Serosurveys to detect SARS-CoV-2 antibodies among high-risk groups in six urban cities of Odisha, India.

INTRODUCTION: Personnel involved in essential services or residing in high-risk areas during the COVID-19 pandemic are at increased risk of getting infected. We evaluated the proportion of personnel infected in several high-risk groups in Odisha using seroprevalence studies. METHODOLOGY: During July to November, 2020, individuals from multiple high-risk groups in 6 urban cities (Bhubaneswar, Berhampur, Cuttack, Malkangiri, Paralakhemundi, and Rourkela) in Odisha, India, were recruited to the study after obtaining written informed consent. Blood samples collected from the study participants were tested for IgG antibodies against COVID-19 in Roche Cobas e441 (Roche Diagnostics, Rotkreuz, Switzerland). Information on socio-demographic variables, association with a confirmed or suspected case, and other details were collected using an electronic data capture tool and analysed with a statistical software. RESULTS: The overall COVID-19 seroprevalence was 34.9% (95%CI 33.6-36.2) among the 5434 individuals. The seroprevalence varied from 21.8% (95% CI, 19.6-24.1) in Rourkela to 54.9% (95% CI, 51.5-58.2) in Bhubaneswar. Seropositivity was maximum among prisoners (47.7%), followed by municipality/ sanitation staff (43.5%), and other office going staff (40.8%). Multivariate logistic regression indicated that participants aged 18-29 years, 30-44 years, residents of slums and vending zone, municipality staff, prisoners, residents of urban cities Malkangiri, Cuttack, Paralakhemundi, Bhubaneswar and those with previous history of COVID-19 were independent co-relates of seropositivity. CONCLUSIONS: The risk of COVID-19 varied among the high-risk groups of Odisha. Periodic seroprevalence studies in future are essential to protect the high-risk personnel involved in frontline activities during the pandemic.

COVID-19 vaccine hesitancy among school children aged 12-14 years: A cross-sectional study from Bhubaneswar, Odisha, India.

INTRODUCTION: Universal coverage of COVID-19 vaccines is of paramount importance for the prevention and control of the pandemic. World Health Organization (WHO) in 2019 declared vaccine hesitancy as one of the top ten global health threats. The study aims to find out the COVID-19 vaccine hesitancy among school children along with their parent's perspectives. METHODOLOGY: A cross-sectional study was conducted among school children (aged 12-14 years) at two schools in Bhubaneswar, Odisha. Data were collected via web-based links using a semi-structured questionnaire among students and their parents. RESULTS: Of 343 children, 79% (271) showed a strong willingness to get vaccinated. Around 91.8% (315) of parents agreed to get their children vaccinated. Fear of side effects (65.2%) was the most common reason for unwillingness. CONCLUSIONS: With only 1/5th of the children not willing to get vaccinated, policymakers should create a multi-centric effort for the universal coverage of the COVID-19 vaccination.

Gender dimensions of health-related challenges among urban poor during COVID-19 pandemic in low-and middle-income countries: a systematic review and gap analysis.

The COVID-19 pandemic has varying effects on men, women, and the transgender population. However, there is a paucity of systematic evidence on how gender and other social determinants of health during COVID-19 are affected in resource constraint urban settings. This review describes the gender dimensions of health-related challenges among the urban poor during COVID-19 in LMICs. We searched 11 scholarly online repositories including PubMed, Embase, Web of Science, CINAHL using the domain "slums," "COVID-19", "LMICs" and "gender identities." We used thematic framework analysis to synthesize qualitative data, and meta-analysis to determine the pooled prevalence. We registered in PROSPERO (CRD42020203783). We identified 6490 records, and 37 articles included. The studies reported stress among 74% women and 78% men, depression among 59% women and 62% men, and anxiety among 79% women and 63% men. Men had more stress than women during COVID-19; men are primarily responsible for household sustenance. Women had more anxiety than men, possibly because they are often the primary caregivers for children and the older population. While the severity varies according to gender identity, their vulnerability mostly related to their literacy and economy, highlighting the significance of including all social determinants in future primary studies. Systematic review registration: https://www.crd.york.ac.uk/prospero/#recordDetails.

