ABSTRACT
Background: Health-care workers at all levels are putting their best efforts to contain the COVID-19 pandemic. In resource-poor country like India, the community health workers are given primary responsibility for prevention and control measures at the village level. Learning from their experiences and addressing constraints will ensure improved service delivery in the face of further waves of pandemic. Aim: The aim of the study is to explore the field level experiences of Accredited Social Health Activists (ASHAs), working in Bhatar block of Purba Bardhaman district, West Bengal, while delivering COVID-19 response services and to elicit the nature of constraints faced by them. Materials and Methods: This was a qualitative study with phenomenological approach conducted among ASHA workers from December 2020 to January 2021. Convenient sampling was done to select 8 participants for data collection by focused group discussion (FGD) using FGD guide. A total of four FGDs with 32 participants were conducted. Data were analyzed using thematic framework approach to identify codes and themes. Results: The experiences are presented under five broad themes and in subthemes. ASHAs were engaged in extensive work amidst various challenges, though they received ample support and cooperation from society and general administration. ASHAs faced issues with inadequate supply of protective equipment and were in need for refresher trainings. Events of social stigma and ostracizations had also surfaced. Limited financial incentives, increased susceptibility to COVID-19, and detachment from family were the main source of stress among ASHAs. Conclusion: The issues identified in this study can be addressed to further utilize ASHAs in delivering services in pandemic context. © Medical Journal of Dr. D.Y. Patil Vidyapeeth 2022.
ABSTRACT
BACKGROUND: Isoniazid preventive therapy (IPT) for child contacts of TB patients, a globally accepted intervention, needs to be evaluated in diverse geographical regions.OBJECTIVES: To assess the extent of IPT coverage and adherence, to ascertain its sociodemographic and programmatic correlates and to explore existing constraints from service providers and beneficiaries´ perspectives.METHODS: A mixed-method study was conducted in January-June 2021 in Paschim Bardhaman District, West Bengal, India. Quantitative assessment was done among 280 child contacts of TB cases registered between January and December 2020 in all TB units in the district. Primary caregivers were interviewed using a pre-designed questionnaire. Two focus group discussions with all senior treatment supervisors of the district and in-depth interviews with 12 purposively selected caregivers of the children were undertaken. Qualitative data were analysed thematically.RESULTS: Only 48.9% (137/280) of child contacts were screened; 58.9% (165/280) were initiated on IPT and 40% (66/165) adhered to a full course. Coverage of the full 6-month IPT among total study participants was 23.6% (66/280). Household visits by health personnel and initial screening significantly predicted increased coverage. Programmatic inadequacies, poor understanding, social stigma and COVID situation were major constraints.CONCLUSION: Coverage of IPT remains unacceptably low and requires health system strengthening for effectively implementing current recommendations of TB preventive treatment.
Subject(s)
COVID-19 , HIV Infections , Antitubercular Agents/therapeutic use , Child , Family Characteristics , HIV Infections/drug therapy , Health Personnel , Humans , Isoniazid/therapeutic useABSTRACT
Introduction. COVID-19 has become a global impediment by bringing everything to a halt starting from January 2020. India underwent the lockdown starting from 22nd March 2020 with the sudden spike in the number of COVID-19 patients in major cities and states. This study focused on how metabolites play a crucial role in SARSCoV- 2 prognosis. Materials and methods. Metabolome profiling of 106 plasma samples and 24 swab samples from symptomatic patients in the Indian population of the Mumbai region was done. COVID-19 positive samples were further segregated under the non-severe COVID-19 and severe COVID-19 patient cohort for both plasma and swab. Results. After analyzing the raw files, total 7,949 and 12,871 metabolites in plasma and swab were found. 11 and 35 significantly altered metabolites were found in COVID-19 positive compared to COVID-19 negative plasma and swab samples, respectively. Also, 9 and 23 significantly altered metabolites were found in severe COVID-19 positive to non-severe COVID-19 positive plasma and swab samples, respectively. The majorly affected pathways in COVID-19 patients were found to be the amino acid metabolism pathway, sphingosine metabolism pathway, and bile salt metabolism pathway. Conclusion. This study facilitates identification of potential metabolite-based biomarker candidates for rapid diagnosis and prognosis for clinical applications. © 2021, Central Research Institute for Epidemiology. All rights reserved.
ABSTRACT
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), a respiratory illness that can result in hospitalization or death. We used exome sequence data to investigate associations between rare genetic variants and seven COVID-19 outcomes in 586,157 individuals, including 20,952 with COVID-19. After accounting for multiple testing, we did not identify any clear associations with rare variants either exome wide or when specifically focusing on (1) 13 interferon pathway genes in which rare deleterious variants have been reported in individuals with severe COVID-19, (2) 281 genes located in susceptibility loci identified by the COVID-19 Host Genetics Initiative, or (3) 32 additional genes of immunologic relevance and/or therapeutic potential. Our analyses indicate there are no significant associations with rare protein-coding variants with detectable effect sizes at our current sample sizes. Analyses will be updated as additional data become available, and results are publicly available through the Regeneron Genetics Center COVID-19 Results Browser.