Rapid assessment of coverage of doxycycline/azithromycin chemoprophylaxis against leptospirosis following floods, Kozhikode district, Kerala, 2018.

BACKGROUND: We estimated coverage of doxycycline chemoprophylaxis (200 mg once weekly) following floods in Kerala, India. METHODS: A cross-sectional survey was conducted to gather data on exposure to flood or stagnant water and receipt and consumption of chemoprophylaxis. RESULTS: Of 1573 individuals interviewed, 152 (10%) were exposed to flood water. Among these, 119 (78%) were eligible for chemoprophylaxis. Of those eligible, 58 (38.2% [95% confidence interval 30.8 to 46.1]) reported consuming the prescribed chemoprophylaxis. CONCLUSIONS: Despite the availability of chemoprophylaxis, consumption was less than ideal. We recommend targeted interventions to improve chemoprophylaxis coverage and public awareness campaigns to enhance its consumption among the affected population.

Association between exposure to artificial sources of ultraviolet radiation and ocular diseases: a systematic review protocol.

OBJECTIVE: The objective of this review will be to determine the association between exposure to artificial sources of ultraviolet radiation and ocular diseases. INTRODUCTION: Numerous studies have established the association between natural ultraviolet radiation and ocular diseases in humans. However, the evidence of the association between artificial sources of ultraviolet radiation and ocular diseases has not been reviewed. INCLUSION CRITERIA: The proposed review will include studies with participants of any age and sex, and documented exposure to artificial sources of ultraviolet radiation and incidence of ocular diseases. METHODS: Databases including PubMed and Embase will be searched. Study selection and full-text screening will be done by two independent reviewers. The search results will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Critical appraisal of the eligible studies for methodological quality will be conducted using JBI checklists. All studies, regardless of their methodological quality, will undergo data extraction and synthesis using standardized data extraction tools. Quantitative papers will, where possible, be pooled in statistical meta-analysis. Heterogeneity will be assessed statistically using the standard χ, and also explored using relevant subgroup analyses based on the different quantitative study designs included in this review. Where statistical pooling is not possible, the findings will be presented in narrative form including tables and figures. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019129372.

An outbreak of bilateral photokeratitis and eyelid erythema following exposure to an artificial source of ultraviolet radiation, Tamil Nadu, India, 2018.

Metal halide lights (MHLs) emit ultraviolet radiation (UVR) and should be used with enclosed fixtures. We investigated a cluster of blurred vision in a locality in South India reported among light music event attendees to identify risk factors. METHODS: We searched for attendees with any eye-related symptoms by door-to-door. We described cases by time, place, and person and inspected the environment to generate a hypothesis. We followed-up the cohort of the attendees to examine the hypothesis of exposure to MHL as the cause of the outbreak. We computed relative risk (RR) and 95% confidence interval (CI) by comparing attack rates among attendees by seating location and duration of exposure. RESULTS: Of the total 500 attendees, we could interview 319 (64%) and 89% (284/319) attendees developed bilateral photokeratitis (median age = 24 years [range: 2-80 years]). Attack rate was higher among female (92% [172/189]) than male (85% [110/130]). Attack rate among those seated within 12 meters from dais was higher (95% [241/253]) than the rest (65% [43/66]; RR = 1.5; 95% CI = 1.2, 1.7) and attack rate was higher among those continuously exposed to MHL (97% [268/277]) than others (38% [16/42]; RR = 2.5; 95% CI = 1.7, 3.7). The duration of exposure was associated with increased risk of bilateral photokeratitis (χ2 test for linear trend = 74; P < 0.00001). During the environmental inspection, we identified the use of MHL with a broken outer envelope. CONCLUSIONS: Photokeratitis was associated with exposure to UVR from MHL with a broken outer envelope. We recommended the usage of MHL along with enclosed fixtures.