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Globally Tuberculosis (TB) is 13th leading cause of mortality and the 2nd leading infectious killer after COVID-19, 1.6 million people died in 2021 from TB (including 187 000 people with HIV). The emergence of COVID-19 pandemic situations on the already overburdened health care system of India may have affected new TB cases notification as well as treatment, setting back the previous achievements made to eliminate TB by 2025. Lockdown-induced under-reporting (80% reduction in TB notification rates) of active TB will affect TB epidemiology as well as NTEP (National Tuberculosis Elimination Program) elimination goal by 2025. There are significant studies which found that COVID-19 is promoting the growth of active tuberculosis in a patient with dormant/latent tuberculosis infection. In the COVID-19 epidemic, diagnosis and treatment of tuberculosis, or tuberculosis and the co-infection with COVID-19, may be compromised as TB and COVID-19 both present with respiratory symptoms that are similar to each other. According to the 2019 India TB Report, 2, 24,000 incident cases per year of paediatric TB are estimated accounting for 22% of global burden. In spite of many similarities and differences, there is still a lack of clarity about the exact epidemiological relationship between COVID-19 and TB. This was a cross-sectional, retrospective, quantitative;research study aimed to know the impact of COVID-19 era on TB (tuberculosis) notifications in India (includes all 36 states and UTs of India). All the 36 participants' states and UTs newly detected tuberculosis cases notifications were followed from 1st January 2017 to 31st December 2022. The total number of newly detected tuberculosis cases notifications from 1st January 2017 to 31st December 2022 was 12290180 (n) including all 36 participants. The (period prevalence) total number of newly detected tuberculosis cases notifications during pre-COVID-19 era (2017-2019) was 5914621 and during the COVID-19 era (2020-2022) were 637559. The total annual newly detected tuberculosis cases notifications (including public and private healthcare facilities) in India including all 36 participants from beginning of year 1st January till 31st December during a year were 1525045, 1997873, 2391703, 1810834, 2145678, 2419047, for years 2017, 2018, 2019, 2020, 2021, and 2022 respectively. The mean of newly detected tuberculosis cases notifications from all public and private healthcare facilities during Pre-COVID-19 era (2017-2019) was 164295 (Std. Err. - 37404.92;[95% Conf. Interval] - 88359.01- 240231;Std. Dev. - 224429.5). The mean of newly detected tuberculosis cases notifications from all public and private healthcare facilities during COVID-19 era (2020-2022) was 177098.9 (Std. Err. - 43081.17;[95% Conf. Interval] - 89639.43 -264558.3;Std. Dev. - 258487). The incidence rate of newly detected tuberculosis cases notifications per lakh population was 112.62;145.94;172.92;129.68;152.44;and 169.63 respectively for years 2017, 2018, 2019, 2020, 2021, 2022. This research study revealed that the incidence rate of newly detected tuberculosis cases notifications per lakh population kept on increasing during the pre-COVID-19 era and it decreased abruptly during the first COVID-19 year 2020 by 25.00 percent (%) compared to previous year of pre-COVID-19 era 2019.
