Social stigma and discrimination faced by COVID-19 patients in an industrial unit: Findings of survey from rural Maharashtra

Introduction

Uncertain situation of the coronavirus disease 2019 (COVID-19) pandemic has led to fear, stigma, and discrimination across all strata of society in varying proportions. Stigmatization increases the suffering of people or those who are at risk of getting the disease and make it harder for public health authorities to control the disease.

Material and Methods

The present study is a questionnaire-based cross-sectional survey conducted over a period of four weeks in the month of July 2021 in a food industry in rural region of western Maharashtra among COVID-19 positive patients. A total of 152 participants were included in the study. The data was analyzed using SPSS software (version 20). Descriptive statistics were used which included frequencies and percentages.

Results

64.5% of the participants were males and 35.5% were females. Approx. 85% of the participants were in age group 15-58 years. 100% of them reported to have faced fear on being tested COVID-19 positive. However, only approx. 2-5% individuals hid their illness from family and friends and 7.9% of them were afraid of getting hospitalized.

Conclusion

It was found that fear was prevalent among all survivors but stigma was found to be minimal which is likely due to widespread awareness through media, IEC campaigns, and active involvement of administration in implementing policies.

Rising trend of dengue in urban areas: A challenge

Context

Dengue, a mosquito-borne illness, is endemic over 100 countries around the world. Dengue cases have been on rise in India in the past decade. The present study was conducted to describe dengue cases of a ward in an urban area.

Aims

To analyse the 5-year trend of cases of dengue fever, the 5-year trend of disease burden attributable to dengue as a proportion of all consultations, and the 5-year trend of mortality attributable to dengue as a proportion of all deaths in an urban area.

Settings

The present study is a retrospective record-based study, carried out from January 2014 to December 2019.

Material and Methods

Descriptive analysis was used to describe the cases. Standard statistical tools such as Chi square for linear trends were utilised for data analysis.

Results

Except for a marginal dip in the year 2017, we observed that the trend of dengue significantly increased during the period of our study (Chi square for linear trend = 217.54; P = 0). We also observed a generally significantly increasing trend in burden of dengue as a disease, measured as a proportion of all consultations (Chi square for linear trend = 14302.72; P = 0). Mortality attributable to dengue measured as a ratio of deaths because of dengue and deaths because of all causes also shows a generally increasing trend with a slight decrease in 2018 (Chi square for linear trend = 371.24; P = 0).

Conclusion

Dengue cases and the percentage of consultations attributable to dengue show an increasing trend over the past 5 years.

Findings of second multicentric follow-up serosurvey among Health Care Workers in government hospitals

Background

The change in serological status of community may be used as input for guiding the public health policy. Hence, the present study was conducted to determine change in seroprevalence of COVID-19 among healthcare workers (HCWs).

Methods

From the baseline multicentric study sample, a subsample was followed up, and a seroepidemiological study was conducted among them between 6 and 22 weeks after the second dose of the vaccination. Multistage population proportion to size sampling was performed for the selection of subsample of HCWs. The serosurvey was conducted using the enzyme-linked immunosorbent assay-based IgG antibody test (COVID KAVACH).

Results

Follow-up serological testing was done in subsample of 1122 participants of original 3253 participants. The mean age of the participants was 34.6 (8.13) years. A total of 300 (26.7%) participants were females. The seroprevalence was 78.52, (95%CI:76-80.1). Among those who were seronegative at initial test, 708 (77.04%) were seroconverted. Those who were not seroconverted (241 (21.5%)) have longer duration from the second dose of the vaccination (93 (31.4) vs. 56 (38.4); p value < 0.001). The COVID-19 infection was significantly associated with seropositive status and being a medical staff was associated with remaining seronegative on follow-up. The higher age (≥50 years) was found to be significantly associated with seroreversion.

Conclusion

Four in five HCWs had detectable antibodies. Seroepidemiological studies carry vital information to control the public health response in the course of the pandemic. The study can also further help as a platform to study the seroconversion and effect of vaccination among HCWs for newer variants of SARS-CoV-2.

