On December 24, 2016, 18 Acute Diarrhoeal Disease (ADD) cases were reported in Thiruper village. We aimed to identify potential exposure and propose recommendations.
We defined a case of ADD as ...occurrence loose stools (≥3 episodes), December 14–30, 2016. We did door-to-door case search, calculated attack rate by age and gender, drew epidemic curve and plotted cases by residence. We conducted a matched case-control study and computed Matched Odds ratio (MOR), 95% confidence interval (95% CI) and Population Attributable Risk (PAR). We collected stool and water specimens for laboratory testing.
We identified 38 (6%) cases among 625 residents. The attack rate of ADD was higher among aged <5 years (16.5%), and female (6.8%). The outbreak lasted between 14–27 December 2016 with multiple peaks. Cases clustered in areas receiving water from damaged pipelines crossing open-defecation area. We compared 38 ADD cases with 76 age, gender and neighbourhood matched controls for different exposures. Consuming water supplied through the damaged subterranean pipeline (MOR = 3.7; 95% CI = 1.1 to 16.4; PAR = 72%) was associated with ADD. The environmental investigation pointed out potential faecal contamination of water through damaged subterranean pipelines near open-air defaecation area of village. The collected stool specimens were negative for pathogens, and water specimens tested positive for Escherichia coli.
We confirmed that the outbreak of ADD in Thiruper village was due to consumption of water contaminated with E. coli supplied through damaged subterranean pipelines post-cyclone. We recommended the replacement of subterranean pipelines and distribution of chlorinated water.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Coronavirus disease-2019 (COVID-19) had a multidimensional impact on human life. It affects the health-related quality of life (HRQoL) which is a perceived measure of physical and mental health. We ...estimated the EuroQol utility value for COVID-19 and the associated factors for those managed at Siddha COVID care centres in Tamil Nadu.
A cross-sectional study was conducted by a telephonic interview of 2000 randomly selected COVID-19 adults tested positive during June 2020 to Jan 2021. We collected sociodemographic, clinical and EQ-5D-5L profile. Mean EQ-5D-5L summary utility values and EQ-VAS scores were estimated. Multivariate regression was used to examine the factors associated with EQ-5D-5L. Study protocol was approved by the Institutional ethics committee of Government Siddha Medical College, Chennai (GSMC–CH–3401/ME-2/050/2021). The committee waived the written informed consent considering the pandemic situation of emerging infectious diseases.
We interviewed 1047 participants. Of the total 68% were males with the median age (IQR) of 38 (29–51) years. The mean EQ-5D-5L utility score and EQ-VAS scores are 0.98 ± 0.05 and 92.14 ± 0.39 respectively. COVID-19 asymptomatic group reported a mean utility score of 0.99 ± 0.03 which is relatively more than the symptomatic group (0.97 ± 0.06),. EQ-VAS score was also reported high among the asymptomatic (95.45 ± 5.95) than the symptomatic (91.40 ± 8.69COVID-19.
The severity of illness and the comorbidity are significantly associated with a low HRQoL of COVID-19 patients.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
India reported first laboratory-confirmed case of coronavirus disease 2019 (COVID-19) on 30 January from Kerala. Media surveillance is useful to capture unstructured information about outbreaks. We ...established media surveillance and described the characteristics of the COVID-19 cases, clusters, deaths by time, place, and person during January–March 2020 in India.
The media surveillance team of ICMR-National Institute of Epidemiology abstracted data from public domains of India's Central and State health ministries, online news and social media platforms for the period of January 31 to March 26, 2020. We collected data on person (socio-demographics, circumstances of travel/contact, clinical and laboratory), time (date/period of reported exposures; laboratory confirmation and death) and place (location). We drew epidemic curve, described frequencies of cases by age and gender. We described available details for identified clusters.
As of March 26, 2020, India reported 694 (Foreigners = 45, 6%) confirmed COVID-19 cases (Attack rate = 0.5 per million population) and 17 deaths (Fatality = 2.5%) from 21 States and 6 Union Territories. The cases were higher among 20–59 years of age (60 of 85) and male gender (65 of 107). Median age at death was 68 years (Range: 38–85 years). We identified 13 clusters with a total of 63 cases and four deaths among the first 200 cases.
