What ails India?

posted Dec 24, 2015, 3:35 AM by SRamachandran Igib
What ails India? The twitter hashtag #whatailsindia is full of issues related to every sphere of life, however, little is known about the medical ailments of Indians. Simple questions like the main reasons for patients to visit doctors or the typical time of onset of  chronic ailments, like obstructive airway disease, diabetes, cardiovascular disease, remain unanswered. The POSEIDON study (Salvi et al Lancet Global Health, Dec 2015) examined the reasons why 204,912 patients visited 7400 general practitioners, in 880 locations spanning all of India, in a single day. This is the first large scale practice-based point prevalence study from India and provides an overview of the disease burden from the medical practitioner point of view. Network based analysis of this large dataset permitted an understanding of the connectivity between ailments and diseases. Changes in network structure, when broken down into decades of age, permitted visualization of age-related trends in disease burden of Indians. We found that in this microcosm of Indian healthcare, respiratory symptoms were the most frequent reasons to visit doctors, while hypertension was the most frequent disease requiring treatment. Importantly, more than a fifth of the hypertensives were less than 40 years old, with metro cities showing greater hypertension burden. There were strong connections between diabetes and cardiovascular disease with a temporal lag of about one decade (diabetes followed by CVD). Non-metro cities, had a higher burden of obstructive airway disease (OAD) and in secondary analyses, utilizing open governance data, we have been able to infer an increase in OAD when LPG penetrance is low. These findings have important implications for multiple government initiatives ranging from national health programs to the “Give It Up” initiative. Further, an editorial on the research paper states that "such high rates of hypertension in younger people has important implications for premature death and disability in the most productive years of life, with economic effects that would extend to the families supported by these people".  Together these emphasize the importance of ongoing research at IGIB on understanding the genesis of cardio-respiratory diseases. POSEIDON represents only the first medical snapshot of the problems faced by Indians, and it is our hope that follow-up studies and prospective medical data collection from the IGIB-HP eHealth Centers (Agrawal et al, PLoS Medicine, June 2013) will give us a more clear data-driven understanding of what ails India.