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PLoS One ; 17(3): e0265236, 2022.
Article in English | MEDLINE | ID: covidwho-1938430


OBJECTIVE: To determine the seroprevalence of the SARS Cov 2 infection among vaccine naive population in a rural district of South India post-second surge. METHODOLOGY: We conducted a cross-sectional study in the five villages of a randomly chosen sub-district in the Bangalore rural district. We did house to house surveys and recruited 831 vaccine naive adults in July 2021. We tested samples for the presence of antibodies (including IgG & IgM) to SARS CoV-2 using the Roche Elecsys SARS-CoV-2 -S assay that quantifies antibodies against the receptor-binding domain (RBD) of the spike (S) protein. RESULTS: We estimated an overall prevalence of 62.7% (95% CI: 59.3-66.0) and an age-and gender-adjusted seroprevalence of 44.9% (95% CI: 42.5-47.4). When adjusted for test performance, the seroprevalence was 74.64% (95% CI: 70.66-78.47). The case-to-undetected-infected ratio (CIR) was 1: 8.65 (95% CI 1:8.1-1:9.1), and the Infection Fatality Rate (IFR) was 16.27 per 100,00 infections as of 13 July 2021. A history of at least one symptom suggestive of COVID-19 or a positive COVID-19 test of self or a family member in the past were significantly associated with seropositivity. CONCLUSION: We report a high seroprevalence of COVID-19 infection despite the advantages of low population density and well-ventilated landscapes in rural areas. CIR and IFR were higher than the previous serosurvey conducted in the same population during the first surge. The thought of achieving herd immunity comes with relief. However, it's vital to put efforts into building population health and rural health infrastructure to avert future health catastrophes.

COVID-19/epidemiology , COVID-19/immunology , SARS-CoV-2/immunology , Adult , Antibodies, Viral/immunology , COVID-19 Vaccines , Cross-Sectional Studies , Female , Humans , Immunoglobulin G/immunology , India/epidemiology , Male , Middle Aged , Prevalence , RNA, Viral/immunology , Rural Population , SARS-CoV-2/pathogenicity , Seroepidemiologic Studies
BMJ Open ; 10(11): e042171, 2020 11 18.
Article in English | MEDLINE | ID: covidwho-934095


OBJECTIVES: To describe the initial dilemmas, mental stress, adaptive measures implemented and how the healthcare team collectively coped while providing healthcare services in a large slum in India, during the COVID-19 pandemic. SETTING: Community Health Division, Bangalore Baptist Hospital, Bangalore. STUDY DESIGN: We used mixed methods research with a quantitative (QUAN) paradigm nested in the primary qualitative (QUAL) design. QUAL methods included ethnography research methods, in-depth interviews and focus group discussions. PARTICIPANTS: A healthcare team of doctors, nurses, paramedical and support staff. Out of 87 staff, 42 participated in the QUAL methods and 64 participated in the QUAN survey. RESULTS: Being cognizant of the extreme vulnerability of the slums, the health team struggled with conflicting thoughts of self-preservation and their moral obligation to the marginalised section of society. Majority (75%) of the staff experienced fear at some point in time. Distracting themselves with hobbies (20.3%) and spending more time with family (39.1%) were cited as a means of emotional regulation by the participants in the QUAN survey. In the QUAL interviews, fear of death, the guilt of disease transmission to their loved ones, anxiety about probable violence and stigma in the slums and exhaustion emerged as the major themes causing stress among healthcare professionals. With positive cognitive reappraisal, the health team collectively designed and implemented adaptive interventions to ensure continuity of care. They dealt with the new demands by positive reframing, peer support, distancing, information seeking, response efficacy, self-efficacy, existential goal pursuit, value adherence and religious coping. CONCLUSION: The novel threat of the COVID-19 pandemic threw insurmountable challenges potentiating disastrous consequences; slums becoming a threat to themselves, threat to the health providers and a threat for all. Perhaps, a lesson we could learn from this pandemic is to incorporate 'slum health' within universal healthcare.

Adaptation, Psychological , COVID-19/epidemiology , Health Personnel/psychology , Pandemics , Stress, Psychological/epidemiology , Urban Population , Adult , COVID-19/complications , COVID-19/psychology , Female , Focus Groups , Humans , India/epidemiology , Male , Middle Aged , SARS-CoV-2 , Stress, Psychological/etiology , Stress, Psychological/psychology , Young Adult