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Introduction Global health is still being impacted by the coronavirus disease 2019 (COVID-19) pandemic. Objectives We evaluated the antibody response in this study in individuals who received two doses of the COVID-19 vaccination, both with and without a history of SARS-CoV-2 infection. Methodology It was a hospital-based cross-sectional study conducted among healthcare personnel at a tertiary institution of a predominantly tribal state in India. Results A total of 187 medical students made up the vaccinee group; the majority (152; 81.3%) were between the ages of 18 and 23; 128 (68.4%) of the students were female; and 104 (55.6%) had received the Covishield (AstraZeneca plc, England, UK) vaccination. Of the subjects, 51 (27.3%) had a history of COVID-19 infection. For those who were infected, the antibody titer peaked after six months, whereas it took twice as long for those who were not. Up to a year later, the antibody titers for Covaxin (Bharat Biotech, Hyderabad, India) and Covishield remained equal; however, Covishield titers drastically decreased while Covaxin stayed constant when an infection history was present. Conclusion The study's findings show that immunization in individuals who have previously contracted COVID-19 induces a higher level of antibody response than immunization in individuals who have not previously contracted the virus.
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BACKGROUND: The government of India is committed to eliminating tuberculosis (TB) by 2025 under the National Tuberculosis Elimination Programme which provides free investigations and treatment as well as incentives for nutritional support during their treatment course. Many TB patients prefer to seek treatment from the private sector which sometimes leads to financial constraints for the patients. Our study aims to find the burden of TB patients in the private sector and the expenses borne by them for their treatment. METHODOLOGY: Sales data of rifampicin-containing formulation drug consumption in the private sector of six districts of Jharkhand was collected from Clearing and Forwarding agencies. Based on the drug sales data, the total incurring costs of the drugs, total number of patients, and cost per patient seeking treatment from the private sector were calculated for the year 2015-2021. ANOVA and the post hoc test (Tukey honestly significant difference (HSD)) were applied for analysis. RESULTS: There was a marked difference amongst all the districts in relation to all the variables namely total costs, cost per patient, and total private patients seeking treatment from the private sector which was statistically significant (p < 0.001). East Singhbhum had the highest out-of-pocket expense and private patients as compared to all six districts. Lohardaga showed the sharpest decline in total private patients from 2015 to 2021. The average cost borne by private patients in 2015 was INR 1821 (95% CI 1086 - 2556) which decreased to INR 1033 (95% CI 507 - 1559) in 2021. CONCLUSION: From the study, it was concluded that the purchase of medicines for TB treatment from the private sector is one of the essential elements in out-of-pocket expenditure (OOPE) borne by TB patients. Hence, newer initiatives should be explored to foresee the future OOPE borne by the patients and decrease OOPE-induced poverty.
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Background: Immunological Survey or serosurveys have yielded useful information regarding the spread of the COVID-19 pandemic in the general population, but the impact of the continuing pandemic on the medical students in India is yet to be fully recognised. In this study we assessed the students who had received at least two doses of the COVID-19 vaccine for their antibody response. Methodology: A Hospital based, age-stratified, cross-sectional Analytical study design was adopted for the survey, carried out in tribal state of India among medical students. Consecutive sampling method was used where serum samples were tested for antibodies against the SARS-CoV-2 nucleocapsid (N) protein. Result: The vaccinee group comprised of 187 students mostly aged between 18-23 years 68.4% were females, 56.6 % were vaccinated with covishield. The mean IgG (Immunoglobin G) titre was 7343.74 AU/Ml, less than 1000 AU/Ml was found in 8% of participants, while more than 8000 AU/Ml was found in 32.1%. Participants who got the covaxin vaccine had a higher median IgG titre (median 6491.8 AU/mL, interquartile range 8898 AU/mL).The antibody titre of male was 0.328 times lower than that of female. Conclusion: Despite the fact that covishield's mean antibody titre was higher, covaxin's protection lasted longer.
