\r\n\tThe objective of this book is to provide a state-of-the-art review of the use of timber in building construction from various perspectives, including manufacturing, fabrication, modeling, design, and construction of residential and other types of buildings. Of special interest will be contributions related to new developments in timber technologies, design, construction, testing, sustainability, LCA, building envelope, and the performance of timber buildings in natural and man-made hazard conditions.
",isbn:"978-1-83768-263-8",printIsbn:"978-1-83768-262-1",pdfIsbn:"978-1-83768-264-5",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"356565153fc7e43f1bf0cb7ba5e7b28a",bookSignature:"Prof. Ali M. Memari",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/12057.jpg",keywords:"Wood, Lumber, Timber Industry, Home Building, Glue-Laminated Wood, Cross-Laminated Timber, Plywood, Fire Resistance, Sustainability, Fabrication, Panelized/Modular, Material Properties",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 31st 2022",dateEndSecondStepPublish:"June 28th 2022",dateEndThirdStepPublish:"August 27th 2022",dateEndFourthStepPublish:"November 15th 2022",dateEndFifthStepPublish:"January 14th 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"2 months",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Dr. Memari is a Professor and Bernard and Henrietta Hankin Chair in Residential Building Construction in the Departments of Architectural Engineering and Civil and Environmental Engineering. During his 30 years of teaching in structural engineering, his research focused on the behavior of structural, architectural, and enclosure components of residential and commercial buildings under natural hazard loading and environmental conditions. He has published over 300 publications.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"252670",title:"Prof.",name:"Ali",middleName:null,surname:"M. Memari",slug:"ali-m.-memari",fullName:"Ali M. Memari",profilePictureURL:"https://mts.intechopen.com/storage/users/252670/images/system/252670.jpg",biography:"Dr. Memari is a Professor and Bernard and Henrietta Hankin Chair in Residential Building Construction in the Departments of Architectural Engineering and Civil and Environmental Engineering at Penn State, and Director of The Pennsylvania Housing Research Center. During his 30 years of teaching and research experience, he has taught various courses related to structural\r\nengineering. He has focused his research on full-scale laboratory testing characterization and evaluation of residential and commercial buildings with respect to structural, architectural, and envelope components under gravity and lateral loads that simulate natural hazards (earthquakes/wind-storms), as well as environmental effects involving building science aspects (heat transfer, air leakage and moisture transport) through building enclosure. 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1. Introduction
The man who moves a mountain begins by carrying away small stones – Confucius.
Drug resistance is a major challenge in the control of Tuberculosis (TB), which itself remains a global public health problem. Resistance is commonly encountered as Multidrug-Resistant Tuberculosis (MDR TB), but a subset, Extensively Drug-Resistant Tuberculosis (XDR TB), which has about a comparatively fivefold increase in mortality, is now identified in 84 countries worldwide and increasing rates are currently reported from 65 countries. The World Health Organization (WHO) has designated 22 countries of the world as high-burden countries for Tuberculosis (HBCTB) and 27 as high-burden countries for multidrug-resistant Tuberculosis (HBC MDR TB), making a total of 36 countries in either of these categories [1]. The latter are countries where at least 4,000 cases of MDR TB are identified per year and/or at least 10% of newly registered TB cases are MDR TB.
MDR TB and XDR TB epidemics are largely driven by transmission and are mainly found in new cases and patients with TB relapse [2]. Since 1994, WHO has been receiving and analyzing data on anti-TB drug resistance from countries via its Drug Resistance Surveillance Project, which depends on continuous data based on rapid molecular diagnostics and drug sensitivity testing (DST). However, neither is widely or routinely available due to prohibitive costs involved, especially in low- and middle-income economies that are also high-burden countries. In these low- and middle-income high TB burden countries, cases of MDR TB are identified mainly through special surveys rather than continuous surveillance reporting. In 2013, only 11 of the 36 HBCTB/HBC MDRTB had up-to-date data through these drug-resistance surveys. From these surveys it is clearly understood that the MDR TB burdens attributed to these countries are only estimates based on notification of cases which in most countries is incomplete and as such may only be the tip of the iceberg (Figures 1 & 2).
Figure 1.
Percentage of new TB cases with MDR-TB (Adapted from WHO Global TB Report, 2014)
Figure 2.
Percentage of previously treated TB cases with MDR-TB (Adapted from WHO Global TB Report, 2014)
Despite these shortfalls in the determination of exact incidences, especially where TB burden is highest, there have been recent global efforts to bridge the gap between diagnosis and appropriate therapy with second- and third-line drugs. Treatment after diagnosis of MDR TB and follow-up of confirmed cases is however bedeviled with unavailability of human resources, accessibility to second-line drugs in high MDR TB areas, and logistics. Global treatment targets have not been met. but there are concerted efforts to achieve them through restructuring of programs and Programmatic Management of Drug-Resistant TB (PMDT).
The key to overcoming MDR TB and XDR TB will eventually lie in the balance between prompt diagnosis and treatment of cases on one hand and prevention of transmission of drug-resistant bacilli to vulnerable populations with whom they are in contact on the other. Particular attention needs to be given to unrecognized groups: the pediatric patients in whom a high degree of clinical skill must be displayed to ensure prompt laboratory diagnosis and the health care workers whose infection can be prevented through deliberate control methods.
2. Epidemiology of MDR TB
It is estimated that more than 90% of new TB cases and death occur in the high TB burden developing countries [3]. Multidrug anti-tuberculous therapy had been found effective when using the Directly Observed Therapy Short Course (DOTS) strategy to improve compliance to treatment of TB. With the emergence of MDR TB, the DOTS strategy was expanded to accommodate second-line drugs in the Directly Observed Therapy short course with MDR diagnosis, management, and treatment (DOTS PLUS) strategy. Treatment failure, however, can still occur leading to relapse and development of drug-resistant TB strains to second-line drugs which is the XDR TB [4].
Multidrug-resistant Tuberculosis (MDR TB) is defined as resistance to at least both Isoniazid and Rifampicin with or without resistance to other first-line drugs. [5]. A subset of this is Extensively Drug-Resistant Tuberculosis (XDR TB) where there is also resistance to fluoroquinolones and at least one injectable second-line drug (such as Amikacin, Kanamycin, or Capreomycin) in addition [6]. XDR TB was first noted in the late 1980s and 1990s and reported by WHO and Center for Disease Control (CDC), USA, in 2004.
In a survey of some of their National Reference laboratories, it was observed that 20% of resistant strains tested were MDR TB, while 10% were XDR TB. Asia and Eastern Europe had the highest rates [7]. From recent reports, about 60% of the global burden of Multidrug-resistant TB is in China, India and Russia occurring in 3.7% of new TB cases (CI: 2.1-5.2%) and 20% of previously treated TB cases (CI:13-26%). In countries where there are data available, 9% of MDR–TB cases have XDR (CI: 6.7-11.2%) and 14.5% have fluoroquinolone resistance (CI: 11.6-17.4%) [8].
According to the WHO, Eastern Europe’s rates of MDR TB are the highest and MDR TB makes up to 20% of all new TB cases, while in The Union State, it accounts for 28% of new TB cases. In Africa, reports of MDR TB based on continuous surveillance as in South Africa [9] show progressively increasing MDR rates despite overall decreasing numbers of TB cases. This is attributed to improved notification through laboratory surveillance. In developing countries with limited access to TB drug sensitivity tests, prevalence of MDR TB is dependent on special national surveys [1] and hospital-based clinical researches as in Nigeria [10-18]. Most of the hospital-based reports in Nigeria indicate that there is some level of MDR TB, which though not documented on a regular basis show progressive increase over time. This case scenario plays out in other developing countries where continuous surveillance or monitoring of MDR TB is not available. In Nigeria, as well as in other high-burden countries such as South Africa and India, it has been noted that the increasing TB prevalence may be driven by HIV coinfection [19]. Most of these reports are, however, based on testing of adult populations.
Pediatric MDR TB has been majorly underreported in continuous surveillance and special surveys. However, in some countries like South Africa, some modest efforts have been made to document and monitor progress of disease in these populations. A recent meta-analysis [20] of WHO data between 1994 and 2011, testing associations between MDR TB and age groups <15 years, and those >15 years, revealed that MDR TB was positively associated with age <15years in Germany, Namibia, South Africa, UK, and USA. The data also revealed that similar proportions of children and adults were diagnosed with MDR TB in many settings. HIV coinfection was found to be in close association with pediatric MDR TB in South Africa invariably due to the high prevalence of HIV in this area.
2.1. Genesis of MDR TB
Drug-resistant TB has microbial, clinical, and programmatic causes [21]. It manifests when there is a selective growth of resistant mutants among the actively multiplying bacillary population in the presence of drugs, thus making the drug ineffective against mutant bacilli. Microbiologically, the emergence of drug resistance depends upon the frequency of drug-resistant mutants in the susceptible bacillary population, the size of the actively multiplying bacillary population in the lesions, and the antimicrobial quality of the drugs used [22]. The frequency of spontaneous mutations that can be developed to each drug are believed to be of the following magnitude: Streptomycin 1 in 106, Isoniazid 1 in 106, Rifampicin 1 in 108, Ethambutol 1 in 107, Pyrazinamide 1 in 106, Fluoroquinolones 1 in 106-8 [23]. When these drug-resistant mutants occur in large bacterial population, they have a tendency to further multiply depending on the corresponding clinical treatment regimen the patient receives. This varies from one program to the other and will depend on what drugs are available to a treatment program and the ease of access the patients have to these drugs.
Administered therapy may be inadequate in the following instances: monotherapy, poor adherence to treatment protocols, erratic or even interrupted treatment, or low drug quality. When there is inadequate treatment, resistance develops because bacilli with drug-resistant mutation proliferate and become the dominant strain in the infected individual. Inadequate treatment of susceptible TB can lead to drug resistance to first-line drugs (MDR TB), which is a marker of a failing susceptible TB treatment program. Likewise, inadequate treatment of MDR TB will lead to drug resistance to second-line drugs (XDR TB), which is a marker of failing MDR TB treatment programs.
Drug resistance of the Mycobacterium tuberculosis isolated from patients may be categorized based on length of previous anti-TB drug therapy they had received prior to the diagnosis of resistance. Acquired drug resistance is described in those who have been inadequately treated for 1 month or more; Relapse in cases previously completed treatment and reported cured; while that of patients who have never been treated previously or treated for less than 1 month is called Primary drug resistance or resistance in new case. The patients grouped as relapse or as new infections which are found to be drug resistant are grouped together as transmission cases; 82% of MDR TB are reported to be transmission cases. The other 18% are acquired cases, which are mostly adult populations. The acquired cases provoke and sustain MDR TB epidemics in both developed and undeveloped countries [24].
2.2. Epidemics of MDR TB
During the late 1980s and early 1990s, epidemics of MDR TB occurred in North America and Europe killing about 80% of those who were infected. Today, the greatest number of cases is in India and China [25-26], although smaller epidemics have been described due to migrations [27]. The convergence of the following were believed to precipitate MDR TB epidemics especially that of XDR TB: High TB burden, high HIV prevalence, suboptimal TB control practices, and introduction of second-line TB drugs into low- and middle-income countries [28-29]. Among the pediatric age group, there is global paucity of data on MDR TB epidemics. Most data obtained have been reported from South Africa [30]. Some of the identical issues that were identified in all these epidemics were that there was delayed diagnosis of MDR TB cases for over 6 weeks to 6 months due in turn to delayed turnaround time for mycobacterial culture and DST. This invariably led to very high mortality rates which first called attention to the need for DST. In the XDR TB epidemic reported in South Africa [29], there was prominence of associated HIV coinfection in most patients who were transmission cases. Another feature was poor observance of infection control precautions such as: inadequate patient isolation and airflow regulation within wards, which made the wards conducive for transmission between patients in contact with MDR TB cases. There was also notable direct transmission from patients to health care workers, which was evident by Tuberculin Skin Test (TST) conversion as well as later linkage mappings that correlated the strains in the patients’ samples with those of the health workers [29].
2.3. Implications of transmission versus acquired cases
In the high-burden countries, there are reportedly 20-35.2% of new cases and 54-62% of relapse cases that develop MDR TB, accounting for 82% of all incidences of MDR TB [1]. Thus, high burdens of MDRTB and XDR TB are eventually perpetuated from direct transmission within communities. In cases where TB–HIV coinfections are also prevalent, this significantly favors direct transmissibility [31]. Direct transmission is therefore the most common way drug-resistant TB is spread and this must be stemmed to arrest the imminent global health threat from TB.
