Tibetan Children’s Village

SummaryBackgroundExisting Tuberculosis (TB) elimination strategies show limited impact, with suboptimal uptake of tuberculosis preventive treatment (TPT) and increasing TB incidence after the COVID-19 pandemic. Real-world evidence on reduction of tuberculosis in high-burden communities is needed to inform future TB elimination strategies.MethodsSince 2017, a comprehensive TB screening and TPT program known as Zero TB in Kids (ZTBK) was implemented in congregate settings of Tibetan communities in India. TB disease, TB infection (TBI), tuberculin skin test (TST) conversion, and TPT uptake were measured periodically.FindingsSchoolchildren and adults in 63 institutes (n = 20,068; 67,637 person-years) were screened. TPT was given to 3847 participants. TB incidence decreased 83% between 2017 [576 (95% CI: 455–718)/100,000] and 2024 [97 (47–179)/100,000]. TB infection (TBI) prevalence decreased 32% between 2017 [22% (95% CI: 21–23%)] and 2024 [15.5% (14–17%)]. TB incidence (640/100,000) and TBI prevalence (28%) were higher in the institutes that were never screened before under ZTBK. Among participants who did not receive TPT, TB disease prevalence decreased 84% between 2017 [910 (95% CI: 675–1204)/100,000] and 2024 [147 (48–343)/100,000], indicating a herd benefit. After one round of TB screening and TPT, between 2018 and 2019, TST conversion decreased 59% for children and 47% for adolescents. Risk of TBI was greater for males (aPR: 1.23; 95% CI: 1.16–1.30). TB risk was 82% lower for schoolchildren receiving TPT. Participants with seizure disorder [aPR: 0.31 (95% CI: 0.15–0.65)] and hepatitis B [0.71 (0.6–0.84)] were less likely to receive TPT.InterpretationSignificant reduction of TB transmission and burden can be achieved using the existing tools of TB control. Surveillance of TBI and TPT must be widely adopted for schools and congregate settings with high TB burden.Funding10.13039/100000002National Institutes of Health-10.13039/100000060National Institute of Allergy and Infectious Diseases (NIAID) (K01-AI148583), STOP TB Partnership (STBP/TBREACH/GSA/W7-7692), NIAID-Johns Hopkins Center for AIDS Research (90100777), Foundations, and Philanthropy.

This study explored the responsiveness of Technical Education, Vocational and Entrepreneurship Training (TEVET) curriculum adaptations for students with Visual Impairment (VI) in Zambian institutions. Grounded in the Social Model of Disability and the Universal Design for Learning (UDL) framework, the research investigated how current Findings reveal that while localized adaptations such as strategic seating, task analysis, and improvised tactile materials are practiced, they are largely driven by individual lecturer initiative rather than systemic policy. Implementation is significantly hindered by a "Disability Gap" characterized by unsuitable infrastructure, a critical shortage of standardized assistive technology, and rigid academic timelines that fail to account for non-visual processing. The study concludes that for TEVET in Zambia to be truly responsive, there must be a transition from adhoc improvisations to formalized, well-funded inclusive standards. Key recommendations include the establishment of a National TEVET Inclusive Resource Fund, mandatory inclusive pedagogy training for instructors, and the adoption of competency-based modularization to provide the temporal flexibility required by learners with VI.

As climate change intensifies water scarcity, sustainable strategies are essential for vegetable production under water-limited conditions. This study evaluates the potential of grafted eggplant onto wild rootstocks under deficit irrigation (DI) to enhance growth, yield, and water productivity (WP). A two-year field experiment in semi-arid regions of India investigated the effects of three DI levels (100, 80, and 60% ETc) in the main plot and five graft combinations (SUR/GIL, SUR/IND, SUR/MAC, SUR/SIS, and SUR/TOR), along with a non-grafted variety Suraj in the subplot, with three replications. The data were analysed using individual and pooled analysis of variance based on a split-plot design. The results showed that fruit yield declined with reduced irrigation across all graft combinations, including the non-grafted control. However, graft combinations with drought-tolerant wild rootstocks, particularly SUR/SIS and SUR/TOR, consistently outperformed non-grafted Suraj under optimal (100% ETc) and deficit irrigation (60% ETc). Under 60% ETc, SUR/SIS recorded the highest yield, with only a 14% reduction compared to 100% ETc, followed by SUR/TOR with a 19% reduction, while non-grafted Suraj showed the highest reduction of up to 25%. WP was highest at 60% ETc, with SUR/SIS achieving 9.47 kg m⁻3 (41% higher) and SUR/TOR reaching 8.22 kg m⁻3 (22% higher) than non-grafted Suraj (6.72 kg m⁻3). The enhanced yield and WP under DI in grafted plants were attributed to superior growth, improved soil–plant water balance, sustained PSII efficiency, and enhanced antioxidative defence mechanisms. Grafting also enhanced fruit quality traits such as length, diameter, total soluble solids, and firmness. Therefore, integrating DI with grafting onto S. sisymbriifolium and S. torvum rootstocks offers a sustainable strategy to enhance yield and WP of eggplant in semi-arid regions. This strategy can be adapted to other fruiting vegetable crops in semi-arid regions to broaden its applicability under changing climatic conditions.

As a result of ongoing political tensions within Tibetan regions of the People's Republic of China, several thousand Tibetans escape across the Himalayas every year to seek refuge in India and Nepal. Prior studies have found a high prevalence of depressive and anxiety symptoms in these refugees, many of whom are young and have been exposed to significant trauma. However, it is not known whether depressive and anxiety symptoms are more prevalent in these refugees than in ethnic Tibetans born and raised in the relative political and social stability of exile communities in North India and Nepal. We conducted a cross-sectional survey of a convenience sample of 319 students attending school at the Tibetan Children's Villages in Northern India to test the a priori hypothesis that adolescents and young adults who escaped from Tibet to India would demonstrate increased depressive and anxiety symptoms when compared to ethnic Tibetans born and raised in exile. The Hopkins Symptom Checklist-25 (HSCL-25) was used to measure depressive and anxiety symptoms. In addition, demographic information on age, sex, country of birth and frequency of family contact was collected. Students born in Tibet had higher mean HSCL-25 depressive and anxiety symptom scores than did ethnic Tibetans born in exile. Female students demonstrated higher depressive and anxiety scores, as did those with limited contact with immediate family. After adjusting for sex, age and frequency of family contact, being born in Tibet was associated with increased HSCL-25 depressive and anxiety symptom scores (depression: F[2, 316] = 29.96, P < 0.0001; anxiety: F[4, 316] = 43.57, P < 0.0001). The experience of being raised in Tibet and escaping to India appears to be a risk factor for increased depressive and anxiety symptoms when compared to being born and raised within an exile community in India or Nepal.