Epidemiological analysis of SARS-COV-2 B.1.617.2 (delta variant) transmission in an educational institute

Background

Despite having an effective COVID-19 vaccine, the COVID-19 pandemic is far from over and the delta variant continues to cause havoc across several continents. The present study was conducted to analyze and describe the occurrence of COVID-19 cases among completely vaccinated individuals.

Methods

In an educational institute in Western Maharashtra, we analyzed a cluster of RTPCR positive COVID-19 cases among fully vaccinated students which occurred in 12 days. The cases were linked to a series of curricular and co-curricular events in the institute. A detailed epidemiological investigation and genome sequencing of cases were conducted. IgG antibodies against S1 protein of novel SARS-CoV-2 were estimated for cases and age, sex, and vaccination status matched controls.

Results

All 37 identified cases were mild COVID. 188 high risk (HR) contacts of the cases were identified. The overall secondary attack was 9.5%. Out of 31 cases and 50 controls, 09 (29%) cases and 08 (16%) controls were found to have IgG antibodies against S1 protein of novel SARS-CoV-2 titer of more than 60 U/ml. Whole-genome sequencing of 15 samples of the cluster showed the presence of the Delta variant of SARS-CoV-2. No correlation was observed between Ct value and IgG S1 antibody titers.

Conclusion

The study provides significant evidence that only vaccination alone does not completely protect against SARS-CoV-2 B.1.617.2 (Delta) variant infection. An all-encompassing multicomponent strategy involving implementation of NPIs, robust contact tracing, early identification and isolation of cases, and high vaccination coverage is the way forward for the prevention of COVID-19.

A study of Hepatitis A and E virus seropositivity profile amongst young healthy adults in India

BACKGROUND

Various Serosurveys and studies provide ample evidence of differing perspectives regarding epidemiology of HAV and HEV in India. This study was conducted to assess the seroprevalence of HAV and HEV and its associated factors with an aim to provide inputs to planners regarding requirement of HAV vaccine.

METHODS

A multi-centric cross sectional survey amongst 4175 healthy trainees (young adults) was carried out in training centres, selected by multistage random sampling, giving equal representation to all regions of India. Sample size was calculated by taking prevalence of HAV seropositivity amongst adults as 60% and alpha 0.05.

RESULTS

Seroprevalence for HAV and HEV was 92.68% (95% CI 91.82, 93.47) and 17.05% (15.90, 18.26), respectively. Logistic regression showed that hand washing without soap, regular close contact with domestic animals, consumption of unpasteurized milk and regular consumption of food outside home were risk factors for HAV (p < 0.05). For HEV, irregular hand washing, consumption of unpasteurized milk and irregular consumption of freshly prepared food were risk factors (p < 0.05).

CONCLUSION

High level of immunity against HAV among the healthy young adults clearly demonstrates that vaccination against HAV is not required at present in our country. The large proportion being susceptible to HEV points towards the requirement of preventive strategies in the form of safe drinking water supply, hygiene, sanitation, increasing awareness and behaviour change with respect to personal hygiene especially hand and food hygiene.

Outbreak of Influenza (H1N1) amongst children in a residential school

BACKGROUND

An outbreak of pandemic Influenza H1N1 occurred from 13 Feb to 20 Feb 2010 in a residential school at Belgaum, India.

METHODS

On report of sudden increase in number of students reporting sick with symptoms suggestive of flu like illness, an investigation was launched to detect the source of infection and to control the spread of infection amongst those not affected. Six random samples of throat from the initial cluster were collected and RT-PCR was done to confirm the diagnosis. The outbreak in this institution was effectively controlled by standard preventive & control measures in the absence of vaccine.

RESULT

In a school of 335 children, 96 cases of Influenza like illness possibly resulting from pH1N1 (2009) were reported with an attack rate of 28.6%. Out of a total of 96 cases reported, 73 (76%) were hospitalized and 23 treated as outdoor patients. Serogroup A of Influenza H1N1 pandemic was identified to be the agent responsible for this outbreak as 06 random samples drawn from initial cluster tested positive on RT-PCR. A visit to an exhibition in the city was possibly the source of exposure amongst the children.

CONCLUSION

An outbreak of Influenza H1N1 infection amongst students in a residential public School was found to be linked to a visit to an exhibition following which the secondary transmission led to further occurrence of cases.