Publications - Pediatrics

Suboptimal anti-tuberculosis drug concentrations and outcomes in small and HIV coinfected children in India: recommendations for dose modifications

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2017-12-01
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Clinical Pharmacology and Therapeutics
This work aimed to evaluate the once-daily anti-tuberculosis treatment as recommended by the new Indian pediatric guidelines. Isoniazid, rifampin and pyrazinamide concentration-time profiles and treatment outcome were obtained from 161 Indian children with drug-sensitive tuberculosis...

Novel interferon-gamma assays for diagnosing tuberculosis in young children in India

Post Date: 
2017-04-01
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International Journal of Tuberculosis and Lung Disease
Setting: The tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) are used as supportive evidence to diagnose active tuberculosis (TB). Novel IGRAs could improve diagnosis, but data are lacking in young children. Design: Children (age 5 years or...

Isoniazid hair concentrations in children with tuberculosis: a proof of concept study

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2016-06-01
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International Journal of Tuberculosis and Lung Disease
Assessing treatment adherence and quantifying exposure to anti-tuberculosis drugs among children is challenging. We undertook a 'proof of concept' study to assess the drug concentrations of isoniazid (INH) in hair as a therapeutic drug monitoring tool. Children aged <12 years initiated on...

Low Vitamin-D levels combined with PKP3-SIGIRR-TMEM16J host variants is strongly associated with tuberculosis and death in HIV-infected and -exposed infants

Post Date: 
2016-02-12
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PLOS One
Background: This study examined the associations of 25-hydroxyvitamin D and specific host genetic variants that affect vitamin D levels or its effects on immune function, with the risk of TB or mortality in children. Methods: A case-cohort sample of 466 South African infants...

Pediatric tuberculous meningitis: model-based approach to determining optimal doses of anti-tuberculosis drugs for children

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2015-10-22
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Clinical Pharmacology and Therapeutics
Pediatric tuberculous meningitis (TBM) is a highly morbid, often fatal disease. Standard treatment includes isoniazid, rifampin, pyrazinamide, and ethambutol. Current rifampin dosing achieves low cerebrospinal fluid (CSF) concentrations, and CSF penetration of ethambutol is poor. In adult...

Source case investigation for children with TB disease in Pune, India

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2014-08-27
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Tuberculosis Research and Treatment
Setting. Contact tracing is broadly encouraged for tuberculosis (TB) control. In many high-burden countries, however, little effort is made to identify contacts of newly diagnosed TB patients. This failure puts children, many of whom live in poor crowded communities, at special risk. ...

Challenges to disclosure of HIV status to perinatally infected children: a study of caregiver perspectives in Pune, India

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2014-06-15
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Journal of Pediatric Infectious Diseases
Effective guidelines around disclosure of HIV status are lacking and limited data from India reveal low rates of HIV disclosure to perinatally infected children. This study, conducted in Pune, India, attempts to understand the experiences of caregivers of perinatally infected children around the...

Maternal pneumococcal capsular IgG antibodies and transplacental transfer are lower in South Asian HIV-infected mother-infant pairs

Post Date: 
2014-03-14
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Vaccine
Background: Our understanding of the mother-to-child transfer of serotype-specific pneumococcal antibodies is limited in non-immunized, HIV-positive women. Methods: We compared geometric mean antibody concentrations (GMCs), geometric mean transplacental...

Pediatric tuberculosis in young children in India: a prospective study

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2013-11-11
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BioMed Research International
Background: India has one of the highest tuberculosis (TB) burdens globally. However, few studies have focused on TB in young children, a vulnerable population, where lack of early diagnosis results in poor outcomes. Methods: Young children (≤ 5 years) with...

Contracting in specialists for emergency obstetric care—does it work in rural India?

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2012-12-31
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BMC Health Services Research
Abstract Background: Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in...

Pooled individual data analysis of five randomized trials of infant nevirapine prophylaxis to prevent breast-milk HIV-1 transmission

Post Date: 
2012-10-19
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Clinical Infectious Diseases
Background: In resource-limited settings, mothers infected with human immunodeficiency virus type 1 (HIV-1) face a difficult choice: breastfeed their infants but risk transmitting HIV-1 or not breastfeed their infants and risk the infants dying of other infectious diseases or...

Vitamin D deficiency is common among HIV-infected breastfeeding mothers in Pune, India, but not associated with mother-to-child HIV transmission

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2012-10-01
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HIV Clinical Trials
A recent report from Tanzania demonstrated an increased risk of being HIV infected or of dying at birth among children born to breastfeeding mothers with low baseline vitamin D levels. We conducted a nested case-control study among HIV-infected pregnant women in western India to confirm the...

Predictors of mortality in hospitalized children with pandemic H1N1 influenza 2009 in Pune, India

Post Date: 
2012-04-15
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Indian Journal of Pediatrics
Objective: To analyse the factors associated with increased mortality among Indian Children with H1N1. Methods: Data were abstracted from available hospital records of children less than 12 y of age, who were admitted to Sassoon General Hospital in Pune, India, with...

Impact of maternal human immunodeficiency virus infection on pregnancy and birth outcomes in Pune, India

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2011-12-15
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AIDS Care
Little is known about birth outcomes for HIV-infected women in India. We examine maternal and neonatal birth outcomes in HIV-infected women within the context of enhanced pre-natal care associated with a randomized clinical trial conducted in Pune, India. Birth outcomes of 212 HIV-infected...

QuantiFERON-TB Gold In-Tube for the detection of Mycobacterium tuberculosis infection in children with household tuberculosis contact

Post Date: 
2011-05-05
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International Journal of Tuberculosis and Lung Disease
Setting : Improved strategies are needed for detecting Mycobacterium tuberculosis infection in children in TB-endemic settings. Objective : To determine the prevalence of M. tuberculosis infection by tuberculin skin testing (TST) and by the QuantiFERON-TB Gold In-Tube (...

The Indian pediatric HIV epidemic: a systematic review

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2008-09-15
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Current HIV Research
Despite an estimated 70,000 Indian children living with HIV infection, little is known about India's pediatric HIV epidemic. Generalizations about epidemiology, natural history, and treatment outcomes from other resource-limited settings (RLS) may be inaccurate for several biologic and social...

Mother-to-child transmission of HIV among women who chose not to exclusively breastfeed their infants in Pune, India

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2007-08-15
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Indian Journal of Medical Research
Background and Objective: The percentage of HIV cases attributed to mother-to-child transmission (MTCT) has increased several fold in recent years. No reports are available on HIV MTCT rates among HIV-infected choosing not be exclusively breastfeed their infants in India. We examined HIV MTCT...

Post-partum TB incidence and mortality among HIV-infected women and their infants in Pune, India 2002-2005

Post Date: 
2007-07-15
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Clinical Infectious Diseases
Background: In contrast with many other countries, isoniazid preventative therapy is not recommended in clinical care guidelines for human immunodeficiency virus (HIV)-infected persons with latent tuberculosis (TB) in India. Methods: Seven hundred fifteen...

Antimicrobial-resistant Shigella sonnei: Limited antimicrobial treatment options for children and challenges of interpreting in vitro azithromycin susceptibility

Post Date: 
2005-06-15
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Journal of Pediatric Infectious Diseases
Background: Antimicrobial-resistant Shigella sonnei is a growing problem in the United States and poses treatment challenges particularly among children. Azithromycin is recommended as an alternative oral agent for shigellosis. Methods: All isolates of Shigella...

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