The prevalence of tuberculosis infection in India: A systematic review and meta-analysis.

Background & objectives: The National Prevalence Survey of India (2019-2021) estimated 31 per cent tuberculosis infection (TBI) burden among individuals above 15 years of age. However, so far little is known about the TBI burden among the different risk groups in India. Thus, this systematic review and meta-analysis, aimed to estimate the prevalence of TBI in India based on geographies, sociodemographic profile, and risk groups. Methods: To identify the prevalence of TBI in India, data sources such as MEDLINE, EMBASE, CINAHL, and Scopus were searched for articles reporting data between 2013-2022, irrespective of the language and study setting. TBI data were extracted from 77 publications and pooled prevalence was estimated from the 15 community-based cohort studies. Articles were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and were sourced using a predefined search strategy from different databases. Results: Out of 10,521 records, 77 studies (46 cross-sectional and 31 cohort studies) were included. The pooled TBI prevalence for India based on the community-based cohort studies was estimated as 41 per cent [95% confidence interval (CI) 29.5-52.6%] irrespective of the risk of acquiring it, while the estimation was 36 per cent (95% CI 28-45%) prevalence observed among the general population excluding high-risk groups. Regions with high active TB burden were found to have a high TBI prevalence such as Delhi and Tamil Nadu. An increasing trend of TBI was observed with increasing age in India. Interpretation & conclusions: This review demonstrated a high prevalence of TBI in India. The burden of TBI was commensurate with active TB prevalence suggesting possible conversion of TBI to active TB. A high burden was recorded among people residing in the northern and southern regions of the country. Such local epidemiologic variation need to be considered to reprioritize and implement-tailored strategies for managing TBI in India.

Hepatitis B virus infection among the tribal and particularly vulnerable tribal population from an eastern state of India: Findings from the serosurvey in seven tribal dominated districts, 2021-2022.

The Global Health Sector Strategy on viral hepatitis (2016-2021) endorsed by the World Health Assembly in 2016, called for the elimination of viral hepatitis as a public health threat by 2030. Odisha, an eastern state of India, has the third-highest percentage of tribal population in the country and limited information is available regarding the prevalence of HBsAg among them. The present study was undertaken to estimate the seroprevalence of hepatitis B surface antigen as well as HBV DNA almost after 12 years of the first prevalence study of HBsAg among the tribal community of Odisha. The present study attempted to estimate the prevalence of HBsAg among the 35 Scheduled tribal (ST) communities and 5 Particularly Vulnerable Tribal Group (PVTG) using the 2,737 number of sera collected as part of a statewide COVID-19 serosurvey, among the tribal populations of Odisha (residing in 7 districts) aged 6-75 years. HBsAg positivity ranged between 1.79 and 2.94% across various age groups. 42.9% of HBsAg positive individuals showed the presence of HBV DNA and the high viral load was 0.10 × 102-6.84 × 108 IU/mL, indicating a high potential to transmit the virus. The HBsAg positivity was 14.18 and 6.06% among the PVTGs, Kutia Khond and Paudi Bhuyan, who were first time surveyed for HBsAg prevalence. The present study documents the prevalence of HBsAg among the major tribal population residing in the eastern state of the country and highlights the need for a statewide survey of Hepatitis B infection and risk factors, coverage and impact of the Hepatitis B vaccination program introduced in 2010-2011 in Odisha among the ST and PVTG population of the state.

Scrub typhus seroprevalence from an eastern state of India: findings from the state-wide serosurvey.

