Estimation of tuberculosis incidence at subnational level using three methods to monitor progress towards ending TB in India, 2015-2020.

OBJECTIVES: We verified subnational (state/union territory (UT)/district) claims of achievements in reducing tuberculosis (TB) incidence in 2020 compared with 2015, in India. DESIGN: A community-based survey, analysis of programme data and anti-TB drug sales and utilisation data. SETTING: National TB Elimination Program and private TB treatment settings in 73 districts that had filed a claim to the Central TB Division of India for progress towards TB-free status. PARTICIPANTS: Each district was divided into survey units (SU) and one village/ward was randomly selected from each SU. All household members in the selected village were interviewed. Sputum from participants with a history of anti-TB therapy (ATT), those currently experiencing chest symptoms or on ATT were tested using Xpert/Rif/TrueNat. The survey continued until 30 Mycobacterium tuberculosis cases were identified in a district. OUTCOME MEASURES: We calculated a direct estimate of TB incidence based on incident cases identified in the survey. We calculated an under-reporting factor by matching these cases within the TB notification system. The TB notification adjusted for this factor was the estimate by the indirect method. We also calculated TB incidence from drug sale data in the private sector and drug utilisation data in the public sector. We compared the three estimates of TB incidence in 2020 with TB incidence in 2015. RESULTS: The estimated direct incidence ranged from 19 (Purba Medinipur, West Bengal) to 1457 (Jaintia Hills, Meghalaya) per 100 000 population. Indirect estimates of incidence ranged between 19 (Diu, Dadra and Nagar Haveli) and 788 (Dumka, Jharkhand) per 100 000 population. The incidence using drug sale data ranged from 19 per 100 000 population in Diu, Dadra and Nagar Haveli to 651 per 100 000 population in Centenary, Maharashtra. CONCLUSION: TB incidence in 1 state, 2 UTs and 35 districts had declined by at least 20% since 2015. Two districts in India were declared TB free in 2020.

Application of drastic model and GIS: for assessing vulnerability in hard rock granitic aquifer.

Geographic information system (GIS) has become one of the leading tools in the field of hydrogeological science that helps in assessing, monitoring, and conserving groundwater resources. Groundwater is a finite resource, which is being overexploited due to increase in demand over the years leading to decrease in its potentiality. In the present study, DRASTIC model has been used to prepare groundwater vulnerable zone in hard rock aquifer of granitic terrain. The main objective is to determine susceptible zone for groundwater pollution by integrating hydrogeological layers in GIS environment. The layers such as depth of aquifer, recharge, aquifer yield, soil type, topography, vadose zone, and transmissivity are incorporated in the DRASTIC model. The final output of the map shows that around 60% of the area falls under low to no risk of pollution zone. The high risk of pollution zones are mostly present towards the margin of southeastern periphery. The lower part of the basin as well as small area on northern side falls under moderate risk of pollution zone. For the assessment of groundwater pollution zone, 24 groundwater samples have been collected from different vulnerable zones. The chemical analysis of sample shows that the southeastern margin of basin has relatively high concentration of nitrate as compared to other parts of the basin. It is present in high pollution zone as well as moderate pollution zone. The present model can be used for assessment and management of groundwater.