Real-World Effectiveness of COVID-19 Vaccine and Identification of SARS-CoV-2 Variants among People Living with HIV on Highly Active Antiretroviral Therapy in Central Kerala of India-An Ambi-Directional Cohort Study.

BACKGROUND: Vaccine effectiveness for first-generation coronavirus disease (COVID-19) vaccines among People Living with HIV (PLHIV) in India remains unexplored. This study entails the estimation of the real-world effectiveness of COVID-19 vaccines (AZD1222/Covishield, BBV152/Covaxin) among PLHIV and the identification of variants of SARS-CoV-2 among those infected with COVID-19. METHODS: An ambi-directional cohort study was conducted among 925 PLHIV above 18 years of age in two districts of central Kerala, India, from February 2022 to March 2023. Selected PLHIV were recruited as Participant Liaison Officers (PLOs) for the follow-up on the study participants. At enrolment, basic details, baseline CD4 count, and a Nasopharyngeal (NP) swab for RT-PCR were collected. In the follow-up phase, NP swabs were collected from subjects with COVID-19 symptoms. Positive subjects had a CD4 count and genomic sequencing performed. RESULTS: The mean age of the participants was 46.93 ± 11.00 years. The majority, 819 (93.6%), of participants had received at least one dose of any vaccine, while 56 (6.4%) were unvaccinated. A total of 649 (79.24%) participants were vaccinated with Covishield and 169 (20.63%) with Covaxin. In the vaccinated group, 158 (19.3%) reported COVID-19 infection. Vaccine Effectiveness (VE) for one dose of any vaccine was 43.2% (95% CI: 11.8-64.5), p = 0.015. The effectiveness of full vaccination with Covishied was 63.8% (95% CI: 39.3-79.2), p < 0.001, and Covaxin was 73.4% (95% CI: 44.3-87.3). VE was highest, at 60.7% (95% CI: 23.6-81.3), when the two doses of the vaccine were given at an interval of less than 6 weeks. Participants with a baseline CD4 count > 350 had greater protection from COVID-19, at 53.4% (95% CI: 19.6-75.3) p = 0.004. The incident cases were sub-variants of Omicron (BA.2, BA.2.38, BA.2.10). CONCLUSIONS: Full vaccination with Covishield and Covaxin was effective against COVID-19 infection among PLHIV on treatment; albeit, that of Covaxin was higher. A gap of 4 to 6 weeks between the two doses of COVID-19 vaccine was found to have higher VE among PLHIV.

Heavy metal contamination in soil and groundwater around industrial areas of Kollam District, Kerala, India.

The present study was intended for assessing the contamination level of various heavy metals in surface soil and groundwater around the automobile workshops situated at different locations in the Kollam District of Kerala state, India. The procured soil and groundwater samples were analyzed for cadmium, zinc, iron, lead, nickel, chromium, copper, manganese, and arsenic using atomic absorption spectrophotometer by following standard procedures. The contamination level of these metals was assessed using the pollution indices like enrichment factor (EF), geo-accumulation index (Igeo), contamination factor (CF), and pollution load index (PLI). The results revealed that the concentrations of all analyzed metals in the surface soils of the automobile workshops were higher than the control. On the contrary, the concentration of no heavy metal in the groundwater was either equal to or higher than the limit prescribed by WHO. However, the concentration levels of Fe, Pb, Cu, and Zn were either equal to or higher than the control values. Based on the Igeo, CF, and EF, it was found that the contamination intensity of the heavy metals in soil decreased in the following order: Fe > Pb > Cd > As > Cr > Zn > Cu > Ni > Mn. From the results of PLI, it was interpreted that the sampling sites S2, S4, and S5 were highly polluted. Non-contamination of underground water from the age-old workshops is the uniqueness of the present study against the other studies, which were completed in alluvial formations with inverse results. In the studied region, the groundwater is stored in the hard rock formations and its hydraulics remains different from alluvial aquifers.