3. MDR TB diagnosis: Clinical versus laboratory methods
Bacteriological confirmation of TB and Drug sensitivity Testing (DST) of patients presenting with clinical features of Tuberculosis is targeted as universal standard for patient care in TB [1]. When this is incorporated into routine clinical care package and results are available for periodic analysis, it forms a strong database for information about drug resistance in that area.
3.1. Clinical criteria
WHO global TB report [1] revealed that only 2.8 million (58%) of the 4.9 million incident pulmonary TB patients notified in 2013 were bacteriologically confirmed (smear- or culture-positive according to a WHO-recommended rapid diagnostic such as Xpert MTB/RIF). The remaining 42% notifications were diagnosed clinically (symptoms, signs, chest X-ray abnormalities, or suggestive histology). Notifications of new cases are mainly from the high-burden countries, majority of which are low- and middle-income economies. Their capacity for confirmatory testing and DST is limited. Although almost half of notified global TB diagnosis is by clinical methods, this form of diagnosis is attended by poor specificity and false-positive diagnosis. Low laboratory rates, on the other hand, may suggest underdiagnosis of true TB cases and contribute to the gap noticed between notified and estimated incident TB cases [1]. The need for skilled health care workers who can make presumptive diagnosis to improve notification while laboratory methods are being scaled-up, especially in the high-burden countries cannot be overemphasized.
However, the drawback of clinical criteria alone to make a diagnosis in MDR TB is obvious. Detection of TB without investigating drug sensitivity potentially can lead to inadequate treatment and this could lead to spread of MDR TB.
3.2. Laboratory diagnosis – Screening and confirmatory tools
The field of TB diagnosis has been dynamic, changing constantly with the new challenges posed by the bacilli: from being fully susceptible to multidrug therapy to the appearance of MDR TB and now XDR TB. Whereas the need to have accurate bacteriological diagnosis and appropriate drug sensitivity has not changed, the tools to achieve these have continued to evolve as newer and hopefully equally or more effective diagnostic technologies are developed. Diagnosis of MDR TB requires culture to confirm TB and drug susceptibility testing or molecular testing. The challenges faced in achieving these include:
Laboratory challenges with technical capacity, biosafety, cost, slow growth
Patient challenges in access to adequately testing facilities – communication, transportation of specimen, and reporting remain critical to success
Policy challenges in who should be tested and when to test given limited public health resources
Increasingly, molecular technologies are being incorporated into drug resistance surveys to simplify logistics. By 2009, the EXPAND –TB (Expanding Access to New Diagnostics for TB) was launched to accelerate access of MDR TB high-risk populations in high TB burden countries to sophisticated but rapid diagnostic molecular techniques and provide laboratory services. The 27 high MDR TB burden countries were equipped with 97 new or refurbished laboratories and line probe assays (DNA strip test that allows simultaneous molecular identification of TB and the most common genetic mutations causing resistance to Rifampicin and Isoniazid) in reference laboratories which can diagnose MDR TB in two days. By December 2010, the WHO issued a policy on the use of another molecular diagnostic test Xpert MTB/RIF as an initial diagnostic test for cases at risk of MDR TB with negative sputum. The Xpert test, a cartridge-based automated diagnostic test that can identify Mycobacterium tuberculosis DNA and resistance to Rifampicin by nucleic acid amplification technique was a sputum only test for pulmonary TB [32].
A review of WHO policy followed in 2013 that Xpert MTB/RIF should be used rather than conventional microscopy, culture, and DST as the initial diagnostic test in adults and children suspected of having MDR TB or HIV associated TB. It may be used for diagnosis of drug-susceptible TB, smear-negative individuals and cases of extra-pulmonary TB testing using non-respiratory specimens such as lymph nodes. By the end of June 2014, 108 countries had benefitted from procurement of Gene Xpert machines. GenoType® MTBDRplus (Hain Lifescience, Germany) was used in the national survey completed in 2012 in Nigeria and is currently being used in the national survey in Sudan. In Pakistan, Xpert® MTB/RIF (Cepheid USA) identified additional cases missed by culture in the national survey completed in 2014. In ongoing surveys in Papua New Guinea and Senegal, Xpert MTB/RIF is being used to screen specimens for rifampicin resistance and identify those requiring further testing at national or supranational TB reference laboratories. Surveys planned in 2014−2015 in Côte d’Ivoire, the Democratic Republic of the Congo, Indonesia, and Zimbabwe will adopt the same testing algorithm [1].
This approach greatly reduces the workload for laboratories and decreases the cost of national surveys. It may also result in the detection of cases that would otherwise have been missed by culture and conventional DST, particularly in settings with delays in transporting sputum samples to laboratories for testing. Although not a complete surrogate for MDR-TB, particularly in settings where levels of drug resistance are low, rifampicin resistance is the most important indicator of MDR-TB and has serious clinical implications for affected patients.
It is noteworthy that the supply of these technologically advanced diagnostics though now in more countries cannot serve the total at-risk populations, because these machines are kept strategically in reference laboratories. There is a critical need to develop within each country a framework that would address the accessibility to reference centers. In the Western Pacific and Eastern Mediterranean regions, it is reported that there was less than one reference center per 100,000 population. In Nigeria, a high TB burden country and the fourth highest African country with MDR TB, there are only 9 reference centers which are inadequate for the whole at-risk population of 170 million.
There is therefore need in the high TB burden areas to still supplement the recent high-tech diagnostic tools with sputum smear microscopy as an initial screening tool and as such be placed in such a way that these can be accessible to all. Improvements in microscopy using fluorescent light emitting diode microscopy, which is more sensitive than light microscopy, has been proposed and adopted in South Africa, and less so in Mozambique, Bangladesh, and Nigeria [1].
The other aspect that needs careful attention in laboratory diagnosis is the need for regular quality assurance of the machines. Likewise, regular capacity training for laboratory personnel to ensure optimal standards of diagnosis and DST Xpert MT/RIF Newer areas of research for improved diagnostics is the research for correlates of protective immunity and host biomarkers of TB that could help determine the potential for susceptibility or protection [33].
4. Unrecognised MDR TB populations
4.1. Pediatric MDR TB
Pediatric TB diagnosis has also been largely based on clinical criteria due to the pauci bacillary nature of their disease [3, 34-36]. In the cases of TB HIV coinfection, the diagnosis of TB disease is usually more difficult because the symptom specificity is reduced due to similarity with chronic HIV-related symptoms, and chest radiograph interpretation is complicated by HIV-related comorbidity and atypical disease presentation. In this case, diagnosis involves linking the child with an adult with confirmed pulmonary TB [37]. However, older children producing sputum can have bacteriological confirmation and where facilities are accessible DST is performed [8]. To date, there is still widespread under-diagnosis of MDR TB in younger children. Children are less likely than adults to acquire MDR TB during treatment due to the lower bacillary load and less-frequent cavity formation [38]. Acquisition of strains of MDR TB through primary transmission has been shown to be same for children as for adults [39].
The implication of this is that with increasing adult MDR TB in populations, there would be increasing incidences of pediatric MDR TB. Once a diagnosis of TB is made, MDR TB should be carefully considered by review of household source cases for drug-resistant disease [40]. Child contacts of adults with coinfection of TB HIV should particularly be screened for MDR TB. The recent efforts to improve on MDR diagnostic tests using non-respiratory specimens should be harnessed for the pediatric age populations so that rapid diagnostic tests become the first-line diagnostic tool for pediatric MDR TB. Outcomes of MDR TB in children depend on prompt diagnosis and initiation of appropriate therapy for drug-resistant strain [41].
5. Challenges in MDR TB therapy
The Global target of MDR TB treatment is to achieve 75% treatment success by 2015. To achieve success in treatment programs, WHO has published a document which contains the guide to Programmatic Management of Drug-resistant TB (PMDT) which covers all key policies in MDR TB care and control. The numbers of cases treated are usually reported in cohorts that commence therapy within a certain year. In this way it is hoped that treatment outcomes would be clearly understood and modifications where necessary would be implemented. WHO [1] reports increasing numbers of cases enrolled into treatment programs for MDR TB and XDR TB of 47% from 2010 to 2013. In specific terms, however, this increase has been achieved mainly in low TB burden countries. The issue of inadequate notification from weak reporting systems in most high-burden countries is also thought to contribute to only a modest increase despite all efforts made at increasing treatment coverage. Notification still plays a crucial part in the monitoring of treatment outcomes. This depends on systematic record collection, storage, and retrieval by electronic means. All these processes are not uniformly accessible in all parts of the same country and also differ significantly from country to country. Adequately trained personnel to manage this process is crucial and a vital gap.
The treatment target of 75% success outcome has only been reached by 29 out of 126 countries that have reported outcome. Only five of the 27 MDR TB high-burden countries have reached 70% treatment successes (Figure 3). The success recorded in high-burden countries is closely related to the implementation of EXPAND TB project and the scale-up of PMDT in these countries. The identified gaps to achieving treatment include unavailability of second-line TB drugs whose costs are prohibitive in many high-burden countries. This requires substantial financial and health care resources [42]. To ameliorate this, the Global Fund facility which procures TB drugs for the public sector of many countries has increased supply and dropped prices of some MDR TB drugs by 2009 [43].
Figure 3.
Treatment outcomes for patients diagnosed with MDR TB by WHO region, 2007-2011 cohorts.
5.1. Clinical and laboratory monitoring
Drugs used in the treatment of MDR TB are less effective, more toxic (90% experience side effects), used for longer duration (usually more than 2 years’ duration), and are more costly than drugs used in susceptible TB (10-100 times more costly) [44]. In the 27 high-burden countries, the expenditure for MDR-TB treatment has increased cost of TB care from an estimated 1.3 billion USD in 2010 to 4.4 billion USD by 2015 [45]. Some of the common adverse effects might also require monitoring such as ototoxicity and renal failure. There is also the need to document improvement by follow-up of bacteriologic cultures. In addition to these, cases need to be monitored because some MDR TB cases are in advanced stages of disease with other end-stage organ failures. MDR TB therapy is often characterized by low treatment completion rates due to death (15%), default (14-23%), and treatment failure (8-9%) [46]. To achieve increased access, compliance, effective therapy, and retention in care, there is a need for close monitoring. This is traditionally done by hospital-based care at MDR TB referral centers for the initial therapy through health care providers. The model of care involves an initial hospitalization until sputum culture conversion followed by ambulatory phase of treatment in the nearest DOTS facility. However, hospital-based care may serve as an obstacle to access. Ambulatory-based care and community-based care have been proposed in management of MDR TB cases [47]. There have been some successful experiences in some countries using these methods [1]. There would be need for collaboration between these models of care especially when dealing with patients with advanced disease who may benefit for some periods from hospital-based care but would need community- or home-based care for terminal stages. Community and Ambulatory care also serve to ensure adequate contact tracing for cases of MDR and XDR TB, which is of great importance given the role of transmission of disease in spreading the MDR TB epidemic.
When contacts are traced, there is need for DST to identify appropriate second-line drugs. Currently, the diagnostic tools recommended are molecular-based testings: Line probe Assays and Xpert MTB/RIF. There is need, however, to establish quality control measures for these tests to avoid false positives and false negatives. Such tools as would ensure international standards for reference laboratories and other peripheral centers have been developed in some countries. Laboratory monitoring also includes structured assessment tools for TB microscopy, which is shared among laboratory networks.
6. Prevention of MDR TB
To achieve success in the control of MDR TB, there would be a need to strengthen existing TB DOTS programs. To achieve this, some areas that should be focused on are the creation of infection control policies both within and outside institutions. Health education of how transmission of disease occurs from cases to vulnerable groups should be emphasized in communities. Community-based care should be strengthened with recruitment of staff for contact tracing of MDR cases, screening of the contacts, treatment administration, and identification of those who are defaulting on treatment or require institutionalized care. There should be expansion in the teams with involvement of all relevant health care partners to strengthen Public–Private Mix initiatives for TB care and control [48-52].
6.1. Infection control
This aims to prevent transmission from cases to other patients or health care workers. The following means could help to ensure the protection of health care staff: Use of N95 mask by all staff on medical and TB isolation wards and in the HIV clinics [53]; HIV testing of all staff with reallocation of those testing positive to lower-risk positions; Annual Chest Xray screening for TB for all staff [24,54].
