BackgroundWithin Kashmir, which is one of the topographically distinct areas in the Himalayan belt of India, a total of 2,236 cumulative deaths occurred by the end of the second wave. We aimed to conduct this population-based study in the age group of 7 years and above to estimate the seropositivity and its attributes in Kashmir valley.MethodsWe conducted a community-based household-level cross-sectional study, with a multistage, population-stratified, probability-proportionate-to-size, cluster sampling method to select 400 participants from each of the 10 districts of Kashmir. We also selected a quota of healthcare workers, police personnel, and antenatal women from each of the districts. Households were selected from each cluster and all family members with age 7 years or more were invited to participate. Information was collected through a standardized questionnaire and entered into Epicollect 5 software. Trained healthcare personnel were assigned for collecting venous blood samples from each of the participants which were transferred and processed for immunological testing. Testing was done for the presence of SARS-CoV-2-specific anti-spike IgM, IgG antibodies, and anti-nucleocapsid IgG antibodies. Weighted seropositivity was estimated along with the adjustment done for the sensitivity and specificity of the test used.FindingsThe data were collected from a total of 4,229 participants from the general population within the 10 districts of Kashmir. Our results showed that 84.84% (95% CI 84.51–85.18%) of the participants were seropositive in the weighted imputed data among the general population. In multiple logistic regression, the variables significantly affecting the seroprevalence were the age group 45–59 years (odds ratio of 0.73; 95% CI 0.67–0.78), self-reported history of comorbidity (odds ratio of 1.47; 95% CI 1.33–1.61), and positive vaccination history (odds ratio of 0.85; 95% CI 0.79–0.90) for anti-nucleocapsid IgG antibodies. The entire assessed variables showed a significant role during multiple logistic regression analysis for affecting IgM anti-spike antibodies with an odds ratio of 1.45 (95% CI 1.32–1.57) for age more than 60 years, 1.21 (95% CI 1.15–1.27) for the female gender, 0.87 (95% CI 0.82–0.92) for urban residents, 0.86 (95% CI 0.76–0.92) for self-reported comorbidity, and an odds ratio of 1.16 (95% CI 1.08–1.24) for a positive history of vaccination. The estimated infection fatality ratio was 0.033% (95% CI: 0.034–0.032%) between 22 May and 31 July 2021 against the seropositivity for IgM antibodies.InterpretationDuring the second wave of the SARS-CoV-2 pandemic, 84.84% (95% CI 84.51–85.18%) of participants from this population-based cross-sectional sample were seropositive against SARS-CoV-2. Despite a comparatively lower number of cases reported and lower vaccination coverage in the region, our study found such high seropositivity across all age groups, which indicates the higher number of subclinical and less severe unnoticed caseload in the community.

Background: Dementia is common in the geriatric population. It has been suggested that early detection leads to benefits for the patient and their family and cuts the costs. The solution to this problem lies in the development of brief and easily applicable tests that are acceptable to patients, their caregivers, and health professionals. The current study was undertaken for screening for dementia using Mini-Cog scale.Methods: Cross sectional study from District Budgam of Kashmir Division done on individuals aged >60 yrs after providing informed consent. All participants underwent comprehensive evaluations using the Mini-Cog scale for Dementia.Results: The overall prevalence of dementia was 57.5%. Majority of the individuals with dementia were illiterate (49.8%) and had completed up to primary education (63.2%). However no statistical significance was seen between marital and educational status with dementia. About 70.8% of the individuals with dementia were not aware of the availability of facilities related to mental issues.Conclusions: Need of the hour is to develop culturally appropriate interventions that could be integrated with dementia services within the primary health care system.

ObjectivesWe designed a population-based survey in Kashmir to estimate the seroprevalence of SARS-CoV-2-specific IgG antibodies in the general population aged 18 years and above.SettingThe survey was conducted among 110 villages and urban wards across 10 districts in Kashmir from 17 October 2020 to 4 November 2020.ParticipantsIndividuals aged 18 years and above were eligible to be included in the survey. Serum samples were tested for the presence of SARS-CoV-2-specific IgG antibodies using the Abbott SARS-CoV-2 IgG assay.Primary and secondary outcome measuresWe labelled assay results equal to or above the cut-off index value of 1.4 as positive for SARS-CoV-2-specific IgG antibodies. Seroprevalence estimates were adjusted for the sampling design and assay characteristics.ResultsOut of 6397 eligible individuals enumerated, 6315 (98.7%) agreed to participate. The final analysis was done on 6230 participants. Seroprevalence adjusted for the sampling design and assay characteristics was 36.7% (95% CI 34.3% to 39.2%). Seroprevalence was higher among the older population. Among seropositive individuals, 10.2% (247/2415) reported a history of COVID-19-like symptoms. Out of 474 symptomatic individuals, 233 (49.2%) reported having been tested. We estimated an infection fatality rate of 0.034%.ConclusionsDuring the first 7 months of the COVID-19 epidemic in Kashmir Valley, approximately 37% of individuals were infected. The reported number of COVID-19 cases was only a small fraction of the estimated number of infections. A more efficient surveillance system with strengthened reporting of COVID-19 cases and deaths is warranted.

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COVID-19 infection is a potentially traumatic experience in terms of the risk of running a Severe Acute Respiratory Syndrome in addition to the social implications of the disease in terms of being isolated and follow up of strict quarantine measures of close contact. The purpose of this study was to assess the prevalence of psychological distress and its risk factors in patients who develop COVID-19 infection. There is scanty evidence regarding the magnitude of COVID-19-related psychological distress (PD) among the general population of India, and Post Traumatic Stress Disorder (PTSD) is a Mental Disorder that develops after a traumatic event that has a life-threatening impact. The aim of this study was to assess COVID-19 infection. Material and methods: This study was conducted among 672 COVID-19 survivors of district Budgam from (March to August 2020). They were contacted by telephone, and psychological distress in the post-COVID recovery period was assessed using the IES-R scale. This is a 22-item scale, and each item is rated on a scale ranging from 0-4. Suitable Statistical Analysis was done to analyze risk factors for the development of any psychological distress. Methods: Descriptive cross-sectional study. Study design: Cross-sectional study from District Budgam of Kashmir Division. Study tool: using the IES-R scale for PTSD. Result: In our study prevalence of psychological distress using IES –R was mild in (7.08 %) of the study participants and moderate in (1.06 %) of the study participants. Psychological distress in study participants was examined by age, sex, employment status, family history, COVID-19 disease status and history of hospitalization. No statistical significance between age, gender, days of hospitalization and PTSD was seen. However, statistical significance with the IES–R score was seen between family history and the presence and absence of symptoms in the study subjects. Conclusion: As the pandemic crisis seems to be ebbing, the current findings help us to identify risk factors and devise pragmatic strategies to curtail the burden of mental issues and successfully meet the challenges that follow the pandemic