The health sector is very critical towards the right information on certain diseases. The critical input for policy decision making, it is essential to provide right source of information about the descriptive epidemiology of diseases, risk factors and liable source. There are thirteen Tropical Neglected Diseases as identified by World Health Organization (WHO) and are common infection condition among the world population. The statistics on Global Burden Disease casualties are becoming alarming day by day and year by year with new cases,even though, continued research are being taken by various institution at different level from all over World. Leishmaniasis is one of the Neglected Tropical Diseases becoming a challenge for medical science in about 98 countries of the World with a mortality rate of over 50,000 per year.Leishmaniasis, a parasitic disease, spread by the bite of female Phlebotomine Sandflies. There are three forms of the disease; cutaneous, mucocutaneous, or Visceral leishmaniasis; of which later has been estimated as most dangerous among all. It is sharing a 90% of prevalence across the globe but frequent in the population residing in the region of Bangladesh, Brazil, Ethiopia, India, Nepal, Saudi Arabia, Afghanistan and the Sudan.
The research focused on Neglected Tropical Disease across the globe has posed a quite challenge for everyone being medical practitioners or policy makers. World Health Organization report on the leishmaniasis is in alarming situation due to new cases in the region of East Africa (Ethiopia, Kenya, South Sudan and Sudan) have caused high morbidity and mortality due to Visceral leishmaniasis. Similarly, cutaneous Leishmaniasis have affected different parts Afghanistan and the Syrian Arab Republic.[6-7] Visceral leishmaniasis have affected about 67% Global Burden of Diseases in India, Bangladesh, Nepal.
Governmental and Non-Governmental agencies are playing a key role in elimination of the disease from the affected communities with the help of effective medication, vaccination and community services. Simultaneously, the medical practitioners are engaged in discovering the effective medication to control the disease. The scientists are working specially the countries of the most affected region to discover new medicine and treatment methods. These efforts are available as published literature and available as guiding path for future.
Various qualitative and quantitative assessment measures are being taken to analyze the research progress in scientific disciplines including leishmaniasis. In earlier days, the bibliometric studies were covering the different aspects of neglected tropical diseases such as Latin American studies[9-10]and social science research. But after 2011 onwards specific research were conducted related to leishmaniasis in general;[12-13] or for specific countries and region such as Iran,[14-15] Latin America, South America. The bibliometric study focusing India were reported in parasitic and neglected tropical disease;lymphatic filariasis; and other neglected tropical diseases such as Ascariasis/Toxocariasis, and Schistosomiasis. However, these literature does not reveal any study covering the research impact of India in the field of leishmaniasis. The objective of this study is analyze literature on leishmaniasis published from India and its research impact in terms of total publication compared with global output, productive institutions, productive authors, productive journals, international collaboration, most popular articles on qualitative parameters citation and Hirch-Index (h-index).
This study is undertaken on the publications on Leishmaniasis by Indian research community. The data is collected from SCOPUS multidisciplinary bibliographic database available over http://www.scopus.com/home.url. The SCOPUS is having hundred percent coverage of PubMed data. The Medical Subject Heading (MeSH) Terms “Leishmania”, “Leishmaniasis”, “Cutaneous Leishmaniasis”, “Mucocutaneous Leishmaniasis”, “Visceral leishmaniasis” available in the article title, abstract and keywords, has been used to retrieve bibliographic data and “India” was used for the country of affiliation of the author using following string for the period 1968 till 2017.
(TITLE‑ABS‑KEY(“Leishmania”) OR TITLE‑ABS‑KEY (“Leishmaniasis”) OR TITLE‑ABS‑KEY(“Kala Azar”) OR TITLE‑ABS‑KEY(“Kala-Azar”) OR TITLE‑ABS‑KEY (“Visceral leishmaniasis”) OR TITLE‑ABS‑KEY(“Cutaneous leishmaniasis”) OR TITLE‑ABS‑KEY(“Mucocutaneous leishmaniasis”) AND AFFIL (India)) AND PUBYEAR > 1967 AND PUBYEAR < 2018.
