ABSTRACT
Congregate work settings are at increased risk for SARS?CoV?2 transmission and predispose to super spreader events. We investigated a COVID?19 outbreak among security guards to identify the risk factors and propose recommendations. We defined a COVID?19 case as a laboratory?confirmed reverse transcription polymerase chain reaction?positive case. We traced the contacts actively and described the cases by time, place, and person. We conducted a case–control study and collected data on potential exposures. We identified 20 (27%) COVID?19 cases among 75 security guards. Among the cases, 17 (85%) were male and 12 (60%) were symptomatic. We recruited all the 20 COVID?19?confirmed cases and 55 COVID?19?negative controls for the case–control study. SARS?CoV?2 infection was higher among those had high?risk exposure (60%, [12/20]) than who did not (16%, [9/55], adjusted odds ratio = 5.9, 95% confidence interval = 1.6?22.1). Having had high?risk exposure with COVID?19 cases led to COVID?19 outbreak among the security guards. We recommended avoiding the activities predisposed to high?risk exposure.
ABSTRACT
Background: A screening program for cervical cancer was established in 2011 in Tamil Nadu. Since the inception of the program, coverage, and dropout of screening has not been analyzed. We conducted a study to describe the referral mechanism in the cervical cancer screening program implemented in Tamil Nadu, to estimate the level of adherence to the referral process by the beneficiaries, and to identify strengths and weaknesses related to the referral mechanism in the program. Methods: This descriptive study was conducted during 2015–2016 in the Tiruchirappalli administrative district of Tamil Nadu. All women aged 30 years and above, who were screened in public health facilities, were the participants. Using a structured form, we collected the data maintained in the registers at the district health administration. We estimated the screening coverage, follow-up evaluation, and dropout rates at different stages of the referral mechanism. We used SPSS and Epi Info software for analysis. Results: Coverage of cervical cancer screening was 4,838(41.6%). We estimated 4,838(41.6%) of screened positives were lost to follow-up for a colposcopy examination. Biopsy samples were obtained from 3425(84%) of those who required a biopsy. Cervical cancer was diagnosed in 159(4.6%) and precancerous lesions in 528(15.4%) women. Conclusion: More than half of the target population was screened in public health facilities. The dropout rate was less than half of those screened at the colposcopy evaluation level. Major pitfalls of the program were human resource issues at referral centers and poor maintenance of meaningful data