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The inpatient department or IPD is the dedicated unit of a hospital/healthcare facility for admitting patients from the OPD (outpatient department), ED (emergency department), or a referred patient usually from lower facilities for a planned care/procedure, for special medical problems that necessitate hospital admission for suitable care and consideration. The index case of SARS-CoV-2 virus infection in India was first suspected (based on clinical grounds) on 27th January 2020, an assumed case of covid-19 in Kerala with a that time recent voyage history of Wuhan, china was affirmed as SARS-CoV-2 virus infection positive case by the NIV (National Institute of Virology) situated at Pune in Maharashtra, on January 30th, 2020 as positive for COVID-19. As per the constitution of India Health is a subject matter of state, hence different states had reserved different percentages of beds in pre-existing health facilities for COVID-19 IPD patients, for example, the Delhi government had reserved 50% of pre-existing ICU (intensive care unit) and ward beds for COVID-19 IPD patient's. Besides the other factors such as fear etc, this new arrangement of hospital care delivery and prioritization of needs of COVID-19 patients may have resulted in the general cancellations of other IPD patients elective procedures leading to a reduced IPD number of patients with diseases other than COVID-19, as priority was shifted to COVID-19 admitted patient's and cases. The first author researcher of this study has found unusual prevalence in the figure of IPD (Inpatient Department) hospital admissions during his normal course of duties at health centres throughout the current ongoing COVID-19 (coronavirus disease-2019) era. To know about the real scenario this epidemiological deductive study was done to confirm that, does the COVID-19 era have affected the number of IPD hospital admissions (positively or negatively) in India? The aim of this 41months comparative, quantitative, deductive, Cross-Sectional Research Study is to assess the impacts of COVID-19 on the prevalence of IPD hospital admissions in India (other than COVID-19), across all public/private/rural/urban health facilities of 36 states and union territories registered on HMIS (Health Management Information System) of Ministry of Health and Family Welfare (MoHFW), Government of India. The total mean number of IPD admissions for the 17 months (2020-2021) COVID-19 pandemic epoch, was 5387311 compared to 7435770 of IPD admission for the pre-pandemic 2 years (2018-2019). The total mean number of IPD admission decreased by 2048459 during the COVID-19 pandemic epoch i.e. 27.55% decrease is observed during COVID-19. This research study revealed that there is a significant decrease in IPD hospital admissions for various medical conditions other than COVID-19 during the COVID-19 pandemic epoch which is a matter of concern for policy and decision-makers.
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BACKGROUND Acute treatment in emergency case management is required for survival and stabilization of critical patients, followed by a shifting to the relevant medical department for further care. However, for the seriously ill critical patients, i.e., when the care provided by the Emergency Department (ED) of the hospital is not enough to enable transfer, death may occur while treatment in the emergency department. This aspect of emergency management is often overlooked, and very few researcher and government is really serious regarding who dies in the ED. AIM AND OBJECTIVE The aim of my study was to determine the total MORTALITY OCCURRING IN INDIA FROM 1ST JANUARY 2019 TO 31ST MAY 2021(LIMITATION HERE DUE TO DATA AVAILABILITY IS LIMITED FROM ACCREDITED SOURCE) of emergency department admissions of public and private health facilities. The objective is to find out if there is increase or decrease in mortality of emergency department admissions during the covid-19 pandemic era by comparing average mortality of ED per month of public, private, rural, urban health facilities before the pandemic from 1st and 2nd year of pandemic i.e. 2020 and 2021 respectively METHODS This research study is a cross sectional retrospective analysis of the mortality occurring at the emergency department of public and private, rural, urban hospitals from 1st January 2019 to May31st 2021 with aim to find out impact of covid-19. Electronic patient records from HMIS (health management information system) of MoHFW (ministry of health and family welfare) , Government of India is collected, observed, analysed, compared for all patients deaths occurring at Emergency Department (ED) of public and private, rural, urban health facilities (_n_ = 452102) during the period JANUARY 2019 TO MAY 2021. RESULTS The study results found that LARGEST TOTAL NUMBER OF DEATH OCCURRED IN THE ED DURING MAY 2021 whereas the least