Post-exposure prophylaxis against rabies at two newly designated intradermal rabies vaccination clinics in Kerala, India.

Background. The two-site intradermal rabies vaccination (IDRV) regimen was recently introduced in Kerala. We aimed to determine factors associated with exposure of category III severity among patients seeking prophylaxis against rabies at IDRV clinics. Methods. This hospital-based, cross-sectional study was done at two clinics in Thiruvananthapuram district, Kerala. Data were collected using a semi-structured questionnaire by direct interview and 320 patients were included. Bivariate analysis of quantitative variables was done using t-test and that of qualitative variables using chi-square test. Results. The mean (standard deviation) age of patients was 32.4 (19.6) years. Among the 320 cases, 202 (63.1%) had category III exposure. Lower extremities were the most frequent site of exposure (146, 45.6%). The most frequent mode of exposure was being bitten by an animal (214, 66.9%), often a dog. Residence in rural areas, exposure to dogs and wounds on the extremities had a significant association with severity of exposure. Conclusion. Animal exposures were more among people from rural areas. About two-thirds of exposures which necessitated post-exposure prophylaxis were category III.

Determinants of childhood tuberculosis - A case control study among children registered under Revised National Tuberculosis Control Programme in a district of South India.

Aim: To study the determinants of Tuberculosis (TB) in children between the age group of 0-14 years receiving treatment under Revised National TB Control Programme (RNTCP) . Methods: A case (registered under RNTCP) control study was undertaken with 41 cases and 82 controls. Results: Factors found to have significance according to binary logistic regression were low-birth weight (LBW) [Odd’s ratio=3.56],Malnutrition [Odd’s ratio=3.96], Passive smoking [Odd’s ratio=6.28] and exposure to fire-wood smoke [Odd’s ratio=6.91]. Conclusion: LBW, malnutrition, passive smoking and fire-wood smoke are the risk factors to be addressed to prevent pediatric TB.

Environmental factors of households in five districts of Kerala affected by the epidemic of chikungunya fever in 2007.

Background. Two epidemics of chikungunya fever were reported from Kerala in 2006 and 2007. We aimed to investigate the environmental factors of households affected by chikungunya fever and to estimate the proportion of population that suffered from the disease during the epidemic in 2007. Methods. A cross-sectional survey was conducted in the 5 heavily affected districts of Kerala during October–November 2007. The 2-stage sampling technique was used to collect data from 10 clusters, each having 18 houses from every district, by interviewing the subjects using a structured questionnaire. The sample size was 900. Results. The proportion of the population affected by chikungunya fever was 57.1% (95% CI: 52.8%–61.4%). There was a significant association between location of houses and disease status. Houses located near a public conveyance facility (within 250 m) were relatively protected from the disease (OR 0.19 [0.06–0.60]). About 69% of the households perceived mosquito infestation as a problem and 46.6% used fumes to avoid mosquitoes. More than 42% of households were not using any anti-mosquito measures at the time of the survey. Stored drinking water was the most common potential breeding source in the houses (23.5%). Households which did not store water inside were protected from the disease (OR 0.22 [0.08–0.65]). Conclusion. The study indicated the persistence of favourable domestic and environmental factors after the epidemic, reflecting the necessity to strengthen anti-mosquito campaigns.