BACKGROUND: Scrub typhus is a mite-borne infectious disease caused primarily by the obligate intracellular bacteria Orientia tsutsugamushi, which is transmitted by chigger mites. The objective of this study was to determine the prevalence of scrub typhus among adults in Odisha, an eastern state of India. METHODS: A descriptive cross-sectional study was conducted to analyse 1840 serum samples from five districts (Khordha, Cuttack, Ganjam, Malkangiri and Sundargarh) of Odisha collected during 2020-2021. Both immunoglobulin G (IgG) and IgM antibodies against scrub typhus were tested using commercial enzyme-linked immunosorbent assay kits. Point estimates of the 95% confidence interval and adjusted odds ratio were calculated. RESULTS: Of 1840 participants, the prevalence of IgG positivity was 1034 (56.19%) and that of IgM was 523 (28.42%). The majority of participants were in the 18-45 y age group (53.7%). Cuttack had the highest IgG positivity (64.54%) and Malkangiri had the lowest (29.32%). The highest and lowest positivity for IgM were found in Malkangiri (40.84%) and Cuttack (25.30%), respectively. CONCLUSIONS: With an increasing number of infections detected in the state, scrub typhus is emerging as a public health threat. Increasing awareness among the general public and healthcare professionals through health education campaigns regarding scrub typhus is essential. Early detection of the disease through the establishment of a laboratory surveillance system is required to control the transmission of scrub typhus.

Impact of smokeless cooking fuel use on health status of women in a rural setting of eastern India.

The sustainable development goals (SDG 7.1) reinforce to ensure that everyone has access to affordable, safe and renewable energy. In India, women are typically responsible for cooking and are most vulnerable to household air contaminants. We conducted a descriptive cross-sectional comparative study in Odisha, India between exclusive LPG (liquefied petroleum gas) users and non-LPG users. A total of 900 women, 450 from each group, were randomly selected. The LPG-users had a better predictor of physical, psychological, social, and environmental wellbeing than non-LPG users. We found the ophthalmic disorders (adjusted odds ratio (AOR) 2.87, 95% CI 1.16-7.10, p = .023), asthma (AOR 2.05, 95% CI 1.15-3.65, p = .015), and ALRI (acute lower respiratory infections) (AOR 9.19, 95% CI 2.06-40.96, p < .004) were significantly higher in non-LPG users in comparison to LPG users. Access to smokeless cooking fuel will improve women's quality of life by eliminating the consumption of biofuel and thereby providing a healthier cooking environment.

A Systematic Review of Water, Sanitation, and Hygiene for Urban Poor in Low- and Middle-Income Countries during the COVID-19 Pandemic through a Gendered Lens.

Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity of systematic information on WASH among the urban poor during the pandemic. We reviewed the opportunities and challenges faced by the urban poor in LMICs during the COVID-19 pandemic. We used the PRISMA guidelines to conduct a comprehensive search of 11 databases, including MEDLINE, Embase, Web of Science, and CINAHL, between November 2019 and August 2021. We used thematic analysis to synthesize the qualitative data and meta-analyses to estimate the pooled prevalence. We screened 5008 records, conducted a full-text review of 153 studies, and included 38 studies. The pooled prevalence of shared water points was 0.71 (95% CI 0.37-0.97), non-adherence to hygiene practices was 0.15 (95% CI 0.08-0.24), non-adherence to face masks was 0.27 (95% CI 0.0-0.81), and access to shared community toilets was 0.59 (95% CI 0.11-1.00). Insufficient facilities caused crowding and long waiting times at shared facilities, making physical distancing challenging. Women reported difficulty in maintaining privacy for sanitation, as men were present due to the stay-at-home rule. Due to unaffordability, women reported using cloth instead of sanitary pads and scarves instead of masks.

Housing-related challenges during COVID-19 pandemic among urban poor in low- and middle-income countries: A systematic review and gap analysis.

