Triple Burden of Obesity,Undernutrition, and Cardiovascular Disease Risk among Indian Tribes

Background

Socio-cultural transitions among individuals from vulnerable groups introduce epidemiological transition, with a concomitant increase in the prevalence of undernutrition, obesity, and cardiovascular disease risks. An accepted conventional wisdom exists for Indian tribes that they are undernourished and away from lifestyle-related diseases. However, the extent of this triple burden affecting them is unknown. In this study, we assessed this triple burden among the 9 major tribes of India.

Methods and Findings

During January 2011 to December 2013, we conducted a cross-sectional study among 1066 men and 1090 women constituting a total of 2156 adults belonging to the 9 major tribal groups: Santals, Oraons, and Koras (West Bengal); Santals, Bhumijs, and Bathudis (Odisha); and Dhodias, Kuknas, and Chaudharis (Gujarat) to estimate the prevalence of the triple burden (undernutrition, overweight or obesity, and hypertension). A high prevalence of undernutrition and hypertension was observed among the Koras (51.9%and 10.6%, respectively), Bathudis (51.3% and 12.1%, respectively), and Oraons (49.6% and 16.5%, respectively). However, the prevalence of overweight and hypertension among the Bhumijs (17.7% and 14.7%, respectively), Dhodias (23.8% and 12.9%, respectively), Kuknas (15.8% and 11.3%, respectively), and Santals of West Bengal (12.2% and 11.8%, respectively) and Odisha (15% and 9.6%, respectively) was most alarming. The prevalence of overweight or obesity among the women was 10.9% and 1.5%, respectively, with 14.0% hypertensive women. The prevalence of overweight and obesity among the men was 14.8% and 1.7%, respectively, with 9.2% hypertensive men. Undernutrition was highly prevalent among men and women. However, data from the past 30 years on systolic blood pressure (SBP) and body mass index (BMI) revealed that the studied tribes were at a higher risk than the general Indian population. In addition, a vast gender disparity with relation to the disease and risk prevalence was observed.

Conclusion

The alarming trend of an increasing prevalence of overweight/obesity, undernutrition, and hypertension is observed among indigenous populations of India, emphasizing the incorporation of a specific health management policy.     

Nutritional assessment by mid-upper arm circumference of santal adults of Purulia, West Bengal, India

The present community based cross-sectional study was undertaken to determine the prevalence of undernutrition using mid-upper arm circumference (MUAC) among adult (> 18 years) Santals of Purulia District, West Bengal, India. It was undertaken at 10 villages of the district. A total of 520 (217 males and 303 females) subjects were measured. Commonly used indicator i.e., MUAC and BMI, were used to evaluate the nutritional status of the subjects. More women (64.7%) then men (54.4%) based on MUAC and women (59.4%) then men (34.6%) based on BMI were undernourished. Significant sex difference both in MUAC (t=2.378, p<0.05) and BMI (t=4.971, p<0.001) were observed. Significant age group difference for MUAC was observed (F=8.93***, df=3) for men and (F=9.52***, df=3) for women. For BMI, these values were F=10.10*** (df=3) F=6.17*** (df=3) respectively. In conclusion, we found that adult Santals of both sexes were under critical nutritional stress, women and the oldest among them were the most.     

Notes on Lodha medicine in Midnapur District,West Bengal,India

This paper provides a brief account of 40 plants associated with herbal remedies among the Lodhas, a tribe of Midnapur district, West Bengal, India. Reports from informants were obtained during field studies between 1977 and 1982. The data are compared with information obtained from some other tribal societies like the Santals and the Oraons inhabiting neighbouring regions. The Lodhas have had a rich herbal folklore, but this is fading due to increasing acculturation and depletion of plant cover.     

