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The discipline of Epidemiology is the scientific study of the distribution and determinants of diseases in populations and their control. It is the study of the occurrence and control of diseases in the context of the social and cultural beliefs and practices of the community in which they occur. Thus, disease is seen not only as the interaction between the host and the microbes but also as the end result of the influence of a variety of factors on this interaction. Thus the study epidemiology helps us to understand the burden of illness, causative factors and natural history of diseases. The application of these principles in the day to day clinical practice would lead to rational decision making in diagnosis and therapeutics (Clinical Epidemiology). 

         The department of epidemiology was started under the PART II scheme of the Government of Tamilnadu with the objectives of identifying the different diseases contributing to the burden of illness in Tamilnadu, to prioritize the health needs and to carry out high quality research in areas relevant to the health needs of the community. The department would also serve as a resource centre for students and doctors seeking to undertake good quality research. The twin objectives of the department are Research and teaching. Some of the thrust areas of the department have been Tuberculosis, Malaria, Anemia, diseases of life style and Child Survival.

MISSION STATEMENT

•  To identify and address priority problems in health relevant to the  region of Tamilnadu and develop appropriate curriculum for medical education

• To achieve excellence in clinical practice, medical education and medical research by the rational use of clinical epidemiology methods and critical appraisal skills, and thereby equip young medical and paramedical graduates with the necessary skills for high quality research and rational clinical practice

 OBJECTIVES 

·          To prioritize the research needs by identifying the different diseases contributing to the burden of illness in our populations. 

·        To carry out high quality research in areas relevant to the health needs of the community 

·        To serve as a resource centre for Ph.D. and other Post graduates to undertake good quality research.  

·        To hold short term and long term courses in research methodology, critical appraisal and biostatistics for clinicians seeking to undertake research. 

·        To establish a state wide health surveillance system for focusing priority problems and build up a database that would be of use for making recommendations to the Government on Health policy issues.

           To bring clinical epidemiology as a subject in the undergraduate curriculum.

ACADEMIC PROGRAMME

M.SC., EPIDEMIOLOGY COURSE  

Master of Science in Epidemiology is a 2 year programme.

Candidates will spend the 1st year at The Tamilnadu Dr. M.G.R. Medical University, Chennai undergoing training courses and being involved in on-going research programmes. During the second year candidates will work on their thesis. The number of seats is limited to four.

ELIGIBILITY

Candidates  seeking  admission for the 1st year of the  Master  of Science  in Epidemiology  should  have  passed  any  one  of  the following examinations recognized by the MCI/DCI/PCI/INC. 

a. Should have passed any one of the following examinations recognized by the Tamilnadu Dr. M.G.R. Medical University or any other University recognized as equivalent thereto.

·        MBBS

·        BDS

·        B.A.M.S.

·        B.U.M.S.

·        B.H.M.S.

·        B.S.M.S.

·        B.V.Sc.

·        M.P.T.

·        M.O.T.

·        M.Pharmacy

·        M.Sc (Nursing)

·        M.Sc. Biostatistics/Statistics

·        M.A. Sociology/Anthropology

·        M.A. Social Work

·        M.Sc. Nutrition

·        M.A.Psychology /Social Psychology/ Health  Education

·        M.Sc., Biochemistry/Anatomy/Physiology/Pharmacology/

·        Microbiology and other Medical related M.Sc's

b) Permanent registration certificate from the concerned Councils

c)  Three years experience in public health or clinical side after passing  

      the above course will be a desirable qualification.

So far, four batches have successfully completed and two batches are undergoing the course.

PH.D PROGRAMME

                     The department is recognized for carrying out Ph.D programme.    So far three scholars have been completed.

 SHORT TERM COURSES/ WORKSHOPS

·        Research Methodology and Bio-Statistics - every three months- for Research Scholars, Post Graduates and all health professionals.  Since 1999 to 2009 XXII RMBS workshop was conducted and nearly 900 participants were trained.