Within health care institutions, TB control officers should be hired as well as cough officer in waiting areas who would identify those that are in hospital for other reasons but who may require TB screening. The duration of hospital admission and stay should be reduced. There should be environmental airflow control to ensure maximal ventilation (natural mechanical ventilation within the ward and the use of outdoor waiting areas for outpatients). MDR TB isolation wards should be created with attention paid to laminar airflow [55].
Infection control programs should be created with plans for intervention should transmission be proved.
7. Conclusions
Underdiagnoses of MDR TB and XDR TB cases pose significant challenge for TB control. The current available means for tracking and monitoring are inadequate since they are reliant on reported data which are usually incomplete. These data overlook transmission to unrecognized populations which sustain MDR TB epidemics. There is also a need to make diagnostic tools more available and accessible for cases and contacts and more reference laboratories provided. These laboratories should be monitored to assure they maintain international standards and produce reliable results. Once diagnosis has been made promptly and accurately, adequate therapy for MDR TB should be instituted. This would require clinical monitoring of cases through collaboration of hospital, community, and ambulatory care services. Control programs should also target health care givers to prevent transmission of MDR TB to them from cases. In essence, routine TB DOTS programs should be strengthened in collaboration with public–private mix initiatives to enhance MDR TB control.
\n',keywords:"Tuberculosis, Drug Resistant, Public Health",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/49082.pdf",chapterXML:"https://mts.intechopen.com/source/xml/49082.xml",downloadPdfUrl:"/chapter/pdf-download/49082",previewPdfUrl:"/chapter/pdf-preview/49082",totalDownloads:1795,totalViews:386,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:0,introChapter:null,impactScore:0,impactScorePercentile:4,impactScoreQuartile:1,hasAltmetrics:0,dateSubmitted:"September 25th 2014",dateReviewed:"July 27th 2015",datePrePublished:null,datePublished:"December 2nd 2015",dateFinished:"September 7th 2015",readingETA:"0",abstract:"Drug Resistance is a major challenge in the control of Tuberculosis which itself remains a global public health problem. Resistance is commonly encountered as MDR TB but a subset, XDR TB which has about a comparatively fivefold increase in mortality is now identified in 84 countries worldwide and increasing rates are currently reported from 65 countries. The actual burden of MDR TB is unknown though estimates have been made based on notification of cases which are usually underreported. More so there is under diagnosis in non HIV immune suppressed adults and pediatric populations largely due to lack of readily accessible diagnostic tools. In some case series, MDR TB has been found occurring mostly in newly diagnosed patients or relapse cases after previous cure and completion of treatment rather than in patients with improperly treated disease. Clinical and laboratory monitoring once therapy has been instituted have also been a daunting task both from institutional and patient points of view. The impact of these factors are highlighted and discussed as the world moves towards attainment of the 2015 global target to halve TB prevalence and death rates within the context of Millennium Development Goals (MDGs).",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/49082",risUrl:"/chapter/ris/49082",book:{id:"4585",slug:"an-overview-of-tropical-diseases"},signatures:"Adeola Orogade",authors:[{id:"96900",title:"Dr.",name:"Adeola",middleName:null,surname:"Orogade",fullName:"Adeola Orogade",slug:"adeola-orogade",email:"orogade@yahoo.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Ahmadu Bello University Teaching Hospital",institutionURL:null,country:{name:"Nigeria"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Epidemiology of MDR TB",level:"1"},{id:"sec_2_2",title:"2.1. Genesis of MDR TB",level:"2"},{id:"sec_3_2",title:"2.2. Epidemics of MDR TB",level:"2"},{id:"sec_4_2",title:"2.3. Implications of transmission versus acquired cases",level:"2"},{id:"sec_6",title:"3. MDR TB diagnosis: Clinical versus laboratory methods",level:"1"},{id:"sec_6_2",title:"3.1. Clinical criteria",level:"2"},{id:"sec_7_2",title:"3.2. Laboratory diagnosis – Screening and confirmatory tools",level:"2"},{id:"sec_9",title:"4. Unrecognised MDR TB populations",level:"1"},{id:"sec_9_2",title:"4.1. Pediatric MDR TB",level:"2"},{id:"sec_11",title:"5. Challenges in MDR TB therapy",level:"1"},{id:"sec_11_2",title:"5.1. Clinical and laboratory monitoring",level:"2"},{id:"sec_13",title:"6. Prevention of MDR TB",level:"1"},{id:"sec_13_2",title:"6.1. Infection control",level:"2"},{id:"sec_15",title:"7. Conclusions",level:"1"}],chapterReferences:[{id:"B1",body:'World Health Organization. Global Tuberculosis Report, 2014. 54-73'},{id:"B2",body:'Donald PR, van Helden PD. The global burden of tuberculosis – combating drug resistance in difficult times. 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Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Shika Zaria, Nigeria
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1. Introduction
Hunger is a complicated issue, and several names are used to characterize its varied manifestations.
Generally, the term “hunger” refers to the distress caused by a deficiency of caloric. According to the United Nations’ Hunger Report, hunger states “define periods when populations are facing significant food insecurity” in which people do not have enough food to survive. Hunger, according to the FAO, is defined as a circumstance in which a person has an unusual and uncomfortable feeling as a result of a deficiency of food components in their diet that is required for a healthy life.
Undernutrition is defined as a deficiency in calories or one or more important nutrients. Undernutrition can arise individuals are unable to get or prepare food, have a disorder that makes it difficult to eat or absorb food or require an excessive amount of calories. Undernutrition is frequently visible: people are underweight, their bones frequently fall out, their skin is dry and stretchy, and their hair is dry and starts falling out. Clinicians can usually diagnose malnutrition based on a person’s appearance, height and weight, and overall health (including information about diet and weight loss). Food is provided to people through the mouth, if possible, in progressively increasing volumes, but it is also supplied via a tube carried from the throat to the stomach or put into a vein (intravenously). Undernutrition is commonly assumed to be caused by a lack of calories (i.e., overall food consumption) or protein. Vitamin and mineral deficiencies are so often thought to be different illnesses. However, when there is a calorie deficiency, vitamins and minerals are often more likely to be present. These, in turn, are the result of several factors, including household food insecurity, poor maternal health or childcare practices, and a lack of access to health services, safe drinking water, and sanitation.
Malnutrition refers to both under- and over-nutrition. Micronutrient deficiency occurs when vitamin and mineral intake or absorption is insufficient to sustain healthy growth and development in children and proper physical and mental function in adults. Poor nutrition, disease, or unmet micronutrient needs during pregnancy and lactation could all be contributing factors [1]. Over 2 billion individuals worldwide suffer from hidden hunger, more than double the 805 million people who do not get enough calories to consume [2]. The subcontinent of South Asia and much of Sub-Saharan Africa are hotspots for hidden hunger. In Latin America and the Caribbean, where diets are less reliant on single staples and where intensive micronutrient interventions, nutrition education, and basic health care are more prevalent, the rates are lower [3]. While the poorest countries bear a disproportionate amount of the expense of hidden hunger, micronutrient deficiencies, especially iron and iodine deficiency, are also widespread in the developed world. The worldwide malnutrition problem is becoming more complicated. Developing countries are shifting away from traditional diets based on minimally processed foods and toward highly processed, energy-dense, micronutrient-deficient foods, and beverages, which contribute to obesity and chronic diseases linked to diet. As a result of this nutritional change, many developing countries are experiencing the “triple burden” of malnutrition, micronutrient deficiencies, and obesity [4]. As a result, people’s food does not provide the vitamins and minerals they require for proper growth and development. It has an impact on two billion individuals all over the world [5]. Micronutrient deficiencies are thought to be responsible for 1.1 million of the 3.1 million children who die each year due to malnutrition [6, 7]. By impairing the immune system, vitamin A and zinc deficiency have a negative impact on children’s health and survival. Zinc deficiency inhibits growth in children and can cause stunting. Iodine and iron deficiencies hampered children’s physical and intellectual development [8].
Women and children have higher dietary needs than men [9]. Throughout pregnancy and conception, the nutritional state of women has a long-term impact on the fetus’s growth and development. Iodine deficiency causes nearly 18 million infants to be born with brain damage each year. Severe anemia is responsible for the deaths of 50,000 women each year after giving birth. In addition, 40 percent of women in impoverished countries suffer from an iron deficiency, which saps their energy. Women, infants, and young children are the primary targets of most initiatives to eliminate hidden hunger and improve nutrition outcomes. Treatments that focus on these people can have a high rate of return on investment by improving later-life health, nutrition, and cognition. Iodine, iron, zinc, and other micronutrient deficits are the most commonly identified micronutrient deficiencies in people of all ages (Table 1). Vitamin A deficiency affects an estimated 190 million preschool children and 19 million pregnant women [10], making it a less common but significant public health issue. Other important micronutrients, such as calcium, vitamin D, and B vitamins like folate, are typically insufficient [11]. Although concealed hunger is most commonly associated with pregnant women, toddlers, and teenagers, it affects people at all stages of their lives. The major objective of this chapter is to present information regarding government programs and food-based techniques in industrialized countries like India to combat hidden hunger.
Micronutrients deficiency
Effects
Vitamin A
Visual impairment, night blindness, increased risk of severe illness and death from common infections; (in pregnant women) night blindness, increased risk of death
Vitamin D
Mood changes, bone loss, muscle cramps, bone and joint pain, fatigue
Vitamin B12
Fatigue, breathlessness, numbness, poor balance and memory trouble.
Folic Acid
Megaloblastic anemia
Iron
Anemia, impaired motor and cognitive development, increased risk of maternal mortality, premature births, low birth weight, low energy
Iodine
Brain damage in newborns, reduced mental capacity, goiter
Zinc
Weakened immune system, more frequent infections, stunting
Table 1.
Micronutrient deficiencies and their effects on people.
2. Methodology for the review of the literature
PubMed, Google, and other databases are searched for relevant material. We conducted a search of all review papers using the keywords “hidden hunger, malnutrition, India.” Additionally, the global scenario, efforts, control programmes, critical evaluations, government reports, agency reports, and publicly available data were analyzed. The necessary data was gathered, compiled, and analyzed.
3. Rank of India in GHI
India’s greatest national treasure is its children; nonetheless, hunger continues to be a significant threat to children’s survival, growth, and development. It has assumed the proportions of a secret emergency in India. India is ranked 94th out of 107 analyzed countries on the 2020 Global Hunger Index (GHI), with a score of 27.2 for a “serious” level of hunger. Additionally, it states that wasting is “very prevalent” among children under the age of five in India. According to the Global Health Initiative, India has the greatest proportion of wasted children (children who are underweight for their height) of any country in the world (17.3 percent). Furthermore, India has 14% of malnourished children under the age of five and 34.7 percent of stunted children under the age of five. Whereas India ranks 101st out of 116 countries on the 2021 Global Hunger Index, with a score of 27.5, India has a severe level of hunger. Pakistan, Nepal, and Bangladesh, India’s neighbors, have achieved a higher ranking. Nepal ranks 77th, Bangladesh ranks 76th, and Pakistan ranks 92nd [12, 13].
4. Outcomes of nutritional interventions
The National Family Health Surveys NFHS-4 (2015–2016) and NFHS-5 (2019–2021) data show falling patterns in some of India’s important health characteristics as a result of these nutritional initiatives [14, 15].
4.1 Data on nutrition indicators as per the last available national survey (NFHS-5)
During the 2019–2020 academic year, the NFHS-5 collected data from around 6.1 lakh households. Many of the indicators in NFHS-5 are comparable to those in NFHS-4, which was conducted in 2015–2016 to allow for temporal comparisons. It serves as a tracking indicator for the country’s Sustainable Development Goals (SDGs), which it wants to accomplish by 2030. Preschool education, disability, access to a toilet facility, death registration, bathing practices during menstruation, and techniques and reasons for abortion are all included in NFHS-5. New target areas in NFHS-5 will offer the necessary feedback for enhancing existing programs and developing new policy intervention techniques. Expanded domains of child immunization components of micronutrients for children are among the topics. Expanded age ranges for evaluating hypertension and diabetes among all people aged 15 and up are among the noncommunicable disease (NCD) components. The NFHS-5 asked for information on the percentage of women and men who had ever accessed the Internet for the first time in 2019.
4.2 Key findings of the NFHS-5
5% of children under the age of five are stunted (low height for their age).
About 3% of children are wasted (low weight for height).
