Background: Health-care workers (HCWs) may get infected by direct or indirect contact with infected patients or other HCWs or from the community as well, depending on the phase through which pandemic progresses. Knowledge about the disease transmission dynamics as the pandemic advances is a need so that appropriate monitoring, prevention and control measures for HCWs can be implemented at local level. The main objective of this study was quadmester-wise comparison of disease transmission dynamics of COVID-19 among HCWs in Kannur district.Methods: A cross-sectional study was carried out among HCWs reported positive for SARS-CoV-2 in Kannur district, Kerala. COVID-19 positive HCWs reported in the district were consolidated and contacted over phone and details were collected using a semi-structured questionnaire. Data were entered into microsoft excel and analysed using statistical package for social sciences (SPSS) trial version. Chi-square test was used to compare differences observed in the two groups and binary logistic regression was done to pick out the significant predictors of variability in disease transmission among the two groups.Results: Total respondents in the first and second quadmester were 243 and 1665, respectively. Factors like gender, clinical features, source of infection, family as source and type of duty taken were found to be statistically significant for the disease transmission dynamics among HCWs.Conclusions: As the pandemic advances, irrespective of the type of work place, self-reporting and regular testing of HCWs will help to check HCWs from getting infected and spreading the disease.

Background: The distribution and determinants of violence against women may vary in time across the region and within the region. It results in women’s physical and psychological sufferings and the final impact will reflect in the health system. Kerala is one of the leading states in India for female literacy and health indices. Still different forms of domestic violence including physical, psychological, economical and sexual violence are prevailing as a public health problem. Among the various domains this study measured the prevalence of psychological violence and identified associated factors, among married women aged 18-55 years in Thiruvananthapuram district.Methods: A community based cross-sectional study was conducted between January and May 2017. Sample size calculated was 270. Multistage cluster sampling was done. Tool used was semi structured questionnaire; conducted house visits and direct interview. Psychological violence was measured using modified scale validated in local language.Results: The life time prevalence of psychological violence was 25.2% (95% CI 20.2-30.6). The predictors of psychological violence found were care obtained during pregnancy (AOR 0.107), household structure (AOR 7.8), in laws’ satisfaction with marriage (AOR 0.046), less communication with own family (AOR 8.6) and partner’s parents quarrel (AOR 31.3).Conclusions: Psychological violence is still prevalent in the community. The associated factors include those relating to habit of the partner, house hold conditions, marital elements and family environment. The study identified nurturing friendly atmosphere in the family and improving familial bond as the core strategy to prevent psychological violence. Similar studies are recommended in each setting separately since risk factors varies with change in settings.

Background: The first case of COVID-19 in Kannur district was reported in first week of March, 2020. An elderly female with multiple co-morbidities and confined to house for many years was detected to be positive for SARS-CoV-2 on third week of May, 2020. She neither had relevant travel history nor was a contact of any confirmed COVID-19 case. A special investigation team was assigned to identify the source of infection.Methods: Index case's residential premises and the concerned local Primary Health Centre (PHC) were visited to get an idea about the background details of the index case. The team members participated in focus group discussions for decision making and reviewing steps involved in the process of investigation. Data collection was done mainly through phone interviews using an open- ended questionnaire. Data collected from family members, relatives, neighbours and local leaders were compiled systematically and summarized descriptively to reach a hypothesis.Results: Rigorous contact tracing of index case and appropriate testing of the contacts were done. Interstate truck drivers bringing fish from outside Kerala, who used to deliver fish to the index case’s house were identified as the source of infection. These truck drivers used to deliver fish in the local fish market also. The district administration was immediately alerted and fish market was disinfected and closed which prevented further mushrooming of cases.Conclusions: Early epidemiological investigation for source identification and elucidation of chain of disease transmission is crucial to clamp down the outbreak efficiently.

Background: The uncontrolled, inappropriate or excessive use of the mobile phone can give rise to social, behavioural and affective problems. Mobile phone addiction has emerged as a challenging public health issue. The aim of the study was to find out the proportion and associated factors of mobile phone addiction among children aged 5-12 years.Methods: A cross-sectional study was conducted among 222 children in the age group of 5-12 years. Data collection was done using a semi-structured questionnaire and outcome variable measured using the diagnostic criteria developed by Lin et al. Chi-square test and binary logistic regression was done to find out the association between exposure and outcome variables.Results: 42.3% of children aged 5-12 years had mobile phone addiction. Factors like higher socio-economic status of the family, educated father, children with normal weight for age, presence of visual problems, headache, poor concentration and disturbed sleep were found to have statistically significant association with the mobile phone addiction. The predictor variables found on regression were higher socio-economic status, children with normal weight for age, disturbed sleep and poor concentration.Conclusions: This study found nearly half of the children belonging to 5-12 years was addicted to mobile phones which is higher than expected and is a serious matter for the growing children. The risk factors found in the study are modifiable to an extent and hence regional and national level strategies has to be implemented in accordance with the available studies to tackle this public health problem.

Background: The state government directed its efforts to mitigate transmission of new variant SARS-CoV-2 called Omicron. This study aimed to describe pathways and characteristics of home isolation (HI) deaths reported in Kerala during third wave of pandemic.Methods: The study adopted retrospective cross sectional descriptive approach, conducted among HI patients who died from January15th to February 15th 2022. The sociodemographic, clinical characteristics and the events that happened prior to deaths were collected through verbal autopsy. The state declared 106 HI deaths with case fatality rate of 2% (95% CI 1.5-2.50%). After screening, 70 HI deaths (54 home deaths and 16 in-transit deaths) were studied.Results: Majority were home deaths (84.29%) followed by in-transit deaths (15.71%). Mortality was higher among older persons (94.28%), females (51.42%), unemployed (68.57%) and patients in rural community. Majority had comorbidities (80%) mainly diabetes mellitus (55.35%). The median interval from symptom onset to death was five days (IQR) 4-8) and that from diagnosis to death was four days (IQR 2-8). Majority reported red flag signs (83.07%) commonly breathlessness (83.34%). Most of the deceased (80%) did not monitor oxygen saturation. The study identified four patterns of HI deaths, primarily due to delay in identification of red flag signs and hospitalization.Conclusions: Non-compliance to oxygen monitoring, slow response towards red flag signs and delay in hospitalization were the main reasons for HI deaths. Stringent monitoring mechanism for HI patients at primary health care and meteoric referral strategy can prevent fatalities in future.