Surveillance of media sources was useful in characterizing the epidemic in the early phase. Hence, media surveillance should be integrated in the routine surveillance systems to map the events specially in context of new disease outbreaks.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Early detection of symptoms of loss of smell and taste lately added for Coronavirus disease 2019 (COVID-19) has the potential for improving pandemic response. In the Indian context, we compared ...proportion experiencing new loss of smell or taste among COVID-19 positive and negative individuals in Chennai city, Southern India.
We did an analytical cross-sectional study among individuals aged 18–80 years undergoing testing at COVID-19 sample collection centres. We ascertained loss of smell and taste using standardised self-reporting and clinical examination procedures. We administered Sino Nasal Outcome (SNOT 22) questionnaire for comprehensive understanding of these symptoms. We compared proportion having symptoms between COVID-19 positive and negative persons. We compared the two assessment methods to compute diagnostic validity indicators.
Of the 277 participants, 169 (61%) were men and mean age of 40.7 years SD = 13.3. Fifty eight (21%) had COVID-19 and 12 (36%) of them were asymptomatic. Predominantly reported symptoms were fever (30%), headache (18%) and cough (18%). Self-reported or clinically identified new loss of smell or taste was higher among COVID-19 positive (n = 13; 22%) than negative persons (n = 23; 11%) p = 0.02. Sensitivity was higher for self-reported or clinically identified loss of smell (17.2%) than that of loss of taste (6.9%). Negative predictive value for loss of smell or taste, self-reported or clinically identified was 81%. Likelihood ratio of positive test was 2.13.
Loss of smell or taste are predominantly reported by COVID-19 confirmed individuals. Objective and subjective assessments of smell and taste may be required to identify those requiring COVID-19 testing.
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The case study presented by the researcher reflects on a dilemma faced during her public health research in a setting in South India. Her case prompts discussions around the public health context, ...ethical dilemmas therein, research challenges and relevance to other situations in public health research.
•Investigating Zika epidemiology through prospective cohort study is carried out first time in Indian and Asian settings.•Positive cases from the 2018 outbreak are thoroughly investigated.•No ...evidence of recent Zika virus transmission among the cohort of pregnant women after the 2018 outbreak in Jaipur city, India•Covid-19 pandemic specific public health measures such as restricted travel and a quarantine for 3-5 months duration can be one of the reasons for no Zika transmission in the community
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
To identify risk factors associated with Coronavirus disease 2019 (COVID-19) in a Tertiary care cancer hospital-based cluster and recommend control measures.
We conducted tracing and confirmation ...among hospital and community contacts. We telephonically interviewed and abstracted information from hospital records and registers. We described the cluster by time, place and person. We conducted unmatched case-control study to compare risk factors and computed Odds Ratio (OR) and 95% confidence interval.
We confirmed COVID-19 in 21 of 1478 tested (1.4%). Secondary attack (%) of COVID-19 among 824 contacts was higher among in-patients of block A (18), household contacts (3.4), housekeeping staff (3.3) and nurses (1.7). The cluster started on April 22 with two successive peaks five days apart and lasted until May 8. Being male, patients aged >33 years OR = 30·7; 95% CI = 3·6 to 264, having hypertension OR = 4·3; 95% CI = 1·1 to 16·7 or diabetes OR = 3·8; 95% CI = 1·0 to 14·1 were associated with COVID-19. Mask compliance was poor (20%) among hospital workers.
We recommended screening of all patients for diabetes and hypertension and isolation/testing of anyone with influenza-like illness for preventing COVID-19 clusters in hospital settings.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Aging is a natural process associated with many functional and structural changes. These changes may include impaired self-regulation, changes in tissues and organs. Aging also affects mood, physical ...status and social activity. There are adverse changes in cognitive behavior, perceived sensation and thinking processes. Regular physical activity can alleviate many health problems; yet, many older adults are inactive. Yoga is one of the scientific and popular lifestyle practice considered as the integration of mind, body and soul. Results of previous studies reported positive effects of yoga on multiple health outcomes in elderly. However, there is scarcity of scientific information where yoga's effect is examined on over well-being and on multiple health outcomes simultaneously in elderly. This protocol describes methods for a 12-week yoga-based intervention exploring the effects of yoga on well-being in physically inactive elderly living in community. Methods and analysis: This two group parallel single blind randomized controlled trial that will be conducted at a designated facility of R.D. Gardi Medical College, Ujjain, Madhya Pradesh, Central India. A 12-week 60-min yoga intervention three times weekly is designed. Comparison group participants will undergo a 60-min program comprising light exercise focusing on conventional stretching to improve mobility. After screening, 144 participants aged 60-80 years will be recruited. The primary outcome is subjective well-being. Secondary outcomes include mobility, fall risk, cognition, anxiety and depression, mood and stress, sleep quality, pain, physical activity/sedentary behavior and cardio-metabolic risk factors. Assessments will be conducted at baseline (0 week), after the intervention (12+1 week) and at follow-up (36+1 week). Intention-to-treat analyses with mixed linear modeling will be applied.