32% are underweight (low weight for their age).
More crucially, according to the most recent national survey, 7.7% of children suffer from severe acute malnutrition.
State-by-state, child nutrition indices indicate a heterogeneous pattern. While many states and UTs have seen improvements, some have seen a slight downturn.
Malnutrition has gotten worse. Stunting has been raised in 11 out of 18 states. Wasting is going up in 14 states.
Stunting: The percentage of stunted children has increased in 13 of the 22 states and UTs surveyed.
Wasted: In comparison to NFHS-4, the percentage of children under the age of five wasted has increased in 12 of the 22 states and UTs surveyed.
Obesity: The percentage of overweight children under the age of five has increased in 20 states and territories.
Children who had diarrhea in the 2 weeks prior to the study increased from 6.6 to 7.2 percent.
4.3 Related indicators
Children under 6 months who were exclusively breastfed also showed a sharp improvement, going from 54.9 to 63.7%.
The proportion of children (12–23 months) who were fully vaccinated improved from 62–76%.
The proportion of anemic children (5–59 months) increased from 58–67%.
Women aged 15–49 who were anemic increased from 53–57% and men of the same age increased from 29–31% between both editions of the NFHS.
In most states and UTs, the sex ratio at birth (SRB) has remained constant or increased.
The majority of the states are at a normal sex ratio of 952 or above.
SRB is below 900 in Telangana, Himachal Pradesh, Goa, Dadra & Nagar Haveli, and Daman & Diu.
States such as Tripura, Manipur, Andhra Pradesh, Himachal Pradesh, and Nagaland have also shown an increase in teenage pregnancies.
Children in the age group (6–23 months) receiving an adequate diet also showed a sharp improvement, from 9.6 to 11.3%.
4.4 The status of child mortality in India
Between 2019 and 2021, the U5MR dropped dramatically from 49.7 to 41.9%.
In India, the U5MR is 41.9 per 1000 live births, whereas the IMR is 35.2/1000 live births, and the NMR is 24.9 per 1000 live births.
Infant and child mortality rates have decreased in most Indian states. The best performers were Sikkim, Jammu & Kashmir, Goa, and Assam, which saw significant reductions in neonatal mortality rate (NMR), infant mortality rate (IMR), and under-five mortality rate (U5MR).
All three categories of child mortality increased in Tripura, Andaman & Nicobar Island, Meghalaya, and Manipur.
Among the 22 states and union territories surveyed, Bihar had the highest prevalence of NMR (34), IMR (47), and U5MR (56), whereas Kerala had the lowest death rates.
In the last 5 years, Maharashtra’s child mortality rate has remained unchanged.
Improved Sanitation and Cooking Facilities: Over the last 4 years, the percentage of households with improved sanitation and clean cooking fuel has increased in almost all of the 22 states and UTs (from 2015 to 2016 to 2019–2020).
Anemia among women and children continues to be a cause of concern. In 13 of the 22 states and UTs, more than half of the children and women are anemic. In addition, despite a significant increase in the consumption of IFA tablets by pregnant women for 180 days or more, anemia among pregnant women has increased in half of the States/UTs compared to NFHS-4.
The state of hidden hunger in India is alarming. A lot of work has been done, and while progress has been made, the pace of improvement is too slow.
5. An initiative taken by the Indian government to tackle hidden hunger
5.1 Direct policy measures
5.1.1 Integrated child development services (ICDS)
Integrated Child Development Services (ICDS) is an Indian government programme that provides Supplementary nutrition, nutrition and health education, vaccinations, health screenings, referral services to children and their mothers under the age of six, non-formal pre-school education, and contraceptive counseling for teenagers. The scheme was initiated in 1975, suspended in 1978 under Morarji Desai’s government, and then reintroduced under the Tenth Five Year Plan. The tenth five-year plan also established a link between ICDS and Anganwadi centers, which are primarily located in rural regions and manned by frontline workers. Along with boosting child nutrition and immunization, the initiative aims to eliminate gender inequality by ensuring equitable access to resources for girls and boys [16].
5.1.2 Mid-day meal scheme
The Midday Meal Scheme is a school meal program in India that aims to improve the nutritional status of school-aged children across the country. On working days, the program provides free lunch to children in primary and upper primary classes who attend government, government-aided, local body, Education Guarantee Scheme, and alternative innovative education centers, Madarsa and Maqtabs, supported by the Sarva Shiksha Abhiyan, and Ministry of Labour-run National Child Labour Project schools. With 120 million children served in 1.27 million schools and Education Guarantee Scheme centers, the Midday Meal Scheme is the world’s largest of its kind. In September 2021, the MoE (Ministry of Education), which serves as the scheme’s nodal ministry, changed the scheme’s name to PM-POSHAN (Pradhan Mantri Poshan Shakti Nirman) Scheme. According to the Central Government, by 2022, the scheme would cover an extra 24 lakh children getting pre-primary education at government and government-aided institutions. The program has undergone various adjustments since its introduction in 1995. The Midday Meal Scheme is established by the National Food Security Act of 2013. The National School Lunch Act in the United States is the legal basis for the Indian school lunch program.
5.1.3 National Health Mission
The National Health Mission (NHM), which combines the National Rural Health Mission with the National Urban Health Mission, was announced by the Indian government in 2013. It was renewed in March 2018 for another year, till March 2020. It is headed by a Mission Director and controlled by National Level Monitors chosen by the Government of India. The National Health Mission (NHM) is responsible for several key initiatives, including Rogi Kalyan Samiti, Hospital Management Society, Untied Grants to Sub-Centres, Health Care Contractors, Accredited Social Health Activists National Mobile Medical Units (NMMUs), Janani Suraksha Yojana, National Ambulance Services Some of the initiatives include Janani Shishu Suraksha Karyakram (JSSK), Rashtriya Bal Swasthya Karyakram (RBSK), maternal and child health wings (MCH Wings), free medications and diagnostic services, district hospital and knowledge center (DHKC), National Iron+ Initiative, and tribal tuberculosis eradication.
5.1.4 Rajiv Gandhi schemes for the empowerment of adolescent girls (RGSEAG)
SABLA is another name for this program. The initiative was unveiled by the Indian government on November 19, 2010, in the Plenary Hall of the Vigyan Bhavan in New Delhi. According to the Plan, adolescent girls between the ages of 11 and 18 will be included in all ICDS programs. The scheme’s goals are to help adolescent girls achieve self-development and empowerment, improve their nutrition and health, raise awareness about health, hygiene, nutrition, adolescent reproductive and sexual health (ARSH), and family and child care, improve their home-based skills, life skills, and vocational skills, mainstream out-of-school adolescent girls into formal or non-formal education, and inform and guide adolescent girls.
Under IGMSY a centrally sponsored scheme sanctioned by the Government of India in October 2010 under which grant-in-aid is distributed to states and UTs. promoting (ideal) infant and young child feeding (IYCF) practices, particularly early and exclusive breastfeeding for the first 6 months; and contributing to a more supportive environment by providing economic incentives to pregnant and nursing mothers for improved health and nutrition.
5.1.6 Mission for integrated development of horticulture schemes
The National Horticulture Mission (NHM) is one of the sub-schemes of the Mission for Integrated Development of Horticulture (MIDH), and it is implemented through State Horticulture Missions (SHM) in selected districts across 18 states and six union territories. Farmers or beneficiaries should contact the district’s Horticulture Officer to receive benefits and assistance under the scheme.
5.1.7 National Food Security Mission
The government of India introduced this centrally funded initiative, termed the “National Food Security Mission,” in October 2007 in response to stagnated foodgrain output and an increasing consumption requirement of India’s growing population. The mission was a spectacular success, with increased output of rice, wheat, and pulses. During the 12th Five Year Plan, the mission was expanded with new targets of an additional 25 million tonnes of food grain output by the end of the Plan, including 10 million tonnes of rice, 8 million tonnes of wheat, 4 million tonnes of pulses, and 3 million tonnes of coarse cereals. Based on previous experience and the performance of the 12th Plan, the program has been extended to 2019–2020, corresponding with the Fourteenth Finance Commission (FFC) period. Rice will account for 5 million tonnes, wheat will account for 3 million tonnes, pulses will account for 3 million tonnes, and coarse cereals will account for 2 million tonnes, to increase foodgrain production by 13 million tonnes.
5.1.8 The mahatma Gandhi National Rural Employment Guarantee Scheme (MGNEREGS)
The Mahatma Gandhi Employment Guarantee Act 2005 (or, NREGA, later renamed as the “Mahatma Gandhi National Rural Employment Guarantee Act” or MGNREGA), is an Indian labour law and social security measure that aims to ensure the “right to work”. This act was enacted on August 23, 2005 by Prime Minister Dr. Manmohan Singh’s UPA government. It aims to improve rural residents’ livelihood security by offering at least 100 days of paid employment per year to each household whose adult members volunteer to perform unskilled manual labour. The MGNREGA was established with the goal of “improving livelihood stability in rural regions by providing at least 100 days of guaranteed wage employment every fiscal year to every household with adult members who volunteer to perform unskilled manual work.”
5.1.9 Swachh Bharat Abhiyan
The Swatchh Bharat Mission (SBM), also known as the Swatchh Bharat Abhiyan or the Clean India Mission, is an Indian government-led campaign to eliminate open defecation and improve solid waste management in 2014. It is a revamped version of the Nirmal Bharat Abhiyan, launched in 2009 but failed to achieve its goals. On October 2, 2014, Prime Minister Narendra Modi launched the campaign in Rajghat in New Delhi. With 3 million government workers and students from around the country participating in 4043 cities, towns, and rural villages, India’s largest cleaning campaign to date.
5.1.10 The National Rural Drinking Water Program
On August 7, 2018, India’s Comptroller and Auditor General (CAG) issued its findings on the “National Rural Drinking Water Programme.” In 2009, the National Rural Drinking Water Program (NRDWP) was created. It strives to provide rural residents with safe and sufficient water for drinking, cooking, and other home requirements on a sustainable basis.
5.1.11 Eat right India campaign
On July 10th, 2018, FSSAI launched “The Eat Right Movement” to boost public health in India and counteract unfavorable nutritional trends associated with lifestyle disorders. On a unified platform, the food industry, public health specialists, civil society and consumer organizations, influencers and celebrities promised to make real efforts to magnify “The Eat Right Movement” in the country.
5.1.12 Poshan Abhiyan
On behalf of the Ministry of Women and Child Development, Prime Minister Narendra Modi launched the POSHAN Abhiyaan in Jhunjhunu, Rajasthan, in March 2018. Its goal is to reduce undernutrition and other related issues by organizing various nutrition-related programs. Stunting, malnutrition, anemia (especially among young children, women, and adolescent girls), and low birth rates are also addressed. It will oversee and evaluate the implementation of all such plans, using existing organizational structures within line ministries where possible. By 2022, it plans to expand interventions supported by the ongoing World Bank-funded ICDS Systems Strengthening and Nutrition Improvement Project (ISSNIP) to all districts in the country.
5.1.13 Pradhan Mantri Matru Vandana Yojana
The Ministry of Women and Child Development administers the Maternity Benefit Scheme, a federally funded program. It is a maternity benefit program that began on January 1, 2017, in all districts of the country.
5.1.14 National Food Security act
The National Food Security Act of 2013 (also known as the “Right to Food Act”) is an Indian law that aims to provide subsidized food grains to about two-thirds of the country’s 1.2 billion people. It was signed into law on September 12, 2013, with a retroactive date of July 5, 2013. The existing government of India’s food security programs is converted into legal entitlements under the National Food Security Act, 2013 (NFSA 2013). The Midday Meal Program, Integrated Child Development Services Program, and Public Distribution System are all part of it. Furthermore, the NFSA 2013 recognizes maternity benefits. The Integrated Child Development Services Scheme and the Midday Meal Scheme are universal. In contrast, the PDS will serve roughly two-thirds of the population (75 percent in rural areas and 50 percent in urban areas).
5.1.15 Mission Indradhanush
The government of India’s health mission is known as Indradhanush. Union Health Minister J. P. Nadda introduced it on December 25, 2014. The effort’s goal is to achieve and maintain 90 percent vaccination coverage in India by 2020. Vaccination is available nationwide against eight vaccine-preventable diseases, including Diphtheria, Whooping Cough, Tetanus, Polio, Measles, a severe form of childhood tuberculosis, Hepatitis B, and meningitis and pneumonia caused by Haemophilus influenza type B, as well as Rotavirus diarrhea and Japanese Encephalitis in selected states and districts.
