Hepatitis: Sehgal SC

Murhekar MV, Murhekar KM, Sehgal SC. · National Institute of Epidemiology (ICMR), Chennai, Tamilnadu, India. · Trans R Soc Trop Med Hyg. · Pubmed #18565560 No free full text.

Abstract: The Andaman and Nicobar Islands, Union Territory of India, are home to six primitive tribes, namely the Great Andamanese, Onges, Jarawas and Sentinelese (Negrito race), and the Shompens and Nicobarese (Mongoloid race). These tribes account for about 8% of the island's population and the Nicobarese constitute >95% of the tribal population. Hepatitis B virus (HBV) infection is highly endemic among them with the prevalence of hepatitis B surface antigen (HBsAg) ranging from 23% among the Nicobarese to 66% among the Jarawas. The high HBsAg prevalence among pregnant mothers (20.5%), a linear increase in the age-specific rates of HBV exposure and the presence of HBsAg-positive individuals in every family suggested a combination of perinatal and horizontal transmission among the Nicobarese. Molecular studies of HBV isolates from the Onges, Nicobarese and Great Andamanese indicated a predominance of genotype D and there was a close similarity between these isolates and isolates from mainland India, suggesting that HBV may have been introduced from mainland India. In contrast, genotype C predominated among the Jarawas, with isolates similar to strains from Southeast Asian countries. Due to its high prevalence, hepatitis B vaccine is included in the childhood vaccination programme in these islands. It might be worth considering a pilot screening programme for chronic HBV patients to detect hepatocellular carcinoma.

Murhekar MV, Chakravarty R, Murhekar KM, Banerjee A, Sehgal SC. · Regional Medical Research Centre (ICMR), Port Blair, Andaman and Nicobar Islands, India. · Arch Virol. · Pubmed #16514497 No free full text.

Abstract: The Jarawas, a classical hunter-gatherer tribe of Andaman and Nicobar Islands, India, were living in isolation for several centuries. They came into contact with the civilized world recently. Serological studies carried out among them revealed that hepatitis B virus (HBV) infection is hyper-endemic. The present study was carried out to investigate the possible origin of HBV infection in Jarawas. Genotyping, RFLP analysis, sequencing, and sequence analysis revealed the prevalence of HBV genotype C, similar to genotype C detected in Thailand, Vietnam, and Myanmar. In contrast, genotype D was prevalent among other non-Jarawa tribes of the island. These data suggest that HBV infection was transmitted from Indo-China to the Andaman Islands during migration of the Jarawas many centuries ago.

Murhekar MV, Murhekar KM, Sehgal SC. · Regional Medical Research Centre (ICMR), Port Blair, Andaman and Nicobar Islands, India. · J Commun Dis. · Pubmed #16295692 No free full text.

This publication has no abstract.

Murhekar MV, Rao RC, Ghosal SR, Sehgal SC. · Regional Medical Research Centre, Indian Council of Medical Research, Post Bag 13, Port Blair 744 101, Andaman and Nicobar Islands, India. · Public Health. · Pubmed #15925681 No free full text.

Abstract: A survey to assess injection related practices carried out among the Nicobarese, a mongoloid tribe of Andaman and Nicobar Islands, India. The survey was carried out using the rapid assessment and response guide of Safe Injection Global Network of the World Health Organization and included review of randomly selected prescriptions of patients attending outpatient clinic of district hospital, interview and observation of injection providers in the district hospital and sub-centres and interview of the general population. The findings of the survey showed that 18.8% of prescriptions included at least one injection. The per capita injection rate was 3 per year. Majority of injections were administered with disposable syringe and needle and in hospital setting. All the injection providers were aware about possibility of HIV transmission through unsafe injections. However, the awareness among the general population was low. More than half of the individuals had preference to injections. It is suggested that remedial measures, such as education of prescribers to reduce the number of injections to a bare minimum, maintaining regular supply of disposable injection equipment, provision of adequate sharps containers with safe disposal facilities and community education be undertaken to avoid future spread of blood-borne pathogens.

Murhekar MV, Murhekar KM, Arankalle VA, Sehgal SC. · Regional Medical Research Centre, Indian Council of Medical Research, Post Bag-13, Port Blair-744 101, Andaman and Nicobar Islands, India. · Trans R Soc Trop Med Hyg. · Pubmed #15910893 No free full text.

