RESUMO
Introduction: To assess the status of bi-directional screening for COVID-19, tuberculosis and diabetes among people attending Non-communicable Disease (NCD), Directly Observed Treatment Short-course (DOTS), and flu clinics of a secondary care hospital in rural northern India. Material and Methods: A cross?sectional, analytical study was conducted among the eligible (aged ?18 years) population who attended the study clinics in a rural sub-district hospital. In the flu clinic, consecutive patients were assessed for screening for TB (symptom-based) and diabetes (random blood sugar) and status of referral to DOTS and NCD clinics. Similarly, the screening for diabetes and COVID-19, Reverse Transcription-Polymerase Chain Reaction (RT-PCR) in the DOTS clinic, and TB and COVID-19 in the NCD clinic were assessed. The independent association of factors with COVID-19 positivity were assessed by calculating the adjusted prevalence ratios (aPR) at 95% confidence interval (CI). Results: Of the 405 people assessed, 279 (68.9%), 102 (25.2%), and 24 (5.9%) were from flu, NCD, and DOTS clinics, respectively. 26 (25.5%) and 22 (91.7%) of NCD and DOTS clinic patients underwent RT-PCR for COVID-19. TB screening in NCD and flu clinics was done among 4 (3.9%) and 7 (12.5%), respectively. A total of 23 (9.0%) were found positive for COVID-19, and no factors other than the presence of COVID-19 symptoms (aPR: 2.89; 95% CI: 1.33–6.29) had any independent association with COVID-19 positive status. Conclusion: The low screening for TB in NCD and flu clinics indicates the need to strengthen the implementation the TB-DM and TB-COVID-19 bidirectional screening. Similarly, the low screening or testing for COVID-19 in the NCD clinic can be improved by the implementation of systematic screening strategies like TB-DM bidirectional screening.
RESUMO
Background: Acute Lower Respiratory Tract Infections (ALRTI) remains the major cause of increased morbidity and mortality in under-five children. Vitamin A has a protective role against infections in children. Vitamin A supplementation is given to under-five children as part of the National Immunization Programme in India. The aim of this study was to find out the effectiveness of vitamin A supplementation in preventing the recurrent ALRTI (?3 episodes per year) in under-five children.Methods: A cross-sectional analytical study was conducted to find out the role of vitamin A supplementation in reducing recurrent ALRTI in under-five children who were enrolled in Anganwadi centers (AWC's) in Villupuram district, Tamil Nadu, India. Two hundred children of 1-5 years of age were selected by random systematic sampling. History was elicited and documents about vitamin A supplementation and previous episodes of ALRTI were verified. The association between recurrence of ALRTI and vitamin A supplementation was analyzed using chi-square test.Results: The mean age of the children in this study is 24'8 months. The median number of episodes of ALRTI per year is 2 (1-3). Among 200 children enrolled in the study, 127 (63.5%) children received vitamin A supplementation and 73 (36.5%) did not receive it. There is a significant decrease in the number of ALRTI episodes (less than 3 episodes per year) in the children who received vitamin A supplementation (p <0.001).Conclusions: Vitamin A supplementation along with the National Immunization Programme had shown reduced' ALRTI episodes. Since, the number of ALTRI episodes are directly proportional to mortality due to pneumonia, reduction in number of episodes can decrease the Under-five mortality. Vitamin A supplementation is an important programme in this regard and needs to be scrupulously carried out.