5.2 Indirect policy measures
Increasing food grain production to ensure food security.
By supporting the production and availability of nutritionally dense food items, we may endeavor to improve the population’s dietary pattern.
Increasing the poor’s purchasing power and lowering their susceptibility in order for them to purchase a balanced, nutrition-dense diet.
Expansion and improvement of the public distribution system
Increasing student awareness of nutrition through school curricula, etc.
Food adulteration should be monitored and prevented.
Initiate more community involvement in nutrition surveillance.
6. Eradicating micronutrient deficiencies: Approaches based on food
The term “hidden hunger” refers to a more subtle sort of shortage produced by consuming inexpensive, satisfying foods that are low in important vitamins and minerals. While the implications of subclinical micronutrient deficiencies are becoming more understood and monitored, they frequently go unreported in the population. This is why vitamin deficits have been dubbed “hidden hunger.” Micronutrient deficits can occur even in places with an adequate food supply to support the population’s energy needs. When people cannot afford to diversify their diets sufficiently with fruits, vegetables, or animal-source foods containing micronutrients, shortages are unavoidable. Micronutrients are vitamins and minerals that humans require in order to boost cellular growth and metabolism. Iron, iodine, and vitamin A deficiency are the most prevalent forms of micronutrient malnutrition with serious public health effects. Other micronutrients have been demonstrated to contribute to illness prevention (e.g., folic acid and calcium) or growth promotion (e.g., zinc) [17].
FAO views food-based initiatives as a sustainable way to address the nutritional needs of population groupings. These are as follows:
Supplementation
Fortification
Bio-fortification
Dietary diversification
Community-based interventions for micronutrient status improvement
6.1 Supplementation
Supplementation is a technical term that refers to the process of delivering nutrients directly to the target population via syrup or pill. It has the advantage of providing an appropriate amount of a specific nutrient or nutrients in an easily absorbed form and is frequently the quickest option to address deficiency in people or demographic groups diagnosed as insufficient. Supplementation programmes are typically used as a temporary treatment and then phased out in favor of long-term, sustainable food-based interventions like fortification and dietary change, which typically involve increasing food diversity.
6.2 Fortification
By 2024, all rice available at ration shops, rice available in mid-day meals, and rice available through all schemes will be fortified, Prime Minister Narendra Modi declared during his 75th Independence Day address from the Red Fort in New Delhi. The Prime Minister’s declaration is crucial for the nation and represents a forward-thinking strategy, as the government distributes approximately 300,000 tonnes of rice annually through various programmes authorized by the National Food Security Act, 2013. (NFSA). The Centre has allocated 328 lakh tonnes of rice under the NFSA for TPDS (Targeted Public Distribution System), MDM (Mid-day Meal), and ICDS (Integrated Child Development Services). Rice fortification will assist in addressing micronutrient deficiencies or “hidden hunger,” both of which contribute to undernutrition, a type of malnutrition. But before we discuss the benefits of the aforementioned declaration, if done properly, let us first define fortification and why it is necessary to combat malnutrition in India [18]. Food fortification is a cost-effective, scalable, and sustainable worldwide solution that tackles micronutrient deficiency. In October 2016, the Food Safety and Standards Authority of India (FSSAI) operationalized the Food Safety and Standards (Fortification of Foods) Regulations, 2016 to fortify staple foods such as wheat flour and rice (with iron, vitamin B12, and folic acid), milk and edible oil (with vitamins A and D), and double fortified salt (with iodine and iron) in order to address India’s high burden of micronutrient malnutrition. The “+F” symbol has been designated for the purpose of identifying fortified foods. Each package of fortified food shall bear the words “fortified with (fortificant name)” and the +F logo. Additionally, it may have the tagline “Sampoorna Poshan Swasth Jeevan” beneath the emblem, which is optional and not required (Figure 1) [19].
Figure 1.
Food fortification logo used on fortified foods in India in Hindi and English language. [Source: https://fssai.gov.in/knowledge-hub-logos.php?pages=2].
Fortification is the process of supplementing staple foods such as rice, wheat, oil, milk, and salt with essential vitamins and minerals such as iron, iodine, zinc, and vitamins A and D to increase their nutritional content. These nutrients may have been present in the food at the time of manufacture or may have been lost during processing.
6.2.1 Need of food fortification
Micronutrient deficiency or malnutrition, commonly referred to as “hidden hunger,” is a severe health concern. Access to safe and nutritious food is critical, and occasionally, owing to a lack of a balanced diet, a lack of variety in the diet, or food insecurity, individuals do not receive essential micronutrients. Often, significant minerals are lost during food processing as well. One strategy for addressing this issue is the fortification of food. This strategy complements other strategies for improving nutrition, such as diet variety and food supplementation. India suffers from a high rate of micronutrient deficiencies caused by Vitamin A, Iodine, Iron, and Folic Acid, which result in night blindness, goiter, anemia, and a variety of birth abnormalities. According to the National Family Health Survey (NFHS-4), anemia affects 58.4% of children aged 6 to 59 months, 53.1 percent of women of reproductive age, and 35.7 percent of children under the age of five. Fortification is an internationally proven technique that addresses the population’s widespread vitamin deficiencies.
6.2.2 Benefits of food fortification
The benefit-to-cost ratio of food fortification is extremely favorable. According to the Copenhagen Consensus, every rupee spent on fortification results in an economic value of nine rupees. Although the equipment and vitamin and mineral premix require an initial investment, the ultimate cost of fortification is quite inexpensive. Even if all programme costs are passed on to customers, the price rise will be between 1 and 2 percent, which is less than the regular price variance. The following are some of the numerous advantages of food fortification:
Because staple foods are extensively consumed, nutrients are added to them. Thus, this is an ideal way to simultaneously improve the health of a wide segment of the population.
It is a safe approach to enhancing people’s nutrition. The addition of micronutrients to food poses no risk to human health. The amount supplied is minimal and considerably below the Recommended Daily Allowances (RDA), and is strictly monitored to ensure safe use.
It is a cost-effective strategy that does not require individuals to alter their dietary habits or eating patterns. It is a socially and culturally acceptable method of nutrient delivery.
It has no effect on the food’s properties such as taste, aroma, or texture [20].
In this circumstance, fortification is the most practical option in terms of population access. This is referred to as the fortification of staple foods. The government of India has recognized this truth. This is why standards for five fortified essentials have been released, along with a logo (+F) to distinguish fortified foods: wheat flour, rice, edible oil, milk, and Double Fortified Salt. Recently, regulations for processed meals such as breakfast cereals, buns, rusks, pasta, and noodles were also released. Additionally, in collaboration with Tata Trusts, the Food Fortification Resource Centre (FFRC) has been located at FSSAI under the Ministry of Health and Family Welfare. The Food Fortification Resource Centre (FFRC) is a non-profit organization dedicated to the advancement of food fortification. The FFRC was established as a resource hub to serve as a shared platform for bringing together all major actors in food, nutrition, and health to collaborate on eradicating hidden hunger (Figure 2) [21].
Figure 2.
Diagrammatic representation of food fortified with minerals and vitamins in India. [Source: https://www.insightsonindia.com/wp-content/uploads/2021/08/F.jpg].
6.2.3 Fortified foods
Salt is an excellent medium for iodine fortification and has been effectively used to combat iodine deficiency around the world. The properties of iodine salts used in fortification Salts of iodates and iodides in sodium and potassium are the two chemical forms employed in salt iodization. Fortification levels range between 30 and 200 parts per million. The WHO recommends that, under typical situations where salt is lost at a rate of 20% from manufacturing to household, an additional 20% be lost during cooking prior to consumption. The average person consumes 10 g of salt each day. This method was developed by the National Institute of Nutrition in Hyderabad to address the dual problems of iron and iodine deficiency. Given the widespread consumption of staple cereals, fortification makes sense. Wheat flour is enriched with iron and other minerals in various countries. There have been concerns concerning the bioavailability of iron from wheat atta due to its high phytate (absorption inhibitor) concentration. Certain chemicals, such as Na-Fe-EDTA and perhaps the enzyme phytase, may overcome phytate’s inhibitory effect. The higher expense of this salt may be offset by the fact that it has a higher bioavailability and therefore requires less fortification. Rice is the staple food for more than half of India’s population. Fortification of rice has been attempted by combining fortified extruded grains from rice flour with unfortified rice (Ultra rice). Wheat flour fortification with thiamin, riboflavin, niacin, and iron has been used successfully for a long period of time.
Vitamin A added to wheat flour showed excellent stability in studies conducted in the United States. In the Philippines and Sri Lanka, efficacy trials on wheat flour fortified with vitamin A and wheat flour fortified with iron are presently underway. Since late 1997, the United States and Canada have required wheat to be fortified with folic acid. In South America, in Chile and Costa Rica, fortification of wheat flour with folic acid has proved helpful in minimizing neural tube abnormalities. Zinc sulphate fortification of wheat flour was observed to decrease iron absorption; however, zinc oxide had no such inhibitory impact. Around 2.2 million tonnes of wheat flour are fortified in India. Since 2000, a few states, including Madhya Pradesh and Gujarat, and a few districts in West Bengal have fortified wheat flour. Numerous countries have enriched cereal products with folic acid to help minimize the prevalence of neural tube abnormalities. Fortification with folic acid, maybe in conjunction with vitamin B12, may also help reduce serum homocysteine levels. Because vitamin A is fat soluble, fats and oils may be useful carriers for it. In India and Pakistan, vegetable ghee (hydrogenated vegetable oil) is fortified. Margarine is vitamin A-fortified in approximately 24 countries, including Brazil, Chile, Colombia, Mexico, and Indonesia. Brazil is conducting trials on vitamin A-fortified soybean oil. Edible oils enriched with vitamin A and D are sold through market channels in India’s Madhya Pradesh and Rajasthan regions. In Venezuela, vitamin A, thiamin, riboflavin, niacin, and iron are added to precooked corn flour. In countries such as Mexico, where corn is the predominant food, fortification of maize with micronutrients is being studied. Maize flour is fortified with iron, zinc, and a vitamin B complex. Maize flour was enriched with soy protein and examined for its ability to aid in the development of the brain in rats. Additionally, research is being conducted to strengthen corn tortillas on a home and industrial scale [22].
6.3 Biofortification
Biofortification is a method that increases the nutrient density of food crops through conventional plant breeding, enhanced agronomic practises, and/or current biotechnology without sacrificing any consumer or farmer-preferred trait [23]. It is acknowledged as a nutrition-sensitive agriculture strategy that has the potential to significantly minimize vitamin and mineral deficiencies [24, 25, 26]. Zinc biofortification of beans, cowpeas, and pearl millet, as well as provitamin A carotenoid biofortification of cassava, maize, rice, and sweet potato, are all ongoing and at various stages of development. The biological process by which biofortified crops improve nutritional status is straightforward: biofortified crops are more nutrient-dense than conventional crops. Individuals will consume [27] and absorb [28] more micronutrients by eating biofortified crops than by eating the same amount of non-biofortified crops, assuming comparable micronutrient bioavailability [29] and retention [30] following heating or processing and storage. Consumption of biofortified staple crops can increase micronutrient intake in communities with a diet deficient in these nutrients.
6.4 Dietary diversification
Increasing dietary diversity is one of the most effective strategies for preventing hidden hunger on a long-term basis [31]. Even when socioeconomic factors are controlled for, dietary diversity is related to improved child nutritional outcomes [32]. In the long run, dietary diversification promotes a balanced and appropriate intake of macronutrients (carbohydrates, lipids, and protein); necessary micronutrients; and additional food-derived compounds such as dietary fiber. The majority of people may receive adequate nutrition from a mix of cereals, legumes, fruits, vegetables, and animal-source foods. Certain populations, such as pregnant women, may require supplements [33]. Effective solutions for promoting dietary diversity include food-based tactics such as home gardening and educating people about proper infant and young child feeding practises, food preparation, and nutrient-saving storage and preservation methods. Several low-cost, food-based approaches for improving micronutrient status can be advocated at the community level. Culturally relevant dietary adjustments should be established to assist individuals in identifying concrete measures that can increase both food supply and micronutrient absorption. This information must be distributed to the public using conventional methods of communication.
6.5 Community-based interventions for micronutrient status improvement
Promoting exclusive breastfeeding for newborns up to 6 months of age and continuing breastfeeding for older infants
Identifying and promoting the use of culturally suitable micronutrient-dense weaning foods.
