India

Site Institution: Public Health Research Institute of India (PHRII)

Research Areas: Infectious Diseases, Chronic Diseases; Cervical Cancer; Maternal Child Health; HIV/AIDS, STIs; Slum Health And Health Disparities In Rural Populations

Site Description:

The Public Health Research Institute of India (PHRII) was established in 2007 to improve the health of Indian women through research and healthcare on issues affecting women’s lives across their lifespan. Founded as a non-profit Charitable Trust, PHRII has been recognized as a Scientific and Industrial Research Organization by the Department of Scientific and Industrial Research, Government of India. We have existing collaborations with the Government of India National Rural Health Mission, District Health & Family Welfare Officer, Rotary International, several community-based organizations, and academic institutions. The Institute also operates

the Prerana Reproductive Health Clinic offering free outpatient services for family planning, reproductive healthcare, cancer screening, and HIV prevention to low-income communities in and around Mysore. PHRII has a full-service laboratory with microbiological, serological, and PCR services for the diagnosis of STI/HIV and conducting Hybrid Capture Assays for HPV DNAdetection. In addition, it operates mobile clinics providing reproductive healthcare in a rural catchment of more than 144 rural villages Mysore District.

Our research infrastructure has also allowed us to increase our community footprint. We have leveraged projects on prenatal care, nutrition, HIV, diabetes, and cardiovascular disease to offer prevention, treatment, and referral services. These include screening women for anaemia, sexually transmitted and reproductive tract infections, and prevention of mother-to-child transmission of HIV. Several large chronic disease studies have also increased our community capacity for preventing non-communicable diseases. We now offer education programs on risk factors for and causes of heart disease and stroke. These include hypertension and Body Mass Index (BMI) screenings, free resting electrocardiograms, and serum glucose testing in the community. In recent years, PHRII has also been collaborating with important stakeholders like Rotary Mysore on another important objective: reducing the burden and death toll from cervical cancer. Cervical cancer is a leading cause of cancer death for Indian women, accounting for about one-in-five cancer deaths among females aged 30 to 69 years. Although it is completely preventable, survival is poor because of late diagnosis and treatment. Low-income women, the group with the highest burden of disease, face the greatest obstacles in accessing cervical cancer screening and treatment services. With the dedicated team, thousands of women have received free screening for cervical cancer at PHRII mobile medical camps—and those found to have pre-cancers have been treated the same day or referred for additional care.

We have carried out more than 7,000 cervical cancer screenings till date out of which, 112 women needed additional follow-up testing as we detected abnormalities. We also treated more than 50 women with cryotherapy for precancerous lesions. All women needing further work-up and follow-up care were managed at JSS hospital, Mysore, or Cheluvamba hospital, Mysore, both of which are long-term collaborators of PHRII. All the staff at our organization are trained in cervical cancer prevention and health screening, and have longstanding expertise conducting awareness programs in both urban and rural communities. Our counsellors are well trained in motivating and educating the women to undergo screening after providing awareness with materials specially designed for low literacy populations. We also identify women in each community with health and leadership qualities and train them as peer educators for prevention of cervical cancer. This has helped us make cervical cancer programs sustainable in many of the areas where we work.

Other features of the site include:

• PHRII has served as a training site for undergraduate, graduate, doctoral, and post-doctoral fellows in collaboration with several US Universities. PHRII has partnered with numerous universities to host Global Health Study Abroad programs focusing on India’s health system and global health research methods. We have also hosted Fulbright research fellows. The PHRII consortium has experienced faculty mentors currently conducting laboratory, clinical, epidemiological, and community-based research and has hosted over 16 pre- and postdoctoral fellows, and 80 students from universities. These students from different backgrounds spend between six weeks to a year onsite to learn and carry out culturally appropriate community-based and biomedical research projects.
• PHRII with JSSAHER, also known as PHRII consortium for this application is also involved in Global Infectious Diseases (GID) training program to establish a research and training focused on the study of the interaction of Infectious Diseases (IDs) with Non-Communicable Diseases (NCD) in Mysore, India. This training program supports post-graduate research, training and capacity building in India to generate a new, focused set of researchers and projects addressing this growing and important health challenge. To date, three fellows have been trained at University of California at Berkeley.
• PHRII Serology, Microbiology, and Molecular laboratories are located in an air-conditioned 1500 sq. ft. space at the institute’s headquarters in Yadavagiri, Mysore. Dr. Anjali Arun, a Pathologist with more than 25 years of experience, oversees the 3 Masters-level technicians at the facility. Equipment includes a minus 80 freezer, 2 refrigerators, an Elisa Reader and Washer, a Biosafety Cabinet, a Thermal Cycler, an Electrophoresis system, a Photo-documentation System, Precision Balances, Vortex apparatus, Centrifuges, an all-purpose autoclave, a VDRL Rotator, Multichannel Pipettes, Regular Pipettes and Pipettors, an Incubator, Trinocular and Binocular Microscopes, and all the equipment required to carry out basic microbiology and biochemistry procedures for diagnosis of STI, HIV and other infectious diseases. In addition, the laboratory has an Uninterruptible Power Supply capable of providing 6 hours of backup, as well as a portable generator to ensure uninterrupted operation of the - 80 freezer.
• PHRII operates the Prerana Reproductive Health Clinic in a 1000 sq. ft. facility located in central Mysore City. The clinic has two fully equipped clinician examination rooms, a stat lab, two counseling rooms, and a waiting room. Equipment includes a computer, printer, scanner, incubator, binocular microscope, refrigerator, sterilizer, and microwave oven. The clinic is open 5 days each week and is staffed by 3 female doctors, 2 nurses, a social worker, and a laboratory technician.
• PHRII is equipped with 6 desktop computers and 12 laptop computers on a Wireless LAN connection to the world wide web. Additionally, the institute has 2 network printers, 2 scanners, and a network server for data backup. PHRII equipment and software are maintained through a local software consulting company. PHRII has more than 5,000 sq. ft of office space, conference rooms, a training center, and a teleconferencing facility. The office also includes a kitchenette and guest room for visiting scholars. PHRII carries out community outreach, education, and research programs throughout Mysore Taluk. To support those efforts the institute has an LCD projector, two laptop computers, screens, four handheld GPS systems, and one Maruti 8-seater van.

