the three most populous middle-income countries.

Methods: This study used cross-sectional data from China (2015 China Health and Retirement Longitudinal Study), India (2017/2018 Longitudinal Ageing Study in India), and Indonesia (2014/2015 Indonesian Family Life Survey), with a total sample of 73,199 respondents aged ≥ 45 years. Three domains of cognitive tests were harmonised across surveys, including time orientation, word recall, and numeracy.

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Background: Chronic cough is a common respiratory symptom with an impact on daily activities and quality of life. Global prevalence data are scarce and derive mainly from European and Asian countries and studies with outcomes other than chronic cough. In this study, we aimed to estimate the prevalence of chronic cough across a large number of study sites as well as to identify its main risk factors using a standardised protocol and definition.

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The Health and Demographic Surveillance System (HDSS) is a valuable longitudinal cohort study that tracks the health and demographic changes of a geographically defined population, serving as a platform for research and evidence-based policymaking. In India, there are nearly 20 HDSS sites covering diverse areas and populations totaling around two million. To foster collaboration, the Indian HDSS Network (IHN) was formed, comprising 19 sites from 16 institutes, covering a population of 1.

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Background: Chronic airflow obstruction is a key characteristic of chronic obstructive pulmonary disease. We investigated whether isolated small airways obstruction is associated with chronic airflow obstruction later in life.

Methods: We used longitudinal data from 3957 participants of the multinational Burden of Obstructive Lung Disease study.

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Background: Pneumonia contributes to about 15% of child deaths globally, with 20% of the overall deaths occurring in India. Although WHO recommends the use of pulse oximeters (PO) in first-level facilities for early detection of child pneumonia in low- and middle-income countries (LMICs), this has not yet been implemented in India. We aimed to assess the feasibility and acceptability of introducing PO in integrated management of neonatal and childhood illnesses (IMNCI) services at primary health centres (PHC) in the rural Pune district.

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Background: Pulmonary rehabilitation (PR) is an effective strategy to improve breathlessness, health status and exercise tolerance and to reduce readmissions and mortality. In India, there is no government health programme for chronic obstructive pulmonary disease (COPD) management while in the private sector availability of PR is limited. Most PR centres are in urban areas, with few services accessible to rural populations.

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, responsible for the coronavirus disease 2019 (COVID-19) pandemic, has been a major public health concern requiring continuous efforts for understanding its epidemiology. Patients infected with SARS-CoV-2 have a wide range of clinical features ranging from asymptomatic infection to mild or severe illness with fatal outcomes or recovery. Population-based seroepidemiological studies are an effective method for measuring the rapid spread of SARS-CoV-2 and monitoring the pandemic's progress.

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Introduction: This study aimed to assess the effect of a reduced dose regime (1 + 1) of PCV10 and PCV13 along with 3-dose regimes on pneumococcal vaccine-type (VT) carriage and immunogenicity in the first two years of life in PCV-naïve Indian children.

Methods: A total of 805 healthy infants aged 6-8 weeks were randomised to 7 groups (n = 115). Six groups received Synflorix(PCV10) or Prevenar13(PCV13) in the following schedules: 3 + 0 (three primary at 6, 10, and 14 weeks); 2 + 1 (two primary 6 and 14 weeks with booster at 9 months; 1 + 1 (one primary at 14 weeks with booster at 9 months).

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Background: Chronic respiratory diseases (CRD), especially asthma and chronic obstructive pulmonary disease (COPD), are common public health problems resulting in a substantial burden of disease for individuals. There is a need to understand the perceptions and practices of primary care physicians ("general practitioners [GPs]") who provide most of the health care in rural India. We surveyed all private and public practitioners listed as practising in a rural area of Western India with the aim of identifying GPs (GPs: graduates, registered and allowed to practice in India) to understand their training, working arrangements, and asthma/COPD workload.

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Controlled Human Infection Model (CHIM) studies provide a unique platform for studying the pathophysiology of infectious diseases and accelerated testing of vaccines and drugs in controlled settings. However, ethical issues shroud them as the disease-causing pathogen is intentionally inoculated into healthy consenting volunteers, and effective treatment may or may not be available. We explored the perceptions of the members of institutional ethics committees (IECs) in India about CHIM studies.

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Background: Community health workers (CHW) contribute to achieving health targets of the Sustainable Development Goals (SDG) and Universal Health Care (UHC) in low- and middle-income countries (LMICs). In India, accredited social health activists (ASHAs) function as health facilitators, service providers, and programme supporters for rural and tribal communities and are at the frontline during the COVID-19 pandemic. We aimed to describe the ASHAs' work roles both before and during the COVID-19 pandemic, explore the tasks ASHAs performed throughout the pandemic, and understand its effects on the evolving role of ASHAs.

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Background: Small airways obstruction is a common feature of obstructive lung diseases. Research is scarce on small airways obstruction, its global prevalence, and risk factors. We aimed to estimate the prevalence of small airways obstruction, examine the associated risk factors, and compare the findings for two different spirometry parameters.

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Background: Recent evidence suggests that soil-transmitted helminth (STH) transmission interruption may be feasible through community-wide mass drug administration (cMDA) that deworms community members of all ages. A change from school-based deworming to cMDA will require reconfiguring of STH programs in endemic countries. We conducted formative qualitative research in Benin, India, and Malawi to identify barriers and facilitators to successfully launching a cMDA program from the policy-stakeholder perspective.

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Objective: To determine the proportion of adults with hypertension who reported: (i) having been previously diagnosed with hypertension; (ii) taking blood pressure-lowering medication; and (iii) having achieved hypertension control, in five health and demographic surveillance system sites across five countries in Asia.

Methods: Data were collected during household surveys conducted between 2016 and 2020 in the five surveillance sites in Bangladesh, India, Indonesia, Malaysia and Viet Nam. We defined hypertension as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg or taking blood pressure-lowering medication.

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Article Synopsis
  • Autonomic modulation plays a key role in physiological activities and can be evaluated through heart rate variability (HRV), which helps identify groups at risk for autonomic dysfunction related to orthostatic stress.
  • This study measured HRV in 379 subjects grouped by Ayurveda's Prakriti types (Vata, Pitta, Kapha) during different postural changes to understand their responses to orthostatic stress.
  • Results showed that the Kapha group had lower baseline HRV and less change in HR and autonomic parameters in response to head-up-tilt compared to Vata and Pitta, indicating a possible predisposition to autonomic dysfunction.
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Several factors including sex and lifestyle have been reported to contribute to the age-related alteration of immune functions. The study was undertaken to determine age-related differences in the proportion of peripheral blood mononuclear lymphocytes in the Indian population using blood samples from 67 healthy adults (33 females and 34 males) aged between 20 and 80 years old. In the linear regression analysis to estimate the relationship with age categories, there was a significant increase in the frequency of natural killer cells with ageing, while their cytolytic activity significantly declined.

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Background: Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study.

Methods: We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries.

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Background: Evidence-based health system guidelines are pivotal tools to help outline the important financial, policy and service components recommended to achieve a sustainable and resilient health system. However, not all guidelines are readily translatable into practice and/or policy without effective and tailored implementation and adaptation techniques. This scoping review mapped the evidence related to the adaptation and implementation of health system guidelines in low- and middle-income countries.

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