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There is no concrete evidence on the burden of TB among the tribal populations across India except for few studies mainly conducted in Central India with a pooled estimation of 703/100,000 with a high degree of heterogeneity. To estimate the prevalence of TB among the tribal populations in India. A survey using a multistage cluster sampling design was conducted between April 2015 and March 2020 covering 88 villages (clusters) from districts with over 70% tribal majority populations in 17 States across 6 zones of India. The sample populations included individuals ≥15 years old. Eligible participants who were screened through an interview for symptoms suggestive of pulmonary TB (PTB); Two sputum specimens were examined by smear and culture. Prevalence was estimated after multiple imputations for non-coverage and a correction factor of 1.31 was then applied to account for non-inclusion of X-ray screening. A total of 74532 (81.0%) of the 92038 eligible individuals were screened; 2675 (3.6%) were found to have TB symptoms or h/o ATT. The overall prevalence of PTB was 432 per 100,000 populations. The PTB prevalence per 100,000 populations was highest 625 [95% CI: 496-754] in the central zone and least 153 [95% CI: 24-281] in the west zone. Among the 17 states that were covered in this study, Odisha recorded the highest prevalence of 803 [95% CI: 504-1101] and Jammu and Kashmir the lowest 127 [95% CI: 0-310] per 100,000 populations. Findings from multiple logistic regression analysis reflected that those aged 35 years and above, with BMI <18.5 Kgs /m2, h/o ATT, smoking, and/or consuming alcohol had a higher risk of bacteriologically positive PTB. Weight loss was relatively more important symptom associated with tuberculosis among this tribal populations followed by night sweats, blood in sputum, and fever. The overall prevalence of PTB among tribal groups is higher than the general populations with a wide variation of prevalence of PTB among the tribal groups at zone and state levels. These findings call for strengthening of the TB control efforts in tribal areas to reduce TB prevalence through tribal community/site-specific intervention programs.

Understanding the drivers for care-seeking among those who present with symptoms of TB is crucial for early diagnosis of TB and prompt treatment, which will in turn halt further TB transmission. While TB is a challenge among the tribal population, little is known about the care-seeking behaviour and the factors influencing care-seeking behaviour among the tribal population across India. This community-based descriptive study was carried out in 17 states of India across 6 zones, covering 88 villages from tribal districts with over 70% tribal population. The sample population included individuals ≥15 years old who were screened through an interview for symptoms suggestive of pulmonary TB (PTB), currently and/or previously on anti-TB treatment. Those with symptoms were then assessed on their health-seeking behavior using a semi-structured interview schedule. Among 74532 eligible participants screened for symptoms suggestive of TB, 2675 (3.6%) were found to be presumptive TB cases. Of them, 659 (24.6%) sought care for their symptoms. While 48.2% sought care after a week, 19.3% sought care after one month or more, with no significant difference in the first point of care; 46.9% approaching a private and 46.7% a public facility. The significant factors influencing care-seeking behaviour were knowledge on TB (OR: 4.64 (3.70-5.83), p < 0.001), age<35 years (OR: 1.60 (1.28-2.00), p < 0.001), co-morbidities like asthma (OR: 1.80 (1.38-2.35), p < 0.001) and blood pressure (OR: 2.59 (1.75-3.85), p < 0.001), symptoms such as blood in sputum (OR: 1.69 (1.32-2.16), p < 0.001), shortness of breath (OR: 1.43 (1.19-1.72), p < 0.001) and weight loss (OR: 1.59 (1.33-1.89), p < 0.001). The cough was the most often reported symptom overall. There were gender differences in symptoms that prompted care-seeking: Males were more likely to seek care for weight loss (OR: 1.78 (1.42-2.23), p<0.001), blood in the sputum (OR: 1.69 (1.25-2.28), p<0.001), shortness of breath (OR: 1.49 (1.18-1.88), p<0.001) and fever (OR: 1.32 (1.05-1.65), p = 0.018). Females were more likely to seek care for blood in sputum (OR: 1.68 (1.10-2.58), p = 0.018) and shortness of breath (OR = 1.35, (1.01-1.82), p = 0.048). The cough did not feature as a significant symptom that prompted care-seeking. Delayed healthcare-seeking behaviour among those with symptoms presumptive of TB in the tribal population is a major concern. Findings point to differences across gender about symptoms that prompt care-seeking in this population. Gender-sensitive interventions with health system strengthening are urgently needed to facilitate early diagnosis and treatment among this population.