Identifying and promoting the use of traditional green-leafed vegetables and fruits to increase dietary diversity.
Micronutrient preservation in fruits and vegetables by solar drying or canning processes.
Promoting kitchen gardening and small animal husbandry.
Increasing year-round access to micronutrient-dense foods.
Numerous issues confront developing nations, including health care, education, sanitation, water supply, and housing. As a result, focusing exclusively on a specific vitamin shortfall or technique will not be the most effective way to reduce micronutrient deficiencies. Complementary public health measures that can help minimize micronutrient deficiency include deworming, malaria prevention, increased access to safe drinking water and sanitation, and childhood immunization. Successful plans address all of these issues holistically and cooperatively, with full political commitment.
7. Conclusions
India ranks 102 out of 116 countries in the Global Hunger Index 2021. While eliminating malnutrition in India would be tough, it is not impossible. Achieving a sustainable end to hunger needs prompt action. Over 2 billion people, or one-third of the world’s population, are malnourished. Malnutrition and micronutrient deficiencies have a significant impact on child and mother mortality, mental impairment, and workforce productivity. The current paradigm of seeing food security only through the lens of energy security must change. Simply pumping grains to satisfy hunger will not provide nutrition and health. The objective should be to ensure that the diet is balanced in terms of macro-and micronutrients. To maintain MN security, laboratory, clinical, and community-based (operations) studies are required. A balanced approach of food fortification, dietary diversity, biofortification, and supplementation aided in the early detection and treatment of clinical deficiencies. A fortification program’s performance can be judged in terms of its public health effects and sustainability. The mechanism for extension must be robust. Support from the media is critical for raising awareness and promoting compliance. Large-scale initiatives including food fortification, dietary diversity, biofortification, and micronutrient supplementation are making significant headway in lowering the morbidity and mortality associated with micronutrient deficiencies. Current programs must be enhanced and work on their effective implementation must be done to ensure that they reach the poor. While targeted legislation must be enacted to rein in the proliferation of schemes, the judiciary must be an active player in the debate on nutritional justice for the people.
Acknowledgments
We pay our profound sense of gratitude to Dr. Satish Kumar Yadav for his assistance, encouragement, and insightful advice throughout in constructing this book chapter. We also apologize for not citing the research papers of all the authors that helped me in better understanding this topic.
Conflict of interest
Authors declare no conflict of interest.
\n',keywords:"hidden hunger, National Program, food fortification, micronutrients",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/81420.pdf",chapterXML:"https://mts.intechopen.com/source/xml/81420.xml",downloadPdfUrl:"/chapter/pdf-download/81420",previewPdfUrl:"/chapter/pdf-preview/81420",totalDownloads:48,totalViews:0,totalCrossrefCites:0,dateSubmitted:"January 8th 2022",dateReviewed:"March 11th 2022",datePrePublished:"April 20th 2022",datePublished:null,dateFinished:"April 20th 2022",readingETA:"0",abstract:"Nearly 2 billion people, or one-third of the world’s population, suffer from micronutrient deficiencies. Micronutrient deficiencies or hidden hunger and the negative consequences of a diet deficient in essential vitamins, minerals, or trace elements continue to be serious public health concerns among Indians. This hidden hunger is especially prevalent among vulnerable populations, such as pregnant women, small children, and teenagers. As a result, the government has developed many national initiatives to combat malnutrition and micronutrient deficiencies, including ICDS, NFSM, Poshan Abhiyan, Swachh Bharat Abhiyan, and others. Governments also use food-based techniques to combat malnutrition and hidden hunger, including supplementation, food fortification, bio-fortification, and dietary diversification. This chapter presents statistics from the NFHS 4 and 5 and numerous national programs and food-based measures taken by governments to combat hidden hunger.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/81420",risUrl:"/chapter/ris/81420",signatures:"Latika Yadav and Neelesh Kumar Maurya",book:{id:"11090",type:"book",title:"Malnutrition",subtitle:null,fullTitle:"Malnutrition",slug:null,publishedDate:null,bookSignature:"Dr. Farhan Saeed, Dr. Aftab Ahmed and Mr. Muhammad Afzaal",coverURL:"https://cdn.intechopen.com/books/images_new/11090.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80355-634-5",printIsbn:"978-1-80355-633-8",pdfIsbn:"978-1-80355-635-2",isAvailableForWebshopOrdering:!0,editors:[{id:"192244",title:"Dr.",name:"Farhan",middleName:null,surname:"Saeed",slug:"farhan-saeed",fullName:"Farhan Saeed"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Methodology for the review of the literature",level:"1"},{id:"sec_3",title:"3. Rank of India in GHI",level:"1"},{id:"sec_4",title:"4. Outcomes of nutritional interventions",level:"1"},{id:"sec_4_2",title:"4.1 Data on nutrition indicators as per the last available national survey (NFHS-5)",level:"2"},{id:"sec_5_2",title:"4.2 Key findings of the NFHS-5",level:"2"},{id:"sec_6_2",title:"4.3 Related indicators",level:"2"},{id:"sec_7_2",title:"4.4 The status of child mortality in India",level:"2"},{id:"sec_9",title:"5. An initiative taken by the Indian government to tackle hidden hunger",level:"1"},{id:"sec_9_2",title:"5.1 Direct policy measures",level:"2"},{id:"sec_9_3",title:"5.1.1 Integrated child development services (ICDS)",level:"3"},{id:"sec_10_3",title:"5.1.2 Mid-day meal scheme",level:"3"},{id:"sec_11_3",title:"5.1.3 National Health Mission",level:"3"},{id:"sec_12_3",title:"5.1.4 Rajiv Gandhi schemes for the empowerment of adolescent girls (RGSEAG)",level:"3"},{id:"sec_13_3",title:"5.1.5 Indira Gandhi Matritva Sahyog Yojna (IGMSY) (a conditional maternity benefit scheme)",level:"3"},{id:"sec_14_3",title:"5.1.6 Mission for integrated development of horticulture schemes",level:"3"},{id:"sec_15_3",title:"5.1.7 National Food Security Mission",level:"3"},{id:"sec_16_3",title:"5.1.8 The mahatma Gandhi National Rural Employment Guarantee Scheme (MGNEREGS)",level:"3"},{id:"sec_17_3",title:"5.1.9 Swachh Bharat Abhiyan",level:"3"},{id:"sec_18_3",title:"5.1.10 The National Rural Drinking Water Program",level:"3"},{id:"sec_19_3",title:"5.1.11 Eat right India campaign",level:"3"},{id:"sec_20_3",title:"5.1.12 Poshan Abhiyan",level:"3"},{id:"sec_21_3",title:"5.1.13 Pradhan Mantri Matru Vandana Yojana",level:"3"},{id:"sec_22_3",title:"5.1.14 National Food Security act",level:"3"},{id:"sec_23_3",title:"5.1.15 Mission Indradhanush",level:"3"},{id:"sec_25_2",title:"5.2 Indirect policy measures",level:"2"},{id:"sec_27",title:"6. Eradicating micronutrient deficiencies: Approaches based on food",level:"1"},{id:"sec_27_2",title:"6.1 Supplementation",level:"2"},{id:"sec_28_2",title:"6.2 Fortification",level:"2"},{id:"sec_28_3",title:"6.2.1 Need of food fortification",level:"3"},{id:"sec_29_3",title:"6.2.2 Benefits of food fortification",level:"3"},{id:"sec_30_3",title:"6.2.3 Fortified foods",level:"3"},{id:"sec_32_2",title:"6.3 Biofortification",level:"2"},{id:"sec_33_2",title:"6.4 Dietary diversification",level:"2"},{id:"sec_34_2",title:"6.5 Community-based interventions for micronutrient status improvement",level:"2"},{id:"sec_36",title:"7. Conclusions",level:"1"},{id:"sec_37",title:"Acknowledgments",level:"1"},{id:"sec_40",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Adeyeye SA, Ashaolu TJ, Bolaji OT, Abegunde TA, Omoyajowo AO. Africa and the Nexus of poverty, malnutrition and diseases. Critical Reviews in Food Science and Nutrition. 2021;5:1-6'},{id:"B2",body:'Naveed M. et al. Biofortification of cereals with zinc and iron: Recent advances and future perspectives. In: Kumar S, Meena RS, Jhariya MK, editors. Resources Use Efficiency in Agriculture. Singapore: Springer; 2020. DOI: 10.1007/978-981-15-6953-1_17'},{id:"B3",body:'Adegboye AR, Bawa M, Keith R, Twefik S, Tewfik I. Edible insects: Sustainable nutrient-rich foods to tackle food insecurity and malnutrition. World Nutrition. 2021;12:176-189'},{id:"B4",body:'Christian AK, Dake FA. Profiling household double and triple burden of malnutrition in sub-Saharan Africa: Prevalence and influencing household factors. Public Health Nutrition. 2021;26:1-4'},{id:"B5",body:'Wim M, Ulimwengu JM, Sall LM, Adama G, Kimseyinga S, Khadim D. Hidden Hunger: Understanding Dietary Adequacy in Urban and Rural Food Consumption in Senegal. IFPRI Discussion Paper 2036. Washington, DC: International Food Policy Research Institute (IFPRI); 2021. 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Retention of provitamin a carotenoids in staple crops targeted for biofortification in Africa: Cassava, maize and sweet potato. Critical Reviews in Food Science and Nutrition. 2015;55:1246-1269'},{id:"B31",body:'Thompson B, Amoroso L, editors. Combating Micronutrient Deficiencies: Food-Based Approaches. Rome: FAO; 2010'},{id:"B32",body:'Arimond M, Ruel MT. Dietary diversity is associated with child nutritional status: Evidence from 11 demographic and health surveys. The Journal of Nutrition. 2004;134:2579-2585'},{id:"B33",body:'FAO Report 2013. Rome: The State of Food and Agriculture; 2013'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Latika Yadav",address:"drlatika27@gmail.com",affiliation:'
Institute of Home Science, Bundelkhand University, India
