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Introduction: We described the COVID – 19 prevention and control activity done in Vadodara district of Gujarat. Objective: Study was done to describe the activities and to identify the gaps in prevention and control of COVID – 19 control activity. Materials and Methods: A cross sectional observational study was conducted between 09.05.2020 to 20.05.2020. Data was collected from urban and rural health units by interviewing officers and health workers involved in covid control activities. Relevant data was extracted from records and IDSP portal. Results: There was a huge increase of CCC beds and CHC beds and total tests from 9th May to 20th May 2020 to meet the demand of the district. There was nearly 14 times increase of CCC beds, nearly fifteen times enhancement of CHC beds and nearly three times enhancement of RT-PCR tests on 20th May 2020 in comparison to 14th May 2020. There was a 21% increase of CH-ICU beds. Conclusion: Motivated Health worker, timely decision by the District Administration, proactive approach and inter-sectoral communication had made the district successful in controlling the situation. Keywords: COVID – 19, Vadodara, Covid Control Centre, Covid Hospital, HCQ.

Background: Infertility is a neglected service component in the public health-care system in India. Objectives: This study aims to assess the availability and practices on prevention and management services for infertility in the district health system. Methodology: A cross-sectional survey of selected health facilities and the staff from 12 district hospitals (DHs), 24 community health centers (CHCs), 48 primary health centers (PHCs), and 48 subcenters was conducted using qualitative and quantitative methods. Interviewed staff included 26 gynecologists; 91 medical officers; 91 auxiliary nurse midwife; 67 laboratory technicians; and 84 accredited social health activist workers. Results: The findings indicate that adequate staff was in place at more than 70% of health facilities, but none of the staff had received any in-service training on infertility management. Most of the DHs had basic infrastructural and diagnostic facilities. However, the majority of the CHCs and PHCs had inadequate physical and diagnostic facilities related to infertility management. Semen examination service was not available at 94% of PHCs and 79% of CHCs. Advanced laboratory services were available in

Background: Present study was conducted to assess the preparedness of the Surguja district to curtail COVID-19.Methods: We conducted a cross-sectional observational study from May 2020 to March 2021 through records of 2 primary health centres areas selected by convenient sampling (farthest and nearest to district headquarters). Data on existing facilities and logistics was from district headquarters. Preparedness was assessed through checklist. Observations were presented as rates, ratios and proportions. Standard error of difference between two proportions was used as test of significance and p value≤0.05 was considered significant.Results: For Surguja district population of 925938 (65% rural), overall attack rate was 1.15%, case fatality rate was 0.96% (102/10636); there was 1 DCH, 9 DCHC, 6 CHCs, 25 PHCs, 3 upgraded PHCs, 197 subcentres, 12 CCC, 01 RT-PCR laboratory and 228 COVID vaccination centres. There were 1151 isolation beds; 300 with oxygen support (26%); ICU beds 134 (11.60%) with 34 ventilators. Cumulative 258229 tests; antigen 67.90%, test positivity rate 4.10% (urban 8.2%, rural 1.7%). This urban-rural difference in test positivity rate was statistically significant (p

As countries roll out vaccines that prevent COVID-19, many scientists are reluctant to say with certainty that the vaccines prevent person to person transmission. All the vaccines authorised for emergency use do this,however there are no conclusive evidence that the COVID-19 vaccine prevents the infection. The limited data available suggests that the vaccines will at least partly reduce transmission, and the studies to determine this with more clarity are underway. One should wait for more data and conclusive evidence to make a statement like “ongoing COVID vaccination will break the chain of transmission”. A vaccine that is highly effective at preventing people from acquiring infection would help to reduce transmission, and till then we need to follow the COVID prevention measures. The best way to prevent infection from COVID-19 is to avoid exposure to the virus.aCOVID-19 is the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) whose main mode of transmission between people, is when an infected person is in close contact with another person, apart from fomite and airborne transmission. Infection occurs when virus enters in the body and begin to multiply while disease occurs when the cells in the body are damaged — as a result of the infection — and signs and symptoms of an illness appear. Approximately 40% to 45% of those infected with SARS-CoV-2 remain asymptomatic and asymptomatic persons can transmit SARS-CoV-2 to others. Asymptomatic SARS-CoV-2 infections have been demonstrated to present with viral loads similar to symptomatic infections. Contact tracing and modelling studies suggest presymptomatic and asymptomatic patients are responsible for approximately 50% of all COVID-19 transmission events.

