Seroprevalence of SARS-CoV-2 infection in the general population of Nepal during the first and second generalized waves of the COVID-19 pandemic-2020-2021.

Few seroprevalence studies have been conducted on coronavirus disease (COVID-19) in Nepal. Here, we aimed to estimate seroprevalence and assess risk factors for infection in the general population of Nepal by conducting two rounds of sampling. The first round was in October 2020, at the peak of the first generalized wave of COVID-19, and the second round in July-August 2021, following the peak of the wave caused by the delta variant of SARS-CoV-2. We used cross-sectional probability-to-size (PPS)-based multistage cluster sampling to estimate the seroprevalence in the general population of Nepal at the national and provincial levels. We tested for anti-SARS-CoV-2 total antibody using the WANTAI SARS-CoV-2 Ab ELISA kit. In Round 1, the overall national seroprevalence was 14.4%, with provincial estimates ranging from 5.3% in Sudurpaschim to 27.3% in Madhesh Province. In Round 2, the estimated national seroprevalence was 70.7%, with the highest in the Madhesh Province (84.8%) and the lowest in the Gandaki Province (62.9%). Seroprevalence was comparable between males and females (Round 1, 15.8% vs. 12.2% and Round 2, 72.3% vs. 68.7%). The seroprevalence in the ecozones-Terai, hills, and mountains-was 76.3%, 65.3%, and 60.5% in Round 2 and 17.7%, 11.7%, and 4.6% in Round 1, respectively. In Nepal, COVID-19 vaccination was introduced in January 2021. At the peak of the first generalized wave of COVID-19, most of the population of Nepal remained unexposed to SARS-CoV-2. Towards the end of the second generalized wave in April 2021, two thirds of the population was exposed.

Core Capacities for Public Health Emergencies of International Concern at Ground Crossings: A Case Study from North India.

OBJECTIVE: International airports, ports, and ground crossings are required to have health units for undertaking public health measures during routine times and specific measures during the time of public health emergency of international concern (PHEIC). This study was conducted at a ground crossing of North India to assess the implementation status of International Health Regulations (IHR) (2005) at a ground crossing in the prevention and control of public health emergencies and to assess the risk of imported infections from a ground crossing. METHODS: A qualitative study was conducted at the selected point of entry. The World Health Organization (WHO) core capacity assessment tool and in-depth interviews were used for data collection in the form of meetings and visits to isolation sites, and general observations were conducted regarding facilities on routine and other infrastructure and equipment that can be used during emergencies. Respondents were recruited using purposive methods. RESULTS: The findings reveal that there is lack of awareness among the travelers, which increases the risks of spreading diseases. The overall implementation status at the ground crossing according to the assessment conducted using WHO Tool was 76%. It showed the need for further strengthening of the implementation at the site. Gaps were identified regarding the local capacity for handling chemical, radiological and nuclear hazards, and shortage of regular staff through stakeholders. CONCLUSION: The findings from this study, as well as the suggestions and recommendations given by stakeholders, should help revise the current strategies of action. Hence, the gaps identified should be fulfilled to better respond to PHEIC at the ground crossings.

Nutritional Status of Adolescent Girls Belonging to the Tea Garden Estates of Sivasagar District, Assam, India.

BACKGROUND: Any deficiency or inadequate dietary pattern can lead to poor nutrition which can further influence both growth and development throughout from infancy to adolescence. Since adolescents represent the next generation of parents, it is important to monitor their nutritional status at this crucial stage. Thus, this study aimed to explore the factors associated with nutritional status among adolescent girls belonging to these tea gardens. OBJECTIVE: The objective of this community-based cross-sectional study was to assess the nutritional status of adolescent girls belonging to the tea garden community and the association of the sociodemographic factors with it. MATERIALS AND METHODS: Anthropometric measurement was taken among adolescent girls in the tea estates of Nazira subdivision of Sivasagar district, Assam. The pattern of dietary intake among adolescents was also studied. The statistical analysis was done using SPSS version 15. RESULTS: The prevalence of thinness and stunting across 265 adolescent girls was 49.4% and 50.6%, respectively. Calorie and protein deficits were found to be 76.60% and 65%, respectively. Majority of the respondents, i.e., 66.80% of the participants, had a poor intake of essential food constituents. Moreover, 76.21% of the respondents were anemic. The association of different sociodemographic factors with thinness, inadequate protein intake, and anemia were found during the study. CONCLUSION: Thinness and stunting along with protein-energy malnutrition and inadequate intake of important food groups were prevalent in adolescent tea community girls. Overall, the public health burden of malnutrition is still a persisting health problem in the tea gardens of Assam.

Developing a community-based breast cancer risk prediction tool for resource-poor settings.

BACKGROUND: With an estimation of every two women newly diagnosed with breast cancer, one dies. It is accounted that 1 in 28 women is likely to develop breast cancer during her lifetime. Developing a risk prediction tool by assessing the prevalence of known risk factors in the community will help public health intervention. METHODOLOGY: A cross-sectional study was conducted among 18-64-year-old women to gather the prevalence of known breast cancer risk factors, through a community survey (sample survey). In this multistage random number-based cluster sampling study, the results were compiled, collated, and analyzed in rates and proportions. Statistical conclusions were made using spreadsheets (Microsoft) and the values were converted into ordinal values using modified Likert scale and median was used to estimate central values. The estimated prevalence of these known risk factors was re-assorted for analysis and these re-assorted data were categorized into range of values across the communities. The internal validity of the survey questionnaire was measured using Cronbach's alpha (α). RESULTS: The analysis of 558 participants was performed for the known risk factors for breast cancer including participant's age, age at menarche, marriage, first childbirth, menopause, family history of breast cancer and benign breast disease, history of abortion, and body mass index. Based on the estimated prevalence of these risk factors, a community-based risk prediction tool was developed with Cronbach's α score of medium internal validity. CONCLUSIONS: The risk assessment tool has collated most of the risk factors of breast cancer that are capable of being measured at community level. The survey findings concluded that the community under survey was bearing moderate risk for breast cancer for women.

Acute encephalitis syndrome surveillance, Kushinagar district, Uttar Pradesh, India, 2011-2012.

In India, quality surveillance for acute encephalitis syndrome (AES), including laboratory testing, is necessary for understanding the epidemiology and etiology of AES, planning interventions, and developing policy. We reviewed AES surveillance data for January 2011-June 2012 from Kushinagar District, Uttar Pradesh, India. Data were cleaned, incidence was determined, and demographic characteristics of cases and data quality were analyzed. A total of 812 AES case records were identified, of which 23% had illogical entries. AES incidence was highest among boys<6 years of age, and cases peaked during monsoon season. Records for laboratory results (available for Japanese encephalitis but not AES) and vaccination history were largely incomplete, so inferences about the epidemiology and etiology of AES could not be made. The low-quality AES/Japanese encephalitis surveillance data in this area provide little evidence to support development of prevention and control measures, estimate the effect of interventions, and avoid the waste of public health resources.