Spatial Mapping of Measles-Rubella Campaign in a Rural Area near Bengaluru, Karnataka, India

Immunization is animportant public health intervention.The Measles-Rubella (MR) campaign was launched during 2017in India for the elimination of measles.This study explored vaccination coverageandspatialmapping using QGIS and Google Earth Pro. WHO-EPI30 clusters sampling technique for evaluation of vaccination coverage was performed in villages within the rural area of a Medical College nearBengaluru.Seven children aged 2-15 years were surveyed per cluster, resulting in 210 children. Smartphones having GPS/Garmin GPS72H (handheld GPS receiver)were used for noting coordinates. Subsequently all these coordinates were plottedfor spatial mapping of vaccination coverage. The geospatial characteristics of the households surveyed were described using spatial mapping. Results indicate that 87.6% were immunized with MR Vaccine under the campaign, but 12.4% remained unimmunized, the reasons given being absence, ignorance, or refusal because of rumours concerning side-effects.The Measles-Rubella campaign coverage was found to be satisfactory. In addition the spatial mapping is a useful tool for measurement of coverage of a vaccination campaign. There was no clustering of unimmunized subjects observed on spatial mapping.

An exploratory study on violence among the college students in Urban Bengaluru, Karnataka, India

Violence often blights people's lives for decades, leading to drug addiction, depression, suicide, school dropout, unemployment, and recurrent relationship difficulties. This exploratory study was conducted among professional degree colleges in urban Bengaluru from January to March 2017; the objectives were to find the magnitude, forms, and substance use in violence. A total of 450 students were studied. One hundred and twenty-three (27.3%) students experienced some kind of violence in the past 1 year and 77 (62.6%) were males. Verbal abuse (65.0%), pushing around (23.6%), and slapping (18.7%) were common forms of violence observed. Substance use was significantly associated with violence.

Community awareness and risk of rabies associated with exposure to animals in India

Background: Rabies is a fatal but preventable disease. Around the world, awareness studies about rabies have been widely used to understand the disease and in its preventive measures. Objectives: The present study was conducted to assess the awareness of rabies as a disease, its transmission, and prevention among the general population and also to assess the perceived health risks associated with exposure to animals. Methods: A cross-sectional study was undertaken across seven representative states in India between July and November 2017. Multistage sampling methodology was followed to select 1012 households as the primary sampling unit, and one adult responsible respondent from each household was interviewed as study participants. Results: Six hundred and eleven (60.4%) participants had heard of rabies. Only 0.2% had extensive knowledge of rabies. Majority (440, 72.0%) of the participants considered rabies as a fatal disease; 77.3% opined that risk of rabies from dogs was high compared to 41.6% who believed that there was little or no risk of rabies from cats. Only 37 (3.7%) participants were aware about preexposure prophylaxis. Conclusion: The awareness on rabies and its prevention in the study population was not satisfactory.

A multicentric community survey on animal exposures among humans in India

Background: Rabies is a 100% fatal disease. There are inadequate data on animal exposures and rabies postexposure prophylaxis (PEP) from community-based field surveys in India. Objectives: The main objective of the study is to estimate the incidence of animal exposures (bite, scratch, or lick) in the study population and to describe the rabies PEP among the cases. Methods: A descriptive survey was conducted in seven states of India between July and November, 2017. In each state, multistage sampling methodology was followed for selection of district, taluka/tehsil, block, and clusters within the block. The primary sampling unit was a household (HH). A case was a patient with animal exposure (bite, scratch, or lick) in the last 1 year from the date of survey. The animal exposure was categorized based on the WHO guidelines (Category-I, Category-II, and Category-III). The patients with the history of multiple animal exposures any time during the survey period was considered as a single case. Results: A total of 1012 HHs were surveyed covering a population of 4294. 3016 (70.2%) participants were from rural settings and 1278 (29.8%) were living in urban settings. 2181 (50.8%) participants were male and 2113 (49.2%) were female. The annual incidence of animal exposure was 1.26% (confidence interval [CI]: 0.93%�59%). The annual incidence in urban setting was 1.33% (0.70 - 1.96) and rural settings were 1.23% (CI: 0.84 - 1.62). Majority (68.5%) of the cases were from rural settings, 61.2% of the cases were in the age group of 15� years. Among the 43 cases who had received PEP, 21 had Category-II exposures, of whom 66.7% had completed vaccination with either five doses intramuscular or four doses intradermal route. Similarly, 22 had Category-III exposures and only 4 (18.2%) cases had received rabies immunoglobulin and completed rabies vaccination. Six ( 11.1%) cases did not receive PEP. There was no report of human rabies case. Conclusion: The incidence of animal exposure was 1.26%. Rabies PEP in the cases was not satisfactory.