Background: We conducted the present study to assess the knowledge, attitude and practice of rabies prophylaxis among medical officers of anti-rabies vaccination clinics of Municipal Corporation of Greater Mumbai (MCGM).Methods: We conducted a cross sectional study in 30 ARV clinics of MCGM. We collected data using pretested, structured, self-administered questionnaire and a facility survey check list. Questionnaire included questions pertaining to epidemiology of animal bite, biologicals supplied, protocols and guidelines for rabies prophylaxis, dosage and route of administration of ARV and training status. We analysed data using Microsoft Excel, 2007. Spearman’s rank correlation and Friedman test was used to examine the relationship between knowledge, attitude, and practice. The results were presented in the form of rates and ratios appropriately and p≤0.05 was considered statistically significant.Results: Mean knowledge, attitude and practice score of the study participants was 74.6%, 68.7% and 41% respectively. The difference between knowledge, attitude and practice was statistically significant (p

Background: On January 30, 2020 WHO declared the COVID-19 as a PHEIC. In response to the increasing number of COVID-19 cases, Government of India started thermal screening of passengers at all PoEs. Present study was conducted to understand the screening activity done at international airports in India, to measure the prevalence of fever in passengers screened and to study the role of thermal screening in early detection of suspected COVID-19 cases.Methods: Descriptive study design was used in current study and secondary analysis of data collected from CSMI airport Mumbai, IGI airport New Delhi, Cochin international airport Kochi and NSCBI airport Kolkata was done by using universal sample size and purposive sampling technique. Results were presented in the form of rates and ratios appropriately. Chi square test was used to examine the usefulness of the screening activity and p≤0.05 was considered statistically significant.Results: At selected international airports, in January, February and March 2020, 5.49%, 19.57% and 79.54% of all arrived passengers were screened. Under Vande Bharat mission 100% of the international passengers arrived were screened and fever detection rate was 95 per million passengers screened. Outcome of the thermal screening at representative airports of North, South, East and West regions of India was significantly different.Conclusions: Thermal screening of passengers at international airports has limited role in early detection of suspected cases of infectious diseases like COVID-19 and has minimum impact on the course of pandemic.

Background: According to Ministry of External Affairs (MEA) – India, in 2015 a total of 8315 people of Indian origin died abroad and more than 65% were from United Arab Emirates (UAE) and Saudi Arabia. Present study was conducted to study the demographic profile and cause of death in case of persons died abroad.Methods: Present descriptive study was conducted in APHO, Mumbai and it was a secondary data analysis. All records during 1st January 2016 to 31st December 2016, available in the office of APHO Mumbai related to clearance of dead body were reviewed. Data analysis was done in line with objectives by using Microsoft Excel. Qualitative data was presented by using number and percentages while quantitative data was presented by using mean and standard deviation.Results: During the reporting period 534 dead bodies arrived at CSMI Airport. Average age of the person died abroad was 48.4 years and more than 85% were males. In more than 65% of cases the reported cause of death was heart related including cardiac arrest and road traffic accidents. More than 50% of dead bodies were from gulf countries.Conclusions: Death was reported in a significant number of Indians travelling abroad and most of them were relatively young. Heart diseases including cardiac arrest and road traffic accidents were the commonest reported cause of death. A targeted health communication strategies for modification of life style and behavior change is recommended for persons travelling abroad.