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PrPC is a metal‐binding protein that is located in the synapse and possesses the ability to bind to various metals, including Cu, Zn, Mn and Fe. Moreover, increasing evidence suggests that PrPC plays essential roles in the maintenance of metal homeostasis in the synapse. Trace elements have a crucial influence on the conformational change of PrPC. Given that other disease‐related proteins such as β‐amyloid protein and its precursor protein (APP) in Alzheimer's disease also exist in the synapse and possess a metal‐binding ability, an interaction between PrP and metals and between PrP and APP, may occur in the synapse; the resulting metal homeostasis may lead to the pathogenesis of prion diseases. 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Management of N and P pollution includes reduction of leaching from farms through crop selection, timely and precise application of fertilizer and building artificial wetlands, proper management of animal waste, reduction of fossil fuel N emission, mitigating N and P from urban sources and restoration of aquatic ecosystem. Mitigation measures need to focus on dual nutrient strategy for successful N and P reduction.",book:{id:"7547",slug:"monitoring-of-marine-pollution",title:"Monitoring of Marine Pollution",fullTitle:"Monitoring of Marine Pollution"},signatures:"Lucy Ngatia, Johnny M. 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Increasing concerns about pollution levels in the oceans and coastal regions have led to multiple approaches for measuring and mitigating marine pollution, in order to achieve sustainable marine water quality. Satellite remote sensing, covering large and remote areas, is considered useful for detecting and monitoring marine pollution. Recent developments in sensor technologies have transformed remote sensing into an effective means of monitoring marine areas. Different remote sensing platforms and sensors have their own capabilities for mapping and monitoring water pollution of different types, characteristics, and concentrations. This chapter will discuss and elaborate the merits and limitations of these remote sensing techniques for mapping oil pollutants, suspended solid concentrations, algal blooms, and floating plastic waste in marine waters.",book:{id:"7547",slug:"monitoring-of-marine-pollution",title:"Monitoring of Marine Pollution",fullTitle:"Monitoring of Marine Pollution"},signatures:"Sidrah Hafeez, Man Sing Wong, Sawaid Abbas, Coco Y. T. Kwok,\nJanet Nichol, Kwon Ho Lee, Danling Tang and Lilian Pun",authors:[{id:"225316",title:"Dr.",name:"Sawaid",middleName:null,surname:"Abbas",slug:"sawaid-abbas",fullName:"Sawaid Abbas"},{id:"259861",title:"Ms.",name:"Sidrah",middleName:null,surname:"Hafeez",slug:"sidrah-hafeez",fullName:"Sidrah Hafeez"},{id:"259890",title:"Prof.",name:"Man Sing",middleName:null,surname:"Wong",slug:"man-sing-wong",fullName:"Man Sing Wong"}]},{id:"35057",doi:"10.5772/33720",title:"Surface Water Quality Monitoring in Nigeria: Situational Analysis and Future Management Strategy",slug:"surface-water-quality-monitoring-in-nigeria-situational-analysis-and-future-management-strategy",totalDownloads:13275,totalCrossrefCites:14,totalDimensionsCites:27,abstract:null,book:{id:"1998",slug:"water-quality-monitoring-and-assessment",title:"Water Quality",fullTitle:"Water Quality Monitoring and Assessment"},signatures:"A.M. Taiwo, O.O. Olujimi, O. Bamgbose and T.A. Arowolo",authors:[{id:"96826",title:"Prof.",name:"Toyin",middleName:null,surname:"Arowolo",slug:"toyin-arowolo",fullName:"Toyin Arowolo"},{id:"138905",title:"Mr.",name:"Adewale Mathew",middleName:null,surname:"Taiwo",slug:"adewale-mathew-taiwo",fullName:"Adewale Mathew Taiwo"},{id:"138908",title:"Mr.",name:"Olanrewaju Olusoji",middleName:null,surname:"Olujimi",slug:"olanrewaju-olusoji-olujimi",fullName:"Olanrewaju Olusoji Olujimi"},{id:"138915",title:"Prof.",name:"Olukayode",middleName:null,surname:"Bamgbose",slug:"olukayode-bamgbose",fullName:"Olukayode Bamgbose"}]},{id:"17390",doi:"10.5772/17734",title:"Spatial Interpolation Methodologies in Urban Air Pollution Modeling: Application for the Greater Area of Metropolitan Athens, Greece",slug:"spatial-interpolation-methodologies-in-urban-air-pollution-modeling-application-for-the-greater-area",totalDownloads:3563,totalCrossrefCites:11,totalDimensionsCites:26,abstract:null,book:{id:"193",slug:"advanced-air-pollution",title:"Advanced Air Pollution",fullTitle:"Advanced Air Pollution"},signatures:"Despina Deligiorgi and Kostas Philippopoulos",authors:[{id:"29291",title:"Prof.",name:"Despina",middleName:null,surname:"Deligiorgi",slug:"despina-deligiorgi",fullName:"Despina Deligiorgi"},{id:"38634",title:"MSc.",name:"Kostas",middleName:null,surname:"Philippopoulos",slug:"kostas-philippopoulos",fullName:"Kostas Philippopoulos"}]}],mostDownloadedChaptersLast30Days:[{id:"64603",title:"Detection and Monitoring of Marine Pollution Using Remote Sensing Technologies",slug:"detection-and-monitoring-of-marine-pollution-using-remote-sensing-technologies",totalDownloads:4539,totalCrossrefCites:16,totalDimensionsCites:29,abstract:"Recently, the marine habitat has been under pollution threat, which impacts many human activities as well as human life. Increasing concerns about pollution levels in the oceans and coastal regions have led to multiple approaches for measuring and mitigating marine pollution, in order to achieve sustainable marine water quality. Satellite remote sensing, covering large and remote areas, is considered useful for detecting and monitoring marine pollution. Recent developments in sensor technologies have transformed remote sensing into an effective means of monitoring marine areas. Different remote sensing platforms and sensors have their own capabilities for mapping and monitoring water pollution of different types, characteristics, and concentrations. This chapter will discuss and elaborate the merits and limitations of these remote sensing techniques for mapping oil pollutants, suspended solid concentrations, algal blooms, and floating plastic waste in marine waters.",book:{id:"7547",slug:"monitoring-of-marine-pollution",title:"Monitoring of Marine Pollution",fullTitle:"Monitoring of Marine Pollution"},signatures:"Sidrah Hafeez, Man Sing Wong, Sawaid Abbas, Coco Y. T. 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In this chapter, a broad overview of recent empirical statistical and machine learning techniques for modelling PM10 is presented. This includes the instrumentation used to measure particulate matter, data preprocessing, the selection of explanatory variables and modelling methods. Key features of some PM10 prediction models developed in the last 10 years are described, and current work modelling and predicting PM10 trends in New Zealand—a remote country of islands in the South Pacific Ocean—are examined. In conclusion, the issues and challenges faced when modelling PM10 are discussed and suggestions for future avenues of investigation, which could improve the precision of PM10 prediction and estimation models are presented.",book:{id:"5356",slug:"air-quality-measurement-and-modeling",title:"Air Quality",fullTitle:"Air Quality - Measurement and Modeling"},signatures:"Jacqueline Whalley and Sara Zandi",authors:[{id:"188593",title:"Associate Prof.",name:"Jacqueline",middleName:null,surname:"Whalley",slug:"jacqueline-whalley",fullName:"Jacqueline Whalley"},{id:"188594",title:"Ms.",name:"Sara",middleName:null,surname:"Zandi",slug:"sara-zandi",fullName:"Sara Zandi"}]},{id:"72766",title:"Industrial Air Emission Pollution: Potential Sources and Sustainable Mitigation",slug:"industrial-air-emission-pollution-potential-sources-and-sustainable-mitigation",totalDownloads:989,totalCrossrefCites:5,totalDimensionsCites:7,abstract:"Air of cities especially in the developing parts of the world is turning into a serious environmental interest. The air pollution is because of a complex interaction of dispersion and emission of toxic pollutants from manufactories. Air pollution caused due to the introduction of dust particles, gases, and smoke into the atmosphere exceeds the air quality levels. Air pollutants are the precursor of photochemical smog and acid rain that causes the asthmatic problems leading into serious illness of lung cancer, depletes the stratospheric ozone, and contributes in global warming. In the present industrial economy era, air pollution is an unavoidable product that cannot be completely removed but stern actions can reduce it. Pollution can be reduced through collective as well as individual contributions. There are multiple sources of air pollution, which are industries, fossil fuels, agro waste, and vehicular emissions. Industrial processes upgradation, energy efficiency, agricultural waste burning control, and fuel conversion are important aspects to reducing pollutants which create the industrial air pollution. Mitigations are necessary to reduce the threat of air pollution using the various applicable technologies like CO2 sequestering, industrial energy efficiency, improving the combustion processes of the vehicular engines, and reducing the gas production from agriculture cultivations.",book:{id:"10178",slug:"environmental-emissions",title:"Environmental Emissions",fullTitle:"Environmental Emissions"},signatures:"Rabia Munsif, Muhammad Zubair, Ayesha Aziz and Muhammad Nadeem Zafar",authors:[{id:"251787",title:"Dr.",name:"Muhammad",middleName:null,surname:"Zubair",slug:"muhammad-zubair",fullName:"Muhammad Zubair"},{id:"318519",title:"Ms.",name:"Rabia",middleName:"Jathol",surname:"Munsif",slug:"rabia-munsif",fullName:"Rabia Munsif"},{id:"320637",title:"Ms.",name:"Ayesha",middleName:null,surname:"Aziz",slug:"ayesha-aziz",fullName:"Ayesha Aziz"},{id:"320675",title:"Dr.",name:"Muhammad Nadeem",middleName:null,surname:"Zafar",slug:"muhammad-nadeem-zafar",fullName:"Muhammad Nadeem Zafar"}]},{id:"48090",title:"Biological Contamination of Air in Indoor Spaces",slug:"biological-contamination-of-air-in-indoor-spaces",totalDownloads:2791,totalCrossrefCites:6,totalDimensionsCites:9,abstract:null,book:{id:"4572",slug:"current-air-quality-issues",title:"Current Air Quality Issues",fullTitle:"Current Air Quality Issues"},signatures:"Anca Maria Moldoveanu",authors:[{id:"25924",title:"Prof.",name:"Anca",middleName:"Maria",surname:"Moldoveanu",slug:"anca-moldoveanu",fullName:"Anca Moldoveanu"}]},{id:"64537",title:"Degradation Pathways of Persistent Organic Pollutants (POPs) in the Environment",slug:"degradation-pathways-of-persistent-organic-pollutants-pops-in-the-environment",totalDownloads:2119,totalCrossrefCites:8,totalDimensionsCites:20,abstract:"Persistent organic pollutants (POPs) are resistant to most of the known environmental degradation processes. Because of their persistence, POPs bioaccumulate in animal tissues and biomagnify along food chains and food webs with potential adverse impacts on human and wildlife health and the environment. Although POPs are resistant to most of the environmental degradation processes, there are some environmental processes mostly microbial degradation that can degrade POPs to other forms that are not necessarily simpler and less toxic. The Stockholm Convention on Persistent Organic Pollutants adopted in 2001 was meant to restrict the production and use of these toxic chemicals in the environment.",book:{id:"7224",slug:"persistent-organic-pollutants",title:"Persistent Organic Pollutants",fullTitle:"Persistent Organic Pollutants"},signatures:"James T. Zacharia",authors:[{id:"28551",title:"Dr.",name:"James T.",middleName:null,surname:"Zacharia",slug:"james-t.-zacharia",fullName:"James T. 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\r\n\tScientists have long researched to understand the environment and man’s place in it. The search for this knowledge grows in importance as rapid increases in population and economic development intensify humans’ stresses on ecosystems. Fortunately, rapid increases in multiple scientific areas are advancing our understanding of environmental sciences. Breakthroughs in computing, molecular biology, ecology, and sustainability science are enhancing our ability to utilize environmental sciences to address real-world problems. \r\n\tThe four topics of this book series - Pollution; Environmental Resilience and Management; Ecosystems and Biodiversity; and Water Science - will address important areas of advancement in the environmental sciences. They will represent an excellent initial grouping of published works on these critical topics.