·        Evidence Based Medicine - every three months only for government doctors. Since 1999 to 2009 XV workshops were conducted and nearly 500 participants were trained.

WORKSHOPS CONDUCTED

Policy Analysis Workshop was conducted in Collaboration with IndiaCLEN

 ·         In collaboration with IndiaCLEN and MCH – Star, a 2 day workshop on “Policy Analysis and Advocacy for Policy Change” was conducted on 16 – 17 March, 2009

Millennium Development Goals (MDG) Workshop            

·        In collaboration with UNICEF Core group meeting was held in 28^th August, 2008.

 ·        Two days State level workshop on MDG was held during 13   – 14 November, 2008.

 Tuberculosis  in Medical colleges

   Essential Nutrition Health Research

    Equity Oriented Health Research

   Priority setting for pediatric research

 Development of Practice Guidelines

Cost-effective Interventions

Ethics in Clinical Practice and Research

Genetics in Medicine

•    Importance of Breast self examination

•    Swine Flu

•    Swine flu update 

•   Obesity

1.      Manjula Datta, Mark Nichter  Introducing culturally sensitive tuberculosis education and context specific patient screening

2. Manjula Datta, 1992 Tuberculosis control in the developing world: A Review: Epidemiology in 
   Medicine, Ed.: G.N. Menon, Interline publishing, Bangalore.

3. Manjula Datta and Mohan Alladi 1995, Epidemiology of Tuberculosis in India: In A Text Book On Respiratory Disease In INDIA - Published by the Oxford University Press.

4. Manjula Datta 1993, You Can’t Exclude The Explanation You Have Not Considered: In Pitfalls In Epidemiology  Edited By Judith Glynn. Elsevier publication.

5. Edwin Amalraj R, Nirmala C, Suniti Solomon and Ganapathy M: aids Knowledge and attitudes of first year medical students, in : Pathak KB, Prakasm CP,Aravind Pandey,eds. Biostatistical aspects of Health, BR Publishing corporation,   New Delhi, page 295-302

TECHNICAL REPORTS

1. Children with cough. A training manual for health workers. Published by UNICEF - 1988.

2.      Dr. K. Anandakannan and Dr. Manjula Datta : Perspectives in Medical Education : 1999 association of Indian University.
      

        REVIEW ARTICLES  

1. Manjula Datta, Samdani, P.G. Udani, P.M. Bermejo, A., Costello, A., Crofton, J., Cundall,D., Cutting, W., Hone, N., Miller, F. and King M. Tuberculosis in Children in India – I, National Medical Journal of India, 1992, 5, 226-234

2. Manjula Datta, Samdani, P.G. Udani, P.M. Bermejo, A., Costello, A., Crofton, J.,Cundall,D., Cutting, W., Hone, N., Miller, F. and King M. Tuberculosis in Children in India – II, National Medical Journal of India, 1992, 5, 226-234.

  RESEARCH PUBLICATIONS  

1. B. Ramamurthy and Manjula Datta : A Collaborative study on Epilepsy - A report on P.L.480 scheme. Proc. Institute of Neurology, Chennai, 1975, 5: 158-164.

2. Manjula Datta, B.Ramamurthy & Z.A. Sayeed : Comparative follow-up of EEG study of 416 patients  with seizures (A preliminary study) Proc.Institute of Neurology, Chennai -1975,5:1675-1679.

3. Manjula Datta : A proposed scheme for diagnosis of tuberculosis in children. Proc. of the symposium on Recent Advances in TB, Bombay 1981.

4. Tuberculosis Research Centre, Chennai. Study of Chemotherapy regimens of 5 & 7 months duration and the role of cortico steroids in the treatment of sputum positive patients with pulmonary tuberculosis in South India. Tubercle,  64-73-91.

5. Manjula Datta; Antibiotic management of respiratory infections by village Health Workers. Thesis presented to McMaster University for Masters Degree in Epidemiology June 1983.