Through this trial, we aim to determine whether elderly people in the intervention group practicing yoga show more favorable primary (well-being) and secondary outcomes than those in the light exercise focusing on conventional stretching group. We assume that yoga may be practiced to maintain health, reduce particular symptoms commonly associated with skeletal pain, assist in pain relief and enhance well-being. We anticipate that practicing yoga will improve well-being and mental health and may lead to significant improvement in depression, pain and sleep quality.Ethics and dissemination: This study is approved by the Institutional Ethics Committee of R.D. Gardi Medical College, Ujjain, IEC Ref No. 09/2018. All participants would be provided with written and verbal information about the purpose of the project and would be free to withdraw from the study at any time. Refusal to participate in the study would not have any negative consequences. Confidentiality of the information of each participant would be ensured. Knowledge obtained would be disseminated to stakeholders through workshops, meetings and relevant scientific conferences.
The trial is prospectively registered with the Indian Council of Medical Research Trial Registry CTRI/2018/07/015051.
Objective
To estimate the prevalence of usage, unsafe practices and risk perception regarding household pesticides in a rural community of Tamil Nadu, India.
Materials and Methods
In a ...cross-sectional survey we used a pre-tested questionnaire and trained interviewers to collect information on household pesticide use for the past 6 months from any adult member of randomly selected households.
Results
Out of 143 households, 95% used at least one household pesticide (95% CI: 93.5–99.5) and 94% used at least one household pesticide specifically for mosquito control. The most commonly used pesticides were mosquito coils (75%), mosquito liquid vaporizers (36%), ant-killing powder (24%) and moth/naphthalene balls (18%). The major non-chemical methods of pest control were rat traps (12%) and mosquito bed nets (7.5%). Out of the mosquito coil users, 61% kept the windows and doors closed while the coil was burning. Out of the moth ball users, 88% left them in the place of use till they fully vaporized. Nearly half of the users did not know that household pesticides were harmful to their health and the health of their children.
Conclusions
The use of household pesticides was highly prevalent in this rural community. The prevalence of unsafe practices while handling them was also high. We recommend that the users of household pesticides be educated about the health hazards and about safe practices and non-chemical methods of pest control be promoted.
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DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
During 2001-2007, the National Institute of Epidemiology (NIE), Chennai, Tamil Nadu, India admitted 80 trainees in its two-year Field Epidemiology Training Programme (FETP). We evaluated the first ...seven years of the programme to identify strengths and weaknesses.
We identified core components of the programme and broke them down into input, process, output and outcome. We developed critical indicators to reflect the logic model. We reviewed documents including fieldwork reports, abstracts listed in proceedings and papers published in Medline-indexed journals. We conducted an anonymous online survey of the graduates to collect information on self-perceived competencies, learning activities, field assignments, supervision, curriculum, relevance to career goals, strengths and weaknesses.
Of the 80 students recruited during 2001-2007, 69 (86%) acquired seven core competencies (epidemiology, surveillance, outbreaks, research, human subjects protection, communication and management) and graduated through completion of at least six field assignments. The faculty-to-student ratio ranged between 0.4 and 0.12 (expected: 0.25). The curriculum was continuously adapted with all resources available on-line. Fieldwork led to the production of 158 scientific communications presented at international meetings and to 29 manuscripts accepted in indexed, peer-reviewed journals. The online survey showed that while most graduates acquired competencies, unmet needs persisted in laboratory sciences, data analysis tools and faculty-to-student ratio.
NIE adapted the international FETP model to India. However, further efforts are required to scale up the programme and to develop career tracks for field epidemiologists in the country.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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