The research impact of publication was taken in terms of citation count. The citation study has been taken as the number of citations received by the articles in first year of its publication (C0) and till the year 2017 (C2017). For the international collaboration, each article published from India was manually analyzed to see the collaboration by Indian authors with International authors. In combination with the above string, separate search strategies have been adopted to retrieve the data for individual, institutional and journal output. Thus, the data obtained using the different search strategies has been subjected to data analysis and interpretation of results. Another quality indicator, h-Index, which quantify the individual quality of the author and Institution was obtained from the database. The data thus obtained from SCOPUS was analyzed for global output, Indian output, share of publication, productive country, productive Indian institute, productive Indian authors, journals publishing Indian articles, international collaboration by Indian authors, and most cited articles authored by Indian authors.
There were 39302 articles available in SCOPUS during 1968 till 2017 (50 Years) on Leishmaniasis. Out of these, 3391 articles were published by authors from India. Figure 1 shows the trends of growth of literature output published globally and India. The global output averaged at 6.19% annual growth rate while India achieved an annual average growth rate of 20.60% per year. Indian research on Leishmaniasis was in infancy state till 1987 (3.45% share) and adolescent up to 2007 (36.21% share) and matured thereafter (60.34% share) (Table 1). In case of the global publication, 44.64% literature were appeared the period of 2008-17 and in case of India, it was 60.34%. The period from 1978-1987 was highly productive in case of average percent growth rate when World literature growth was 127.94% and Indian literature growth was 357.14% than its previous period. For India, the highly productive year was 1979, 1999, and 2014. These high productive years for India were due to awareness and financial support from national and international organization participated in eradication program in India and South-East Asian region.[23-25]
Table 2 presents the distribution of 11 most productive countries on Leishmaniasis with more than two percent of global publications. The global publication ranges from 2.63% to 19.36%, where United States holds top rank with the highest number of publications (7609 papers; 19.36% share), followed by Brazil (6019 papers; 15.31% share) and United Kingdom (3548 papers; 9.03% share). India ranked fourth in terms of total publication (3391 papers; 8.64% share). France, Spain, Germany, Iran, Italy, Switzerland and Canada ranked from fifth to eleventh. The etiological evidence of Leishmaniasis in these countries ranges epidemics of the disease.
In terms of citation impact by these countries, the articles published from USA have accumulated highest number of citations (317646 citations) with an Average Citation Per Paper (ACPP) of 1.75 citations per paper. The articles published from United Kingdom had 1,39,870 citations with ACPP of 39.42 citations per paper and Brazil had 1,06,261 citations with an ACPP of 17.65 citations per paper. Articles published from Canada were most frequently cited and were more impactful with an ACPP of 44.99 citations per paper, followed by Switzerland (ACPP=43.59). Indian papers accumulated 69,985 citations and ranked fifth, with an ACPP of 20.61 citations.
The quality parameter used for benchmarking based on Hirsch Index, USA has highest value (h-Index=211) followed by United Kingdom (h-Index=149) and Germany (h-Index=110). The India has h-Index value of 93, which make it ranked eighth, higher than Spain, Italy and Iran.
In this study, it is found that there were ten Indian institutes, which had published hundred or more articles on various aspect of leishmaniasis during 1968‑2017. The publication performance of these ten Indian institutions was measured in terms of total publication, publication share, total citations, average citation per paper and h-Index is given in Table 3. It is found that these ten institutes had contributed 76.41% of total Indian publication on leishmaniasis. ‘Indian Institute of Chemical Biology, Kolkata’ topped the rank with 566 articles (16.69% share), followed by Banaras Hindu University Varanasi (419 publications; 12.36% share) and Central Drug Research Institute Lucknow (376 publications; 11.09% share). Other institutes ranked from 4th to 10th and the percent share of publication ranges from 9.73% to 3.04%.