Abstract: Hepatitis B virus infection is highly endemic among the tribes of Andaman and Nicobar Islands, India. We screened 223 hepatitis B surface antigen-positive members of these tribes for hepatitis delta virus infection (HDV). The infection was observed only among the Nicobarese. Considering the serious consequences of HDV infection, we suggest that the tribes of these islands should be monitored for HDV infection.

Murhekar MV, Murhekar KM, Sehgal SC. · Regional Medical Research Centre, Indian Council of Medical Research (ICMR), Post Bag-13, Port Blair 744101, Andaman and Nicobar Islands, India. · Vaccine. · Pubmed #15530686 No free full text.

Abstract: Hepatitis B infection is highly endemic among the primitive tribes of Andaman and Nicobar Islands, India and it is necessary to initiate hepatitis B vaccination for control of this infection. A pilot project of mass hepatitis B vaccination using indigenously developed vaccine was initiated among Nicobarese tribe of Car Nicobar Island. Sero-protection rates after second and third year were 89% and 85.5%, respectively. The rate of chronic infection in the vaccinated population after three years was 1.86% compared to the pre-vaccination rate of 20.7%. Considering high sero-protection rates and low cost, the indigenous vaccine could be used for vaccination programme in this tribal community.

Natarajaseenivasan K, Vijayachari P, Sugunan AP, Sharma S, Sehgal SC. · National Leptospirosis Reference Centre, Regional Medical Research Centre (ICMR)Port Blair, India. · Indian J Med Res. · Pubmed #15489552 links to  free full text

Abstract: BACKGROUND & OBJECTIVES: The available serological techniques for the diagnosis of leptospirosis have less sensitivity during the early stage of the disease. Understanding of leptospiral proteins expressed during acute and convalescent phases of leptospirosis, would be help the develop of new serodiagnostic strategies. Therefore, the present study was carried out to identify (i) an antigen that is conserved among the various pathogenic leptospira; (ii) best protein antigen to which immune response can be identified in the acute phase; and (iii) best protein antigen which is present in convalescent sera which can be used for seroepidemiological studies. METHODS: Quantitative immunoblot analysis was performed using acute and convalescent phase human sera along with sera from normal healthy individuals and from patients with typhoid, malaria and hepatitis as the controls. All the samples were analyzed for the leptospiral protein recognition by using IgM and IgG immunoblots. Leptospiral cell fractionation was performed using triton X-114 and lysozyme and further the conservation of leptospiral proteins was also performed. RESULTS: In confirmed cases of leptospirosis, the IgG recognition in acute phase sera was 30.2, 39.5, 27.9, 55.8 and 27.9 per cent for the leptospiral proteins p32, p41/42, p58, p62 and p82 respectively. The IgG has considerably increased to 65.1, 55.8, 46.5, 67.4 and 48.8 per cent against the same proteins during convalescent phase. The IgM recognition was 32.6 , 32.6, 30.2 and 37.2 per cent for acute phase sera and 32.6, 37.2, 44.2 and 41.9 per cent for convalescent phase sera for the leptospiral proteins p14, p25, p32 and p41/42, respectively. Leptospiral proteins like p62 and p82 were recognized among all the control groups with 3.3-15.3 per cent for IgG recognition. INTERPRETATION & CONCLUSION: Leptospiral protein p32 was found to be highly sensitive and specific and could be useful for the development of newer techniques for diagnosis and seroepidemiological studies. Combination of p32 and p41/42 for IgG and p14, p25, p32, p41/42 for IgM would increase the sensitivity of these techniques further.

Murhekar MV, Murhekar KM, Sehgal SC. · Regional Medical Research Centre, Indian Council of Medical Research, Port Blair, Andaman and Nicobar Islands, India. · Ann Trop Paediatr. · Pubmed #15005972 No free full text.

Abstract: A sero-survey to assess the prevalence of hepatitis B virus infection was carried out among the Nicobarese children attending different primary schools of Car Nicobar Island. A total of 1574 children were screened for different serological markers of infection. Overall, 44% of the children had evidence of HBV infection with 23% positive for HBsAg. The prevalence rates were found to increase linearly with age. The implications of these findings in relation to control of hepatitis B in the tribal population of these islands are discussed.