6. K. Sivadasan, C.N. Paramasivan, & Manjula Datta et. Al. : Bacteriology of Acute Respiratory infections in Children.Indian J.Med. Microbiol., 5, Oct. 1987. 237-244.
7. C.N. Paramasivan, K. Sivadasan, Manjula Datta et.al.: Non Fermenting Gram Meg. Bacilli associated with Acute Respiratory infection Children in Chennai. Journal of Tropical Paediatrics Vol.33. Dec.1987. PP 343-345.

8. G.R. Sharma, S.Kailasam, Manjula Datta et.al. : Classification of children as slow or rapid acetylators based on  concentrations of Isonaized in Saline following oral administration of Body weight and surface area Related dosages of the drug. Indian Paediatrics,

9. Manjula Datta - Status of smear positive pulmonary tuberculosis patients after chemotherpay under the District Tuberculosis Programme: Paper presented at the 45th National Conference on TB & Chest Diseases held at Rohtak in January 1991. Ind.J.Tub.1991, 38,63.

10. B. Ramamurthy, Manjula Datta, Kanthimathi David : Anticonvulsant drugs and women with seizures. Published in the Souvenir of the VII Convention on the All India Co-ordination Committee of RCOG, Chennai.

11. B. Ramamurthy, Manjula Datta, Kanthimathi David : Anticonvulsant drugs and women with seizures, Journal of Obstetrics and Gynecology India, Vol.42 August, 1992. No.4. Page 438 - 441.

12. Shuk Han Cheng, Barry Walker K., Douglas B., Lowri Denis A., Mitchision, Rajiswamy, Manjual Datta and Prabhakar R., Monocytle antimycobacterial activity before and after mycobacterium bovis BCG Vaccination in Chengalpattu, India and London, United Kingdom. Infection and Immunity, 1993, Vol.61,kNo.10,Page 4501-4503.

13. Manjula Datta. You cannnot exclude the explanation you have not considered. The Lancet, 1993, 342,345-347.

14. Manjula Datta, Radhamani, M.P., Selvaraj, R. Paramasivan, C.N., Gopalan, B.N., Sudeendra, C.R. and Prabhakar, R. Critical assessment of smear- Positive pulmonary tuberculosis patients after chemotherapy under District Tuberculosis Programme. Tubercle and Lung diseases, 1973, 74, 180-186.

15. Soumya Swaminathan and Manjula Datta Primary Complex. Indian Academy of Paediatrics Journal of Practical paediatrics, 1993,1,21-23.

16. Nirmala Chandrasekaran, Edwin Amalraj, R., Manjula Datta, Krishnamurthy, P.V. Vijayasarathi, Subramaniam, S.and Rajasambandam, P. - Hereditary pattern of cancer. Indian Journal of cancer, 1994, 31,86-91.

17. Nirmala Chandrasekaran, Edwin Amalraj, R., Manjula Datta, Krishnamurthy, P.V. Sankaran, JR., and Rajasambandam, P. - Association between obesity and hypertension in South Indian Patients. Indian Heart Journal,1994, 46, 21-24.

18. Sara Mathew, Paramasivam, C.N., Manjula Datta and Prabhakar, R. - Vancomycin for controlling contamination of selective Kirchner's liquid Medium in the culture of gastric lavage for tubercle bacilli. Indian Journal of Medical Research, 1995, 102, 152-155.

19. Selvakumar, N., Vanajakumar, Gopi, P.G., Venkataramu, K.V., Manjula Datta, Paramasivan, C.N. and Prabhakar, R. 1995, - Isolation of tubercle bacilli from sputum samples of patients in the field studies by the cetylpyridinium chloride - sodium chloride and sodium hydroxide methods. Indian Journal of Medical Research. 102, 149-151

20. Daniel Herbert, Paramasivan, C.N., Manjula Datta, Vallishayee, R.S., and Prabhakar, R., 1995: IgG antibodies against antigens of various mycobacterial species in children and in pre - & post BCG young adults. Indian Journal of Tuberculosis, 42, 15-21.