Background & objectives: Malaria is an important public health problem in Andaman & Nicobar archipelago. Among the three districts, Nicobar is the most endemic district where API is >2. In this district, the malaria incidence in Car Nicobar Tehsil has declined steadily over the past 10 years. A renewed initiative to consolidate this gain is being made with the ultimate objective of achieving zero indigenous transmission of malaria in Car Nicobar. So, the present study undertook a close environmental monitoring of water bodies for assessing changes in the risk potential of mosquito vector breeding habitats which can augment the elimination programme. Methods: The breeding habitats of anopheline mosquitoes were sampled in 16 areas of Car Nicobar Island for eight time periods during 2017-2020. Along with anophelines, various associated water parameters (n=60) were estimated, viz. physicochemical (n=13), and biological, which included culicine mosquito immatures, insect predators (n=5), phytoplanktons (n=31) and zooplanktons (n=10). Results: In the 16 study sites, overall 1126 surface water stagnating bodies constituting 21 different habitat types were surveyed. Of these, 17 were positive for anopheline breeding. Water bodies from three villages were consistently found to be positive for anopheline breeding. However, early instars of anopheline larvae were more abundant compared to the late instars. Four anopheline species were recorded, including Anopheles sundaicus, A. barbirostris, A. insulaeflorum and A. subpictus, in which 48 per cent were A. sundaicus. Multivariable analysis indicated that anopheline density was significantly higher in permanent water bodies than in temporary habitats (P<0.05) (high risk of anophelines). The highest pH (≥8.2), dissolved solids (≥0.39) levels showed significantly (P<0.05) decreased larval densities (lower risk of breeding), adjusted with breeding sites and season. Nitrite levels increased (P=0.022) larval densities. Interpretation & conclusions: The present study facilitated estimating the productive period of a larval habitat enabling target larval sources to reduce adult populations. Implementing larviciding strategy before monsoon season is presumably the most cost-effective strategy. The output can be utilized for environmental monitoring of mosquito breeding risk in other malaria endemic areas, particularly where medium/large water bodies are the predominant breeding sites for malaria vectors.

The Andaman and Nicobar Islands have been historically known to be endemic for malaria1. However, during the past few years, its prevalence has been declining in three districts of the union territory, viz. (i) Nicobar; (ii) South Andaman; and (iii) Middle & North Andaman (Table 1). This is due to the strengthening of vector control activities (indoor residual spraying, weekly application of larvicides, etc) by local malaria department. Various health campaigns focused on adopting preventive measures against mosquito bites (repellents and bednets), enhanced the disease awareness among the community and helped in the early treatment seeking behaviour.

The Culicidae mosquito family breeds in various natural and artificial water bodies. Phytotelmata are plant structures that hold water and are used by many mosquito species during their life cycle. Mosquitoes are disease vectors, and phytotelmata play an important role in harbouring them. Investigating these phytotelmata will facilitate to develop appropriate site specific vector control strategy. Approximately 750 phytotelmata in 16 locations on Car Nicobar Island was examined. Mosquito larvae were collected from different habitats such as tree holes, root holes, leaf axils, and bamboo stumps. On average, the number of larvae per 10 ml of water ranged from 0.003 to 3.833. Among the 16 mosquito species identified, there were vectors of malaria ( Anopheles sundaicus ), dengue ( Aedes aegypti and Aedes albopictus ) and filariasis ( Culex quinquefasciatus ), belonging to seven genera. The most common phytotelmata were coconut trees (17.5%) followed by Java apple trees (10.3%) and bamboo stumps (7.1%). The most widespread mosquito species was Aedes edwardsi , followed by Aedes malayensis and Ae. albopictus , and the per cent of phytotelmata that contained these species were 42.6, 22.0, and 16.8% respectively. Anopheles mosquitoes had the highest container index (6.1%) in root holes, while Aedes and Culex mosquitoes were more frequently found in bamboo stumps. The alpha biodiversity indices indicated that the mosquito population in Car Nicobar Island was highly diverse ( S = 16; DMg = 36.9). Tree holes showed the highest diversity, as all 16 species were collected from them. Assessment of phytotelmata, there is a significant relationship observed between mosquito genus, village, habitat, and tree families, on the remote island of Car Nicobar. Considering the presence of disease-transmitting mosquito vectors in the phytotelmata, these habitats should be considered when implementing control measures to eliminate mosquito-borne infections.

