Effectiveness of Training for Teachers in Early Identification of Skin Disorders Among Primary School Attending Children - A Quasi-Experimental Study Protocol

Skin diseases are the leading cause of morbidity in children. As children spend most of their time in schools, training teachers on the detection of skin changes and timely referral will prevent or reduce the complications. Hence, we propose a quasi-experimental study to evaluate the effectiveness of training for teachers in the early identification of skin disorders among primary school children in a rural area of southern India. The teachers of government and government-aided schools in the field practice area of Model Rural Health Research Unit, Tirunelveli, will be the intervention group. The same schools in the nearby village will be the control group. The investigators and the National Institute of Epidemiology, ICMR, Chennai will develop and validate the training manual. Using the manual, the principal investiga-tor will train the teachers on identifying and referring skin changes and provide a training manual, model register and referral slip to each teacher. The investigators will review the schools quarterly and collect the number of children identified and referred from both groups before and after the intervention. Thus, the trained teachers will be a resource to achieve the objectives of the school health program, comple-menting the health services.

Pneumococcal conjugate vaccine rollout in India: Expectations and challenges

India is one among the four Asian countries with the greatest number of deaths due to pneumococcal infection among children under 5 years. pneumococcal conjugate vaccine (PCV) has been introduced in a phased manner in five major Indian states. Ambiguity remains in choosing the appropriate type of PCV and optimum schedule with maximum effectiveness specific for each country. Here, we discuss the evidences with respect to serotype coverage, immunogenicity, reactogenicity and dosage schedule for introduction of PCV13 in India. In addition, the expected PCV impact and the challenges are detailed. PCV13 is expected to provide >75% serotype coverage for invasive pneumococcal disease (IPD) serotypes in Indian children combined with the replacement by nonvaccine serotypes which is unpredictable due to lack of complete data. Nasopharyngeal (NP) surveillance is easy, feasible and can replace IPD surveillance in resource-poor settings. Continuous IPD as well as NP surveillance in all the regions are necessary to assess the impact of PCV in India.