Fertility and mortality differentials among selected tribal population groups of north-western and eastern India

Selection potential based on differential fertility and mortality has been computed for six tribal groups inhabiting different geo-climatic conditions, namely: Sahariya, Mina and Bhil of the State of Rajasthan, north-western India, and Munda, Santal and Lodha of the State of West Bengal, eastern India. Irrespective of the methodology, the total index of selection was found to be highest among Lodhas (0.668), followed by Sahariyas (0.524), Santals (0.462), Bhils (0.386), Mundas (0.353) and Minas (0.334). Incidentally, Lodha and Sahariya are two of the seventy-four notified primitive tribal groups of India, and these two study populations show the highest index of total selection, mainly because of a higher embryonic and postnatal mortality. The relative contribution of the fertility component to the index of total selection is higher than the corresponding mortality component in all tribal groups. The analysis of postnatal mortality components indicates that childhood mortality constitutes the bulk of postnatal mortality, suggesting that children under 5 years need better health care in these tribal groups.     

KINSHIP MATTERS: WOMEN's LAND CLAIMS IN THE SANTAL PARGANAS, JHARKHAND

This article discusses the strengthening of kinship ties amongst the Santal community in a village in Jharkhand state in India. The context of progressive marginalization from the state and markets has resulted in the Santals asserting their adivasi identity by recourse to customary institutions as well as rigidifying patrilineal rules of inheritance. While this leads generally to an erosion of women's rights to inherit land, under certain circumstances women are supported by kin elders when they bring grievances to the legal courts. Women's relationship to their kinship group thus seems ambiguous: kinship can simultaneously be not only a source of deprivation and suppression but also a way of staking claims to resources, especially in the face of the inadequacies of formal state mechanisms.     

Genetic study of five populations of Bihar, India.

Four-hundred fifty-nine people, including 106 Santals, 43 Bhuiyas, 107 Sakaldipi Brahmins, 108 Chamars, and 95 Ansari Muslims, of the Giridhi district of Bihar have been tested for transferrin, group-specific component, phosphoglucomutase subtypes, and glyoxalase-I, 6-phosphogluconate dehydrogenase, and adenylate kinase types. Genetic distance estimates by both dendrogram and principal component methods for these 5 populations and the Oraons on the basis of 19 alleles at 6 polymorphic loci indicate 2 major clusters: Brahmins and Muslims, the latter of which is composed of two subclusters (Santals and Bhuiyas, and Oraons and Chamars). The Santal and Bhuiya tribes both speak Mundari, whereas the Oraons speak a Dravidian language. The Chamars, although low-caste Hindus, seem to have a non-Europoid origin, as do the Oraons.     

Identification of novel indigenous Bacillus thuringiensis isolates

Internally Transcribed Spacers (ITS) characterization and distribution of Repetitive Extragenic Palindromic (REP) sequences were studied in the genome of 223 field isolates of Bacillus thuringiensis from Madurai, India. They were characterized by morphological, biochemical and molecular methods. One hundred and twenty four of a total 223 isolates fitted ITS characterization of B. thuringiensis varieties known. Significant genomic variation was observed among seven isolates using REP primers. The ITS PCR product (EMBL accession number AJ639659) exhibited 98% nucleotide sequence homology with B. thuringiensis and placed the origin of indigenous isolate LDC-7 closer to B. thuringiensis on the basis of phylogenetic analysis.     

Sequence and phylogenetic analysis of the thrombospondin-related adhesive protein gene of Babesia gibsoni isolates in dogs in South India