21. Kolappan, C., Selvaraj, R., Abdul Khudoos, Appe Gowds, B.N. Manjula Datta and Prabhakar, 1995: Repeatability of nerve thickness assessment in the clinical examination for leprosy: Leprosy review, 66, 224-226.
22. Manjula Datta, 1996:Zinc Supplementation reduced duration and severity of diarrhoea in Children; Evidence Based Medicine 1, 3: p75.

23. Sowmya Swaminathan, Umadevi P., Shantha S., Radha Krishnan A., and Manjula Datta, 1998 : Serodiagnosis of tuberculosis in children : an evaluation of two kits. Indian Journal of Paediatrics.

24. Manjula Datta, 1999 : Review: Killed Whole cell vaccines prevent Cholera for two years. Evidence Based Medicine 4, 2: p 42.

25. Tuberculosis Research Centre 1999 Trial of BCG in the prevention of Tuberculosis, Indian Journal of Medical Research.

26. Edwin Amalraj R, Nirmala C, Suniti Solomon and Ganapathy M: AIDS AWARENESS AMONG SCHOOL STUDENTS, INDIAN  JOURNAL OF COMM MEDICINE 1995, VOL 20 (1-4);36-40

27. Anuradha S, Suniti Solomon, Jayapaul, Ganapathy and Edwin Amalraj R: GENITAL ULCER DISEASE AND ACQUISITION OF HIV INFECTION: Indian J Med Microbiol 1992, vol 10(4):265-269

28. Kumarasamy N, Suniti Solomon, Jayaker Paul SA, Rosy and Edwin Amalraj R: SPECTRUM OF OPPORTUNISTIC INFECTION, Int J STD and AIDS 1995, Vol 6(6): 447-449

29. Suniti Solomon, Kumarasamy N, Edwin Amalraj R and Ganesh AK: PREVALENCE AND RISK FACTORS OF HIV-1 AND HIV-2 INFECTION IN URBAN AND RURAL AREAS OF TAMILNADU, INDIA, Int J STD and AIDS 1998; vol 9(1): 98-103

30. Kumarasamy N, Suniti Solomon, Jayaker SA, Edwin Amalraj R and Sridhar S: NEUROLOGICAL MANIFESTATION IN AIDS PATIENTS IN SOUTH INDIA, J of Neuroimmunology 1995; Vol 63:100

31. Kumarasamy N, Suniti Solomon, Ganesh AK and Edwin Amalraj R: CLINICAL CHARACTERISATION OF PERSONS WITH HIV AND TUBERCULOSIS IN SOUTH INDIA, AIDS 1996, Vol 10 (Suppl 2):S41

32. Samuel N.M and Edwin Amalraj R. Evaluation of the Regional Medical Library of the Tamilnadu Dr. M.G.R. Medical University in Chennai. Indian J of Medical Education 1997; pp 18-23.

33. Edwin Amalraj R and Raja D. Attitudes of Health Care professionals towards organ donation. Indian J of Urology Mar 2000. Manjula Datta, 2000:Commentary on ‘ Trimethoprim –sulfamethoxazole decreased morbidity and mortality in HIV-1 infected patients with Tuberclosis ACP Journal Club vol 132 (2) ; pp 45.

34. Newman S, Sarin P, Kumarasamy N, Edwin Amalraj R, Madhivana P , Flanigan T et al. Marriage, Monogamy, and IV: a profile of HIV-infected women in South India. Int J of STD & AIDS 2000, Vol 11(4):250-253

35. Ramachandran G, Suresh , Kalpana S and Charles Christopher Kanagam, Invirto antimicrobial activity of p-toluene sulfonates, Indian Journal of Applied Microbiology, Vol -4, pg 11-14, 2009

36. Kalpana.S,Manjula Datta, Stigma in tuberculosis, International journal of sociology, 2002.

37. Kalpana S and Manjula Datta, HIV positivity among multidrug resistant tuberculosis  patient, Abstract Ref No-13048,
    International AIDS conference /FOCIS 2004, Bangkok Thailand, 11-16 July  2004.