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Background The Indian state of Jharkhand has the highest rate of wasting (29%) among young children. Mobile audio call follow-up can be used to assess such children with severe acute malnutrition (SAM). Aim This study evaluated SAM children during the COVID-19 outbreak and learn more about the status of their home/community care, and caregivers' awareness of integrated child development services (ICDS) and COVID-19 prevention. Methods Contact numbers of caregivers for discharged children were obtained from 54 malnutrition treatment centers (MTCs). In April and June 2020, mentors conducted follow-up interviews using mobile phone calls. Results Seven children (1.72%) were reported dead and 400 were alive, mostly girls (59.5%). Only a few caregivers observed post-discharge ailments (15.4%) and weight loss (7.7%) in their children. Children aged six to 24 months were characterized by continued breastfeeding (88.0%) at most five to six times a day (45.8%). Most of the children were not fed as per maternal infant and young child feeding protocols. Age in months with an adjusted odds ratio (OR) of 0.55 (1.00-1.11) as a 95% confidence interval (CI), age category, with an adjusted OR of 4.32 (1.71- 10.94) as 95% CI, and breastfeeding with adjusted OR 1.85 (1.07- 3.21) as 95% CI were three major predictors for a well-fed child. Conclusion Community involvement is crucial in the follow-up of children with SAM for effective rehabilitation. Mobile phone audio call follow-up is a relatively cost-effective approach to tackle geographic barriers and COVID-19 lockdown-induced situations. There are major gaps mainly in informing caregivers on how to manage COVID-19 with breastfeeding.
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Background: In the COVID-19 pandemic age, vaccination hesitancy also known as vaccine refusal is a cause for worry since it hinges on the five Cs of confidence, complacency, convenience, calculation, and shared responsibility. The current study was to pinpoint the elements that contribute to breastfeeding women's hesitation to receive the coronavirus disease-19 (COVID-19) vaccine. Materials and Methods: A cross-sectional observational study was carried out at the Department of Obstetrics and Gynaecology, Tertiary Care Hospital, Ranchi, Jharkhand. Result: Out of 365 nursing mothers, 242 (66.3%) were hesitant to get the COVID-19 vaccination. Those who chose not to receive the COVID-19 vaccination mostly belong to those aged 18 to 25 (38.1%), living in rural regions (44.9%), and belonging to non-tribal ethnic groups (41.1%). On application of logistic regression, it was found that rural areas had 3 times higher rate of vaccine hesitancy than urban residents, and that husbands' education levels up to the 12th grade had a 3.55 times higher rate and 5 times agriculture by husband's occupation, which was statistically significant (P value less than 0.05) The most prevalent grounds for rejection were fear of side effects (85.8%) and worry of adverse effects on newborns (83.48%). Conclusion: Both husband and wife, who had completed high school and were aware of the vaccination, were fearful of the COVID-19 vaccine. Concerns about the side effects and undesirable effects of vaccination on their newborns were the main reasons for refusal.
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Background Vaccination is more widespread when the determinants and hesitancy of vaccination are identified, especially in vulnerable groups, such as pregnant women. Pregnant women if infected with COVID-19 are more likely to get severe COVID-19 illness and adverse neonatal outcomes as compared to non-pregnant women. The present study was designed with the aim to estimate the rate of COVID-19 vaccine acceptance and to identify the associated factors which influence the vaccine acceptance. Methods This study was a hospital-based cross-sectional study conducted in the Obstetrics Department of Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, from February 2022 to April 2022. Our study included 298 pregnant women above 18 years who were willing to participate in the study. Information was collected by face-to-face interview using a structured and pretested questionnaire. Binomial logistic regression (univariate and multivariate) was used to identify the associated factors on vaccination acceptance. Results Among 298 pregnant women, 234 expressed willingness to receive vaccine, giving an acceptance rate of 78.52%. The educational status, ethnicity, occupation of the woman and husband, and type of family showed no significant relationship with the vaccine acceptance. On multivariate logistic regression analysis, the determinants found to be significantly associated with COVID-19 vaccine acceptance among pregnant women were as follows: Muslim religion (aOR=0.27, CI: 0.12-0.61), gravida >2 (aOR=1.84, CI: 1.30-2.61), and awareness that COVID-19 vaccine has been approved by the government (aOR=3.03, CI: 1.45-6.36). Awareness that COVID-19 infection causes more severe complications in pregnant women than non-pregnant women (aOR=1.89, CI: 0.93-3.87) and hypertension (aOR=0.36, CI: 0.11-1.20) were non-significantly associated. Conclusion The acceptance of COVID-19 vaccination was high in this study and was well received especially by mothers who had knowledge about the importance of vaccination during pregnancy. Concerns about the side effects of vaccination and the possibility of harming the baby were the main reasons for refusal. During prenatal care, health care providers should reinforce the benefits of COVID-19 vaccination during pregnancy.