The abysmal health of the urban poor or slum dwellers was attributed to structural inequities such as inadequate housing, water, and sanitation. This review aimed to assess housing-related opportunities and challenges during the COVID-19 pandemic among urban poor in low-and middle-income countries. For study identification, a comprehensive search was performed in 11 databases that yielded 22 potential studies. The inadequate housing infrastructure makes the lives of the urban poor more precarious during COVID-19. Typically, the houses lacked lighting, ventilation, and overcrowding. This review reflected that it is crucial to reimagine housing policy for the urban poor with an emphasis on pandemic/epidemic guidelines.

Dynamicity and persistence of severe acute respiratory syndrome coronavirus-2 antibody response after double dose and the third dose with BBV-152 and AZD1222 vaccines: A prospective, longitudinal cohort study.

Introduction: Vaccines are available worldwide to combat coronavirus disease-19 (COVID-19). However, the long-term kinetics of the vaccine-induced antibodies against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have not been sufficiently evaluated. This study was performed to investigate the persistence and dynamicity of BBV-152 (Covaxin)- and AZD1222 (Covishield)-induced immunoglobulin-G (IgG) antibodies over the year and neutralizing antibodies' status after 1-month of booster dose. Materials and methods: This 52-week longitudinal cohort study documented antibody persistence and neutralizing antibodies status among 304 healthcare workers (HCWs) from six hospitals and research facilities in Odisha, enrolled during January 2021 and continued till March 2022. IgG antibodies against spike receptor-binding domain (RBD) of SARS-CoV-2 were quantified in an automated chemiluminescence immune assay-based (CLIA) platform and a surrogate virus neutralization test (sVNT) was performed by enzyme-linked immunosorbent assay (ELISA). Results: Among these 304 HCWs vaccinated with double doses, 154 HCWs (50.66%) were Covaxin recipients and the remaining 150 (49.34%) were Covishield recipients. During the follow-ups for seven times, a total of 114 participants were identified as vaccine breakthrough cases. In 190 non-infected HCWs, the median antibody titer was significantly waned from DD2 to DD10, both for Covaxin (231.8 vs. 42.7 AU/ml) and Covishield (1,884.6 vs. 369.2 AU/ml). No statistically significant differences in antibody titers were observed based on age, gender, comorbidities, and blood groups. The median inhibition activity of sVNT increased from 23.8 to 91.3% for Covaxin booster recipients and from 41.2 to 96.0% for Covishield booster recipients. Among 146 booster dose recipients, 48 were breakthrough cases after booster and all were contracted by the omicron variant. Conclusion: This year-long follow-up study found a 7- and 5-fold antibody waning in Covaxin and Covishield recipients, respectively, without any breakthrough infection history. However, individuals with booster breakthrough had mild symptoms and did not require hospital admission. The data also indicate the possible escape of omicron variants despite the presence of vaccine-induced neutralizing antibodies.

Trend in seroprevalence of SARS-CoV-2 (IgG antibody) among tribal-dominated population: Findings from Jharkhand, India.

Background & objectives: Serosurvey of COVID-19 provides a better estimation of people who have developed antibodies against the infection. Undertaking such a serosurvey in certain districts of India which are densely populated with prominent tribes can provide valuable information regarding seropravelance of SARS-CoV-2 antibodies among such indigenous populations. In this context, two rounds of population-based, cross-sectional serosurveys for SARS-CoV-2 IgG antibody were carried out in Jharkhand, a tribal-dominated State of India, to compare the seroprevalence of SARS-CoV-2 infection and to determine the associated demographic risk factors. Methods: The surveys were carried out in June 2020 and February 2021 in ten districts of the State of Jharkhand. Blood samples were collected from the residents of the selected districts by random sampling and tested for anti-SARS-CoV-2 antibodies using an automated chemiluminescence immunoassay platform. A total of 4761 and 3855 eligible participants were included in round 1 and round 2, respectively. Results: The age- and gender-standardized seroprevalence for COVID-19 during round 1 was 0.54 per cent (0.36-0.80) that increased to 41.69 per cent (40.16-43.22) during round 2 with a gap of eight months in between. The seropositivity among male and female participants was 0.73 and 0.45 per cent, respectively, during the first round and 51.35 and 33.70 per cent, respectively, during the second round. During the first round, 17.37 per cent of the participants were tribal with seropositivity of 0.24 per cent (0.02-0.87), and during the second round, 21.14 per cent were tribal with seropositivity of 39.14 per cent (35.77-42.59). Compared to tribal group, non-tribal participants had an adjusted odds of 1.24 (95% confidence interval=1.04-1.48) for SARS-CoV-2 seropositivity. Interpretation & conclusions: COVID-19 seroprevalence was found to be low during the first round (0.54%) of the survey, possibly due to the travel restrictions during lockdown better adherence to social distancing and wearing of face masks among the people. Understanding the dynamics of SARS-CoV-2 transmission and the susceptibility to infection at the individual as well as community level will inform decision and help policy makers to design and implement effective public health strategies to mitigate the pandemic in this State.