38. Kalpana S. Kumarasamy V, Prabha C and Manjula Datta, TH1 CYTOKINE PATTERNS IN BCG VACCINATED AND NON-VACCINATED CHILDREN, Abstract No 1020,  36th International Union World Conference on Lung Health, to be held in Paris, France, 18-22 October 2005

39. Kalpana S. Kumarasamy V, Prabha C and Manjula Datta, “INTERFERON-GAMMA AND TNF-a LEVEL IN BCG VACCINATED AND   NON-VACCINATED CHILDREN  ”  abstract no.129, the International Conference on tuberculosis and Lung Diseases on  1-4 July 2008 at the ICC, Durban.

40. Selvam Jerard M, Wares, F. Perumal M, Gopi P.G. Sudha G, Chenadrasekaran V., Santha T, Health Seeking behaviour of new semar positive TB patients under a DOTS programme in Tamil NAdu, India, 2003, International Journal of Tuberculosis and Lung Diseases volumer 11, No.2 Feb 2007, pp 161-167(7)

RESEARCH

RESEARCH PROJECTS  APPROVED BY UNIVERSITY

  Ongoing Project

Study on “Prevalence Group A Streptococcus infection among slum children in Chennai,”.

 PROJECTS COMPLETED IN COLLABORATION WITH INDIACLEN, CHENNAI.

           1. A project to assess the Knowledge of and attitude toward organ donation among medical persons was undertaken and completed last year. This has been accepted for publication in the Indian Journal of Nephrology.

           Source of funds: University.

          2.  A study of the distribution of health manpower in the state of Tamilnadu has been just completed with the help of the Dept. of Humanities, IIT Madras

           Source of funds: University

        3. Cost effectiveness of different types of providers of supervision in DOTS in the Treatment of TB.

          The strategy of DOTS (Directly observed therapy, short course) widely adopted by the WHO, advocates twice weekly regimen for treatment. However, it is considered that the methodology of supervision, which is vital tuberculosis unit based on local condition.          

4.This study aims to study the effectiveness of different types of treatment providers in a achieving cure rates in the programs and to estimate the cost effectiveness associated with the treatment.

          This is a nationwide multi centric study that the department will be coordinating

.
                     Source of Funding: INCLEN

         5. Investigation of risk factors and transmission of Drug Resistant Tuberculosis

          The magnitude of primary and acquired drug resistance to one or more anti-tuberculosis drugs in India is not known. It is essential to have this information in order to assess the National Control Program, and to suggest modifications, if required. There is need for continuous surveillance for drug resistant tuberculosis in India where DOTS strategy is being implemented to cover increasing number of districts. Thus the objectives

are to investigate the magnitude of drug resistant pulmonary tuberculosis amongst patients with active sputum positive disease.
          This is also a nationwide multi centric study in which the department will be participating.

          Source of Funding : INCLEN

       6. Diagnosis of pyrexia of unknown origin:

           Pyrexia of unknown origin (PUO) remains one of the major diagnostic challenges for the clinicians. There is no set of routine investigations that patients with PUO should be subjected to. Aim of this study is to describe the spectrum of diseases that may give rise to PUO in patients attending the clinics with fever and to delineate the diagnostic approach of these patients and to standardize the diagnostic technique of these patients.

          Source of funding : University

      7. Vitamin A level Recurrent Respiratory Infections in children:

          The factors responsible for causing recurrent respiratory infections are different in different regions and appear to vary with time. Vitamin A has increased mortality rate among children and remains an important factor in maintaining the integrity of the respiratory mucosa. This study will elucidate the role of Vitamin A as a risk factor for recurrent or prolonged respiratory infections in children living in the poorer areas of Madras City. Gender differentials in Health Care (Ph.D Project)
         

This study aims to elucidate the role of gender in access, availability and utilization of health care among the rural and urban poor. The information gained will be utilized to develop a training programme for health workers in order to minimize the gender gap in health care delivery.

