BackgroundKyasanur Forest Disease (KFD) is a highly infectious viral illness transmitted by infected ticks through contact with monkeys and other forest animals. Till date there is no definite treatment available for KFD. Hence, vaccination is considered to be an important public health intervention to control KFD. This study aimed at estimating the vaccination coverage for primary and booster doses of KFD vaccine and exploring the perceived barriers to vaccination in the affected villages of Goa, India during 2015–18.Methodology & principal findingsIn this explanatory mixed methods study, vaccine coverage was estimated bydata obtained from the KFD vaccination registers maintained at the health centers catering to the KFD affected villages. To understand the barriers to vaccination,key informant interviews were conducted among implementing health officers, medical officers and nurses involved in vaccination. Perceptions of vaccinees and community members were studied through in-depth interviews and focus group discussions.Out of the 35,500 targeted population (6–65 years)for KFD vaccination, 32% received one dose and 13.2% received two doses. The coverage for first booster and annual booster was 4.9% and 0.5% respectively. The drop out from first to second and third doses was 57% and 85% respectively. 69% of doses were delivered during community outreach programmes and remaining at health facilities. Inadequate vaccine stock, inappropriate timing of vaccination campaign, lack of awareness and misconceptions related to indications of vaccines, travel distance for follow up doses given at community health centre and pain due to injection were perceived as reasons for poor vaccination coverage.ConclusionsKFD vaccination coverage was poor in the villages affected by KFD in Goa. Both left-out and drop-out phenomena were observed in KFD vaccination. Vaccine implementation plan has to consider suitable time for the local people, maintain adequate vaccine stock and encourage community-based vaccination campaigns instead of facility-based to achieve optimal vaccine coverage.

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Background: COVID-19 is a highly transmissible and pathogenic viral infection caused by SARS-CoV-2, which emerged in Wuhan, China and became a global pandemic. The aim of our study was to ascertain knowledge, attitudes and practices of pharmacists who are among the Frontline Healthcare Workers involved in infection control and prevention of COVID-19; employing a pre-designed semi-structured questionnaire.Methods: This descriptive cross-sectional study employing a pre-designed semi-structured questionnaire was carried out among 200 pharmacists in Goa, using simple random sampling method. The study period was 1 month during March-April 2020.Results: Out of 200 pharmacists, the name of the disease was known by 87%, mode of transmission by 94.5% and major symptoms of the disease by 61%. Very few (28.5%) participants knew that quarantine is for asymptomatic contacts of the disease. Majority (69%) were aware that persons at risk should be placed under observation for 2 weeks. Only 18% knew that 6 feet constitutes close contact. A large number (93%) were aware of the preventive measures for the disease. Most participants possessed the right attitudes and followed correct practices- 96% were willing to avoid foreign travel, 90% preferred to avoid shaking hands during the ongoing disease transmission, 93% cover their face while coughing/sneezing and 98% maintain good hand hygiene.Conclusions: The knowledge among pharmacists of Goa though limited, was adequate in terms of epidemiology and clinical presentation of the novel disease. They possessed the right attitudes and followed appropriate preventive practices.

Introduction Five states in India are reporting sporadic outbreaks of Kyasanur Forest Disease (KFD). Goa experienced an outbreak of KFD in 2015. It remains as an important differential diagnosis for tropical fever in the endemic regions. Few studies among neighboring two states (Karnataka and Kerala) have described the epidemiological characteristics of KFD. However, there is no study which describes the same among cases in the state of Goa. Hence, we planned to understand the epidemiology (time, place, and person distribution) of the disease including seasonal pattern with forecasting using zero-inflated negative binomial regression and time series models. We also explored geo-spatial clustering of KFD cases in Goa during 2015–2018 which would help design effective intervention to curb its transmission in Goa. Results Blood samples of all suspected cases of KFD during 2015 to 2018 were tested using reverse transcriptase-polymerase chain reaction technique. Reports of these results were periodically shared with the state surveillance unit. Records of 448 confirmed cases of KFD available at the State Integrated Disease Surveillance Programme were analyzed. The mean (SD) age of the patients was 41.6 (14.9) years. Of 143 cases with documented travel history, 135 (94.4%) had history of travel to forest for cashew plucking. Two thirds of cases (66.3%) did not receive KFD vaccine prior to the disease. Case fatality rate of 0.9% was reported. Seasonal peaks were observed during January to April, and forecasting demonstrated a peak in cases in the subsequent year also during January–April persisting till May. Around 40 villages located along the Western Ghats had reported KFD, and affected villages continued to report cases in the subsequent years also. Case density-based geographic maps show clustering of cases around the index village. Conclusion Most of the confirmed cases did not receive any vaccination. KFD cases in Goa followed a specific seasonal pattern, and clustering of cases occurred in selected villages located in North Goa. Most of the patients who had suffered from the disease had visited the forest for cashew plucking. Planning for public health interventions such as health education and vaccination campaigns should consider these epidemiological features.

Background: Hysterectomy (removal of uterus) has many indications like fibroids, dysfunctional uterine bleeding, uterine prolapse and chronic pelvic pain. The purpose of this study is to know the level of awareness of women about hysterectomy, to study their experiences, to assess their involvement in decision making process and to develop a suitable protocol, counselling and education material to ensure women’s involvement.Methods: This is a cross sectional study using validated semi-structured interview questionnaire over 6 months (1st December, 2018 to 31st May, 2019) in Goa Medical College. Data was entered in epidata manager and analysed using SPSS 22 version. Categorical variables were expressed in percentages and proportions and quantitative variables in mean±SD. Significance was checked using Chi square test and association between dependent and independent variables was assessed by using bivariate analysis. P value <0.05 was taken as significant.Results: A total of 149 women were recruited into the study who were admitted for hysterectomy. The mean age of women was 49.3 years. The awareness with respect to various aspects of hysterectomy was good in 23.4% subjects and poor in 76.6% subjects. The awareness was significantly related to level of education (p=0.002), urban location (p=0.016) and socioeconomic status (p=0.028). Education was significant factor in decision-making process (p< 0.05). It was observed that good experience had positive correlation to their perception about hysterectomy.Conclusions: It was concluded that awareness about hysterectomy was significantly related to education, urban location and socio-economic status of women. Pre-operative education would help to reduce the post-operative symptoms for a women undergoing hysterectomy.