SARS-CoV-2 IgG antibody responses in rt-PCR-positive cases: first report from India.

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody responses remain poorly understood and the clinical utility of serological testing is still unclear. AIM: To understand the relationship between the antibody response to SARS-CoV-2 infection and the demographics and cycle threshold (C t) values of confirmed RT-PCR patients. METHODOLOGY: A total of 384 serum samples were collected from individuals between 4-6 weeks after confirmed SARS-CoV-2 infection and tested for the development of immunoglobulin class G (IgG) against SARS-CoV-2. The C t values, age, gender and symptoms of the patients were correlated with the development of antibodies. RESULTS: IgG positivity was found to be 80.2 % (95 % CI, 76.2-84.2). Positivity increased with a decrease in the C t value, with the highest (87.6 %) positivity observed in individuals with C t values <20. The mean (±sd) C t values for IgG positives and negatives were 23.34 (±6.09) and 26.72 (±7.031), respectively. No significant difference was found for demographic characteristics such as age and sex and symptoms and antibody response. The current study is the first of its kind wherein we have assessed the correlation of the RT-PCR C t with the development of IgG against SARS-CoV-2. CONCLUSION: Although C t values might not have any relation with the development of symptoms, they are associated with the antibody response among SARS-CoV-2-infected individuals.

COVID-19 in children in Odisha state, India: a retrospective review.

We retrospectively analysed the swab samples tested for COVID-19 from 7 March 2020 to 17 August 2021 at the Indian Council of Medical Research-Regional Medical Research Centre, Bhubaneswar, Odisha. 553 763 nasopharyngeal swabs were collected from individuals suspected with COVID-19 in Odisha state. 75 190 (13.6%) samples were positive by reverse transcription-PCR. There were 5988 (8%) cases in children and young people under 18 years old. Odisha reported 996 153 COVID-19 cases which resulted in 6985 deaths in adults and 36 in children and young people under 18 years old.

IgG antibody response against nucleocapsid and spike protein post-SARS-CoV-2 infection.

OBJECTIVES: Coronavirus disease-19 (COVID-19) pandemic became the greatest public health challenge globally. Study of dynamicity and durability of naturally developed antibodies against SARS-CoV-2 are of great importance from an epidemiological viewpoint. METHODS: In this observational cohort study, we have followed up the 76 individuals who tested positive for SARS-CoV-2 infection by real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) for 16 weeks (post-enrolment) to record the periodic changes in titre, concentration, clinical growth and persistence of naturally developed SARS-CoV-2 antibodies. We collected serum samples from these individuals for 16 weeks with a frequency of weekly and fortnightly during each follow-up and tested them in two CLIA-based platforms (Abbott Architect i1000SR and Roche Cobas e411) for testing SARS-CoV-2 antibodies both qualitatively and quantitatively. RESULTS: We recorded the antibody magnitude of these individuals 10 times between September 2020 and February 2021. We found a waning of antibodies against nucleocapsid antigen protein but not a complete disappearance by the end of 16 weeks. Out of 76 cases, 30 cases (39.47%) became seronegative in qualitative assay, although all the sera samples (100%) remained positive when tested in quantitative assay. CONCLUSION: The lower persistence of anti-nucleocapsid SARS-CoV-2 antibody may not be the exact phenomenon as those cases were still seropositive against spike protein and help in neutralising the virus.

