ABSTRACT
An unprecedented outbreak of dengue occurred during 2017 in Kerala. Thiruvananthapuram was worst affected. We carried out a joint investigation with the Health department of the State, to understand the epidemiological and entomological factors involved in this outbreak, so as to develop strategies to contain it. Blood samples from suspected patients were collected from three worst affected areas and genomic analysis of the Dengue virus (DENV) was performed. Also, a cross sectional entomological survey was carried out in these areas. The data obtained was compared with the available secondary data of DENV in Kerala. The investigations revealed a genetic shift from the erstwhile predominant DENV2/DENV3 serotypes to the newly introduced DENV1 Asian genotype during the current outbreak. Breeding indices of Aedes aegypti, the predominant vector species was also found to be remarkably high. Asian genotype of DENV1 was detected in field collected Ae. aegypti also. The index cases of the Asian genotype of DENV1 in Kerala were detected from Erumeli village (gateway to the famous Sabarimala shrine) among two plantation workers migrated from the neighbouring Karnataka state, during 2013. This introduced virus strain attained an epidemic proportion in 2017 in Thiruvananthapuram, owing to immunologically naïve population and high receptivity.
ABSTRACT
Background: India is going through a phase of demographic transition leading to population aging and feminization of aging resulting in increased proportion of elderly women than men. Problems faced by the elderly women are more critical than men due to family and social conditions prevailing in India. Objective: The study made an attempt to assess the quality of life (QOL) using the World Health Organization QOL (WHOQOL-BREF) scale and sociodemographic factors affecting QOL of elderly women residing in a community setting in South Kerala. Methods: A community-based, cross-sectional study to assess the QOL of elderly women using WHOQOL-BREF questionnaire. Data were collected from 160 elderly women. Results: 2.5% (95% confidence interval [CI]: 0.07-4.84) of the study participants were having "very good" QOL. 38.8% (95% CI: 31.2-46.4) had "good," 43.1% (95% CI: 35.4-50.8) had "poor," and 15.6% (95% CI: 9.98-21.22) had "very poor" QOL, respectively. QOL was least in the psychological domain followed by physical and health-related, social, and environmental domains. Logistic regression revealed age above 70 years (adjusted odds ratio [OR] - 11.3), nonpossession of property (adjusted OR - 8.99), neglecting attitude by family (adjusted OR - 6.9), and absence of visit by friends and relatives (adjusted OR - 9.9) as risk factors, whereas residing in the urban area as a protective factor (adjusted OR - 0.1) for poor QOL. Conclusion: It is possible to improve the QOL of elderly women by providing financial security, ensuring care, and by enhancing social relationships of elderly women.