Profile of COVID-19 breakthrough cases and its comparison with unvaccinated COVID-19 cases among healthcare workers in a tertiary care centre in North Kerala.

Background: Healthcare workers (HCWs) were the most vulnerable group during COVID-19 pandemic and had faced many challenges including high rate of breakthrough infections. Aims: To study the incidence of reported breakthrough infections among HCWs in Government Medical College, Kozhikode and to compare profile of COVID-19 infection between fully vaccinated and unvaccinated COVID-19 positive HCWs. Settings and Design: The research was conducted as a prospective study for a duration of 78 weeks from 1st of March 2020 through 31st of August 2021 in Government Medical College, Kozhikode. Methods and Material: The study was conducted among HCWs in a COVID-19 tertiary care institute. Real-time data were collected from 401 breakthrough cases and 390 unvaccinated COVID-19 positive HCWs through telephonic interviews. Statistical Analysis Used: Univariate analysis was done using frequency for categorical variables and mean and standard deviation for quantitative variables. Chi-square test was used to find out statistical significance. Results: Incidence of breakthrough infection was found to be 5.62% with 43.3% being asymptomatic. Fever was the most predominant symptom (62.5%). None of the breakthrough cases developed complication requiring intensive care (ICU). There was a reduction in incidence of acute post-COVID-19 syndrome in vaccinated group (17.45%) compared to unvaccinated group (57.2%). Conclusions: COVID-19 vaccination plays a key role in preventing severity, complication, and ICU admissions in COVID-19 infection. Incidence of post-COVID-19 syndrome is also less among fully vaccinated compared to unvaccinated individuals.

Nipah Virus Infection in Kozhikode, Kerala, South India, in 2018: Epidemiology of an Outbreak of an Emerging Disease.

BACKGROUND: An outbreak of the rare and highly pathogenic Nipah virus infection occurred in Kozhikode, Kerala, India, during May 2018. METHODOLOGY: Outbreak control activities included laboratory case confirmation and isolation. Contact surveillance was initiated and close contacts were home quarantined for the maximum incubation period of the disease. Field visits and verbal autopsy of the deaths were done to elicit the details of exposure. RESULTS: Of the 18 confirmed cases, 16 succumbed (case fatality rate, 88.8%). The mean incubation period was 9 days. The transmission was person to person wherein the primary case served as a point source for 15 other cases including 2 health-care workers. The mean age of the affected cases was 41 years with male preponderance. More than 2600 contacts were under surveillance. The outbreak was contained within 3 weeks and declared closed by July the same year. CONCLUSION: Early detection of the outbreak and prompt isolation of cases along with strengthening of infection control practices and barrier nursing helped in containing the outbreak.

Quality of life and sociodemographic factors associated with poor quality of life in elderly women in Thiruvananthapuram, Kerala.

BACKGROUND: India is going through a phase of demographic transition leading to population aging and feminization of aging resulting in increased proportion of elderly women than men. Problems faced by the elderly women are more critical than men due to family and social conditions prevailing in India. OBJECTIVE: The study made an attempt to assess the quality of life (QOL) using the World Health Organization QOL (WHOQOL-BREF) scale and sociodemographic factors affecting QOL of elderly women residing in a community setting in South Kerala. METHODS: A community-based, cross-sectional study to assess the QOL of elderly women using WHOQOL-BREF questionnaire. Data were collected from 160 elderly women. RESULTS: 2.5% (95% confidence interval [CI]: 0.07-4.84) of the study participants were having "very good" QOL. 38.8% (95% CI: 31.2-46.4) had "good," 43.1% (95% CI: 35.4-50.8) had "poor," and 15.6% (95% CI: 9.98-21.22) had "very poor" QOL, respectively. QOL was least in the psychological domain followed by physical and health-related, social, and environmental domains. Logistic regression revealed age above 70 years (adjusted odds ratio [OR] - 11.3), nonpossession of property (adjusted OR - 8.99), neglecting attitude by family (adjusted OR - 6.9), and absence of visit by friends and relatives (adjusted OR - 9.9) as risk factors, whereas residing in the urban area as a protective factor (adjusted OR - 0.1) for poor QOL. CONCLUSION: It is possible to improve the QOL of elderly women by providing financial security, ensuring care, and by enhancing social relationships of elderly women.

Economic impact of chikungunya epidemic: out-of-pocket health expenditures during the 2007 outbreak in Kerala, India.

The southern state of Kerala, India was seriously affected by a chikungunya epidemic in 2007. As this outbreak was the first of its kind, the morbidity incurred by the epidemic was a challenge to the state's public health system. A cross sectional survey was conducted in five districts of Kerala that were seriously affected by the epidemic, using a two-stage cluster sampling technique to select households, and the patients were identified using a syndromic case definition. We calculated the direct health expenditure of families and checked whether it exceed the margins of catastrophic health expenditure (CHE). The median (IQR) total out-of-pocket (OOP) health expenditure in the study population was USD7.4 (16.7). The OOP health expenditure did not show any significant association with increasing per-capita monthly income.The major share (47.4%) of the costs was utilized for buying medicines, but costs for transportation (17.2%), consultations (16.6%), and diagnoses (9.9%) also contributed significantly to the total OOP health expenditure. The OOP health expenditure was high in private sector facilities, especially in tertiary care hospitals. For more than 15% of the respondents, the OOP was more than double their average monthly family income. The chikungunya outbreak of 2007 had significantly contributed to the OOP expenditure of the affected community in Kerala.The OOP health expenditure incurred was high, irrespective of the level of income. Governments should attempt to ensure comprehensive financial protection by covering the costs of care, along with loss of productivity.

Determinants of childhood tuberculosis--a case control study among children registered under revised National Tuberculosis Control Programme in a district of South India.

AIM: To study the determinants of Tuberculosis (TB) in children between the age group of 0-14 years receiving treatment under Revised National TB Control Programme (RNTCP). METHODS: A case (registered under RNTCP) control study was undertaken with 41 cases and 82 controls. RESULTS: Factors found to have significance according to binary logistic regression were low-birth weight (LBW) [Odd's ratio = 3.56],Malnutrition [Odd's ratio = 3.96], Passive smoking [Odd's ratio=6.28] and exposure to fire-wood smoke [Odd's ratio = 6.91]. CONCLUSION: LBW, malnutrition, passive smoking and fire-wood smoke are the risk factors to be addressed to prevent pediatric TB.