number of deaths occurred in February 2019 (limitation is data availability up to May 2021 from accredited sources). During the first year of the pandemic, average mortality per month (Jan2020-Dec2020) in the emergency department (ED) of rural, urban, public and private hospitals in India was 16067per month whereas before the pandemic it was 12542 per month while during second year of pandemic i.e. 2021 the average mortality increased to 21758 per month (up to May 2021). DISCUSSION Recently a new strain omicron has again disrupted the normal life and lockdown and other measures are being implemented by different countries to save lives. The mortality at ED are having various aetiologies, clinical severity at time of admission has a direct correlation with mortality, which requires the necessity of advanced triage system. There exists a lack of proper knowledge and advanced directives in the beginning i.e. December 2019 of the covid-19 pandemic era. CONCLUSIONS Due to novel disease majority of clinicians have challenging situation as well as Emergency Medicine (EM) teams faced a sudden increase in the number of cases with limited resources. Furthermore, a lack of proper knowledge and directives may have hindered access to proper care, as witnessed in many part of the world and available in various literatures. The authors hope that this study will help global researchers as well as policy makers to promote further research and discussion into preparation methods for such pandemics to reduce patient risk of death in the ED. KEYWORDS Emergency department, Death, Covid-19, Pandemic, Health facilities
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BACKGROUND The safety of women is of significance and prime concern in India due to a huge female population, equity issues, gender issues, lack of positive deviance at community level, illiteracy, socio-economic factors, migration from rural to urban areas, inaccessibility to legal help and of course many more factors. The SARS-CoV-2 pandemic had presented a challenge even for developed nations around the world regarding women's protection in the ongoing pandemic era & especially in the lockdown period when it's really difficult to go out and shout for help. AIM AND OBJECTIVES The main aim of this research is to find out impact of SARS-CoV-2/Covid-19 Pandemic on violence against women in India across different states and union territories from the beginning of pandemic i.e. January 2020. The objective is TO FIND OUT THAT THE COVID-19 ERA HAS A POSITIVE OR NEGATIVE IMPACT OVER VIOLENCE AGAINST WOMEN. Data from various accredited sources were continuously collected, observed and analysed for this research study. SETTINGS & DESIGN The month-wise and state-wise data indicating number of complaints registered with National Commission for Women in India(NCW) under different categories are presented in different table 1, 2, 3, 4,5,6,7,8 (see at end) will be discussed and displayed. The period of study is from January 2018 to 2021 December. This is a retrospective cross-sectional continuous observational qualitative and quantitative as well as comparative study. The two years of covid-19 pandemic i.e. 2020 and 2021 is compared two previous two years to know the impact of covid-19 on violence against women in India. MATERIALS & METHODOLOGY The data is collected from accredited and reliable sources of National commission for women, India as well as various other sources listed in this research study. The data obtained is analysed by using Microsoft Office software. To reduce the length of article the detailed description and analysis is not provided in this version. RESULT INCREASE IN VIOLENCE AGAINST WOMEN IN INDIA IS SEEN IN THIS COVID-19 PANDEMIC ERA as compared to pre-pandemic years under observation. SEE Figure 1 and figure 2:- comparison of number of cases of domestic violence and various forms of violence to know the impact of SARS-CoV-2 pandemic and lockdown situations in India. DURING THE SECOND YEAR OF PANDEMIC I.E. 2021 THE TOTAL NUMBERS OF NATURE-WISE REPORT OF THE COMPLAINTS RECEIVED BY NCW WAS 30865 WHICH IS AN INCREASE BY 55.03 % COMPARED TO 2018 AND 56.43 % AS COMPARED TO 2019. CONCLUSION India should have various strategies to ensure safety of women and their mental health issues in such pandemic like situations. It seems that present laws and regulations are insufficient to give the desired results. The barriers of legal and protective system and delivery of helpful services etc. constraints should be rectified added with a proper dynamic plan to carry on usual women protection services even in pandemics and natural disasters. _KEYWORDS- _SARS-COV-2, PANDEMIC, VIOLENCE, WOMEN, LOCKDOWN, DOMESTIC ABUSE