Babesia gibsoni, the causative agent of canine piroplasmosis, is a tick-borne intraerythrocytic protozoan parasite predominantly reported in Asian countries. The present study aimed at genotypic characterization of B. gibsoni isolates prevalent in dogs in Kerala, a southern state of India. Blood samples were collected from 272 dogs in Kerala and B. gibsoni infection was detected by microscopy and polymerase chain reaction (PCR). Molecular confirmation of B. gibsoni parasites was carried out by 18S rRNA nested-PCR, followed by sequencing. Nested-PCR detected a higher percentage of dogs (40.44%) positive for B. gibsoni infection than microscopy where 15.81% dogs were detected positive for infection. Genetic characterization of B. gibsoni isolates (n = 11) prevalent in dogs in the state of Kerala was carried out by PCR amplification and sequencing of the 855 bp thrombospondin-related adhesive protein (TRAP) gene fragment. Phylogenetic analysis of the B. gibsoni TRAP (BgTRAP) gene revealed that B. gibsoni isolates from Kerala formed a distinct cluster with the isolates from north India and Bangladesh, away from other East Asian isolates. Nucleotide analysis of the tandem repeats of BgTRAP gene showed considerable genetic variation among Indian isolates that was shared by B. gibsoni isolates of Bangladesh but not by the isolates of East Asian countries. The results of the present study further confirmed that B. gibsoni parasites in a distinct genetic clade are endemic in dogs in India and Bangladesh. However, elaborate studies are required for better understanding of the genetic diversity of B. gibsoni.     

Genetic polymorphisms at three loci in two populations of Manipur, India

The Phayengs and Khurkhuls are sections of the Meiteis, the largest community in Manipur, India. Racially they are Mongoloids, and marry mostly among themselves. The present study reveals the frequencies of ABO blood groups as A1 (36.54%), B (28.85%), O (25.96%) and A1B (8.65%) in the Phayengs (n = 124) and A1 (39.84%), B (21.14%), O (22.76%) and A1B (16.26 %) in the Khurkhuls (n = 123). The subtype A2 is completely absent in both. The gene frequencies are ABO*A1 = 0.262, ABO*B = 0.212 and ABO*O = 0.526 for the Phayeng and ABO*A1 = 0.334, ABO*B = 0.206, ABO*O = 0.526 among the Khurkhuls. The Phayengs show a frequency of Rh negatives as 1.92%, the frequency of the RH*d allele being 0.139. The incidence of HB E is 38.46% resulting into the frequency of HB*E = 0.266. This is the highest value so far reported from Manipur State. No Rh(D) negative individuals have been encountered among the Khurkhuls, and the incidence of HB E is 16.26%, the frequency of HB*E being 0.085.     

Reproductive rate of the Indian mustard aphid (Lipaphis erysimi pseudobrassicae) on different Brassica oilseeds: colmparisons with Swedish strains of mustard (Lipaphis erysimi erysimf) and cabbage aphid (Brevicoryne brassicae)

The reproductive rate of the Indian mustard aphid (Lipaphis erysimi pseudobrassicae), a serious pest on Brassica oilseeds in India, was compared with that of Swedish strains of mustard aphid (L. e. erysimi) and cabbage aphid (Brevicoryne brassicae) on six common Indian and Swedish Brassica oilseed cultivars. There were clear differences between L. e. erysimi and L. e. pseudobrassicae in the relative suitability of the cultivars, emphasisipg the biological differences between these aphids. B. brassicae had similar reproductive rates on all cultivars.
In addition, the reproductive rate of L. e. pseudobrassicae was measured on both young and old plants of the six Brassica oilseed cultivars and 14 Indian rai (B. juncea) cultivars. Among the six Brassica cultivars, the reproductive rates were highest on turnip rape and toria (B. campestris), and lowest on yellow sarson (B. campestris) and rai (B. juncea). The ranking of the cultivars was similar for young and old plants. There were no significant differences between the rai (B. juncea) cultivars tested, neither among young nor among old plants. These results from laboratory studies are compared with field data from India on the relative susceptibility of different Brassica oilseed cultivars to L. e. pseudobrassicae.     

