Navigating diagnostic and therapeutic challenges in ocular manifestations of Hansen's disease and trachoma: A narrative review.

Neglected tropical diseases (NTDs) encompass a group of approximately 20 diseases prevalent in tropical and subtropical regions, closely associated with poverty, affecting over a billion people in low-income countries. This manuscript aims to explore the ocular manifestations and burden of two significant NTDs, namely Hansen's disease and trachoma while addressing gaps in understanding and management. Hansen's disease, caused by Mycobacterium leprae , has a long history and presents with diverse neurological and ocular manifestations. Despite the availability of treatment, ocular complications persist, leading to significant visual impairment in some cases. The manuscript emphasizes the importance of early diagnosis, regular ophthalmic examinations, and follow-ups to prevent and control ocular complications, reducing the burden of visual impairment and blindness. Trachoma, caused by Chlamydia trachomatis , remains the leading infectious cause of blindness in underdeveloped and remote areas. The manuscript highlights the clinical diagnosis and implementation of the World Health Organization's (WHO's) SAFE (surgery, antibiotics, facial hygiene, and environmental sanitation) strategy to prevent transmission and associated blindness. However, challenges in health surveillance tools and underreporting of trachoma cases are addressed, emphasizing the need for improved strategies to combat the disease effectively. Through a comprehensive review of the ocular manifestations and management of Hansen's disease and trachoma, this manuscript contributes to the existing knowledge base and enhances a deeper understanding of these NTDs. Addressing gaps in understanding and management emphasizes the importance of implementing WHO's strategies and collaborative efforts to achieve the global goal of reducing the burden of NTDs and improving community health and well-being. The manuscript underscores the significance of early intervention, preventive measures, and technological advancements, providing valuable insights for policymakers, healthcare professionals, and researchers working in the field of NTDs.

Active Screening for Pulmonary Tuberculosis Among Jail Inmates: A Mixed Method Study From Puducherry, South India.

BACKGROUND: Sustainable Development Goal 3 (SDG) aims to end the epidemic of TB by 2030. To achieve this goal, active screening should be initiated in the target populations. These target populations are those without access to proper healthcare like jail inmates. With pulmonary tuberculosis (PTB) being cosmopolitan in India, passive case finding alone cannot suffice to achieve the above-mentioned goal. Thus, active case finding (ACF) becomes the need of the hour. So, we aimed to conduct a mixed methods study that has a quantitative component, i.e., to actively screen the prison inmates for PTB, and a qualitative component, i.e., to know the perceptions of jail inmates towards PTB and the stigmas associated with it. METHODOLOGY: This was a mixed-method study conducted in the Central Jail, Puducherry. The quantitative component involved a facility-based cross-sectional study design and the qualitative component involved a focused group discussion (FGD). Participants were screened for PTB and diabetes mellitus (DM) and their anthropometry (weight, height, body mass index {BMI}, waist-to-hip ratio {WHR}) was noted. Presumptive cases were identified as those with symptoms of cough for more than two weeks with or without other concomitant symptoms. They were subjected to cartridge-based nucleic acid amplification test (CB-NAAT) assay. Data were entered in MS Excel 2017 and analyzed using SPSS version 16 (Armonk, NY: IBM Corp). For the qualitative exercise, purposive sampling with maximum variation technique was done to enroll a diverse subset of population for the FGD. Iterative analysis of the content was performed by the team to generate codes and themes. RESULTS: Out of all the 187 inmates screened, 10.7% were symptomatic. On CB-NAAT examination of the symptomatic inmates, none turned positive. The inmates with presumptive TB were older by age and had a higher proportion of illiteracy and existing co-morbidity (p≤0.05). While random blood sugar (RBS) levels of >140 mg/dL were recorded in 19.7% of inmates, RBS levels of >200 mg/dL considered diagnostic were noted in 5.34% of inmates. A total of 2.67% of the inmates were newly diagnosed with diabetes mellitus. The further management of the newly diagnosed inmates was taken over by the medical supervision team of the Central Jail. From the FGD, thematic manual content analysis was performed. A total of 24 codes were generated. After merging similar codes and removing duplications, the remaining 16 codes were grouped into six broad themes. Conclusions were drawn by interpretation of these themes. CONCLUSION: ACF is important as it is associated with early detection and treatment. It must be done periodically. During the FGD, we came across negative ideologies and stigmas associated with PTB among jail inmates. We used the same platform to clear those ideologies and recommend frequent health education exercises even in socially ostracized communities like jail inmates.