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BACKGROUND: Curiosity and need are the major forces driving invention and discoveries. The covid-19 pandemic is said to be originated from Wuhan of Hubei province in china. This statement has raised many questions and doubts about origin and spread of disease and the controversy is still going on. The geographical location of Wuhan in relation to sea is of significant value in relation to covid-19 pandemic as observed in this research. The CITY OF WUHAN is located on both banks of the Changjiang (the Great River, a.k.a the Yangtze River) about six hundred miles upstream from Shanghai and the PACIFIC OCEAN. It is about four hundred miles upstream from Nanjing. Its location is supremely strategic, being where the Hanshui (Han River) joins the Changjiang. The Wuhan Huanan Seafood Wholesale Market was in news and highlighted by several media and news agency as probable source of origin of covid-19. The Huanan Seafood Market located in Wuhan is a live animal and seafood market in Jianghan District, Wuhan City, and the capital of Hubei Province in Central China. OBJECTIVE: This continuous observational research analysis aimed to assess the IMPACT OF GEOGRAPHICAL LOCATIONS PARTICULARLY COASTAL INFLUENCE on the total/average/maximum/minimum confirmed cases and deaths from COVID-19/SARS-CoV-2 pandemic in 36 states and union territories of India, during COVID-19 pandemic from the beginning of pandemic cases in January 2020 in India with SPECIAL FOCUS ON COASTAL STATES AND UNION TERRITORIES OF INDIA. The coast is also known popularly as the coastline or seashore is the area where land meets the sea or ocean, or as a line that forms the boundary between the land and the ocean. The term coastal state and union territories is used to refer to a state where interactions of sea and land of states occur. The study also aims to find SAFEST GEOGRAPHICAL LOCATION IN COVID-19 PANDEMIC. METHODS: This is a novel cross-sectional mixed (quantitative and Qualitative) continuous observational research study. The information on the number of cases and deaths due to COVID-19 pandemic in 36 states and union territories of India is obtained from Health Department, Ministry of Health and Family Welfare (MoHFW), Government of India, and data were matched and analyzed from online websites as well. The impact of geographical locations on the total/average/maximum/minimum confirmed cases and deaths from COVID-19/SARS-CoV-2 pandemic in 36 states and union territories of India was analyzed with Microsoft office and with more data collection STATA 15.1 FOR WINDOWS (64BIT) WILL BE USED WHEN REQUIRED WITH MICROSOFT OFFICE IN NEXT VERSION-3 OF ARTICLE (FOR BIGGER ANALYSIS) FOR EPIDEMIOLOGICAL COMPARISON BY CALCULATING INCIDENCE, PREVALENCE, MORTALITY RATE AND OTHER INDICATORS. THE STUDY FOR GLOBAL CORRELATION OF THIS RESEARCH IS ALSO UNDER PROCESS BY THE AUTHOR. For the purpose of research INDIA IS DIVIDED INTO FOUR GEOGRAPHICAL AREAS, 1 Coastal states and union territories (total ten in numbers), 2 Island groups (three in numbers), 3 north eastern states and east area i.e. Laddakh 4 other states and union territories having plain areas (14 in numbers). RESULTS: The findings showed that total numbers of death from covid-19 is HIGHEST IN COASTAL STATES and union territories with a count of 323674 since beginning of the pandemic whereas the islands group reported the lowest total 184 numbers of deaths from covid-19 as on 05 Jan 2022, 08:00 IST (GMT 5:30) . The average death from covid-19 is highest in coastal states and union territories group with a count of 32367.4 followed by other states and union territories group with a count of 10431.21429. The islands group reported the lowest average numbers of death from covid-19 with a count of 61.33. A similar trend was found for numbers of confirmed cases with COASTAL STATES ON TOP having largest number of covid-19 cases. IN THIS VERSION 2 THE PREVALENCE RATES ARE ALSO CALCULATED PER 100000. CONCLUSIONS: The research observation found that coastal states and union territories of India have larger number f daily cases of COVID-19 and mortality 867 per 100000 as compared to other geographical locations of the country. The observation also found that islands have least number of cases and deaths 115 per 100000 due to covid-19 pandemic. This study also gives rise to hypothesis that coastal locations are at greater risk of covid-19 infection and mortality whereas islands are safest places in covid-19 pandemics. KEYWORDS: COASTAL STATES, COVID 19, MORTALITY, CONFIRMED CASES, UNION TERRITORIES, GEOGRAPHICAL IMPACT