Global positioning system & Google Earth in the investigation of an outbreak of cholera in a village of Bengaluru Urban district, Karnataka.

Background & objectives: The global positioning system (GPS) technology along with Google Earth is used to measure (spatial map) the accurate distribution of morbidity, mortality and planning of interventions in the community. We used this technology to find out its role in the investigation of a cholera outbreak, and also to identify the cause of the outbreak. Methods: This study was conducted in a village near Bengaluru, Karnataka in June 2013 during a cholera outbreak. House-to-house survey was done to identify acute watery diarrhoea cases. A hand held GPS receiver was used to record north and east coordinates of the households of cases and these values were subsequently plotted on Google Earth map. Water samples were collected from suspected sources for microbiological analysis. Results: A total of 27 cases of acute watery diarrhoea were reported. Fifty per cent of cases were in the age group of 14-44 yr and one death was reported. GPS technology and Google Earth described the accurate location of household of cases and spot map generated showed clustering of cases around the suspected water sources. The attack rate was 6.92 per cent and case fatality rate was 3.7 per cent. Water samples collected from suspected sources showed the presence of Vibrio cholera O1 Ogawa. Interpretation & conclusions: GPS technology and Google Earth were easy to use, helpful to accurately pinpoint the location of household of cases, construction of spot map and follow up of cases. Outbreak was found to be due to contamination of drinking water sources.

Prevalence of Chronic Obstructive Pulmonary Disease and its Association with Tobacco Smoking and Environmental Tobacco Smoke Exposure among Rural Population.

A fi eld survey was conducted for chronic obstructive pulmonary disease (COPD) epidemiology in the rural fi eld practice area of Kempegowda Institute of Medical Sciences, Bangalore, India, which covers a population of 44,387 to fi nd out the prevalence of COPD in adult subjects of 35 years and above using cluster sampling technique and to determine the association of tobacco smoking, environmental tobacco smoking (ETS) exposure and type of cooking fuel used with COPD. The overall prevalence of COPD was 4.36%. The prevalence among males and females were 5.32% and 3.41% respectively. The prevalence was found to be increasing with an increase in age. The tobacco smoke and exposure to ETS was signifi cantly associated with higher odds of COPD with adjusted odds ratio 2.97 and 2.67 respectively. Thus, there was a signifi cant association between tobacco smoking and ETS exposure with COPD.

Rural Rabies Prevention Project - A ‘One Health’ Experiment in India: An Overview.

Aim: To assess the feasibility of implementing "one health approach" to prevent human rabies and control animal rabies in a rural community. Study Design: Health services research in a rural setting. Place and Duration of Study: A medical college and a veterinary college along with an animal welfare organization delivered a wide array of "integrated services" in three villages' i.e. Kumbalagodu, Thagachikuppe and Gerupalya near Bangalore, India comprising a population of 10,220 persons for a period of two years from December, 2009 to November, 2011. The nearby three villages of Ramohally, Vinayakanagara and Bhimanakuppe with a population of 6,023 persons formed the control group, with no project inputs. Methodology: This consisted of household surveys at the beginning and end of two years ; rabies awareness campaigns; clinical and laboratory surveillance of rabies in dogs; rabies post-exposure prophylaxis (PEP) in humans; pre-exposure rabies prophylaxis (PrEP) by intradermal route in school children, pet dog owners and veterinarians ; mass dog vaccination and deworming; and sero-surveillance in both dogs and humans. Results: The ratio of veterinary and medical manpower in study villages was 1: 11 and dog to human ratio was 1: 23.The information, education and communication materials developed and used were domestic outdoor wall writings (11), domestic indoor annual wall calendar (2000), school book labels (1000); game charts (16); wall posters (65); flip chart (15); rabies educational DVD (1). There were 102 local cable television transmissions on rabies prevention. 69 persons received rabies PEP. PrEP was given to 368 school children, pet dog owners and veterinarians. Sixty one human serum samples were analyzed by rapid fluorescent focus inhibition test for rabies antibody detection. Sixteen veterinarians were trained to use direct rapid immunohistochemical test (dRIT) for rabies diagnosis. Six ruminants were confirmed rabid by dRIT. There were no cases of human rabies. The cost of entire project was US $ 85,958. Conclusion: A blend of medical, veterinary and animal welfare services were successfully delivered through a "one health" approach. Based on this success a "conceptual model" was evolved to propagate its replication in other rural communities across India.