",coverUrl:"https://cdn.intechopen.com/series/covers/25.jpg",latestPublicationDate:"August 8th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:1,editor:{id:"197485",title:"Dr.",name:"J. Kevin",middleName:null,surname:"Summers",slug:"j.-kevin-summers",fullName:"J. Kevin Summers",profilePictureURL:"https://mts.intechopen.com/storage/users/197485/images/system/197485.jpg",biography:"J. Kevin Summers is a Senior Research Ecologist at the Environmental Protection Agency’s (EPA) Gulf Ecosystem Measurement and Modeling Division. He is currently working with colleagues in the Sustainable and Healthy Communities Program to develop an index of community resilience to natural hazards, an index of human well-being that can be linked to changes in the ecosystem, social and economic services, and a community sustainability tool for communities with populations under 40,000. He leads research efforts for indicator and indices development. Dr. Summers is a systems ecologist and began his career at the EPA in 1989 and has worked in various programs and capacities. This includes leading the National Coastal Assessment in collaboration with the Office of Water which culminated in the award-winning National Coastal Condition Report series (four volumes between 2001 and 2012), and which integrates water quality, sediment quality, habitat, and biological data to assess the ecosystem condition of the United States estuaries. He was acting National Program Director for Ecology for the EPA between 2004 and 2006. He has authored approximately 150 peer-reviewed journal articles, book chapters, and reports and has received many awards for technical accomplishments from the EPA and from outside of the agency. Dr. Summers holds a BA in Zoology and Psychology, an MA in Ecology, and Ph.D. in Systems Ecology/Biology.",institutionString:null,institution:{name:"Environmental Protection Agency",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"38",title:"Pollution",coverUrl:"https://cdn.intechopen.com/series_topics/covers/38.jpg",isOpenForSubmission:!0,editor:{id:"110740",title:"Dr.",name:"Ismail M.M.",middleName:null,surname:"Rahman",slug:"ismail-m.m.-rahman",fullName:"Ismail M.M. Rahman",profilePictureURL:"https://mts.intechopen.com/storage/users/110740/images/2319_n.jpg",biography:"Ismail Md. Mofizur Rahman (Ismail M. M. Rahman) assumed his current responsibilities as an Associate Professor at the Institute of Environmental Radioactivity, Fukushima University, Japan, in Oct 2015. He also has an honorary appointment to serve as a Collaborative Professor at Kanazawa University, Japan, from Mar 2015 to the present. \nFormerly, Dr. Rahman was a faculty member of the University of Chittagong, Bangladesh, affiliated with the Department of Chemistry (Oct 2002 to Mar 2012) and the Department of Applied Chemistry and Chemical Engineering (Mar 2012 to Sep 2015). Dr. Rahman was also adjunctly attached with Kanazawa University, Japan (Visiting Research Professor, Dec 2014 to Mar 2015; JSPS Postdoctoral Research Fellow, Apr 2012 to Mar 2014), and Tokyo Institute of Technology, Japan (TokyoTech-UNESCO Research Fellow, Oct 2004–Sep 2005). \nHe received his Ph.D. degree in Environmental Analytical Chemistry from Kanazawa University, Japan (2011). He also achieved a Diploma in Environment from the Tokyo Institute of Technology, Japan (2005). 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is a Professor of Statistics and Dean of the School of Mathematics and Statistics, Yunnan University, China. He was elected a Yangtze River Scholars Distinguished Professor in 2013, a member of the International Statistical Institute (ISI) in 2016, a member of the board of the International Chinese Statistical Association (ICSA) in 2018, and a fellow of the Institute of Mathematical Statistics (IMS) in 2021. He received the ICSA Outstanding Service Award in 2018 and the National Science Foundation for Distinguished Young Scholars of China in 2012. He serves as a member of the editorial board of Statistics and Its Interface and Journal of Systems Science and Complexity. He is also a field editor for Communications in Mathematics and Statistics. His research interests include biostatistics, empirical likelihood, missing data analysis, variable selection, high-dimensional data analysis, Bayesian statistics, and data science. He has published more than 190 research papers and authored five books.",institutionString:"Yunnan University",institution:{name:"Yunnan University",country:{name:"China"}}},{id:"1177",title:"Prof.",name:"António",middleName:"J. R.",surname:"José Ribeiro Neves",slug:"antonio-jose-ribeiro-neves",fullName:"António José Ribeiro Neves",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1177/images/system/1177.jpg",biography:"Prof. António J. R. Neves received a Ph.D. in Electrical Engineering from the University of Aveiro, Portugal, in 2007. Since 2002, he has been a researcher at the Institute of Electronics and Informatics Engineering of Aveiro. Since 2007, he has been an assistant professor in the Department of Electronics, Telecommunications, and Informatics, University of Aveiro. He is the director of the undergraduate course on Electrical and Computers Engineering and the vice-director of the master’s degree in Electronics and Telecommunications Engineering. He is an IEEE Senior Member and a member of several other research organizations worldwide. His main research interests are computer vision, intelligent systems, robotics, and image and video processing. He has participated in or coordinated several research projects and received more than thirty-five awards. He has 161 publications to his credit, including books, book chapters, journal articles, and conference papers. He has vast experience as a reviewer of several journals and conferences. As a professor, Dr. Neves has supervised several Ph.D. and master’s students and was involved in more than twenty-five different courses.",institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"11317",title:"Dr.",name:"Francisco",middleName:null,surname:"Javier Gallegos-Funes",slug:"francisco-javier-gallegos-funes",fullName:"Francisco Javier Gallegos-Funes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/11317/images/system/11317.png",biography:"Francisco J. Gallegos-Funes received his Ph.D. in Communications and Electronics from the Instituto Politécnico Nacional de México (National Polytechnic Institute of Mexico) in 2003. He is currently an associate professor in the Escuela Superior de Ingeniería Mecánica y Eléctrica (Mechanical and Electrical Engineering Higher School) at the same institute. His areas of scientific interest are signal and image processing, filtering, steganography, segmentation, pattern recognition, biomedical signal processing, sensors, and real-time applications.",institutionString:"Instituto Politécnico Nacional",institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"428449",title:"Dr.",name:"Ronaldo",middleName:null,surname:"Ferreira",slug:"ronaldo-ferreira",fullName:"Ronaldo Ferreira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428449/images/21449_n.png",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. 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In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},subseries:[{id:"3",title:"Bacterial Infectious Diseases",keywords:"Antibiotics, Biofilm, Antibiotic Resistance, Host-microbiota Relationship, Treatment, Diagnostic Tools",scope:"
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\r\n
\r\n\tThis topic will focus on the current challenges and advantages in the diagnosis and treatment of bacterial infections. We will discuss the host-microbiota relationship, the treatment of chronic infections due to biofilm formation, and the development of new diagnostic tools to rapidly distinguish between colonization and probable infection.
",annualVolume:11399,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",editor:{id:"205604",title:"Dr.",name:"Tomas",middleName:null,surname:"Jarzembowski",fullName:"Tomas Jarzembowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKriQAG/Profile_Picture_2022-06-16T11:01:31.jpg",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorTwo:{id:"484980",title:"Dr.",name:"Katarzyna",middleName:null,surname:"Garbacz",fullName:"Katarzyna Garbacz",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003St8TAQAZ/Profile_Picture_2022-07-07T09:45:16.jpg",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorThree:null,editorialBoard:[{id:"190041",title:"Dr.",name:"Jose",middleName:null,surname:"Gutierrez Fernandez",fullName:"Jose Gutierrez Fernandez",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institutionString:null,institution:{name:"University of Granada",institutionURL:null,country:{name:"Spain"}}},{id:"156556",title:"Prof.",name:"Maria Teresa",middleName:null,surname:"Mascellino",fullName:"Maria Teresa Mascellino",profilePictureURL:"https://mts.intechopen.com/storage/users/156556/images/system/156556.jpg",institutionString:"Sapienza University",institution:{name:"Sapienza University of Rome",institutionURL:null,country:{name:"Italy"}}},{id:"164933",title:"Prof.",name:"Mónica Alexandra",middleName:null,surname:"Sousa Oleastro",fullName:"Mónica Alexandra Sousa Oleastro",profilePictureURL:"https://mts.intechopen.com/storage/users/164933/images/system/164933.jpeg",institutionString:"National Institute of Health Dr Ricardo Jorge",institution:{name:"National Institute of Health Dr. Ricardo Jorge",institutionURL:null,country:{name:"Portugal"}}}]},{id:"4",title:"Fungal Infectious Diseases",keywords:"Emerging Fungal Pathogens, Invasive Infections, Epidemiology, Cell Membrane, Fungal Virulence, Diagnosis, Treatment",scope:"Fungi are ubiquitous and there are almost no non-pathogenic fungi. Fungal infectious illness prevalence and prognosis are determined by the exposure between fungi and host, host immunological state, fungal virulence, and early and accurate diagnosis and treatment. \r\nPatients with both congenital and acquired immunodeficiency are more likely to be infected with opportunistic mycosis. Fungal infectious disease outbreaks are common during the post- disaster rebuilding era, which is characterised by high population density, migration, and poor health and medical conditions.\r\nSystemic or local fungal infection is mainly associated with the fungi directly inhaled or inoculated in the environment during the disaster. The most common fungal infection pathways are human to human (anthropophilic), animal to human (zoophilic), and environment to human (soilophile). Diseases are common as a result of widespread exposure to pathogenic fungus dispersed into the environment. \r\nFungi that are both common and emerging are intertwined. In Southeast Asia, for example, Talaromyces marneffei is an important pathogenic thermally dimorphic fungus that causes systemic mycosis. Widespread fungal infections with complicated and variable clinical manifestations, such as Candida auris infection resistant to several antifungal medicines, Covid-19 associated with Trichoderma, and terbinafine resistant dermatophytosis in India, are among the most serious disorders. \r\nInappropriate local or systemic use of glucocorticoids, as well as their immunosuppressive effects, may lead to changes in fungal infection spectrum and clinical characteristics. Hematogenous candidiasis is a worrisome issue that affects people all over the world, particularly ICU patients. CARD9 deficiency and fungal infection have been major issues in recent years. Invasive aspergillosis is associated with a significant death rate. Special attention should be given to endemic fungal infections, identification of important clinical fungal infections advanced in yeasts, filamentous fungal infections, skin mycobiome and fungal genomes, and immunity to fungal infections.\r\nIn addition, endemic fungal diseases or uncommon fungal infections caused by Mucor irregularis, dermatophytosis, Malassezia, cryptococcosis, chromoblastomycosis, coccidiosis, blastomycosis, histoplasmosis, sporotrichosis, and other fungi, should be monitored. \r\nThis topic includes the research progress on the etiology and pathogenesis of fungal infections, new methods of isolation and identification, rapid detection, drug sensitivity testing, new antifungal drugs, schemes and case series reports. It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",annualVolume:11400,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",institutionString:null,institution:{name:"Sichuan University",institutionURL:null,country:{name:"China"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"302145",title:"Dr.",name:"Felix",middleName:null,surname:"Bongomin",fullName:"Felix Bongomin",profilePictureURL:"https://mts.intechopen.com/storage/users/302145/images/system/302145.jpg",institutionString:null,institution:{name:"Gulu University",institutionURL:null,country:{name:"Uganda"}}},{id:"45803",title:"Ph.D.",name:"Payam",middleName:null,surname:"Behzadi",fullName:"Payam Behzadi",profilePictureURL:"https://mts.intechopen.com/storage/users/45803/images/system/45803.jpg",institutionString:"Islamic Azad University, Tehran",institution:{name:"Islamic Azad University, Tehran",institutionURL:null,country:{name:"Iran"}}}]},{id:"5",title:"Parasitic Infectious Diseases",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",annualVolume:11401,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",editor:{id:"67907",title:"Dr.",name:"Amidou",middleName:null,surname:"Samie",fullName:"Amidou Samie",profilePictureURL:"https://mts.intechopen.com/storage/users/67907/images/system/67907.jpg",institutionString:null,institution:{name:"University of Venda",institutionURL:null,country:{name:"South Africa"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"188881",title:"Dr.",name:"Fernando José",middleName:null,surname:"Andrade-Narváez",fullName:"Fernando José Andrade-Narváez",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRIV7QAO/Profile_Picture_1628834308121",institutionString:null,institution:{name:"Autonomous University of Yucatán",institutionURL:null,country:{name:"Mexico"}}},{id:"269120",title:"Dr.",name:"Rajeev",middleName:"K.",surname:"Tyagi",fullName:"Rajeev Tyagi",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRaBqQAK/Profile_Picture_1644331884726",institutionString:"CSIR - Institute of Microbial Technology, India",institution:null},{id:"336849",title:"Prof.",name:"Ricardo",middleName:null,surname:"Izurieta",fullName:"Ricardo Izurieta",profilePictureURL:"https://mts.intechopen.com/storage/users/293169/images/system/293169.png",institutionString:null,institution:{name:"University of South Florida",institutionURL:null,country:{name:"United States of America"}}}]},{id:"6",title:"Viral Infectious Diseases",keywords:"Novel Viruses, Virus Transmission, Virus Evolution, Molecular Virology, Control and Prevention, Virus-host Interaction",scope:"The Viral Infectious Diseases Book Series aims to provide a comprehensive overview of recent research trends and discoveries in various viral infectious diseases emerging around the globe. The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. This series will focus on various crucial factors related to emerging viral infectious diseases, including epidemiology, pathogenesis, host immune response, clinical manifestations, diagnosis, treatment, and clinical recommendations for managing viral infectious diseases, highlighting the recent issues with future directions for effective therapeutic strategies.",annualVolume:11402,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",editor:{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",institutionURL:null,country:{name:"India"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",fullName:"Emmanuel Drouet",profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",institutionString:null,institution:{name:"Grenoble Alpes University",institutionURL:null,country:{name:"France"}}},{id:"188219",title:"Prof.",name:"Imran",middleName:null,surname:"Shahid",fullName:"Imran Shahid",profilePictureURL:"https://mts.intechopen.com/storage/users/188219/images/system/188219.jpeg",institutionString:null,institution:{name:"Umm al-Qura University",institutionURL:null,country:{name:"Saudi Arabia"}}},{id:"214235",title:"Dr.",name:"Lynn",middleName:"S.",surname:"Zijenah",fullName:"Lynn Zijenah",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSEJGQA4/Profile_Picture_1636699126852",institutionString:null,institution:{name:"University of Zimbabwe",institutionURL:null,country:{name:"Zimbabwe"}}},{id:"178641",title:"Dr.",name:"Samuel Ikwaras",middleName:null,surname:"Okware",fullName:"Samuel Ikwaras Okware",profilePictureURL:"https://mts.intechopen.com/storage/users/178641/images/system/178641.jpg",institutionString:null,institution:{name:"Uganda Christian University",institutionURL:null,country:{name:"Uganda"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"profile.detail",path:"/profiles/195993",hash:"",query:{},params:{id:"195993"},fullPath:"/profiles/195993",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()