Arankalle VA, Murhekar KM, Gandhe SS, Murhekar MV, Ramdasi AY, Padbidri VS, Sehgal SC. · National Institute of Virology, 20-A Dr Ambedkar Road, 411001 Pune, India. · J Gen Virol. · Pubmed #12810887 links to  free full text

Abstract: To understand the possible origin of hepatitis B virus (HBV), three of the four hyperendemic, primitive accessible tribes of the Andaman and Nicobar islands, India, were investigated. The Nicobarese tribe was investigated in 1989 and 1999. The S gene from 65 HBV isolates was amplified by PCR and sequenced. Genotyping and serotyping were carried out on the basis of phylogenetic and amino acid analyses of S gene. All 20 Nicobarese-89 isolates, nine Onges-99 isolates and the single Andamanese-99 HBV isolate were classified as genotype D. Of the Nicobarese-99 isolates, 32 (91.4 %) and three (8.6 %) were genotypes D and A, respectively. Per cent nucleotide identity between the S sequences representing different tribes varied from 98.06 to 98.59 % and varied from mainland isolates by 1.6-2.0 %. Although southeast Asian origin is postulated for the Nicobarese tribe, the presence of different genotypes suggests introduction of HBV after migration to these islands, probably from mainland India, 200 years back, when these islands became inhabited as a part of penal settlement during the British regimen.

Murhekar MV, Murhekar KM, Sehgal SC. · Regional Medical Research Centre (ICMR), Post-Bag 13, Port Blair-744 101, Andaman and Nicobar Islands, India. · J Viral Hepat. · Pubmed #12753343 No free full text.

Abstract: Jarawas, a classical hunter-gatherer tribe of Andaman and Nicobar islands have lived in isolation for several centuries. It is only recently have they started to come in contact with the outsiders, shedding their hostility. Since then, several disease outbreaks have been reported amongst them. Screening of sera samples collected during one such outbreak showed very high endemicity of hepatitis-B infection with over 60% of the individuals positive for hepatitis B surface antigen (HBsAg). The rates of HBsAg observed among the Jarawas are probably the highest ever reported in the world and warrant immediate control measures which would prevent further spread of this infection in the community.

Murhekar MV, Murhekar KM, Arankalle VA, Sehgal SC. · Regional Medical Research Centre, Indian Council of Medical Research, Post Bag 13, 744-101, Andaman and Nicobar Islands, Port Blair, India. · Vaccine. · Pubmed #12297387 No free full text.

Abstract: Hepatitis-B infection is highly endemic among the primitive tribes of Andaman and Nicobar Islands, India. A pilot project of hepatitis-B vaccination using indigenously developed (Shanvac-B) was initiated among the Nicobarese tribe in Car Nicobar Island. The 936 individuals negative for HBsAg and anti-HBs were administered three doses of the vaccine at 0, 1 and 6 months. The vaccine was found to be safe and efficacious with sero-protection rates of 49.1, 86.9 and 96.7% after first, second and third dose. Considering the high endemicity of the infection and small number of the tribal population, it is necessary to initiate hepatitis-B vaccination programme for this community. Since the vaccine was found to be cost-effective, it could be adopted for hepatitis-B vaccination in this community.

Murhekar MV, Murhekar KM, Arankalle VA, Sehgal SC. · Regional Medical Research Centre (Indian Council of Medical Research), Port Blair, Andaman & Nicobar Islands. · Epidemiol Infect. · Pubmed #12113491 No free full text.

Abstract: Andaman and Nicobar Islands, Union Territory of India, is home to six primitive tribes. Preliminary serological studies carried out earlier among the four accessible tribes revealed that hepatitis B virus (HBV) infection is hyper-endemic among them. The present study was carried out to understand important modes of transmission and to identify possible risk factors associated with HBV infection among the Nicobarese tribe. The epidemiology of HBV infection in these islands appears to be distinct with a high prevalence of the chronic carrier state (22.2%) associated with a comparable proportion of the population being anti-HBs positive (26.3%). More than half of the HBsAg and anti-HBs negative individuals have anti-HBc antibodies. Age, past history of hospital admission, intramuscular injections and number of carriers in the tuhet were found to be significantly associated with exposure to hepatitis B virus. Horizontal transmission through close contact with carriers and perinatal route appears to be an important mode of transmission of HBV in this community. Besides this, use of unsafe injections represents an independent risk factor for acquiring HBV infection in this population. Introducing HBV vaccine in the infant immunization programme and improving injection safety would help to control the infection in the tribal community of these islands.