Pooled testing for SARS-CoV-2 infection in an automated high-throughput platform.

BACKGROUND: Active detection of SARS-CoV-2 infection through testing is elementary for the control of COVID-19 pandemic. The implementation of large-scale RT-PCR testing has led to a rise in the demand for testing kits whose availability is always a concern. OBJECTIVE: To find out the feasibility of pooled testing in a high-throughput platform. METHODOLOGY: Pooled testing was conducted in Roche cobas 6800 in 2 methods. Firstly, the simple two-stage testing algorithm was conducted for 1410 samples individually and then as pooled samples. Secondly, we evaluated the sensitivity of cobas 6800 for the detection of a single positive sample within a pool of negative samples. RESULTS: Implementing the five-sample Dorfman pooling to test 1410 samples, we identified 42 (2.9%) individual SARS-CoV-2-positive samples and 27 (9.5%) positive pool samples. The pooling strategy precisely identified all the positive samples. All individually negative samples were also accurately determined by pooling. There was 100% sensitivity of detecting positive samples in a pool of negative samples even up to 1:64 dilution. There was a threefold increase in total throughput in one-third of the cost per day. CONCLUSION: A high-throughput platform such as Cobas 6800 can effectively increase the testing capacity by twofold to threefold by adopting the pooled testing strategy for successful management of SARS-CoV-2 and helping in the containment of community transmission.

Serological surveys to inform SARS-CoV-2 epidemic curve: a cross-sectional study from Odisha, India.

This was a population based cross-sectional study carried out to estimate and compare the seroprevalence, hidden prevalence and determine the demographic risk factors associated with SARS-CoV-2 infection among adults in the three largest cities of Odisha, India, and ascertain the association with the progression of the epidemic. The survey carried out in August 2020 in the three largest cities of the state of Odisha, India. Blood samples were collected from the residents using random sampling methods and tested for anti- SARS CoV-2 antibodies using an automated CLIA platform. A total of 4146 participants from the 3 cities of Bhubaneswar (BBS), Berhampur (BAM) and Rourkela (RKL) participated. The female to male participation ratio was 5.9:10 across the three cities. The gender weighted seroprevalence across the three cities was 20.78% (95% CI 19.56-22.05%). While females reported a higher seroprevalence (22.8%) as compared to males (18.8%), there was no significant difference in seroprevalence across age groups. A majority of the seropositive participants were asymptomatic (90.49%). The case to infection ratio on the date of serosurvey was 1:6.6 in BBS, 1:61 in BAM and 1:29.8 in RKL. The study found a high seroprevalence against COVID-19 in urban Odisha as well as high numbers of asymptomatic infections. The epidemic curves had a correlation with the seroprevalence.

Seroprevalence of SARS-CoV-2 in Bhubaneswar, India: findings from three rounds of community surveys.

The study aims to estimate and compare the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence, the fraction of asymptomatic or subclinical infections in the population, determine the demographic risk factors and analyse the antibody development at different time points among adults in Bhubaneswar city, India. This was a serial three-round cross-sectional, community-based study where participants were selected from the residents of Bhubaneswar city using multi-stage random sampling. Blood samples were collected during household visits along with demographic and clinical data from every participant. Total anti-SARS-CoV-2 antibody present in serum was assessed using the electro-chemiluminescence immunoassay platform. Temporal comparisons of the community seroprevalence were performed against the detected number of cumulative cases, active cases, recoveries and deaths. A total of 3693 participants were enrolled in this study with a cumulative non-response rate of 18.33% in all the three rounds. The gender-weighted seroprevalence for the city in the first round was 1.55% (95% confidence interval (CI) 0.84-2.58), second round was 5.27% (95% CI 4.13-6.59) and in the third round was 49.04% (95% CI 46.39-51.68). In the first round, the seroprevalence was found to be highest in the elderly population, whereas the seroprevalence for the second and third phases was highest in the age group of 30-39 years. Seroprevalence showed an increasing trend over the three time periods, with the highest seropositivity rates among individuals sampled between 16 and 18 September 2020. By the third round, 93.93% of those who had previously been tested positive by real-time reverse transcription polymerase chain reaction had seroconversion and 46.57% of those who had been tested negative also showed seroconversion. Infection to case ratio during first round was 27.05, for second round and third round it was 5.62 and 17.91, respectively.