One third of the world's population is infected with one or more of the most common soil-transmitted helminths (STH). Albendazole (ALB) is being administered with diethyl carbamazine (DEC) in filariasis endemic areas to eliminate lymphatic filariasis (LF) and helminth infections. In this study, the cumulative impact of seven annual rounds of mass drug administrations (MDA) of DEC and ALB on STH infection in school children in selected villages in southern India was determined. During 2001-2010, seven MDAs were implemented by the Tamil Nadu s0 tate h0 ealth d0 epartment, India. LF and STH infections were monitored in school children from 18 villages of the two treatment arms (viz, DEC alone and DEC+ALB). Kato-Katz cellophane quantitative thick smear technique was employed to estimate STH infections at three weeks, six months and one year post MDA. Prior to treatment, an overall STH prevalence was 60 per cent. After each MDA, infection markedly reduced at three weeks post-treatment in both the arms. The prevalence increased at six months period, which was maintained up to one year. After seven rounds of MDA, the infection reduced from 60.44 to 12.48 per cent in DEC+ALB arm; while the reduction was negligible in DEC alone arm (58.77 to 52.70%). Seven rounds of MDA with DEC+ALB reduced the infection load significantly, and further sustained low level of infection for 10 years. However, complete parasite elimination could not be achieved. To curtail STH infection in the community, MDA should be regularized and environmental sanitation measures need to be improved by effective community-based campaigns.

To determine the role of vector control in further decreasing the transmission of bancroftian filariasis achieved by mass drug administration and the long-term impact on filariometric indices. Three rounds of annual mass drug administration, with diethylcarbamazine and ivermectin, were complemented by vector control (mainly using polystyrene beads) in villages of Tirukoilur, south India, during 1995-99. Subsequently, drug administration is being carried out with diethylcarbamazine and albendazole or diethylcarbamazine alone. We evaluated the impact of mass drug administration used alone or in conjunction with vector control (from 1995 to 2005) on vector transmission indices (such as transmission intensity index, monthly biting rate, monthly transmission potential and annual transmission potential). We analysed data on filarial infection in the community to estimate the prevalence of microfilaraemia and antigenaemia using chi2 analysis and Fisher's exact test. Vector density greatly decreased in villages where vector control was used as an adjunct to mass drug administration and almost no infective mosquitoes were found in the small numbers still remaining. Filarial antigenaemia was low and continued to decrease significantly in the age group 15-25 years in villages receiving mass drug administration with vector control in contrast to villages receiving only mass drug administration. The gains of mass drug administration were sustained only with the integration of vector control measures. We advocate the incorporation of vector control in the Global Programme to Eliminate Lymphatic Filariasis as it can potentially decrease the time required for eliminating lymphatic filariasis.

Lymphatic filariasis (LF) has become a major public health and socioeconomic problem in different parts of the globe. About 63% of the world's population with LF resides in Southeast Asia Region1 and approximately 1/3rd of the affected people live in India. It is estimated that 554.2 million people in India are at risk of LF infection in 243 districts across 20 states and union territories.

Wolbachia are common intracellular bacteria that are found in arthropods and nematodes. These endosymbionts are transmitted vertically through host eggs and alter host biology in diverse ways, including the induction of reproductive manipulations, such as feminization, parthenogenesis, male killing and sperm-egg incompatibility. Since they can also move horizontally across species boundaries, Wolbachia is gaining importance in recent days as it could be used as a biological control agent to control vector mosquitoes or for paratransgenic approaches. However, the study of Wolbachia requires sophisticated techniques such as PCR and cell culture facilities which cannot be affordable for many laboratories where the diseases transmitted by arthropod vectors are common. Hence, it would be beneficial to develop a simple method to detect the presence of Wolbachia in arthropods. In this study, we described a method of staining Wolbachia endobacteria, present in the reproductive tissues of mosquitoes. The reliability of this method was compared with Gram staining and PCR based detection. The microscopic observation of the Gimenez stained smear prepared from the teased ovary of wild caught and Wolbachia (+) Cx. quinquefasciatus revealed the presence of pink coloured pleomorphic cells of Wolbachia ranging from cocci, comma shaped cells to bacillus and chain forms. The ovaries of Wolbachia (-) cured mosquito did not show any cell. Although Gram's staining is a reliable differential staining for the other bacteria, the bacterial cells in the smears from the ovaries of wild caught mosquitoes did not take the stain properly and the cells were not clearly visible. The PCR amplified product from the pooled remains of wild caught and Wolbachia (+) Cx. quinquefasciatus showed clear banding, whereas, no banding was observed for the negative control (distilled water) and Wolbachia (-) Cx. quinquefasciatus. The Gimenez staining technique applied, could be used to detect the members of the endobacteria Wolbachia easily, even in a simple laboratory without any special facilities or even in the field condition and for handling large number of samples in a shorter duration.