Murhekar MV, Sehgal SC, Murhekar KM, Padbhidri SP, Chitambar SD, Arankalle VA. · Regional Medical Research Centre (ICMR), Port Blair, Andaman and Nicobar Islands, India, National Institute of Virology (ICMR), Pune, India. · J Viral Hepat. · Pubmed #12081610 No free full text.

Abstract: The Andaman and Nicobar Islands, Union Territory of India, are home to six primitive tribes. Studies carried out earlier among these tribes revealed very high rates of hepatitis B infection. We have now studied hepatitis A and E infection among them. A total of 951 serum samples were collected from four accessible tribes (Nicobarese, Shompens, Onges and Great Andamanese) and tested for antibodies against hepatitis A and E viruses. In addition, 240 serum samples collected a decade earlier from age-stratified Nicobarese were also screened. Hepatitis A virus (HAV) infection was found to be highly endemic among all the tribes, whereas hepatitis E virus (HEV) infection was common among the Nicobarese and Shompens. The age group-wise prevalence of these infections among the Nicobarese showed different patterns, HAV prevalence rising significantly from those aged 10 years and thereafter reaching a plateau, whereas HEV prevalence was found to be more evenly distributed over all age groups, but rising somewhat after 30 years of age. Over the last decade, the prevalence of HAV among the Nicobarese has declined slightly, particularly in those aged 10 years or less whereas HEV infection has more than doubled over all age ranges. Different HEV prevalence observed among the tribes could not be attributed to differences in sanitation or water supply. This fact and the different age-wise patterns of HAV and HEV prevalences is suggestive of different modes of transmission of HEV that are not shared. The highest rates for HEV were among those tribes which reared pigs suggesting that pigs might serve as reservoir of HEV. Further studies are needed, however, to validate these findings.

Murhekar MV, Murhekar KM, Das D, Arankalle VA, Sehgal SC. · Regional Medical Research Centre (ICMR), Port Blair. · Indian J Med Res. · Pubmed #10969487 No free full text.

Abstract: BACKGROUND & OBJECTIVES: Andaman and Nicobar Islands, is the home of six primitive tribes. No information is available on the prevalence of hepatitis B virus (HBV) infection among them. Hence a study was undertaken with the objective of assessing the sero-prevalence of HBV infection among the four accessible tribes of these islands. METHODS: A total of 1266 serum samples were collected from four tribes i.e., Nicobarese, Shompens, Onges and Great Andamanese and tested for the presence of HBsAg and anti-HBs. Information about different risk factors associated with HBV infection was also collected from the Nicobarese tribe. RESULTS: The overall seropositivity rate of HBsAg among the Nicobarese was 23.3 per cent (95% C.I. 21.0-25.9). Hepatitis B was also found to be an important health problem among the Shompens and Onges with HBsAg positivity of 37.8 and 31.0 per cent respectively. The age-wise distribution of these serological markers among Nicobarese tribe indicate that the infection is very common in all the age groups. The sero-prevalence was also found to be very high among the children. CONCLUSIONS & INTERPRETATION: The findings of the present study indicate that hepatitis B infection is hyper endemic among the primitive tribes of these islands. Though none of the risk factors studied in the Nicobarese was found to be significantly associated with HBV infection, the fact that almost 20 per cent of the women in the reproductive age group were positive for HBsAg indicates the possibility of vertical transmission among the Nicobarese. Further studies are required to find out other modes of transmission.

Murhekar KM, Murhekar MV, Bharadwaj AP, Singh SS, Manu V, Sehgal SC. · No affiliation provided · Trop Doct. · Pubmed #16884639 No free full text.

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Murhekar KM, Hamza A, Murhekar MV, Sehgal SC. · No affiliation provided · Trop Gastroenterol. · Pubmed #15303478 No free full text.

This publication has no abstract.

Murhekar MV, Murhekar KM, Sehgal SC. · No affiliation provided · Trop Doct. · Pubmed #15117151 No free full text.

This publication has no abstract.