Occurrence of three genotypic clusters of Bemisia tabaci and the rapid spread of the B biotype in south India

The whitefly, Bemisia tabaci (Gennadius) (Homoptera: Aleyrodidae), is generally considered to have originated from the Indian subcontinent, although little information has so far been collected on the molecular diversity of populations present in this region. The genetic diversity of B. tabaci populations from Karnataka State, south India was analysed using the random amplified polymorphic DNA‐polymerase chain reaction (RAPD‐PCR) technique and partial mitochondrial cytochrome oxidase I (mtCOI) gene sequences (689 bases) of 22 selected samples. A total of 108 whitefly samples analysed by RAPD‐PCR produced 89 polymorphic bands, and cluster analyses grouped them according to their geographic origin into ‘north’ and ‘south’ Karnataka. Phylogenetic analysis of mtCOI gene sequences with reference B. tabaci sequences from other Asian countries divided them into three genotypic clusters. Each cluster was supported with high bootstrap values (82–100%) and the individuals belonging to each cluster shared high nucleotide identities (up to 100%). This indicated at least three distinct genotypes, apparently indigenous to India, which are also present in China, Malaysia, Nepal, Pakistan, and Thailand. These coexist with the B biotype, which was first reported in India in 1999, and has since spread rapidly to other states in south India. The B biotype was more common than the indigenous B. tabaci, in locations where it had been present for more than 2 years. This is reminiscent of the situation in the Americas during the early 1990s, where the B biotype replaced existing biotypes and caused unprecedented losses to agriculture.     

New record of nucleopolyhedroviruses in tea looper caterpillars in India

Tea production in North-East India hit a record loss due to the widespread severe outbreak of a mixed brood of three species of looper caterpillar pests of geometrid moths (Lepidoptera) in 2008-2010. In addition to Buzura suppressaria, two newly recorded geometrids, viz., Hyposidra infixaria and Hyposidra talaca have caused widespread severe damage in recent years. In the present study we report the nucleopolyhedroviruses (NPV) isolated from the tea looper caterpillar from North-East India. We identified and characterized the NPV by cloning and sequencing a partial segment of polyhedrin gene of virus infected larvae of B. suppressaria, H. talaca and H. infixaria. A comparison of deduced amino acids of polyhedrin gene among H. talaca, H. infixaria and B. suppressaria showed that same strain was found to infect all the three loopers in India, which show high sequence identity with B. suppressaria Chinese isolates. Based on the polyhedrin sequence homology, it is predicted that a variant of B. suppressaria Chinese isolate of NPV found to infect H. talaca, H. infixaria and B. suppressaria in India.     

Genetic characterization of two hill stream fish species Barilius bendelisis (Ham.1807) and Barilius barna (Ham.1822) using RAPD markers

Genetic structure of four wild populations of two hill stream fishes Barilius bendelisis (Ham.1807) and B. barna (Ham. 1822) from Uttarakhand, India, was studied using RAPD markers. Eight selective primers provided distinct and consistent RAPD profiles in both the species, producing a total of 47 and 35 scorable bands in B. bendelisis and B. barna respectively. The bands in the range 666–4,830?bp were scored for consistent results. The RAPD profiles generated by all the eight primers revealed varying degrees of polymorphism (25.00–50.00?%). The average genetic diversity (h) was estimated as 0.1661 and 0.1606 among the four populations of B. bendelisis and B. barna respectively.     

Mesostigmatid mite infestations of rodents in diverse biotopes of central and southern India