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Almost all the countries around the world are experiencing high levels of air pollution. How does pollution impact our body in times of COVID-19? Air pollution and related climatic-environmental changes is one of the prime concern and biggest challenge globally in 21st century faced by most of the nations. The global impact of this public health problem can be assessed and understood from the data of morbidity and mortality as well as DALY (disability adjusted life years) & QALY (quality adjusted life years), YLL (years of life lost) measurements. Today global air is having several varieties and types of air pollutants which are taking lives of people on daily basis and the death count may be more as compared to covid-19 deaths. The finest and smallest particulate matters present in air as byproducts of several human and industry related activities are able to infiltrate the respiratory system through inhalation while breathing, leading to respiratory and cardiovascular system(CVS) diseases, reproductive and central nervous system(CNS) diseases and malfunctioning as well as various carcinoma. Ozone (O3) protects us from harmful effects of UV (ultra violet) radiations which can cause cancers, skin diseases as well as mutations etc but at the same time it is harmful when in high concentration at ground level, affecting the respiratory and cardiovascular system. Added to this other pollutants present in air such as nitrogen oxide(NO), sulfur dioxide(SO2), Volatile Organic Compounds (VOCs), dioxins, and polycyclic aromatic hydrocarbons (PAHs) are all important air pollutants which are known to be harmful to human beings. Carbon monoxide (CO) can bind with haemoglobin (Hb) very tightly (not allowing oxygen to be released at tissue level causing tissue hypoxia) forming carboxy-haemoglobin which can cause poisoning when breathed in at high levels. Heavy metals for example lead (Pb) can lead to direct poisoning (plumbinism or saturnism) or chronic intoxication can lead to a variety of CNS, GIT(gastrointestinal tract), and reproductive system diseases, depending on the exposure. Air pollution usually causes respiratory problems such as Chronic Obstructive Pulmonary Disease (COPD), asthma, bronchiolitis, lung cancer, cardiovascular events, central nervous system dysfunctions, and cutaneous diseases. Added to this, the climate change resulting from environmental pollution affects the geographical distribution of many infectious diseases like natural disasters as well as affects social and environmental determinants of health. The only way to tackle this problem is through public health awareness, strategies to reduce air pollution as well as environmental protection measures with a multidisciplinary Intersectoral approach by scientific experts of national and international organizations. The global leaders must address the emergence of this threat and propose sustainable and suitable solutions to deal this challenging issue. KEYWORDS: Covid-19, air pollution, environment, health, disease, policy, pollutant, public health
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The First human case of the covid-19 global pandemic was reported from Wuhan city of China in December 2019. On 27th January 2020, India found a suspected case of covid-19 in Kerala with a recent travel history of Wuhan;china. The suspected case was reported as positive by the National Institute of Virology located at Pune in Maharashtra, India on January 30, 2020 as positive for COVID-19 infection. This was the first documented COVID-19 case in India. The government of India responded to this novel disease by enforcing nationwide lockdown starting on 25/03/2020 and ending on 31/05/2020. In this retrospective observational quantitative and qualitative study I have done assessment of the impact of covid-19 lockdown measures on OPD health services for some important non communicable diseases. The data is collected, observed, analyzed for the years 2020 and 2019 and the lockdown period of April-May 2020 is compared with the same duration of 2019 (excluding period of 7 days of lockdown in march) . The OPD (outpatient Department) services for the patients of Diabetes, Hypertension, Stroke (CVA), Acute Heart Disease, Mental Illness, Epilepsy, Ophthalmic, Dental and oncology were selected for this observational retrospective study-analysis. IN VERSION 2 TIME SERIES ANALYSIS (LONGER PERIOD) WILL BE APPLIED TO TEST THE SIGNIFICANCE OF DIFFERENCE BETWEEN PRE AND POST INTERVENTION (LOCKDOWN). The study found as compared to 2019 when lockdown and pandemic was not in existence, 2020 lockdown period have notable reduction in various OPD health services. The study have derived conclusion that lockdown reduced number of OPD patients and hence reduced access to the health services for non-communicable disease which is the major burden of disease in India as well as at global levels. In the final conclusion the author feel the need of more emphasis and priority for NCDs care in any situations of emergency like pandemic and natural calamities, lockdowns etc which usually disrupt routine healthcare. Routine healthcare is very essential in context of chronic diseases which can be converted to acute emergency conditions like CVA. KEYWORDS: OPD, HEALTH FACILITY, COVID-19, LOCKDOWN
