Facilitators And Barriers to Hypertension Control, Fol-lowing the Implementation of India Hypertension Con-trol Initiative (IHCI) In Thiruvananthapuram District – A Qualitative Study

Background: India Hypertension Control Initiative (IHCI) was launched in 2017 to improve the control rate of hypertensive patients on treatment. Thiruvananthapuram was one of the 26 districts in the coun-try where the programme was initially rolled out. Methods: A qualitative cross-sectional study was conducted among stakeholders involved in the imple-mentation of IHCI of Thiruvananthapuram district. Purposive sampling method was used for the selec-tion of samples. A total of 25 in-depth interviews were carried out. Results: The major facilitators which propelled hypertension control were uniformity in drug prescrip-tion, proper documentation of patient data along with indicators for measuring control rates and a de-faulter tracking mechanism. Clinical inertia among doctors, increased workload and sending of bystand-ers for monthly follow-up are the major barriers that affected hypertension control. Conclusions: Replication of good practices performed under IHCI into similar health settings or pro-grammes can be encouraged. Apart from the few barriers seen at the programme level, the already exist-ing barriers at the health system level need to be addressed immediately through efforts such as e-Health incorporation and trainings.

Microbial Quality of the Lake Inside Thiruvananthapuram Zoological Garden, Kerala, India.

A study of the microbial water quality of the lentic body inside Thiruvananthapuram Zoological Garden was carried out. The water in the lake is used for cleaning the cages of the zoo animals and for their bath. Total viable count, coli form count and E.coli count for the water found was exceeding the limits as prescribed by WHO and CPCB. Prevalence of indicator bacteria like Escherichia coli was observed during the study period. Isolation of Staphylococcus sp and Pseudomonas sp was done and are identified and confirmed biochemically. Klebsiella oxytoca and Enterobacter cloacae were identified by the sequencing of 16S rRNA and COI genes. The sequence and phylogenetic similarity search done with all entries in the DNA sequence database, GenBank using BLAST and identified. Bacterial results hint towards the pollution status of the water body. Bacterial count studies showed a higher number of bacterial colonies present in the water during the Monsoon Period. The animals under capture are more sensitive to diseases than in wild. A regular monitoring of the water is needed to check water borne diseases.