These most productive Indian institutions have accumulated a total of 67,250 citations with an ACPP of 25.96 citations. The Banaras Hindu University was most impactful with highest citations (15,582 citations) with an ACPP of 37.19 citations per paper followed by Banaras Hindu University Institute of Medical Science with 12,420 citations (ACPP=37.64 citations) and Indian Institute of Chemical Biology Kolkata with 11,331 citations (ACPP=20.02 citations). However, the articles of All India Institute of Medical Science were most impactful with highest average citation paper among all. It had ACPP of 62.55 citations for it 154 publications cited by 9633 times. The impact of the research in terms of quality reflected by various parameters and h-Index is one of them.[28-29] The top three ranked institutions on parameter of h-Index were Banaras Hindu University Varanasi (h-Index=62), Banaras Hindu University Institute of Medical Science Varanasi (h-Index=54) and Indian Institute of Chemical Biology Kolkata (h-Index=49).
The 3391 articles were published by 19788 authors either singly or jointly with authors from national or international institutions. Table 4 presents the status of ten most productive Indian authors and their citation impact who have published more than one percent of Indian leishmaniasis articles during 1968-2017. It is found that these ten authors were associated with five Indian institutes where Rajendra Medical College and Hospital Patna, Central Drug Research Institute Lucknow and Indian Institute of Chemical Technology Kolkata have two authors and Banaras Hindu University Medical Science Varanasi, Jawahar Lal Nehru University Delhi and Vardhman Mahavir Medical College New Delhi have one author each. These ten authors have contributed 1304 articles, which was 38.45% share of cumulative total Indian output. Four authors had published more than hundred articles on Leishmaniasis. Of these most productive author, S. Sunder from Banaras Hindu University Institute of Medical Sciences Varanasi was most productive with 371 articles (10.94% share) followed by P. Das (232 articles; 6.84%), A. Dube (109 articles; 3.21%) and P. Salotra (102 articles; 3.01% share). All other authors had contributed articles ranges between 77 to 100.
P. Salotra from Vardhman Mahavir Medical College, New Delhi was most impactful with highest number of citations for his 102 publication. P. Salotra had scored a total of 68379 citations at the rate of 670.38 citations per paper. Unlike other Bibliometric measures, the h‑index is another very important parameter to account the lifetime achievement of a scholar’s work and h‑index can give fairer measure of an academic’s overall impact.[30,31] P. Salotra has highest h-Index value of 93. The second most impactful author was S. Sunder with 16255 citations (h-Index=65) with an ACPP of 43.81 citations, followed by C.P. Thakur with 3869 citations (h-Index=34) with an ACPP of 50.25 citations. Other than these three most productive authors, P. Das have forth ranked in terms of citation but was ranked eleventh in average citation per paper and H.K. Majumdar ranked tenth in overall publication and ranked sixth on overall citations but ranked fourth on average citation per paper. On the parameter of h-Index A. Dubey ranked forth, however, he was ranked fifth on total citations (Table 4).
