Right from its inception in 1964, the department of Biostatistics, laid a strong foundation for its research activities by focusing on the demographic aspects of the headquarters town, Vellore. The agglomeration population of this town is 5,02,000 in 2011, and it was 4,23,425 in the year 2001, figure as revealed by the census enumeration. An intensive survey of Vellore town was carried out for the first time with the purpose of need in medical research. This survey popularly known as “Household Survey of Vellore Town” was undertaken by the department of Biostatistics, during 1964-65. It covered the entire town consisting of 25,994 families with a population of 1,27,075. This study revealed not only a mere population count but also many useful demographic and socio-economic characteristics of the inhabitants of Vellore. From 1966 onwards, several research projects have been carried out by the department of Biostatistics in Vellore town and adjoining rural areas. A brief description of a few of these projects followed by their objectives is provided below:
A study on methods of evaluation of Primary Health Centres, sponsored by ICMR was carried out during 1966-69. Studies on Epidemiological aspects of leprosy were conducted during 1966-70, with the support of Swedish Red Cross and U.S. Department of Health, Education, and Welfare. In order to estimate the prevalence and pattern of epilepsy and stroke, an epidemiological survey was carried out on behalf of the Department of Neurological Sciences from March 1968 to December 1968, covering a total population of 2,58,576.
A study on patterns of health expenditure was carried out during 1970-73, with the financial aid from Indian Council of Medical Research. During 1978-80, a research study sponsored by Indian Council of Social Sciences Research was carried out to examine the socio-economic and demographic correlates of medical care utilization and health behaviour.
A unique five-year longitudinal study, the first of its kind in India, funded by National Center for Health Statistics, USA was launched in 1969 to investigate the interaction of gestational age and birth weight, and its relation to infant mortality and the incidence of congenital defects; to study maternal blood pressures before and during pregnancy, and its relation to toxaemia of pregnancy; and to study the relationship of consanguineous marriages to the continuation of pregnancy, infant mortality, the incidence of congenital defects, and gestational age and birth weight of the child. These studies revealed many useful findings regarding the effect of inbreeding on maternal and child morbidity and mortality. These findings were published in thirteen research monographs and several articles. Conclusions from this longitudinal study were based on the follow up data relating to 14243 pregnancies both in rural and urban sample populations.
The babies registered in this study formed the cohort for another longitudinal, ICMR supported study during 1977-80, in order to examine the effects of prenatal factors on development during the first 7 years of life. ICMR continued to support for a further longitudinal study of the same cohort, during 1981-85, to examine the protein energy malnutrition and growth, development and morbidity pattern in children. At the end of this project, the cohort was 16 years old (born in 1969). This cohort was followed up for a three year study from 1985, funded by Population Council, New York, to investigate the determinants of female age at marriage.
The same cohort with additional inputs is presently followed up to examine the inter-generational changes in maternal health and child growth and development. This five-year project, launched in 1989 under the sponsorship of National Centre for Health Statistics, USA, utilizing the data base formed from 1969 spanning over 3 generations, has a unique place in bio-medical research in India and the data base created is indeed an invaluable asset for many biomedical research investigators. Another longitudinal study of five years’ duration aiming to assess the growth and development of children during adolescence was also carried out during 1989-94.
The research project started in 1996 included follow up of the earlier cohort who are likely to produce their off springs. This project will enable us to have inter-generation a comparison of various aspects. This is a major project of the Department that was funded by USAID.
Another research project of 2 years’ duration funded by the Indian Council of Social Science Research in 1996 aimed to determine the factors influencing decision making on health and medical care expenditure at the individual and family level. The objectives were (i) to determine the factors influencing the decision making on health expenditure and medical care expenses, (ii) to find out the expenditure at the different stages of medical care seeking behaviour and for the persons confined to bed at home, and (iii) to develop theories on decision making on health expenditure.
The department of Biostatistics is one of the seven centres that participated in the multicentric project, “Study on Abuse in Family Environment in India” (IndiaSAFE), funded by International Council for Research on Women (ICRW), Washington. The department was also the data management co-coordinating center for this project.
Currently, specific research collaborations between Biostatistics department, clinical departments at CMC and international institutions, have focused into two broadly defined areas of life course epidemiologic research in young adults of the Vellore Birth Cohort (1969-2013). The cohort subjects were born during 1969-73 and later followed up in different phases of life such as, infancy, childhood , adolescence and young adulthood. Research studies on this birth cohort have focused on the following two broad epidemiological areas:
Early growth and Adult Chronic Diseases
Determining factors that are associated with adult chronic diseases including diabetes, hypertension and other cardiovascular risk factors, considering factors that are specific to early growth (including birth, childhood and adolescence), as well as related to maternal health. Statistical analyses involved models useful in determining the adult diseases from life course perspectives.
A major research project sponsored by British Heart Foundation had been undertaken in collaboration with the Child Health Unit – 1, to examine the risk factors for cardiovascular disease in young adults and its relationship with birth measurements, parental measurements and postnatal growth measurements. In 2013-14, a repeat assessment of cardiovascular risk factors in Vellore Birth Cohort (VBC) after 12 years was initiated in collaboration with Endocrine and Biostatistics department.
Early Growth and Markers of Ageing
Evaluating factors that are predictive of early markers of ageing which includes physical capabilities and ocular factors. This study evaluates developing models, for example, whether poor growth in childhood is predictive of early ageing in a cohort of individuals followed from birth to young adulthood.
A study in collaboration with ophthalmology department has been initiated to examine the physical markers and ocular markers of ageing in adults in Vellore Birth Cohort and its relationship to poor growth in childhood, which is funded by the Public Health Foundation of India (PHFI) and London School of Hygiene and Tropical Medicine (LSHTM).
The department also took the privilege in assisting data management and statistical report writing for the WHO Phase I and Phase III measles vaccine trial from 2006 – 2012. The main objectives of these studies were to study the safety and Clinical Tolerability of attenuated Measles Vaccine administered as an aerosol to healthy subjects and to compare the immunogenicity of measles vaccine delivered via a nebulizer/vaccine combination product with a licensed subcutaneous vaccine in infants respectively.
More than 500 research papers have been published so far, by staff members of the department of Biostatistics as the main authors and/or co-authors. Apart from this, the staff members of the department participate in various conferences held in India and abroad and present papers on topics related to medicine, public health and demography.
The department of Biostatistics, in addition to its own research projects, has assisted many other Departments of Christian Medical College, Vellore and its sister institutions in studies on nutritional diseases, fertility and contraception, peptic ulcer, leprosy deafness, CNS and CVS disorders, primary health care and schizophrenia.
Last but not the least, the goal of good education and knowledge is worth being a good human. Each and every person in this department lives by this goal as they help each other for workshops and the Christmas celebrations held every year.