Prevalence of domestic accidents in the rural field practice area of a medical college in Bangalore, Karnataka.

Domestic accidents are worldwide health problems. A cross-sectional study was conducted in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore. A total of 5419 individuals were selected from 30 clusters (villages) using cluster sampling technique. Of the 5419 study population, 50.9% (2748) were males and the rest were females. The prevalence of domestic accidents in the rural community was found to be 9.6% (522 individuals who had sustained domestic accidents), was found to be more in females compared with males, which was statistically significant with P-value =0.0077 (Z value =9.09). Falls 43% (225) was the most common type of domestic accidents. The most common place of occurrence of domestic accidents was 46% (243) kitchen, most frequent site of injures in domestic accidents was upper limbs.

Rabies in a blind patient: Confusion after corneal transplantation.

Two blind persons received corneal transplants from a single donor who showed no signs of rabies before he died. One of the recipients, a young girl, died 16 days later of rabies and the other recipient survived. We discuss the possible mode of transmission of rabies to the first recipient and the management of the second recipient.

Global positioning system: A new tool to measure the distribution of anemia and nutritional status of children (5-10 years) in a rural area in south India.

Global positioning system (GPS) is a satellite-based navigation system that is of late being used in health care. Objectives: The aims of the study were to describe the geographical distribution and assess the prevalence of anemia and malnutrition in children aged 5-10 years with GPS. Subjects and Methods: This exploratory study was conducted over a period of 2 months in the rural field practice area of a medical college situated in Bangalore during June-July 2012. Children aged 5-10 years were the study subjects. Results: GPS was used for describing the geographical distribution of anemia and nutrition status on the Google earth map. The prevalence of anemia in the study subjects was 8.7%. The prevalence of underweight, stunting, thinness, and severe thinness among the study subjects was 52.8%, 28.5%, 23.5%, and 29.1%, respectively; however, overweight and obesity were observed only in 0.9% and 1.2% of the study subjects, respectively. Conclusion: GPS was easy to use and was able to demonstrate the actual distribution of morbidity at the household level in the rural area.

Prevalence of bronchial asthma and its association with smoking habits among adult population in rural area.

A cross-sectional study was conducted in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore. A total of 3194 adult individuals (18-70 years) were selected from 30 villages (clusters) using a cluster-sampling technique. Individuals with symptoms suggestive of asthma were subjected for clinical examination for the diagnosis of asthma. Among the 3194 respondents, 1518 (47.5%) were males and 1676 (52.5%) were females. The prevalence of bronchial asthma was 2.88%. The prevalence of asthma was higher among those reporting a history of current smoking. Among current smokers, the number of cigarettes/bidis/hookah smoked daily did not differ (P > 0.05) between individuals without asthma and with asthma, whereas the mean number of years of smoking did differ (P < 0.001). There was significant association between tobacco smoking and bronchial asthma.

A clinico epidemiological study of tetanus cases admitted to epidemic disease hospital, Bangalore.

A descriptive study was conducted among tetanus cases admitted to epidemic disease hospital (EDH), Bangalore from October 2006 to March 2007 to describe the socio demographic characteristics of tetanus cases, the clinical presentation and the treatment given to tetanus cases. A total of 80 cases were admitted during this period. Out of the 80 tetanus cases, 71% were from rural area, 55% unimmunized, 47.5% were agricultural workers. A total of 25 (31.25%) deaths were observed during the study period. No case was administered anti tetanus serum outside the epidemic disease hospital.

Usefulness of direct recording scale as a new tool for growth monitoring.

The present study was conducted to assess the acceptability and usefulness of Direct Recording Scale (DRS) as a tool for growth monitoring of under five children in a rural community area of Karnataka among 46 mothers. A total of 40 children were followed up for one year, 50% mothers preferred having DRS at home, 87.5% mothers said DRS, helps in detecting undernutrition, 48% mothers needed no help in using DRS, 50% mothers were regular in weight recording, 87.5% mothers wanted the weight recording done once in three months. All families had accepted DRS as a tool for growth monitoring.

A study on the effectiveness of DOTS on tuberculosis patients treated under RNTCP.

A total of 88 Tuberculosis patients who registered for treatment were followed up until their completion. These patients were given treatment under the Government of India implemented RNTCP in the year 1999-2000 in a Tuberculosis unit in Bangalore Mahanagara Palike. Majority of the patients were male and from lower middle class In the present study the cure rate was 72.00 %, treatment completion was 80.55%, default patients were 22.72% and chronic cases were 6.25%.