Background: Preterm births are an enormous global problem on families, medical system and economy. The rates of preterm birth are increasing and one of the contributors is growing use of Assisted Reproduction Techniques (ART) leading to multifetal gestations. Some risk factors for preterm birth are specific to women who conceive by ART. Since there is limited data from India, this pilot study was undertaken to assess the magnitude of preterm birth among pregnancies conceived by ART and to study the contributing factors.Methods: Clinic based descriptive cohort study through eight ART clinics in Mumbai for one year. Data was collected using an in-depth questionnaire on socio-demographic characteristics, medical history, ART details, course and complications during pregnancy, mode of delivery, pregnancy outcome, risk factors related to preterm birth and neonatal outcome. Complete details of 113 participants who completed the study were analyzed.Results: Study showed high incidence of preterm birth (76.23%) among women conceived with ART. Multiple gestations were observed in 45.1%. Pregnancy related complications like heterotrophic pregnancy (3%), pre eclampsia (15%) and gestational diabetes (11%) were high. Incidence of caesarean section was very high (98%). Neonatal outcome was good with 98% live births and only 2 still births.Conclusions: Present study highlights that preterm birth, multiple pregnancies, pregnancy related complications like preeclampsia, gestational diabetes and caesarean sections are very high among women conceived by ART. With growing use of ART there is an urgent need to develop a National ART Surveillance system in India like the one in Centre for Disease Control Atlanta to get complete data on the pregnancy course and outcomes of ART conceptions. Efforts to limit the number of embryos transferred should be strengthened to prevent multiple births.

Human Immunodeficiency Virus (HIV-1) poses a serious threat to the developing world and sexual transmission continues to be the major source of new infections. Therefore, the development of molecules, which prevent new HIV-1 infections, is highly warranted. In the present study, a panel of human hemoglobin (Hb)-α subunit derived peptides and their analogues, with an ability to bind gp120, were designed in-silico and their anti-HIV-1 activity was evaluated. Of these peptides, HbAHP-25, an analogue of Hb-α derived peptide, demonstrated significant anti-HIV-1 activity. HbAHP-25 was found to be active against CCR5-tropic HIV-1 strains (ADA5 and BaL) and CXCR4-tropic HIV-1 strains (IIIB and NL4-3). Surface plasmon resonance (SPR) and ELISA revealed direct interaction between HbAHP-25 and HIV-1 envelope protein, gp120. The peptide prevented binding of CD4 to gp120 and blocked subsequent steps leading to entry and/or fusion or both. Anti-HIV activity of HbAHP-25 appeared to be specific as it failed to inhibit the entry of HIV-1 pseudotyped virus (HIV-1 VSV). Further, HbAHP-25 was found to be non-cytotoxic to TZM-bl cells, VK2/E6E7 cells, CEM-GFP cells and PBMCs, even at higher concentrations. Moreover, HbAHP-25 retained its anti-HIV activity in presence of seminal plasma and vaginal fluid. In brief, the study identified HbAHP-25, a novel anti-HIV peptide, which directly interacts with gp120 and thus has a potential to inhibit early stages of HIV-1 infection.

Background: On 12th September 2011, unusual poultry deaths were reported from a poultry farm at Putimari Christianpara under Tehatta Gram Panchayat. On 14th September there were more deaths accordingly, samples were collected and sent to the Regional Disease Diagnostic Laboratory, Kolkata. Preliminary reports confirmed the presence of avian influenza. High Security Disease Detection Laboratory at Bhopal confirmed avian influenza. The state Govt notified the outbreak as avian influenza on 19th September 2010. This outbreak was investigated and epidemiological characteristic & containment measures were described. Material and Methods: Operational definition of avian influenza was established. Fever surveillance in animals and human beings was conducted within 10 kms radius of epicenters. Culling was conducted. All health workers, and cullers were examined and prophylaxis was administered. Results: Out of total 56 Gram Panchayat 25(45%) were affected. Out of 568 villages 131(23%) were affected. Out of 131 affected villages 22 were in the core area and the rest outside. Population affected was estimated to be 400007. Mean population covered per day was 104603 (26%). Conclusion: In all 217 cases were detected with upper respiratory tract but none matched the case definition of avian influenza. Key words: Avian Influenza, H5N1, Surveillance, Culling, Nadia District, West Bengal