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BACKGROUND: Medicines play a crucial role in treating various diseases. Most individuals, in their haste to get through their day, have developed the bad habit of improperly discarding their unwanted or expired prescriptions, which poses a number of risks to human health and contributes to environmental degradation. Disposal procedures of unused and expired pharmaceuticals among health care personnel at tertiary care centers have been the subject of very little research to date. Therefore, the purpose of this study is to examine how medical staff at Rajendra Institute of Medical Sciences in Ranchi, Jharkhand, handle stale or unwanted prescription drugs. METHODS: The design of the study was cross-sectional analytical conducted among 385 health care professionals. Pretested semi-structured questionnaires prepared in Google Forms (Google LLC, Mountain View, California, United States) have been used for evaluation. RESULTS: The completely filled questionnaires were analyzed, evaluated, and expressed in the percentage using Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States). The most common method of disposal of unused and expired medications was throwing them in the dustbin. CONCLUSIONS: In this study, although, all the participants were health care professionals, because of the hectic schedule majority of them used unsafe methods of drug disposal. So, in order to protect our ecosystem, appropriate policy should be made to implement the methods for the safe disposal of unused and expired medications.
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BACKGROUND: Chickenpox is a benign, self-limiting disease caused by the varicella-zoster virus (VZV) that is transmitted from person to person with direct contact or airborne spread, which usually lasts for five to seven days. There was a sudden increase in the number of cases of fever along with rashes at two sites in Jharkhand, India. We aimed to survey and establish the etiology and investigate the extent of the disease. METHODS: We defined the case of chickenpox as a person with acute onset of diffuse maculo-papulovesicular rash. From the clinically suspected cases, blood samples were collected and tested for anti-VZV immunoglobulin M and immunoglobulin G antibodies (depending on the clinical features) with an enzyme-linked immunosorbent assay (ELISA) kit (Novatec Immundiagnostica GmbH, Dietzenbach, Germany). A detailed history was collected from each case including the history of contacts and immunization status. RESULTS: The outbreak investigations were done at two villages of the two different blocks and one school in the Bharno block. According to the case definition, 16 persons were found affected by the varicella-zoster/chickenpox infection who belonged to five different households of Itkhori village in Chatra district. The age group varied from four to 45 years. The mean age was 20.28 years. Out of 16 cases, 10 (62.5%) cases complained of fever, rashes, and itching, two (12.5%) reported rashes and fever, and four (25%) complained of itching along with rashes. While at the Bharno block of Gumla district, out of 62 cases that fulfilled the case definition, 55 (88.7%) cases complained of fever, rashes, and itching, two (3.2%) reported itching and rashes, one (1.6%) reported vomiting along with fever and rashes, one (1.6%) complained about pain and rashes, one (1.6%) complained of cough with rashes, and four (25%) complained of itching along with rashes. There was neither any death nor any serious complication noted due to varicella. CONCLUSION: Chickenpox is still widespread in Northern parts of India like Jharkhand. Most of the cases were self-limiting and recovered at the Itkhori block, while at the Bharno block, there were 20 active cases and the rest were either recovered or were still in the recovery phase.
