ABSTRACT
BACKGROUND: COVID-19 pandemic resulted in widespread and devastating physical, emotional, societal, and economic repercussions among workers in India. OBJECTIVES: To evaluate the impact of COVID-19 and to understand the challenges faced and coping mechanism adopted among fishermen community from the coastal area of Karnataka. METHODOLOGY: This community-based mixed-methods study included participants from a coastal Karnataka fishermen's community. Questionnaire based personal interviews collected information on sociodemographics, COVID-19 diagnosis, treatment, and related costs, COVID-19-appropriate behavior and were screened using DASS-21. Focus group discussions and key informant interviews were conducted to acquire qualitative data. RESULTS: Quantitative data collection involved 107 participants, predominantly males [70.1%], aged between 46-60 years [37.4%] and low socioeconomic status [79.4%]. Among 107, 51 participants reported to have probable COVID-19 symptoms. Around 11% had tested for COVID-19 and two were admitted in hospital with mean hospital stay of seven days. According to DASS-21, 20.6%, 15.9% and 9.3% of participants screened positive for depression, anxiety and stress respectively. Nearly one third of the participants were found to have significant socioeconomic impact.Major challenges faced included loss of livelihood, inaccessibility to health care, repayment of loans, stigma related to COVID-19 and meeting educational expenses of children with one dropping out of college. Activities of local self-help groups in the community and grass root level marketing strategies to sell fish were highly successful in mitigating the impact as a community. CONCLUSION: COVID-19 had a significant impact on fishermen community and implies a need for better pandemic and disaster preparedness strategies in the community.
ABSTRACT
Background': India is ranked second in the world in terms of tobacco use and tops the list of eight high-burden countries that account for two-thirds of the new tuberculosis (TB) cases globally. As tobacco smoking among TB patients is associated with unsuccessful TB treatment outcomes, effective smoking cessation interventions for TB patients is essential to combat this double pandemic. Aim: The study determined the effectiveness of nicotine replacement therapy (NRT) on smoking reduction and cessation among pulmonary TB patients. Settings and Design: The study included 300 pulmonary TB patients undergoing antitubercular treatment in government health care centers of Dakshina Kannada district in southern India. Materials and Methods: The participants in this two-armed, single-blinded, placebo-controlled, block-randomized trial were divided equally (n = 150) for experimental arm (brief advice + NRT) and control arm (brief advice + placebo). The total duration of treatment and follow-up was 6 months. Unadjusted relative risk (URR) and adjusted relative risk (ARR) were calculated for treatment outcomes at 95% confidence interval (CI). Generalized linear regression analysis was performed upon variables with P value less than 0.2. Results: After 6 months of intervention including follow up, there was a significant reduction in self-reported smoking (ARR = 1.08, 95% CI 1.01-1.17, P = 0.03) in the experimental arm compared with the control arm. Biochemically verified smoking abstinence was not significantly different between the two arms (ARR = 1.01, 95% CI 0.72-1.38, P = 0.97). Conclusion: The study showed statistically significant effectiveness of NRT for self-reported smoking reduction.
