Problematic Internet Use Among Adolescent School Attendees: A School-based Study From Tamil Nadu, India.

OBJECTIVE: To investigate the prevalence of problematic internet use (PIU) among adolescents and determine the associated factors contributing to PIU. METHODS: In April/May 2023, a cross-sectional study was conducted among adolescents studying in grades 9 to 12 in government and private non-residential schools in Western Tamil Nadu, India. Participants completed a semi-structured questionnaire assessing demographic characteristics, behavioral patterns, and internet usage. The Problematic and Risky Internet Use Screening Scale (PRIUSS) was employed to quantify PIU. RESULTS: Out of 1795 participants, 398 (24.5%) were identified with PIU. Prevalence rates of PIU were similar between adolescents studying in English (n = 189; 25.4%) and Tamil medium (n = 209; 23.7%), with no significant differences based on gender [boys (n = 270, 25.4%) and girls (n = 121, 22.2%)]. Students possessing personal gadgets showed higher PIU [n = 287 (27%) Vs. n = 111 (20%)]. Specific risk factors for PIU identified students in English medium and scoring below 80% [OR (95%CI) 1.5 (1.1, 2.3); P = 0.029 ] and those with multiple gadgets at home [1.3 (1.01, 1.7); P = 0.04]. CONCLUSION: Adolescents have a high prevalence of PIU. Implementing school-based educational programs will mitigate excessive internet usage.

Protocol for establishing a model for integrated influenza surveillance in Tamil Nadu, India.

The potential for influenza viruses to cause public health emergencies is great. The World Health Organisation (WHO) in 2005 concluded that the world was unprepared to respond to an influenza pandemic. Available surveillance guidelines for pandemic influenza lack the specificity that would enable many countries to establish operational surveillance plans. A well-designed epidemiological and virological surveillance is required to strengthen a country's capacity for seasonal, novel, and pandemic influenza detection and prevention. Here, we describe the protocol to establish a novel mechanism for influenza and SARS-CoV-2 surveillance in the four identified districts of Tamil Nadu, India. This project will be carried out as an implementation research. Each district will identify one medical college and two primary health centres (PHCs) as sentinel sites for collecting severe acute respiratory infections (SARI) and influenza like illness (ILI) related information, respectively. For virological testing, 15 ILI and 10 SARI cases will be sampled and tested for influenza A, influenza B, and SARS-CoV-2 every week. Situation analysis using the WHO situation analysis tool will be done to identify the gaps and needs in the existing surveillance systems. Training for staff involved in disease surveillance will be given periodically. To enhance the reporting of ILI/SARI for sentinel surveillance, trained project staff will collect information from all ILI/SARI patients attending the sentinel sites using pre-tested tools. Using time, place, and person analysis, alerts for abnormal increases in cases will be generated and communicated to health authorities to initiate response activities. Advanced epidemiological analysis will be used to model influenza trends over time. Integrating virological and epidemiological surveillance data with advanced analysis and timely communication can enhance local preparedness for public health emergencies. Good quality surveillance data will facilitate an understanding outbreak severity and disease seasonality. Real-time data will help provide early warning signals for prevention and control of influenza and COVID-19 outbreaks. The implementation strategies found to be effective in this project can be scaled up to other parts of the country for replication and integration.

Oxygen Scarcity and COVID-19: Lessons Learned During the May-June 2021 Peak, Karnataka, India.

SUMMARY: Oxygen is a most essential medical gas. This report shows the observations during the second wave of oxygen management in Karnataka, India, where there was an unprecedented rise in COVID-19 cases during May-June 2021. The state was allocated 731 metric tons against the actual requirement 1200 (63%). While there were several bottlenecks in the production, filling, transportation, and refilling, there were issues with supply-chain management, which led to the death of 24 patients on life-support in a district. The pandemic showed fragility in existing supply chain management and warrants further streamlining to address future crises.

Clinical profile of patients infected with suspected SARS-CoV-2 Omicron variant of concern, Tamil Nadu, India, December 2021-January 2022.

Background & objectives: COVID-19 cases have been rising rapidly in countries where the SARS-CoV-2 variant of concern (VOC), Omicron (B.1.1.529) has been reported. We conducted a study to describe the epidemiological and clinical characteristics and outcomes of COVID-19 patients with 'S' gene target failure (SGTF, suspected Omicron). Furthermore, their clinical outcomes with COVID-19 patients with non-SGTF (non-Omicron) were also compared. Methods: This study was conducted in Tamil Nadu, India, between December 14, 2021 and January 7, 2022 among patients who underwent reverse transcription-PCR testing for SARS-CoV-2 in four laboratories with facilities for S gene screening. Consecutively selected COVID-19 patients with SGTF were telephonically contacted, seven and 14 days respectively after their date of positive result to collect information on the socio-demographic characteristics, previous history of COVID-19, vaccination status and clinical course of illness along with treatment details. To compare their outcomes with non-SGTF patients, one randomly suspected non-Omicron case for every two suspected Omicron cases from the line-list were selected, matching for the date of sample collection and the testing laboratory. Results: A total of 1175 SGTF COVID-19 patients were enrolled for this study. Almost 6 per cent (n=72) reported a history of previous infection. 141 (13.5%) suspected Omicron cases were non-vaccinated, while 148 (14.2%) and 703 (67.4%) had received valid one and two doses of COVID-19 vaccines, respectively. Predominant symptoms reported included fever (n=508, 43.2%), body pain (n=275, 23.4%), running nose (n=261, 22.2%) and cough (n=249, 21.2%). Five (0.4%) of the 1175 suspected Omicron cases required oxygen supplementation as compared to ten (1.6%) of the 634 suspected non-Omicron cases. No deaths were reported among omicron suspects, whereas there were four deaths among suspected non-Omicron cases. Interpretation & conclusions: Majority of the suspected Omicron cases had a mild course of illness. The overall severity of these cases was less compared to the suspected non-Omicron cases.

Kyasanur Forest Disease, is our surveillance system healthy to prevent a larger outbreak? A mixed-method study, Shivamogga, Karnataka, India: 2019.

BACKGROUND: Kyasanur Forest disease (KFD) is a tick-borne zoonosis that is endemic in Karnataka. Against the backdrop of the recent geographical expansion of KFD, indicating the inadequacy of policy and surveillance systems, the present study was performed to evaluate the KFD surveillance system in Shivamogga. METHODS: US Centers for Disease Control and Prevention guidelines for surveillance system evaluation were followed. Nine attributes of the system towards its objectives were evaluated in a mixed study in Shivamogga. RESULTS: Two of three medical officers and four of six health staff at the institutions visited were found to be untrained in KFD surveillance. Integrated disease surveillance formats did not capture KFD data. Surveillance (tick, monkey, human) was mostly driven by the Health Department. Some of the critical findings of the evaluations were the absence of an animal and entomological surveillance line list, non-standardized reporting formats for human suspects, varying delays in the time-to-test across laboratories (2-16 days), and a lack of systematic data-sharing practices. Significant issues that emerged in the interview were deforestation with a change in ecosystem dynamics, limited diagnostic capacity, non-availability of point-of-care tests, outdated surveillance guidelines, a confusing surveillance perimeter (5 km), non-existing co-ownership among stakeholders, limited vaccine production capacity, and inadequate operational research. CONCLUSIONS: The system should consider integrating a One Health approach with defined ownership of activities among stakeholders. Revision of the guidelines is mandatory.