Recent research projects include:

• Neurocognitive Symptoms in COVID19 recovered patients in Mysore district, Karnataka
• Yoga for Healthy Aging (YHA) Study: A Mind-Body Intervention to Reduce Multimorbidity in the Elderly
• Survey to know COVID 19 vaccine uptake decision process, hesitancy, knowledge and attitude towards vaccine among the Slum dwellers, Pregnant women and parents of children between 3-17 years in Mysore district
• Self-sampling of HPV DNA testing for cervical cancer screening among women in Mysore district
• Experience of Diabetes in Young Adults in Mysore District.
• Understanding Genetic Diversity in the Mysore region of India: a Pilot Project
• Increasing Maternal Support during Prenatal, Birth and Postnatal periods in Mysore district, Karnataka
• A qualitative study to explore the reproductive health challenges among non-pregnant women tobacco farm laborers in Mysore District, India
• Women's Stress in South India: Year Three
• The Kadime Ottada (Low Pressure) Study: Inspiratory Muscle Strength Training for Hypertension in Older Adults in Rural Mysore, India

Site Institution: Sri Ramachandra Institute of Higher Education and Research (SRIHER)

Research Areas: Environment Health, Air Pollution

Site Description:

The Sri Ramachandra Institute of Higher Education and Research SRIHER), Chennai, is a leading medical university in India with faculties of medicine, dentistry, pharmacy, allied health sciences, biomedical sciences, nursing and physiotherapy functioning within a single campus. A 1000 bedded super-specialty hospital and an elaborate infrastructure for classrooms and laboratories support the administration of more than 100 undergraduate and graduate degree programs across the various faculties. A network of sophisticated research laboratories provides world class facilities for engagement in clinical, bio medical and public health research.

This site will emphasize training in environmental health, focused on the impact of indoor air pollution, and cleaner household fuel alternatives on respiratory diseases and other health outcomes. Indian census data indicates the slum population will surge to 109 million by 2017, or around 9% of the total population of 1.28 billion on that year. Most of these homes are likely to use of biomass fuels for household energy, generating levels of household air pollution that have been associated with acute respiratory infections, chronic obstructive pulmonary disease, lung cancer and with infant premature deaths as well as contributing substantially to ambient air pollution. The collaboration between the Environmental Health Sciences at Berkeley, and the Department of Environmental Health Engineering, SRMC-RI(DU) over the past 15 years has produced achievements in academic infrastructure, training, exchange, and research findings. SRU launched in 2010 the first master’s program in public health for occupational and environmental health in South Asia with direct support from a grant of the NIH FIC International Training and Research in Occupational and Environmental Health, which also provided support for SRMC-RI(DU) faculty and postdoctoral researchers to receive mentorship and training from UC Berkeley. SRMC-RI(DU) has also become the leader for Indian national and regional assessments of household pollution and health outcomes. It is positioned to provide field experience to U.S. candidates in multiple sites throughout India to be trained in and promote air pollution assessments and public health interventions to improve slum health.

The Department of Health Engineering (EHE), at SRIHER has established itself as an eminent global environmental health research group with accreditations as a WHO Collaborating Center for Research and Training in Occupational and Environmental Health and a Center for Advanced Research in Environmental Health (Air Pollution) for the Indian Council of Medical Research Government of India. With a network of more than 40 institutional collaborators that include numerous US, European and Indian universities, governmental and non-governmental research institutions, the faculty at EHE has been involved in numerous national and global research and training efforts in the areas of air pollution epidemiology, exposure assessment, environmental chemistry and environmental/occupational medicine. Most notably, support from the Fogarty International Center, NIH and a decade long collaboration with University of California, Berkeley resulted in extensive capacity building at SRIHER for undertaking air pollution and health effects research in LMIC settings. An important outcome of this collaboration was also the development of a full-fledged MPH program in Occupational and Environmental Health, one of the few such offerings available in India. With nine faculty members, 40 research staff members and two administrative assistants, the group has some of the most extensive human and laboratory resources for research and training in multiple domains of occupational and environmental health.

Faculty at EHE-SRIHER has a long history of collaboration with governmental agencies including the State and Central Pollution Control Boards (in charge of ambient air quality monitoring/regulation), Directorate of Public Health and the National Rural Health Mission Offices. These have been valuable in facilitating access to available secondary data, granting of relevant permissions and approvals as well as facilitating interactions with communities through their network of village level social workers. Faulty have also been engaged in interactions with Central and State Ministries as part of expert groups involved with air quality actions. The collaboration with the Indian Council of Medical Research has been very central for the engagement of the EHE-SRIHER team in identified national priority areas of environmental health research that has included household air pollution research. Finally, as a WHO Collaborating Center, EHE-SRIHER is engaged in numerous capacity building efforts to administer training to a wide network of professionals within academic/research organizations and industry.

A well-established academic/research infrastructure together with a proven track record of engagement in national/global inter-institutional linkages at SRIHER provides an excellent scientific environment for investigators on this application to undertake complex population level assessments.