Background: National Rural Health Mission introduced ‘Nischay Yan’, a free assured referral transport, since 1st April 2011 in Nadia district, West Bengal, India to reduce neonatal mortality rate (NMR). We conducted a cross sectional study to estimate the prevalence of awareness and utilization of the scheme along with factors associated with its use in mothers and to describe the strengths and gaps in the scheme. Method: A total of 575 mothers of children born between 1st July and 31st December 2011 in 23 clusters were surveyed. Univariate and multivariate logistic regression was done to study the determinants of awareness and utilization of Nischay Yan services. Result: Out of 575 mothers, 77.9% were aware of Nischay Yan and knew the number 102.Majority of the mothers (96.9%) got the information from ANM and ASHA. Only 187 of 575 (32.5%) mothers had availed the services of Nischay Yan. Of the187 mothers who availed Nischay Yan, 164 (87.7%) utilized it for delivery and 23(12.2%) for the purpose of neonatal care. ASHA escorted only 42 (22.4%) of 187 mothers. Of the187 mothers who utilized Nischay Yan, 77% availed the ambulance from doorstep and (82.4%) had to wait up to one hour to get the Nischay Yan. Half of 187 mothers reached a facility in two hours. One hundred seventy one (44%) of 388 mothers did not utilize Nischay Yan because of non availability of the ambulance. On Univariate analysis mothers characteristics such as age (OR=2.9, 95% C.I=1.8 -5.1), living in nuclear family (OR=1.7, 95% C.I=1.03-2.8), Knowing the telephone number102 (OR=43.9,95% C.I=4.7-410.3), Knowing the danger sign for referral of pregnant woman(OR=6.5, 95% C.I=3.01-14.07), having three antenatal check-ups (OR=21.9, 95% C.I=2.2-219.5) and Possessing functioning mobile or landline phone (OR=12.44, 95% C.I=1.3-112.4) were significantly associated with use of Nischay Yan. Conclusion: Majority of the mothers were aware of Nischay Yan scheme while only one third utilized it. Mothers who knew the number 102 and had functioning telephones were more likely to use Nischay Yan ambulance. Major cause of non use of Nischay Yan was non-availability of ambulance. The ambulance density was adequate as per programme but less as per requirement. Keywords: Ambulance, Nischay Yan scheme, Neonatal Mortality, Awareness, Nadia and West Bengal

Introduction: Neonatal mortality is the main barrier to reduction of infant mortality in West Bengal. Home based simple newborn care by mothers in the neonatal period can reduce neonatal mortality. The practices of mothers in this aspect in Nadia are not known. A cross sectional survey of mothers of Nadia with the objectives of describing their neonatal care practices, determine factors associated with it. Methods: Nadia district has a population of 5 million and estimated pregnancies of 74000. We used PPS method cluster sampling technique. We needed 575 mothers in 23 clusters assuming 52% prevalence at 5% precision, 95% Confidence interval and design effect 1.48.Structured questionnaire was used for data collection on different socio-demographic and health system related factors and mothers’ newborn care practices. Data was analysed using Epi info 3.5 software. Results: Among 575 mothers, 518 (90.1%) kept the neonates cord stump clean. Delaying the first bath of the neonate was least practiced 292 (50.8%). Only 39 (6.8%) mothers had all safe practices. Living below poverty line (Adjusted OR 5.2, C.I. 3.4-7.8), not registering in the first trimester (Adjusted OR 2.6, C.I 1.6-4.2), maternal education not more than secondary level (Adjusted OR 2.3, C.I. 1.3-3.9) and having home delivery(Adjusted OR 3.2, C.I. 1.5-6.8) were significant factors for non-adoption of at least five safe practices. The overall neonatal morbidity rate was 57 per 1000 live births (33 /575) and neonatal mortality rate was 10 per 1000 live birth (6/575). Median contacts with the health system in the mothers having unsafe practices was 6 (range 0-11) compared to 10(range 1-11) in the other group. Out of 33 sick neonates 26(78.8%) were from mothers with unsafe practices. Conclusion: Poor and uneducated were unaware of safe newborn care practices especially for hypothermia. They had more neonatal sickness and deaths. They had less contact with the health system. There is a need to reach out to such vulnerable group and improve their coverage in existing facilities. Training of ASHA in Home based newborn care and educating mothers can be cost effective option for this section to save neonates by promoting best neonatal practices. Keywords: Risk factors, Unsafe practices, Neonatal morbidity, ASHA, Rural Nadia, West Bengal