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BACKGROUND: The proper, timely, adequate delivery of effective and high quality child health and reproductive (RCH) services is of greatest significance and utmost priority mainly because of situations erupting from the current ongoing pandemic of covid-19 as well as other cofactors in the state of Rajasthan, India. This significance and priority is particularly due to many factors such as huge as well as increasing population with limited qualified, skilled human resources OBJECTIVE OF STUDY: The key objective is to find out the effects of SARS-CoV-2/ Covid-19 pandemic on the Reproductive and Child Health Programme of Rajasthan in India over the 3 months after Lock down enforcement nationwide in March 2020. SETTINGS & DESIGN: Different indicators of RCH programme i.e. immunisation, maternal and child health, family planning) for Rajasthan were observed, studied, collected and compared with previous year 2019for the period of April/May/June -2019 and 2020. The percent increase and downfall is observed, calculated, presented, from the available data to find out the status of delivery of essential RCH health services. The need assessed and percent of achievement of assessed need is also compared and future achievement projected as per achievement. MATERIALS & METHODOLOGY: To know the effect of pandemic era on RCH health programme of Rajasthan during the period from3 months after lock-down announced in the month of March 2020 i.e. April/May/June 2020 in Rajasthan the data observed, calculated and obtained from HMIS (Health Management Information System- of Ministry of Health and Family Welfare (MoHFW), Government of India for RC Health programme, (Reproductive and Child Health). RESULT: The results of data analysis for RCH services, functioning in the state of Rajasthan during the month during the period from April to June 2020 (during the period from lockdown) as compared to 2019(no lockdown, for same duration suggest that the immunisation services were badly affected during the period from the lockdown period in 2020. It is possible that new born children and the older ones have not received/delivered proper immunisation services during the period from the lockdown as evident from the data observation-analysis. CONCLUSION: India and different states have launched several plans and strategies to deal with covid-19 pandemic. However this study report found that insufficient attention has been given to very essential services of RCH in Rajasthan as evident from the results of this study. The problems in the delivery of healthcare services should be dealt with properly, timely, adequately added with a proper update of the latest dynamic plan to carry on essential health delivery services even in pandemics and other situations of emergencies. Rajasthan should develop an exclusive updated latest dynamic plan to deal with situations to guarantee delivery of very essential services such as RCH during the period from pandemics or any other natural calamities-emergencies. The ongoing Covid-19 pandemic has disclosed the vulnerability of women and children and at the same time teaches us about the importance of equity in healthcare. The children and women who are considered most vulnerable in emergencies and distress must have special supportive healthcare all the time especially during the period from pandemics-emergencies and other natural disasters. KEYWORDS- HEALTH, DECREASE, PANDEMIC, SERVICES/SERVICE, COVID-19, SARS-COV-2
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BACKGROUND: My research aimed to assess the impact of lockdown on SARS-CoV-2/COVID-19 pandemic 13 days before lockdown, first and second 13 days during lockdown, and 13 days after the lockdown on the trends in the incidence, prevalence and mortality in the state of Bihar, India, during COVID-19 pandemic. METHODS: The information on the number of cases and deaths due to COVID-19 pandemic in Bihar was obtained from Health Department Bihar, Ministry of Health and Family Welfare, Government of India, and lockdown data were obtained from online websites as well. The impact of lockdown for 13 days before lockdown, first and second 13 days during lockdown, and 13 days after the lockdown on the incidence, prevalence and mortality due to the COVID-19 pandemic in Bihar was analyzed with Microsoft office and stata 15.1 for windows (64bit) will be used with Microsoft office in next version-2 of article. RESULTS: The findings showed that except for Incidence /100000/ new death there was a trend toward a decline, and except for Prevalence/100000/confirmed cases from beginning of pandemic all other prevalence have increased. The total and observation period mortality rate due to the COVID-19 pandemic also increased. CONCLUSIONS: The findings indicate that 13 days after the lockdown, incidence, daily cases of COVID-19 and the growth of the disease showed a declined trend, but there was no significant decline in the prevalence and mortality.