Unintentional Child Injury in Rural and Urban Siddlagatta, Karnataka, India: A Community-Based Survey.

INTRODUCTION: Despite Indian children constituting approximately 31.4% of the population aged 0 to 14, a comprehensive exploration of childhood injuries within this demographic remains limited. This study aimed to examine the occurrence of unintentional injuries among children aged six months to 18 years in the Siddlagatta area and assess associated risk factors. METHODOLOGY: A community-based, cross-sectional study on unintentional child injuries was carried out from March 2018 to September 2020 across 11 sites in India. Employing a two-stage cluster sampling method with probability proportionate to size, 2341 urban and rural families were selected from each site. Data on unintentional injuries sustained over the past 12 months were collected using the WHO child injury questionnaire, tailored and validated for the Indian context. RESULTS: The study encompassed 10,335 individuals in households, including 2695 children aged 6 months to 18 years. Among them, 309 children experienced 390 unintentional injuries in the preceding year, excluding minor incidents. A prevalence rate of 11.5% (95% CI: 10.3-12.7) was identified for unintentional injuries among children, excluding minor cases. Falls were the most prevalent injury type (183 cases, 53.8%), while poisoning incidents were the least frequent (one case, 0.2%). More than 50% of incidents occurred within domestic settings. CONCLUSIONS: This study's outcomes underscore the prominence of fall-related injuries across all age groups and genders. Homes and schools emerged as primary settings for these injuries, highlighting the need for targeted preventive measures.

STEPS: A Solution for Ensuring Standards of TB Care for Patients Reaching Private Hospitals in India.

BACKGROUND: In India, the private sector diagnoses and treats more patients with TB than the public sector. Gaps in the TB care cascade were observed more among the patients diagnosed in the private sector. CONCEPT: The System for TB Elimination in Private Sector (STEPS) model evolved as a solution to address gaps in the quality of care for patients in the private sector by ensuring standards of TB care. STEPS has 3 components: a consortium of private hospitals, a coalition of all professional medical associations, and a STEPS center in each private hospital. STEPS centers act as a single window for notification, linkage for social welfare measures, contact investigation, chemoprophylaxis, direct benefit transfers, and treatment adherence support. INTERVENTION: STEPS was piloted in 14 districts in the state of Kerala. All 14 districts formed consortiums of private hospital management for policy support and a coalition of professional medical associations for advocacy with doctors. STEPS centers were established in 318 private hospitals. RESULTS: Notification to National TB Elimination Program from the private sector improved by 26% when compared to the previous year. Among the patients notified from the private sector, microbiologically confirmed cases increased by 81%, rifampicin resistance testing at baseline increased by 56%, and the percentage of those informed of their HIV status increased by 95%. The percentage of patients notified from the private sector with their treatment outcome reported improved from 39% (2018) to 99% (2019). CONCLUSION: The STEPS model demonstrated that a low-cost locally customized private sector engagement model is feasible and is beneficial to society. STEPS could be one of the major solutions for supporting patients reaching the private sector.

Outcome of tuberculosis treatment in patients with diabetes mellitus treated in the revised national tuberculosis control programme in Malappuram District, Kerala, India.

SETTINGS: Kerala State, India has reported the greatest dual burden of Tuberculosis (TB) and Diabetes Mellitus (DM). Malappuram district in Kerala has monitored and recorded DM status and its control from 2010 under Revised National Tuberculosis Control Program (RNTCP). OBJECTIVES: To assess, under programme conditions, comprehensiveness of recording DM status among TB cases and the TB treatment outcomes among DM patients (disaggregated by glycemic control) and compare with-non DM patients. DESIGN: This retrospective record review included 3,116TB patients from April 2010 to September 2011.DM was defined as per international guidelines and TB treatment outcomes were categorized as favourable(cured and treatment completed) and unfavourable(death, default, failure and transfer out). Relative Risk (RR) and 95% confidence intervals(CI) were calculated to assess the risk of unfavourable outcomes. RESULTS: DM status was recorded in 90% of TB cases and 667 (24%) had DM. 17% of DM patients and 23% of patients with unknown DM status had unfavourable outcomes but this difference was not statistically significant. Unadjusted RR for poor glycemic control or unknown control status for unfavourable outcome were (2.00; 95% CI 0.97-4.13) and (2.14; 95% CI 1.11-4.13). CONCLUSION: This study could not confirm an adverse association between DM or its control during treatment and the course of response to TB treatment.DM screening in TB cases and recording of DM care needs to be improved to enable more conclusive evidence.