School of Public Health
The Indian Network for Streptococcus pneumoniae and PCV Impact Research (INSPIRE)
India accounts for a disproportionately high fraction of the global pneumococcal disease burden compared with its population size, mostly due to subnational regions of very high rates of disease compared with other states in the country and other countries in the world.
The Indian Network for Streptococcus pneumoniae and PCV Impact Research (INSPIRE) Project is a partnership led by the Johns Hopkins Bloomberg School of Public Health International Vaccine Access Center (IVAC), in collaboration with the International Clinical Epidemiology Network (INCLEN) and is designed to evaluate the impact of PCV introduction in the Indian Universal Immunization Program (UIP).
The primary aim is to determine the impact of PCV by comparing serotype patterns before and after PCV introduction among young children with invasive pneumococcal disease; changes in nasopharyngeal colonization patterns among children 1-35 months hospitalized with pneumonia, and among healthy community children aged 1-59 months. This study will establish and maintain a surveillance network to measure the impact of routine infant vaccination with PCV on serotypes causing invasive pneumococcal disease among young children under 3 years of age in India. The study is taking place at 7 hospital sites and 2 community sites in northern India. Data generated from INSPIRE will provide evidence to policy makers on changes in pneumococcal disease burden in young children, pneumococcal community transmission changes as a result of PCV introduction, that can help policy makers support, optimize, and advocate for the expansion of the PCV immunization program in India and in other countries.
PI Mentor: Anita Shet
As part of my Global Health Established Field Placement, I was placed in New Delhi, the capital city of India. Here, I worked with the team from the International Vaccine Access Center at Hopkins for the INSPIRE (Indian Network for Streptococcus pneumoniae and PCV Impact Research project) project. This project is designed to evaluate the impact of PCV (Pneumococcal Conjugate Vaccine) introduction in the Indian Universal Immunization Program (UIP). Through this field placement, I gained insight into the epidemiology, presentation, and treatment of childhood pneumonia and invasive bacterial disease. I was also involved in assisting the management of the operations of a large multi-center. My main role was to enable the establishment of monitoring pulse oximetry and oxygen saturation measurements as a simple and non-invasive method of documenting the severity and outcomes of pneumonia among young hospitalized children.
This role was particularly exciting to me as it aligned closely with a project I had worked on for my third term Vaccine Policy class. Working on the real-world impact of PCV introduction in India was all the more interesting.
Despite having spent a large portion of my life growing up in India, I had never lived or worked in Delhi. To get a feel of the project, I worked at the Maulana Azad Medical College Hospital. Here, I worked closely with the research staff to understand the screening and recruitment process of patients into the study. I also helped interview participants that were being recruited to understand their backgrounds and concerns. I was familiarized with the various sample collection and lab techniques that are involved in testing for pneumonia and invasive pneumococcal disease. I also learned about the protocol through which patients are followed up with over their hospital stay and helped identify ways to optimize the same. I initiated the use of pulse oximeters for monitoring oxygen saturation levels at the site and was able to see how the doctors and staff used it as a standard and accurate measurement process. I was also taken on visits to our other sites and helped coordinate meetings with the PIs at each site.
My stay in Delhi was extremely enjoyable. Having multiple people from Hopkins in the city allowed us to meet up, make plans and explore. Delhi has a rich history and has a large range of monuments and iconic places to visit. It is central, allowing trips to other cities like Jaipur and Agra over the weekends. It is a vibrant city with warm people, lots of colors and very good options for food.
During our first week in Delhi, Baldeep Dhaliwal from the team at IVAC visited to help us set up. She familiarized us with the workplace and the local partners, easing the transition process. My faculty PI, Dr. Anita Shet provided constant communication and guidance. She was open to my input and helped me get closely involved with the project.
The GHEFP is a valuable opportunity to experience real-world public health settings. I cherished my time in Delhi on both a personal and professional level.
With a doctor at the hospital site
Discussing the protocol with research staff
Using Pulse Oximeter to measure Oxygen Saturation levels
Maulana Azad Medical College Entrance
Maulana Azad Medical College Building