Examination of 165 rodents trapped in domestic, peridomestic, and feral biotopes of central and southern India revealed the presence of 1,359 mesostigmatid mites. Rodents in central India were infested with 1 species of mite, Laelaps nuttalli; 98% of these mites were recovered from the peridomestic rodent Bandicota bengalensis. Material from the burrow nest of a peridomestic rodent examined in central India revealed the mite, Hypoaspis miles. Rodents from the diverse biotopes of southern India were infested by 8 species of mites: L. nuttalli, Laelaps buxtoni, Laelaps myonyssognathus, Androlaelaps aduncus, Androlaelaps marshalli, Androlaelaps sp. A, Hypoaspis sp. 1, and Hypoaspis sp. 2. Sheep from nearby villages regularly graze in feral biotopes. From the hair of these sheep, 2 species of mesostigmatid mites were recovered, A. aduncus and A. marshalli. The sheep appeared to aid the dispersal of rodent-infesting mites passively. Laelaps nuttalli was the predominant mite species found on the peridomestic rodent B. bengalensis. In both central and southern India, the prevalence, mean intensity, and relative density of this mite were much higher on peridomestic rodents than on domestic and feral rodents. A significant negative correlation was found between the numbers of mites and fleas infesting rodents in central India. A highly significant positive association between A. marshalli and A. aduncus on the feral rodent Tatera indica was recorded. In southern India, the overall prevalence of the 8 species of mites was highest on Mus platythrix. However, the combined prevalence of these mites on 2 feral rodents T. indica and M. platythrix was lower than their prevalence on B. bengalensis. Similarly, the combined values for mean intensity and relative density of these mites on the 2 feral rodents were lower than on the peridomestic rodent B. bengalensis.     

Prevalence and diversity of avian hematozoan parasites in Asia: a regional survey

Tissue samples from 699 birds from three regions of Asia (Myanmar, India, and South Korea) were screened for evidence of infection by avian parasites in the genera Plasmodium and Haemoproteus. Samples were collected from November 1994 to October 2004. We identified 241 infected birds (34.0%). Base-on-sequence data for the cytochrome b gene from 221 positive samples, 34 distinct lineages of Plasmodium, and 41 of Haemoproteus were detected. Parasite diversity was highest in Myanmar followed by India and South Korea. Parasite prevalence differed among regions but not among host families. There were four lineages of Plasmodium and one of Haemoproteus shared between Myanmar and India and only one lineage of Plasmodium shared between Myanmar and South Korea. No lineages were shared between India and South Korea, although an equal number of distinct lineages were recovered from each region. Migratory birds in South Korea and India originate from two different migratory flyways; therefore cross-transmission of parasite lineages may be less likely. India and Myanmar shared more host species and habitat types compared to South Korea. Comparison between low-elevation habitat in India and Myanmar showed a difference in prevalence of haematozoans.     

South East Asia faces severe shortage of safe blood

South East Asia is experiencing a severe shortage of safe blood. The region collects only 7 million units a year but needs a total of 15 million units. This problem is worsened by inappropriate use of blood without separation into its components, with 80-85% of blood being used as whole blood. In addition, the Supreme Court in India has banned the use of blood from professional blood sellers because they were considered to be a high-risk group of HIV. Unscreened blood is also allowed to flourish in both Bangladesh and Pakistan because these countries do not have any national blood policy. Moreover, even with blood screening in India, hepatitis B and C are present because the virus is not tested in this country. In the screened blood in India, the seroprevalence of hepatitis B is 0.06-8.5% and that of hepatitis C is 1.2-3%. While in Islamabad, Pakistan, testing results showed that 8.1% of blood was infected with hepatitis C. Lastly, 5-10% of HIV infections in Southeast Asia are transfusion-induced.     

Association between ABO blood group and osteoporosis among postmenopausal women of North India

The present study is an attempt to examine possible associations between ABO blood groups and the risk of osteoporosis among postmenopausal women of North India. This cross-sectional study involved 250 postmenopausal women from North India, ranging in age from 45 to 80 years. Four anthropometric measurements (height, weight, waist circumference and hip circumference), blood sample (ABO status and haemoglobin concentration) and grip strength (dominant as well as non-dominant hand) of all the participants were taken. Bone mineral density (BMD) was evaluated by using dual energy X-ray absorptiometry (DXA) at lumbar spine (L1–L4) and proximal femur. Analysis of data revealed that at lumbar spine (L1–L4) osteoporosis was more prevalent among individuals with blood group A (31.58%), followed by those with blood group B (29.67%), AB (28.57%) and then blood group O (15%), whereas for proximal femur individuals with blood group AB (21.43%) showed the highest prevalence of osteoporosis followed by a decreasing trend from blood group A (17.54%) to B (12.08%) and then O (5%). Total prevalence of osteoporosis was 26.4% in lumbar spine and 13.2% in proximal femur, indicating that lumbar spine had an elevated risk for osteoporosis among postmenopausal women. All the anthropometric variables, haemoglobin concentration as well as grip strength of individuals with blood group O demonstrated non-significant differences with non-O blood group except for weight and body mass index, where differences were statistically significant. Women with blood group O exhibited significantly higher bone mineral density for lumbar spine (0.90 g/cm² vs. 0.85 g/cm², p < 0.05) and proximal femur (0.87 g/cm² vs. 0.79 g/cm², p < 0.05) as compared to those with non-O blood group, thereby suggesting an increasing risk of osteoporosis among individuals with non-O blood group.     

