Seroprevalence of SARS-CoV 2 antibodies & its determinants in children of 5-to-18-year age group in an urban setting, Kerala.

Background: There were limited data on the true burden of COVID 19 infection in children since the majority of the infections are asymptomatic or paucisymptomatic. This study aimed to measure the prevalence of SARS CoV2 antibodies in children of the 5-to-18 years age group. Methods: A community-based cross-sectional study was conducted in the field practice area attached to a tertiary care hospital in Kerala. Two hundred four children of the 5-to-18 year age group were enrolled in our study. The data regarding sociodemographic details, symptoms suggestive of COVID 19, exposure to confirmed COVID 19 cases and history of COVID 19 positivity were collected from the study participants. 2 ml venous blood was collected from each participant, and the seroprevalence of SARS CoV2 combined antibodies was assessed using WANTAI antibody test kit. Results: The seroprevalence of SARS Cov2 antibodies in children of 5-to-18 years age group was 41.7% (95% CI,34.9% to 48.43%). The seroprevalence was high in the 13-to-15 year age group, almost similar in both gender and socio-economic groups. The seropositivity was significantly associated with history of confirmed COVID 19 positivity, children with a history of symptoms suggestive of COVID 19 and the presence of positive contact in the household (P < 0.05). Seroprevalence was also significantly high in children whose mothers were health care workers. Conclusion: Approximately 41.7% of children showed seropositivity to COVID 19 infection. More than 50% of the children remain susceptible. Among seropositive, 56.5% were asymptomatic. Thus there is a need to test even asymptomatic children in COVID 19 positive households.

Prevalence of Tuberculosis Infection among Adults of Thiruvananthapuram District of Kerala as Measured by Interferon Gamma Release Assay - A Cross-Sectional Study.

Background: To achieve the goals of the end tuberculosis (TB) strategy, strategies for management of TB infection (TBI) have to be expanded. The first step to devise policies is to understand the distribution and determinants of TBI in the community. The objectives of the study were to estimate the prevalence of TBI using Interferon Gamma Release Assay (IGRA) and its determinants among the adult population of Thiruvananthapuram district, Kerala. Materials and Methods: A community-based, cross-sectional study using the stratified cluster sampling was carried out among the adults. TBI was detected using IGRA conducted on whole blood sample. Data on determinants were collected using a structured questionnaire by the face-to-face interview. The prevalence of TBI was estimated. Univariate and multivariate analysis was conducted to identify the determinants. Results: Age standardized prevalence of TBI among 396 adults was 20.5% (95% confidence interval [CI] 16.52-24.48). On adjusting for the possible confounders, increasing age (adjusted odds ratio [OR] 1.028; 95% CI 1.008-1.048; P = 0.005), history of contact with active TB disease (adjusted OR 7.61; 95% CI 4.43-13.05; P < 0.001), childhood contact (adjusted OR 8.20; 95% CI 3.14-21.41; P < 0.001), and household contact (adjusted OR 10.12; 95% CI 5.39-18.98; P < 0.001) were found to be the determinants of TBI in this population. Conclusion: The present study observed that nearly one-fifth of the adult population in the Thiruvananthapuram district has TBI. For the programmatic management, factors such as increasing age and contact history may be considered for the elimination of TBI in the state.

Hospital-based sentinel surveillance for bacterial meningitis in under-five children prior to the introduction of the PCV13 in India.

INTRODUCTION: A hospital-based sentinel surveillance network for bacterial meningitis was established in India to estimate the burden of bacterial meningitis, and the proportion of major vaccine-preventable causative organisms. This report summarises the findings of the surveillance conducted between March 2012, and September 2016 in eleven hospitals. METHODS: We enrolled eligible children with bacterial meningitis in the age group of one to 59 months. CSF samples were collected and processed for biochemistry, culture, latex agglutination, and real-time PCR. Pneumococcal isolates were serotyped and tested for antimicrobial susceptibility. RESULTS: Among 12 941 enrolled suspected meningitis cases, 586 (4.5%) were laboratory confirmed. S. pneumoniae (74.2%) was the most commonly detected pathogen, followed by H. influenzae (22.2%), and N. meningitidis (3.6%). Overall 58.1% of confirmed bacterial meningitis cases were children aged between one, and 11 months. H. influenzae meningitis cases had a high (12.3%) case fatality rate. The serotypes covered in PCV13 caused 72% pneumococcal infections, and the most common serotypes were 14 (18.3%), 6B (12.7%) and 19F (9.9%). Non-susceptibility to penicillin was 57%. Forty-five (43.7%) isolates exhibited multidrug resistance, of which 37 were PCV13 serotype isolates. CONCLUSIONS: The results are representative of the burden of bacterial meningitis among under-five children in India. The findings were useful in rolling out PCV in the National Immunization Program. The non-susceptibility to penicillin and multidrug resistance was an important observation. Timely expansion of PCV across India will significantly reduce the burden of antimicrobial resistance. Continued surveillance is needed to understand the trend after PCV expansion in India.