Factors Associated with High Prevalence of Multibacillary Leprosy in West Bengal: A Case-Control Study.

BACKGROUND: High proportion of multibacillary (MB) among newly diagnosed leprosy cases poses a public health challenge. OBJECTIVES: This study aimed to find out the factors associated with the high burden of MB leprosy in West Bengal. MATERIALS AND METHODS: This case-control study was conducted from August 2020 to December 2022 in three high-endemic districts (annual new case detection rate ≥10/lakh) of West Bengal. OBJECTIVES: MB cases registered under the National Leprosy Eradication Programme were considered as case and paucibacillary (PB) cases were considered as control. Weighted sample sizes for cases and controls in each of the three districts were selected using simple random sampling from the list of registered leprosy patients. Requisite data were collected through structured interview with a validated questionnaire in Bengali. R, version 4.1.1 (R Foundation for Statistical Computing, 2021, Vienna, Austria) was used for data analysis. A binary logistic regression model was prepared with the type of leprosy as a dependent variable. RESULTS: Three hundred and ninety-eight individuals, 204 MB and 194 PB, participated in this study with 1.97% nonresponse rate. Gender, marital status, and diagnostic delay (adjusted odds ratio = 2.75 [1.66,4.65]) were associated with developing MB. Not perceiving the symptoms seriously (90, 56% [PB], 97, 51% [MB]), lack of knowledge about the disease and its complications (47, 29% [PB], 53, 28% [MB]), delayed referral by the private practitioners (11, 7% [PB], 22, 12% [MB]) were the major reasons of delay. CONCLUSION: This study identified a vulnerable group - married and migrated males. Changing from annual screening to quarterly screening along with capacity building and awareness generation of the targeted population is the need of the hour for eradicating the disease.

COVID-19 exposure during pregnancy and low birth weight in community development blocks, Purba Bardhaman: A retrospective cohort study.

Introduction: COVID-19 exposure during pregnancy is hypothesized to affect the birth weight of the children. Community based findings on such hypothesis are scarce in West Bengal. This study was conducted with the objective to determine the relationship between low birth weight (LBW) and maternal exposure to COVID-19. Materials and Methods: In this retrospective cohort study, mothers of children, who were born between February 2020 and October 2021 and who were registered in the subcenters of Purba Barddhaman district, West Bengal, were selected as study population. Mothers who were diagnosed as COVID-19 positive during the antenatal period were considered as 'Pregnancy with COVID' and others were considered as 'Pregnancy without COVID'. The minimum required sample size using Fleiss formula were 119 and 476, respectively, whose were selected through multi-stage random sampling. A schedule was used to collect data through review of relevant records of antenatal registers of sub-centers of selected individuals. The association was checked through multivariate logistic regression model where P < 0.05 was considered statistically significant. Results: Incidence of LBW in COVID pregnancy, Non-COVID Pregnancy group were 30.3% and 18.7%, respectively. COVID positivity during pregnancy shows relative risk of 1.62 and attributable risk of 38.28% for LBW baby as pregnancy outcome. Multivariate analysis reveals that LBW babies are significantly associated with COVID status during pregnancy (AOR 2.18, 1.3-3.63) after adjusting for anemia in pregnancy, incomplete antenatal visits, mothers age ≥30 years, parity and periods of gestation. Conclusion: The study concludes that COVID positivity during pregnancy significantly increases the risk of LBW as pregnancy outcome.

Gap Analysis in Workforce and Infrastructure in the Subcenters for Upgradation to Health and Wellness Center in a Community Development Block of Purba Bardhaman District, West Bengal.