Genetic variation and population structure of interleukin genes among seven ethnic populations from Karnataka,India

The extent of genetic variation and the degree of genetic differentiation among seven ethnic populations from Karnataka, India (Bunt, Havyak, Iyengar, Lingayath, Smartha, Vaishya, Vokkaliga), was investigated using four single nucleotide polymorphisms (SNPs: IL-1A 4845, IL-1B 3954, IL-1B 511 and IL-1RA 2018) of the interleukin gene cluster. Allele frequencies varied by threefold among these populations, which also differed for gene diversity and heterozygosity levels. The average degree of population subdivision among these castes was low (F _ST = 0.02). However, pair-wise interpopulation differentiation ranged from 0–7%, indicating no detectable differentiation to moderate differentiation between specific populations. The results of phylogenetic analysis based on genetic distances between populations agreed with known social and cultural data on these ethnic groups. Variation in the allele frequencies, as well as differentiation, may be attributed to differential selection and demographic factors including consanguinity among the ethnic groups. Information on the distribution of functionally relevant polymorphisms among ethnic populations may be important towards developing community medicine and public health policies.     

Re-emergence of glanders in India — Report of Maharashtra state

Glanders, a notifiable highly contagious disease primarily of equids, is a disease of high zoonotic importance. Caused by gram-negative bacillus, Burkholderia mallei, the disease was restricted to certain pockets of India with sporadic cases. Recently, a major outbreak of glanders occurred in India starting from Maharashtra. Following clinical signs and symptoms and laboratory investigations on serum, nasal swab and pus swab samples, it was confirmed as glanders among equines in Pune and Panchgani areas of Maharashtra. One pus sample and three nasal swabs yielded B. mallei isolates while 23 serum samples were found positive for glanders by complement fixation test (CFT). The disease was successfully controlled in the state by following strategies for prevention of spread of the disease to other areas in accordance with Glanders and Farcy Act, 1899. Follow up of the occurrence in Maharashtra revealed negative status based on testing and physical surveillance on more than 3,500 equines thereafter. Investigations indicated that the nidus of infection may be present elsewhere in North India.     

Molecular cloning and phylogenetic analysis of human immunodeficiency virus type 1 subtype C: a set of 23 full-length clones from Botswana

To better understand the virological aspect of the expanding AIDS epidemic in southern Africa, a set of 23 near-full-length clones of human immunodeficiency virus type 1 (HIV-1) representing eight AIDS patients from Botswana were sequenced and analyzed phylogenetically. All study viruses from Botswana belonged to HIV-1 subtype C. The interpatient diversity of the clones from Botswana was higher than among full-length isolates of subtype B or among a set of full-length HIV-1 genomes of subtype C from India (mean value of 9. 1% versus 6.5 and 4.3%, respectively; P < 0.0001 for both comparisons). Similar results were observed in all genes across the entire viral genome. We suggest that the high level of HIV-1 diversity might be a typical feature of the subtype C epidemic in southern Africa. The reason or reasons for this diversity are unclear, but may include an altered replication efficiency of HIV-1 subtype C and/or the multiple introduction of different subtype C viruses.