Deaths among tuberculosis patients of the western state of India: A secondary record based analytical study on its determinants.

INTRODUCTION: India has a significant TB burden, and ongoing attempts are being made to eradicate the disease. Globally, the number of TB deaths is declining, but not quickly enough to meet the End TB Goals. The National Strategic Plan (NSP) 2017-2025 in India set in motion an ambitious effort to expand the scope and efficacy of the National Tuberculosis Elimination Program (NTEP). METHODS: A descriptive retrospective study based on secondary data was conducted on information obtained from the electronic TB notification register for 2019, abstracted from Ni-kshay. Further, descriptive analysis was undertaken to identify the factors associated with deaths and successful treatment outcomes. The binomial logistic regression model estimates the crude relative risk and a 95% confidence interval to describe the association between predictor variables and TB treatment outcomes. RESULTS: After applying the eligibility criteria for the study population, a total of 1,44,643 (88%) TB patients were included in the study. 1,35,934 (94%) TB patients had completed the treatment and survived, while 8709 (6%) TB patients died. A significant association of treatment outcomes was observed in age, gender, key population, site of diseases, type of case, type of health facilities, HIV and Diabetes. When a logistic regression was applied, the model showed the association of the independent variables with the risk of death in TB patients. CONCLUSION: The epidemiological factors associated with treatment outcomes among TB patients should be audited systematically. A structure of TB death surveillance and response system should be established with a mortality audit, including a community-based death review (CBDR) and a facility-based medical audit (FBMA) in case the patient is hospitalized or discharged from a hospital.

Parents perceptions and intention to vaccinate their children against COVID-19: Results from a cross-sectional national survey in India

BackgroundDespite the success of adult vaccination against COVID-19, providing vaccines to children remains a challenge for policymakers globally. As parents are primary decision-makers for their children, we aimed to assess parents perceptions and intentions regarding COVID-19 vaccination in India. MethodsA cross-sectional web-based study was designed, parents or caregivers (N=770) were recruited through snowball sampling using Google form. Cross-tabulation was performed by parents intention to vaccinate their children against COVID-19 virus with sociodemographic characteristics and their risk perception towards COVID-19, trust in the healthcare system, and their history of vaccine hesitancy behavior. Multivariable logistic regression analysis was performed to compute the predictors of child vaccination intention among Indian parents. Results770 parents across the country have completed the survey. Of the 770 participants, 258 (33.5%) have shown intent to vaccinate their children. The stated likelihood of child vaccination was greater among parents who had a bachelors degree or higher education (aOR: 1.98, 95% CI: 1.15-3.51); as well as among parents who intended to vaccinate themselves (aOR: 2.35, 95% CI: 1.30-4.67). Parental concerns centered around vaccine safety and side effects. ConclusionIndian parents reported high knowledge of the COVID-19 virus and were aware of the development of a novel vaccine. However, about one-third of parents intended to vaccinate their children, and about half of them were not sure whether to vaccinate their children or not against the COVID-19 virus. The study highlighted the need for health promotion strategies that promote vaccine uptake among parents.

Knowledge and opinion about smoke-free laws and second-hand smoke among hospitality venue managers in Gujarat and Andhra Pradesh, India

Background: India’s Smoke-Free Law (SFL) was implemented in 2004 andreinforced on 2nd October 2008. This research attempts to understand the knowledgeand opinion of hospitality venue (HV) managers about second-hand smoke (SHS)and SFL as well as self-reported compliance with SFL in two Indian states.Methods: A survey was conducted among 804 randomly sampled HVs from projectSTEPS (Strengthening of tobacco control efforts through innovative partnershipsand strategies) in Gujarat and Andhra Pradesh, India. Four hundred and threeHVs from two districts in Gujarat and 401 HVs from six districts in Andhra Pradeshwere selected. The owner, manager or supervisor of each HV was interviewedusing a pre-tested structured interview schedule. Association of opinion scaleswith respondents’ background characteristics was assessed through the analysisof variance (ANOVA) method.Results: Out of the 403 respondents in Gujarat and 401 in Andhra Pradesh, 56.1%and 84.3% had knowledge about SFL respectively. Compliance of HVs with SFLwas 21.8% in Gujarat and 31.2% in Andhra Pradesh as reported by the managers.Knowledge about SHS was noted among 39.7% of respondents in Gujarat and25.4% in Andhra Pradesh. Bivariate results indicated that more educated HVmanagers showed higher support for smoke-free public places (P < 0.001) andwere more concerned about the health effects of SHS exposure (P = 0.002).Conclusion: Complete self-reported compliance with, and knowledge of SFL aswell as SHS was not found in Gujarat and Andhra Pradesh. The education level ofHV managers is an important determinant to ensure compliance with SFL in publicplaces.

Promoting tobacco cessation by integrating ‘brief advice’ in tuberculosis control programme

Background: There is an enormous health burden caused by the co‑prevalence oftuberculosis (TB) and tobacco use in India. This intervention study was undertakenin district Vadodara, Gujarat, India to promote tobacco cessation by integrating‘brief advice’ for tobacco cessation in TB patients who were tobacco users andregistered for treatment under TB control programme, based on the testedstrategies advocated by World Health Organization (WHO) and the InternationalUnion against Tuberculosis and Lung Diseases (The Union).Materials and Methods: Brief advice for tobacco cessation based on five A’s,advocated by the WHO and the UNION was incorporated into the on‑goingTB Control programme in India in the year 2010. The tools were developed foreducation, training and capturing data. All the registered TB patients receivingdirectly observed treatment short‑course (DOTS) who used tobacco in any formwere offered brief advice during routine interaction for treatment.Results: A total of 46.3% of TB patients, predominantly males (89.6% males and10.3% females) were current users of tobacco; 39.1% used smokeless tobacco,35.9% were smokers and 25% were dual users, that is, smoked as well as usedsmokeless tobacco. At the end of treatment, of the 67.3% patients who wereoffered brief advice, quit tobacco use, 18.2% re‑lapsed while 14.5% were lostto follow‑up.Conclusion: A significant numbers of TB patients use tobacco with adverse impacton TB control programmes. Our study shows that it is feasible to introduce ‘briefadvice’ strategy as a cost effective intervention for tobacco cessation among TBpatients with careful monitoring

Case of foreign body in Wharton's ductcausing silolithiasis.

A case of swelling of submandibular gland in a 20-year-old male is reported. This eventually proved to be caused by a foreign body-thorn in the Wharton's duct.