Risk factors for SARS-CoV-2 infection among health workers in India: a case control study.

Background: COVID-19 was declared as a Public Health Emergency of International Concern on 30th January 2020. Compared to the general population, healthcare workers and their families have been identified to be at a higher risk of getting infected with COVID-19. Therefore, it is crucial to understand the risk factors responsible for the transmission of SARS-CoV-2 infection among health workers in different hospital settings and to describe the range of clinical presentations of SARS-CoV-2 infection among them. Methodology: A nested case-control study was conducted among healthcare workers who were involved in the care of COVID-19 cases for assessing the risk factors associated with it. To get a holistic perspective, the study was conducted in 19 different hospitals from across 7 states (Kerala, Tamil Nadu, Andhra Pradesh, Karnataka, Maharashtra, Gujarat, and Rajasthan) of India covering the major government and private hospitals that were actively involved in COVID-19 patient care. The study participants who were not vaccinated were enrolled using the incidence density sampling technique from December 2020 to December 2021. Results: A total of 973 health workers consisting of 345 cases and 628 controls were recruited for the study. The mean age of the participants was observed to be 31.17 ± 8.5 years, with 56.3% of them being females. On multivariate analysis, the factors that were found to be significantly associated with SARS-CoV-2 were age of more than 31 years (adjusted odds ratio [aOR] 1.407 [95% CI 1.53-1.880]; p = 0.021), male gender (aOR 1.342 [95% CI 1.019-1.768]; p = 0.036), practical mode of IPC training on personal protective equipment (aOR 1. 1.935 [95% CI 1.148-3.260]; p = 0.013), direct exposure to COVID-19 patient (aOR 1.413 [95% CI 1.006-1.985]; p = 0.046), presence of diabetes mellitus (aOR 2.895 [95% CI 1.079-7.770]; p = 0.035) and those received prophylactic treatment for COVID-19 in the last 14 days (aOR 1.866 [95% CI 0.201-2.901]; p = 0.006). Conclusion: The study was able to highlight the need for having a separate hospital infection control department that implements IPC programs regularly. The study also emphasizes the need for developing policies that address the occupational hazards faced by health workers.

Urban-rural differences in menstrual problems and practices of girl students in Nagpur, India.

Menstruation in adolescent girls is often associated with menstruation related problems and poor practices. The study was planned to investigate the menstrual related problems and menstrual practices among school going adolescent girls. The study was a community based cross sectional study in a girls school in Nagpur. Majority of menstrual practices were significantly better in urban girls as compared to rural girls (P<0.05). Majority of the girls (71.83%) had at least one problem related to menstrual cycles. There was a significant difference in proportion of menstrual problems in rural and urban girls (P<0.01). Menstrual problems are a common source of morbidity in this population.

Can the Griess Nitrite Test and a Urinary Pus Cell Count of ≥5 Cells Per Micro Litre of Urine in Pregnant Women be Used for the Screening or the Early Detection of Urinary Tract Infections in Rural India?

OBJECTIVES: Urinary Tract Infection (UTI) is a common problem in pregnancy due to the morphological and the physiological changes that take place in the genitourinary tract during pregnancy. Screening methods may be useful, because a full bacteriological analysis could be reserved for those patients who are symptomatic or those who have positive screening test results. The exact prevalence of UTI in rural, pregnant women is unknown. The present study was undertaken to estimate the prevalence of UTI in pregnant women and for ascertaining the utility of the Griess Nitrite test and the Urinary Pus Cell Count of ≥5 cells per micro litre test for the screening or the early detection of UTI in them at primary health care clinics. Occurrence of urinary complaints was compared in UTI and non UTI women. METHOD: We conducted a study on 300 randomly selected, pregnant women from rural areas. Urine cultures, pus-cell counts and the Griess nitrite test were used for diagnosis of UTI. The screening tests for UTI were evaluated in terms of their sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and the percentage of correctly classified. RESULTS: In the present study, the prevalence of UTI was found to be 29/300 (9.6%, 95% confidence interval 9.57-9.63). The specificities of the two screening tests were comparable (97.05% and 94.47%). Also, the negative predictive values of the two tests were almost similar (97.77% and 96.96%). The percentage of correctly classified by the Griess nitrite test and the urine pus cell count were found to be 95.33% and 92.33% respectively. The proportion of the women with various urinary complaints was significantly higher (P<0.00) in the UTI subjects as compared to that in the non-UTI subjects. CONCLUSION: Urine culture remains the gold standard for the detection of asymptomatic bacteriuria. The Nitrite test of uncentrifuged urine was observed to be the best among the screening tests which were evaluated in terms of their efficiency and validity.

Qualitative analysis of parents' experience of hearing loss of their school going children of a rural area of Nagpur.

INTRODUCTION: Qualitative research methods provide a means of collecting and interpreting narrative or observational data about such interactions, leading to a deeper understanding of the process of health care delivery. This approach was used to clarify key themes from parents' comments about challenges on paths to detect hearing impairment. MATERIALS AND METHODS: An exploratory descriptive qualitative research design is used. In-depth interviews by using a semi-structured questionnaire and focus group discussions (FGD) were held with parents, and other study groups. A study was conducted in Deaf Dum Rural School, Saoner, Nagpur district, Maharashtra, India. Purposive voluntary sampling is utilized. Semi-structured and in-depth interviews and FGD were conducted in private rooms. A FGD guide covered open-ended comments to the set of questions. RESULTS: Parents of 65 children (59%) replied to the questionnaire. Out of them, 55 (85.6%) were the parents of school children resides in the hostel. The majority of the children have profound hearing impairment (75.86%). Theme analysis revealed perceptions about causes, ways, and means of early detection, and powerful emotions experienced by parents at FGD. CONCLUSIONS: Reaching beyond numerical analyses, qualitative studies allow for expression of junior doctors, Deaf and Dump School teacher and parents' thoughts, feelings, and experiences. This study provides a means of collecting and interpreting narrative or observational data.

Hypertension and hearing impairment in workers of iron and steel industry.

The objectives of the present study were to study the (i) prevalence of hypertension and hearing impairment in iron and steel industry workers, (ii) association between hypertension and hearing impairment, (iii) association between hypertension and hearing impairment, with duration of exposure, and (iv) correlation between levels of sound and noise induced health problems viz. hypertension and hearing impairment in a cross sectional study involving Workers working in iron and steel industry at Nagpur. Of a total of 804 workers, 770 workers participated in the study. There were five sections in the factory; Steel melting section (SMS), rolling mill section (RMS), quality control department (QCD), maintenance department (MD) and administration department (AD). Workers working in SMS, RMS, & QCD formed a continuously exposed group (CEG); workers of MD and AD formed intermittently exposed group (IEG). Workers were interviewed, examined and information was collected in a pre-tested pro-forma. Blood pressure was measured, and tuning fork tests were done to assess hearing ability. Prevalence of hypertension among CEG (25.51%) was significantly higher than IEG (14.05%). (X2-14.28, df-1, P<0.001). There was positive association between duration of exposure and prevalence of hypertension. The prevalence of hearing impairment was significantly more in CEG (20.5%) as compared to IEG (8.91%). (X2-11.69, df-1, P<0.001). Occurrence of hearing impairment was also directly proportional to the duration of exposure. The correlation between level of sound exposure and hearing impairment was found to be significant (r=0.98; P<0.05), the correlation between level of sound and hypertension was found to be statistically insignificant (r=0.84; P>0.05). The results of the present study indicate that hypertension and hearing impairment are commoner in workers continuously exposed to high levels of occupational noise.