In the recent past, ICMR- NIRBI (NICED) Epidemiological Divison was involved in large-scale multi-centric studies to generate robust evidence that are guiding force for public health decisions in the country in the following domains:

Vaccine Trials:
The division showed a single-dose immune response and flexibility in dosing of oral cholera vaccine, establishing 28-day schedule of two doses is non-inferior to conventional two doses. ICMR-NICED was involved in a multicentric pentavalent rotavirus vaccine trial leading to the inclusion of the vaccine in UIP. This division also demonstrated the interchangeability of currently available two rotavirus vaccines in health system. Other major trials undertaken were phase III COVAXIN trial, mRNA COVID vaccine, IPV vaccine trials, and rBCG trial. The programmatic introduction of the Typhoid Conjugate Vaccine showed effectiveness in preventing childhood typhoid. Upcoming trials include Phase III dengue, HPV and bivalent typhoid-paratyphoid vaccines.

Disease Burden Estimation:
The division conducted enteric disease burden in India, leading to introduction of typhoid vaccine in UIP along with environmental surveillance for Salmonella typhi in the urban slums. We looked at burden of influenza among geriatric population and assessed cost-effectiveness of a vaccination program. Other disease burden initiatives were of Cholera and Dengue. Perceived health needs in rural Bengal and malnutrition status among school children were assessed.

Implementation Project
The division is assessing impact of oral cholera vaccine through public health system in vulnerable districts of West Bengal.

Antimicrobial Resistance:
The division carried out the prescription audit in tertiary care hospitals for diarrhea and acute respiratory infections. A multi-component educational intervention was designed to improve knowledge of non-qualified allopathic practitioners of urban slums of Kolkata.

We conducted a randomized controlled trial to study the impact of a package of interventions (point-of-care tests, electronic clinical decision algorithm, training, communication) on antibiotic prescriptions for Acute Febrile Illnesses.

Based on findings of the field validation study of rapid diagnostic kit for uncomplicated urinary tract infection at the primary health care level, the studied kit has been taken up by the NHSRC for further evaluation and rolling out.
The department conducted a UNEP-funded project on Environmental priorities of Antimicrobial resistance in India and the salient recommendations were considered in the National Action Plan – Antimicrobial Resistance (NAP-AMR 2.0, 2022-2026).
A tier-specific customized framework for antimicrobial stewardship implementation is under development post assessment of prescription practices, structural capacities in primary, secondary and tertiary tier hospitals of West Bengal.
The division has undertaken a project on the effectiveness of Point-of-Care Test based Decision-Making Algorithm vs. Behavioral Interventions for Prescribers in Promoting rational antibiotic usage in Common Infections.

Diseases under the National Program/Response
The department is also part of two multicentric studies to support NTEP activities for TB elimination by 2025. In one of such project hand held x ray machine is under use in community in camp mode in two rural blocks of Murshidabad district to identify suspected pulmonary TB cases confirmed further by TruNAAT.

The division is involved in implementation of NACO HIV Sentinel Surveillance in eastern and north eastern regions of India. Other HIV-related research includes addressing nutritional and metabolic comorbidities of CLHIV & PLHIV, identifying HIV Drug Resistance, and developing a conceptual framework on the impact of climate change on HIV responses in India.

The Division was also a part of the nationwide serosurvey for COVID infection.