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Ivermectin was popular drug on trial for preventive and therapeutic role in COVID-19. However, there is disagreement concerning the validity of its clinical efficacy. Hence, we conducted a Meta-analysis and Systematic review for effect of Ivermectin Prophylaxis in prevention of COVID-19. The online databases of PubMed (Central), Medline, and Google scholar for randomized controlled trials, non-randomized trial and prospective cohort study were searched up to March 2021. Nine studies were included for analysis, out of which four were Randomized controlled Trial (RCTs), Two Non-RCTs and three cohort studies. Four randomized trial evaluated prophylactic drug Ivermectin, two combination of topical nasal carrageenan and oral Ivermectin two study used in combination of personal protective equipment (PPE) one with Ivermectin and one with Ivermectin/ Iota-Carrageenan (IVER/IOTACRC). In the pooled analysis we observed non-significant less COVID-19 positivity rate in the prophylaxis group as compared with non-prophylaxis group (Relative Risk (RR) = 0.27 and Confidence Interval (CI) = 0.05, 1.41) with significant heterogeneity (I2 = 97.1%, P < 0.001) The pooled analysis involving the Non-RCTs studies also did not observe significant reduction in the COVID-19 positivity rate in the prophylaxis group as compared with non-prophylaxis group (RR = 0.01 and CI = 0.00, 7.97) with significant heterogeneity between the studies (P < 0.001).Hence,we conclude that Ivermectin is not the 'magical silver weapon' against COVID-19.
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Background: The first 1000 days of life is a unique window of opportunity when the foundation of overall optimum health and neurodevelopmental growth across the lifespan is established. Objective: To explore the level of knowledge and practice of service providers in delivering maternal, infant, and young child nutrition (MIYCN) services at the point of care. Methodology: This was a cross-sectional study done in the department of Obstetrics and Gynecology and Pediatrics of RIMS, Ranchi, Jharkhand from May to September 2019. Result: The practices and counseling skills of nursing staff pertaining to maternal nutrition interventions like IFA and calcium supplements was good. Though counseling on maternal minimum dietary diversity, frequency, and quantity of meals was done during the antenatal care period, its knowledge and expected total weight gain during pregnancy were suboptimal. The practice of early initiation of breastfeeding was significantly higher in those who delivered normally (79%) than those by cesarean section (7%). The nursing staff's knowledge and technical skills on early initiation and exclusive breastfeeding were good, but inadequate for cesarean section. Forty-one percentage of recently delivered women were counseled on colostrum feeding, 17% about positioning and attachment, and 38% on exclusive breastfeeding (EBF) during the first 6 months. In the pediatrics OPD and immunization clinic, 93% of mothers with an infant below 6 months of age, received counseling on EBF, 47% on feeding during illness, and 13% on breastfeeding difficulties and their solutions. Sixty percentage of mothers of children >6 months old received counseling on timely introduction of complementary feeding and 40% on minimum dietary diversity. Forty percentage of mothers were counseled on feeding techniques during and after illness. Conclusion: The nursing staffs were providing the services related to MIYCN during antenatal, intranatal, and postnatal services, sick child visits, and immunization visits but their technical knowledge and skills on the specific components were not in accordance with the standard guidelines.
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Background: Coronavirus disease (COVID-19) vaccination becomes a crucial weapon in the pandemic's control. Two vaccines, Covishield and Covaxin, are approved in India to vaccinate against the virus. Hence, the present study was done to determine the factors associated with the development of adverse events after taking the COVID-19 vaccine in a tribal state of India. Materials and Methods: This was a cross-sectional analytical study. All persons who were willing to participate in our study and had received the first or second dose of the COVID-19 vaccine from January 1 to March 31, 2021, were included. We got 1497 complete responses via (free, web-based Google Docs Editors suite offered by google, Founders- Larry Page Sergey Brin. Menlo Park, California, United States). So our final sample size came out to be 1497 in which analysis was done. The data was compiled in MS excel sheets (Microsoft version 2013, Microsoft Corporation, Redmond, Washington, United States) and a template was generated which was further analyzed in SPSS version 20 (version 25.0; IBM Corp., Armonk, NY, USA). Results: The total number of respondents who participated in the surveillance of adverse events following immunization (AEFI) was 1497. Among them, a majority have taken the Covishield vaccine followed by Covaxin. The majority of participants were female of age group less than 30 years and above 18 years with a mean age of 33.63 ± 51.51. The most common AEFI was pain at the site of injection, after the first and second dose followed by fever after the first and second dose within 24 h following immunization. Conclusion: We conclude that factors like the type of vaccine, gender, and participants who have allergies have a higher risk of presenting the adverse events after the COVID-19 vaccination.