Most productive journals publishing Indian
The Indian authored papers were published in 3348 national and international journals. Table 5 presents the status of top 18 journals, which have published one percent or more papers on leishmaniasis. These journals have published 938 articles which is 27.66% of total Indian publications. ‘Plos Neglected Tropical Diseases’ (IF2016=3.834) was most productive journal which has published 86 articles (2.54% share). As far as the Impact Factor (IF) is concerned, the Indian authors have published four papers in “Journal of Infectious Diseases” which has its IF2016 6.273. Thirty-Four papers have been published in “Journal of Immunology, Neurosurgery and Psychiatry,” which has IF2016 of 4.856; Forty-Seven articles in Antimicrobial Agents and Chemotherapy (IF2016=4.302) and Forty-Two papers in Journal of Biological Chemistry (IF2016=4.125). The other high impact factor journals where Indian authors have published their paper were ‘New England Journal of Medicine’ (IF2016=72.406); ‘Lancet (IF2016=47.831) and ‘Nature’ (IF2016=40.137)
International Collaboration by Indian Authors
India had most collaborated research with USA (339 articles; 10% share) followed by UK (144 articles; 4.25%), Switzerland (120 articles; 3.54%) and Belgium (112 articles; 3.30% share). Nepal and Germany have over two percent collaboration, while Australia, Bangladesh, France, Canada, Spain and Brazil have over one percent collaborated articles with India. Netherlands, Sweden and Saudi Arabia have less than one percent collaborated articles with India. Indian authors were more impactful when they have collaborated research with Sweden (8117 citations) with ACPP of 279.9 per paper, followed by Netherlands (8095 citations) with ACPP of 279.84 and Saudi Arabia (7380 citations) with an ACPP of 273.33 citations. (Table 6)
Most Cited Articles Authored by Indian Authors
Out of 3391 papers published from India, 2936 (86.58%) articles received at least one citation till 2017 (TC2017) during 1968‑2017 with sum cumulative total of 69,985 citations. There were 280 articles which have scored one citations, and rest other more than two. There were six articles, which have received 500 or more citations since their publication until 2017 and can be referred as highly cited articles. These six articles appeared in different national and international journals. Of these six articles, five articles were published in collaboration with international institutions and one published from single Indian institution. Two articles appeared in the ‘Lancet’ (IF2016=47.831) journal and one each in ‘Colloids and Surfaces B: Biointerfaces’ (IF2016=3.887); ‘Clinical Microbiology Reviews’ (IF2016=19.958); ‘Nature Reviews Microbiology’ (IF2016=26.819) and ‘Lancet Infectious Diseases’ (IF2016=19.864). Figure 2 presents the status of most cited Indian articles with more than 500 citations. The article by Lozano et al. (2012), scored highest TC2017=4920 with an average annual citation rate of 615 citations pear year ranked 1st. Naghavi et al. (2015) was second highly cited article with TC2017 of 1744 citations with average annual citation of 581.33 citations. Kumari et al. (2010), was the only highly cited article with Indian affiliation which was cited by 1323 times with average annual citation of 147 citations and was ranked third. Other articles were ranked from forth to sixth. The article Naghavi et al. (2015), was most impactful as it was early recognized by the number of citations received in its first year of publication. It was immediately get cited in the year it was published (C0=163) and very early rise in citations. The article which get recognition through early citations can be considered as most impactful. Moreover, the most cited article Lozano et al. (2012), was in sleeping state for two years (C0=1) with two citations only in first two years of publication and nine citations in third year. Thereafter, it had gained momentum and become most cited article (TC2017=4920).
Leishmaniasis is one of the thirteen Tropical and Neglected Disease identified by WHO. About 98 countries have its etiological impact where Nepal, Bangladesh, India, Afghanistan, Saudi Arabia, Brazil Sudan are most affected region. The agencies are working towards the better health remedies to eradicate the disease from the society. The assessment of research impact helps policy and decision makers to frame better policies to achieve the Targeted goals. Literature analysis tools such as bibliometrics is helping in such decision making. Leishmaniasis is becoming a global disease due to new cases appearing every year reported through Global Burden of Diseases. The study was aimed to anlyse the productivity of Indian contribution in Leismaniasis research conducted through data obtained from SCOPUS. Globally, about 39302 articles were published where India was ranked fourth in terms of global publication and had contributed 8.64% share of total publication. Indian research impact in terms of citation ranked fifth whereas USA was ranked first. Among Indian institutes, Indian Institute of Chemical Biology was most productive in terms of total publication whereas All India Institute of Medical Science was most impactful. Indian research was most impactful when it was having collaboration with Switzerland. The Indian research was published in some of the very high impact journals such as New England Journal of Medicine, Nature and Lancet. The Indian research was in infancy state initially but it has matured since last ten year and becoming most impactful with the time. The study highlighted the strength of the Indian research and shall be able to enhance the awareness among the stockholders in better policy decisions.