Health system preparedness & community participation in Japanese encephalitis/acute encephalitis syndrome (JE/AES) prevention in a tribal district of Odisha, India.

BACKGROUND & OBJECTIVES: Japanese encephalitis/acute encephalitis syndrome (JE/AES) is one of the major zoonotic arbodiseases that has a significant effect on human and animal health. Though many studies have been published on the epidemiology and transmission mechanisms of JE/AES, but there is little evidence on health system preparedness, including community-based engagement. This study was undertaken to explore a multi-stakeholder perspective on health system preparedness for the prevention of JE/AES in a tribal district of Odisha, India. METHODS: This study was conducted at Malkangiri district of Odisha. A total of nine focus group discussions (FGDs) among women having under-five children, community volunteers, and community health workers (CHWs), and 20 in-depth-interviews (IDIs) among community leaders, healthcare providers, and programme managers were conducted. The FGDs and IDIs were digitally recorded, transcribed, translated and analysed using content analysis approach. RESULTS: Health system preparedness for the prevention of JE/AES was improved, including effective vector management, implementation of the surveillance system, and vaccination programme. The JE vaccine was introduced under Universal Immunization Programme in Odisha in 2016. Behavioural Change Communication activities were provided with the support of community volunteers on Village Health Nutrition and Sanitation Day (VHNSD) under Gaon Kalyan Samiti (GKS) platforms. The CHWs were actively involved in vector management and raising sanitation and hygiene awareness. INTERPRETATION & CONCLUSIONS: Community participation and coordination between different stakeholders have a significant impact on the successful implementation of the programme. It was suggested that there was a need for a sustainability approach to active participation, orientation and capacity building training among CHWs and community volunteers to successfully implement the programme.

Diagnostic accuracy comparison of three fully automated chemiluminescent immunoassay platforms for the detection of SARS-CoV-2 antibodies.

BACKGROUND: Serological test is an essential surveillance tool to track down the extensiveness of SARS-CoV-2 transmission and subsequently to move out from the enforced lockdown stage. OBJECTIVE: The study measures the diagnostic accuracy of three popular chemiluminescent immunoassay (CLIA) based automated platforms for the detection of anti-SARS-CoV-2 antibodies and compares their agreements. STUDY DESIGN: Serum samples of 594 COVID-19 positive patients and 100 samples from pre-COVID cases were tested by three CLIA based automated platforms: Abbott architect i2000SR, Roche cobas e411 and Yhlo iFlash 1800 and their diagnostic accuracy were compared by the area under the curves (AUC) value obtained from receiver operator characteristic (ROC) curves. Cohen's kappa statistic and McNemar's test were used to interpret the agreement between the platforms. RESULTS: All three platforms showed high specificity as claimed by the manufacturer. Sensitivity was calculated as 64.48 % (58.67-70.3) for Abbott, 80.48 % (76.62-84.34) for Roche and 76.94 % (72.65-81.23) for Yhlo. AUC was maximum for Roche (0.929). The Cohen's kappa value was determined in between 0.69-0.89 as the inter-rater agreements. CONCLUSION: The overall statistical analysis demonstrated cobas e411 as the diagnostically most accurate platform among the three.