Risk factors for SARS-CoV-2 infection among health workers in India: a case control study.

Background: COVID-19 was declared as a Public Health Emergency of International Concern on 30th January 2020. Compared to the general population, healthcare workers and their families have been identified to be at a higher risk of getting infected with COVID-19. Therefore, it is crucial to understand the risk factors responsible for the transmission of SARS-CoV-2 infection among health workers in different hospital settings and to describe the range of clinical presentations of SARS-CoV-2 infection among them. Methodology: A nested case-control study was conducted among healthcare workers who were involved in the care of COVID-19 cases for assessing the risk factors associated with it. To get a holistic perspective, the study was conducted in 19 different hospitals from across 7 states (Kerala, Tamil Nadu, Andhra Pradesh, Karnataka, Maharashtra, Gujarat, and Rajasthan) of India covering the major government and private hospitals that were actively involved in COVID-19 patient care. The study participants who were not vaccinated were enrolled using the incidence density sampling technique from December 2020 to December 2021. Results: A total of 973 health workers consisting of 345 cases and 628 controls were recruited for the study. The mean age of the participants was observed to be 31.17 ± 8.5 years, with 56.3% of them being females. On multivariate analysis, the factors that were found to be significantly associated with SARS-CoV-2 were age of more than 31 years (adjusted odds ratio [aOR] 1.407 [95% CI 1.53-1.880]; p = 0.021), male gender (aOR 1.342 [95% CI 1.019-1.768]; p = 0.036), practical mode of IPC training on personal protective equipment (aOR 1. 1.935 [95% CI 1.148-3.260]; p = 0.013), direct exposure to COVID-19 patient (aOR 1.413 [95% CI 1.006-1.985]; p = 0.046), presence of diabetes mellitus (aOR 2.895 [95% CI 1.079-7.770]; p = 0.035) and those received prophylactic treatment for COVID-19 in the last 14 days (aOR 1.866 [95% CI 0.201-2.901]; p = 0.006). Conclusion: The study was able to highlight the need for having a separate hospital infection control department that implements IPC programs regularly. The study also emphasizes the need for developing policies that address the occupational hazards faced by health workers.

Assessment of prevalence of depression and its associated factors among tuberculosis patients in Ernakulam district, Kerala.

BACKGROUND: India is one of the few countries where Tuberculosis is still widely prevalent. People with TB, often suffers from depression. It is estimated that more than 300 million people suffer from depression at the global level, accounting to 4.4 percent of the world's population. OBJECTIVES: Primary objective-To assess the prevalence of depression among tuberculosis patients in Ernakulam district using PHQ9. Secondary objective-To assess the factors associated with depression among tuberculosis patients in Ernakulam district. METHODOLOGY: A cross sectional study was carried out among the tuberculosis patients who were currently under treatment from December 2019 to March 2020 in Ernakulam district of Kerala. From the 8 TUs of Ernakulam, 8 clusters were selected using PPS. 485 adult TB patients from these clusters were interviewed using PHQ9 questionnaire to assess prevalence of depression. RESULTS: The prevalence of depression among the TB patients in Ernakulam district was found to be 16.1%. The proportion of TB patients with depression were significantly higher among the age group of 18-40 years (36.3%), unmarried (54%) and from urban area of residence (19%). It was also significantly higher among previously treated patients (45.7%) & MDR TB patients (43.8%). CONCLUSION: It was observed that one-sixth of TB patients suffered from depression. Hence it is crucial that TB patients need to be regularly assessed for depression and managed appropriately. Since depression has affects adherence to TB treatment & thereby result in delay of TB elimination in the state.

Role of male partners in birth preparedness and complication readiness: A qualitative study.

Background In familial and societal matters, men are the decision-makers and economic resource providers in many patriarchal societies. It is important to assess the involvement of men in birth preparedness and complication readiness (BPCR), as men act as gatekeepers to women's health. We examined the role, motivators and barriers for participation of male partners of pregnant women in BPCR. Methods This qualitative study was based on the grounded theory approach. Data were collected through 29 in-depth interviews conducted among husbands (n=8), mothers (n=8), mothers-in-law (n=8), health professionals (n=5) and focus group discussions (FGDs) with pregnant women (FGD, n=3). Interviews and FGDs were transcribed; themes and sub-themes were generated and conclusions were drawn by triangulation of the data. Results Men were found to have a major role in BPCR. They supported their pregnant wives by maintaining their health, providing financial support and helping them in the decision-making process regarding treatment. They also provided complication readiness support by arranging transportation and facilitating the process of hospital admission. Conclusions Our study emphasizes how changes have occurred in the attitudes and practices over generations regarding men's role in BPCR and their participation during delivery. However, there is a long way to go for which transference of knowledge and cultural transformation have become necessities.

Motivators and Barriers for Physical Activity among Health-Care Professionals: A Qualitative Study.

BACKGROUND: Physical inactivity is one of the critical risk factors for lifestyle-related diseases. In Kerala, the life expectancy of doctors who are considered the gatekeepers of health was found to be 13 years lower than the general population. OBJECTIVE: The objective was to identify the motivators and barriers for physical activity among doctors and nurses belonging to public and private health-care sectors in Ernakulam district. METHODOLOGY: Qualitative study was conducted using a grounded theory approach. A total of 30 in-depth interviews and 8 focus group discussions were conducted among doctors and nurses, respectively. The audio-recorded data were transcribed, coded, and thematically analyzed. RESULTS: The main themes identified were motivators, barriers, and future considerations for physical activity. The factors motivating doctors were the fear of noncommunicable diseases and to stay fit, while the nurses were more concerned about their body image. The common barriers were gender, lack of time, laziness, bad climate, and safety issues. Overreliance on medication and prioritizing their patients' health over their own were additional barriers. CONCLUSION: Physical activity among doctors and nurses is severely compromised. Provision of a favorable environment and behavior change is needed to combat the silent epidemic of physical inactivity.

Prevalence of anemia and its association with dietary pattern among elderly population of urban slums in Kochi.

BACKGROUND: Anemia is common among the elderly and it is the reason behind their poor survival. Anemia among the elderly is consistently disregarded, which can even incite cardiovascular complexities. The risk of physical decline for the elderly with iron insufficiency is twofold than that of others in the same age. The elderly populace dwelling in urban slums is progressively influenced. Hence, the objective was to study the prevalence of anemia among elderly dwelling in urban slums of Kochi corporation and its association with the dietary pattern. METHODOLOGY: A cross-sectional study was carried out among 165 elderly (60 years of age and above), residing in urban slums of Kochi corporation. The hemoglobin level was measured using Heamocue and the dietary pattern was assessed by a structured pretested questionnaire eliciting a 7-day dietary recall. RESULTS: The prevalence of anemia among the elderly was observed to be 60.6%, out of which 66% were females and 49% were males. The elderly females were found to be more vulnerable to anemia. CONCLUSION: Anemia was found to be significantly high among the elderly population in urban slums of Kochi. Regular screening and management of anemia along with dietary awareness have become the need of the hour.