CONTEXT: The government of India has recently decided to upgrade subcenters (SCs) to health and wellness centers (HWCs) for providing comprehensive quality services. AIMS: The present study was undertaken to determine workforce- and infrastructure-wise gaps in the SCs for upgradation to HWCs and assess knowledge of the auxiliary nurse midwives (ANMs) regarding services to be delivered through HWCs. SETTINGS AND DESIGN: This cross-sectional study was conducted in Bhatar block of Purba Bardhaman district between August and October 2019. SUBJECTS AND METHODS: Workforce and infrastructure availability was assessed using a checklist in 38 SCs and knowledge was assessed using a questionnaire among ANMs. STATISTICAL ANALYSIS USED: Data entry and analysis was done in Microsoft™ Excel™. RESULTS: No Subcentre had Community Health Officer and 23.7% of Subcentre were without second ANM. 28.9% of the ANMs had adequate knowledge about services to be delivered through HWCs. Infrastructurally, lack of staff residential facility (76.3%), water supply (34.2%), and inadequate civil construction (34.2%) were major barriers. CONCLUSIONS: Adequate recruitment of HCWs, infrastructure upliftment, and proper training of HCWs in the SCs are the need of the hour.

Effectiveness of preventive measures against COVID-19: A systematic review of In Silico modeling studies in indian context.

BACKGROUND: In the absence of any approved treatment or vaccine against novel Severe Acute Respiratory Syndrome Coronavirus -2 (SARS-CoV-2) infection, Non-Pharmaceutical Interventions (NPIs) are the cornerstone to prevent the disease, especially in a populous country like India. OBJECTIVES: To understand the effectiveness of NPIs reported in the contemporary literatures describing prediction models for prevention of the ongoing pandemic of SARS-CoV-2 specifically in Indian population. METHODS: Original research articles in English obtained through keyword search in PubMed, WHO Global Database for COVID19, and pre-print servers were included in the review. Thematic synthesis of extracted data from articles were done. RESULTS: Twenty-four articles were found eligible for the review - four published articles and twenty pre-print articles. Compartmental model was found to be the most commonly used mathematical model; along with exponential, time varying, neural network and cluster kinetic models. Social distancing, specifically lockdown, was the most commonly modelled intervention strategy. Additionally, contact tracing using smartphone application, international travel restriction, increasing hospital/ICU beds, changes in testing strategy were also dealt with. Social distancing along with increasing testing seemed to be effective in delaying the peak of the epidemic and reducing the peak prevalence. CONCLUSION: Although there is mathematical rationality behind implementation of social distancing measures including lockdown, this study also emphasised the importance of other associated measures like increasing tests and increasing the number of hospital and ICU beds. The later components are particularly important during the social mixing period to be observed after lifting of lockdown.

Prevalence of Intestinal Parasitosis among Under-Five Children in a Rural Community of Purba Bardhaman District, West Bengal.

CONTEXT: Intestinal parasitosis (IP), a group of diseases caused by one or more species of protozoa and helminths, is still considered a neglected tropical disease and a public health concern in India. Poor sanitation and unhygienic conditions largely contribute to sustained transmission, primarily among children, adversely affecting health and development. The problem needs area-specific assessment and interventions. AIMS: The present study aimed at determining the prevalence of IP and its correlates among under-five children in a rural community of Purba Bardhaman district, West Bengal, India. SETTINGS AND DESIGN: A descriptive cross-sectional study was conducted in Bhatar Block of Purba Bardhaman district. SUBJECTS AND METHODS: Mothers/caregivers of 294 under-five children (selected through multistage sampling) were interviewed for background characteristics at the household level, and stool samples from each child were collected, transported, and examined for ova/parasite/cysts following standard guidelines. STATISTICAL ANALYSIS USED: Statistical analysis of the data obtained was done using SPSS (V20). RESULTS: The overall prevalence of IP was 17.0%. Majority of the intestinal parasites were protozoa (42, 84%), of which the most common was Giardia lamblia (24, 48.0%). Age of the child and practice of defecation showed a significant association with IP on logistic regression. CONCLUSIONS: Protozoa, mainly G. lamblia, contributes for majority of intestinal parasitic infections among the study population, and children belonging to the age group of 25-60 completed months and with open-field defecation practice have higher risk of acquiring them.