 
         Source of funding : ICMR

 .8 The  CEU functioning at the Department of Epidemiology has collaborated with the IndiaCLEN in the writing of RFP (Research Funding Proposal) on the “Care & Support”, strategic information development and analysis, training and capacity building activities and evidence based district planning on the HIV services – a Multi Centric Study.

9.IndiaCLEN, Chennai has also requested collaboration of the CEU of this University in writing a RFP for a USAID/INDIA funded project on Health of the Urban Poor Programme (HUP).

PROJECTS BY  POST GRADUATES 

1. Prevalence and Determinants of Obesity among School Girls (9-13years) and Association of Early Menarche with Childhood Obesity

2. Assessment of Nutritional Status and Dietary Pattern of Urban College Girls - A Cross Sectional Study

3. Obstetric Care Seeking Behaviour among Married Women of Reproductive Age Group in Arakkonam Town, Tamilnadu

4. Prevalence of Hypertension among Rural Population in the District Of Ariyalur.

PROJECTS COMPLETED BY PH.D SCHOLARS 

1. A case control study on determinants of risky sexual behavior, among clients in selected hospitals, Erode district.
2. Patterns of cytokine response among BCG Vaccinated and Non-vaccinated Children
3. “An Immuno Epidemiological study on the effect of Neonatal BCG vaccination by intracellular killing of Mycobacterium Tuberculosis by macrophages” and submitting his thesis by end of June, 2009 and he is awaited for viva-voce examination.

PROJECTS COMPLETED BY POST GRADUATES 

1.   Risk factors for respiratory infections with special reference to Vitamin A.

2.   Impact of an education programme on the oral health of the children in  orphanages.

3.   Prevalence Severity and associated factors of Dental Caries among 3 -6    year old Children.

4.   Risk behavior acquisition and it relation to knowledge about oral cancer   risk factors among college students of Chennai City.

5.   Barriers to health seeking for oral problems.

6.   Prevalence and severity of Dental Fluorosis and associated risk factors in      Salem Taluk.

      7.   Utilization behavior patterns of Siddha System of Medicine in Chennai.

      8.   Perception of patients taking Siddha Medicine.

PROPOSED PROJECTS

1. Study on “Prevalence of anemia among young adolescent girls in     corporation schools of Chennai”.  

2. Study on “ To assess the prevalence of hypertension among school children in the age group of (10-17)years.

SERVICES

Epidemiology / Statistical consultation

        Researchers will be given guidance from protocol development of medical research for their Ph.D work/Postgraduate Dissertation.

      A nominal fee will be charged for the Statistical Analysis of  research data

             PG Dissertation                                           Rs.   500 / -

             Ph.D Thesis                                                 Rs 1,000 /

CLINICAL EPIDEMIOLOGY UNIT

The Department of Epidemiology, TN Dr. MGR Medical University has been functioning as the Clinical Epidemiology Unit of the IndiaCLEN.  A Separate Identity for the CEU has been established in 2006.The Department has been carrying out the projects in the IndiaCLEN with funding from the INCLEN.  The CEU is also holding meetings on academic subjects and journal clubs which have been regularly attended by Doctors from Medical Colleges who were also members of the IndiaCLEN. Clinical Epidemiology Unit was established with the following objectives:

l      To build a research Network in the State of Tamilnadu, through appropriate capacity building in the affiliated institutions of the Tamilnadu Dr. M.G.R. Medical University

l      To hold short term and long term courses in research methodology, critical appraisal and Bio-statistics for clinicians seeking to undertake research.

LIST OF CEU  MEMBERS

 
FACULTIES