Introduction: Worldwide, Extrapulmonary Tuberculosis (EPTB) accounts for 15-20% of all cases of TB. The diagnosis of EPTB is a big challenge, as the number of Mycobacterium tuberculosis(MTB) bacilli in the tissues and other organs is often very low. Truenat MTB/RIF (rifampicin) is a novel method, which is battery operated, point-of-care and chip-based Real Time Polymerase Chain Reaction (RT-PCR) micro device. Aim: To evaluate Truenat as a screening test in the diagnosis of EPTB in comparison with microscopy and culture. Materials and Methods: A prospective cross-sectional study was carried out over a year in which samples from suspected cases of EPTB fitting in the inclusion criteria were subjected to Ziehl-Neelsen (ZN) staining for smear microscopy, culture on Lowenstein Jensen (LJ) medium and PCR for MTB by Truenat. Comparisons were made between the tests and the data was presented using summary statistics with 95% Confidence Interval (CI). Results: A total of 248 samples were received from suspected cases of EPTB. Out of the different samples tested, 9 (3.6%) were positive with Truenat MTB. The predominant type of EPTB observed in the study was lymph node Tuberculosis (TB) (66.6%) followed by intestinal, pleural and skeletal TB. Out of the 106 samples tested for culture, four were culture positive for MTB and out of 178 samples tested for microscopy, three were positive for acid fast bacilli. Sensitivity, specificity, Negative Predictive Value (NPV), Positive Predictive Value (PPV), observed agreement of Truenat with culture and microscopy were 100%, 95.1%, 100%, 44.4%, 95.3% and 100%, 96.6%, 100%, 33.3%, 96.6%, respectively. Conclusion: Truenat MTB test is a cost-effective rapid molecular test with good sensitivity and specificity for the diagnosis of EPTB in low resource settings.

The immense impact of the coronavirus disease 2019 (COVID-19) pandemic on older adults living in nursing homes (NH) and other long-term care facilities, who at baseline are at increased risk of infection due to fragility, cognitive impairments, and complex comorbidities, has renewed the attention of researchers to the unmet needs of this population. It is well known that the built environment can significantly influence human health, a reality which is often overlooked in the setting of NHs. Recognizing how qualities of the NH built environment can influence resident outcomes, particularly in the context of the COVID-19 pandemic, can provide architects and medical professionals implementable strategies. As such, we conducted a systematic literature review from May to November 2021 to identify components of the NH built environment and their potential impacts on the health and well-being of NH residents during the COVID-19 pandemic. Relevant articles were identified with a search of Scopus, Web of Science, and PubMed scientific databases, as well as a search of gray literature. The initial search resulted 481 articles, though after the application of eligibility criteria and full-text screening, 17 articles remained for inclusion. From these, a total of 24 built environment features were identified, divided across four domain levels of NHs: Overall Facility, Building, Service Space, and Residential Room. These features were differentially linked to improved facility infection control, decreased COVID-19 incidence and mortality from COVID-19, better air quality, and enhanced resident health, quality of life, and socialization. This research defines a set of design/architecture strategies that NHs may implement to improve COVID-19-related outcomes as well as the overall health and quality of life of their residents. Additional research utilizing primary data and testing these identified interventions is needed to provide stronger evidence-based suggestions.

Independent polio immunization campaign monitoring is carried out to assess the quality and impact of supplementary immunization activities. It is critical in guiding any necessary mid-course corrections if gaps or problems are found. The need of the hour is to maintain this status by continuing the immunization activities without any discrimination based on caste, creed, sect, state or religion. It was a great sight to witness the Polio workers in the interiors of the country doing a great job to make INDIA proud and continue as a POLIO ELIMINATED COUNTRY. All the credit goes to these workers who tirelessly cycles and walks withstanding the rain and sun that made India a POLIO FREE country. Objective of this article is to highlight some of the observations by a WHO external monitor posted in a District of Tamilnadu.

No abstract

Introduction: Hepatitis B is a potentially life-threatening liver infection caused by the Hepatitis B virus (HBV). The established routes of transmission are from mother to infant, sexual contact, and exposure to blood or body fluids. Though HBV is preventable by vaccine and robust infection control practices, outbreaks of HBV infection do occur in India. However, the state of Kerala with its health parameters, one among the best in the country, cannot afford to have continuing outbreaks. An unusual increase in the reported cases of Hepatitis B in a rural area of Pathanamthitta district of Kerala, called for an outbreak investigation. Aims: To describe the epidemiological features, to determine the risk factors associated with HBV transmission, and to suggest measures to prevent future transmission. Methods: A community-based case-control study (1:2) was undertaken. A total of 162 participants (54 cases and 108 age, gender, and neighborhood matched controls) took part in the study. Focus group discussions were conducted with subject experts to develop an interview schedule assessing 40 risk factors. It was further reviewed by the University of Sydney. Data was collected by trained Junior Health Inspectors and Junior Public Health Nurses of the Primary Health Centers. Data was analyzed using SPSS v. 20. Proportions were compared by Univariate analysis, sub-group analysis, and logistic regression. Population Attributable Risk (PAR) was also calculated. Results and Conclusion: More than 90% of the infections were IgM anti-HBc positive, suggesting a recent infection. Interventions during hospitalization [OR: 7.98 (95% CI – 2.17--29.4)], family history of Hepatitis B [OR. 4.14 (95%CI – 1.73--9.9)], and laboratory investigations [OR: 3.99 (1.72--9.31)] were found to be significant risk factors. PAR was highest for laboratory interventions (32%). Vaccinating household contacts and strict enforcement of infection control practices could substantially reduce the burden of this fatal disease.