Introduction: The knowledge of epidemiologic characteristics and transmission dynamics of a novel pathogen, such as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) among close contacts can help in planning and development of effective control policies in different parts of the world. Aim: To assess the epidemiological and clinical outcome of close contacts of Coronavirus Disease (COVID-2019) cases admitted in a tertiary COVID hospital and to assess the role of risk factors in predicting the epidemiological outcome of these contacts. Materials and Methods: The current retrospective cohort study was conducted among 1286 close contacts of COVID-19 patients admitted to Government Medical College, Thrissur, Kerala. The data collection was done by a semi-structured telephonic interview by the contact tracing team. The questions included the type of exposure to the index case, symptoms if any, date of last exposure with COVID-19 positive patients, and final COVID-19 status of the contact at the end of 14 days. The association of risk factors of COVID-19 positivity was done using binary logistic regression. Results: Proportion of close contacts of COVID-19 who developed the disease was 24.2% (21.87-26.52%). The mean incubation period was found to be 4.22 days (C.I-3.71-4.65). The serial interval mean was found to be 5.24 days (C.I 4.764-5.716). The proportion of household contacts of COVID-19 cases who developed the disease was found to be 26% (C.I-23%-29%). The majority (52.4%) of infections among contacts were asymptomatic. Most common symptom among the COVID-19 positive was fever (32.8%) followed by cough (16.1%). The most common risk factors of infection among primary close contacts were sharing the same room (adjusted odds ratio-2.394) and common use of fomites (adjusted odds ratio-1.953) while use of a mask was found to be protective (adjusted odds ratio-0.570). Significant factors associated with the type of contact with infection were workplace-related contact (adjusted odds ratio-6.629), household contact (adjusted odds ratio-4.856), and travel-related contact (adjusted odds ratio-2.899). Conclusion:The study concludes important risk factors of transmission among close contacts of COVID-19 as being in a household, workplace and travel related contact where the use of mask was found to be protective. The study also concludes that most of the COVID-19 infections in close contacts are asymptomatic.

Background: Out-of-pocket expenditure in health has substantial negative side effects. They may lead to impoverishment. The knowledge of pattern of health care utilization and out of pocket expenditure is imperative for policy making in health care. Objectives of this study were to study utilization pattern of health care services of the population in a rural area of Thrissur district and study of the self-reported chronic morbidity profile and out of pocket expenditure for chronic diseases among the population.Methods: A community based cross sectional study was conducted in Tholur panchayath area of Thrissur district of Kerala. The calculated sample size was 552 households. House hold was considered as primary sampling units. All family members of the house hold were included in the study. Cluster sampling method was adopted. Data was collected using a pre tested semi-structured questionnaire.Results: A total of 809 individuals from 583 households were found to have chronic diseases. Among them, 54.8% were utilizing private health facility for their treatment. Majority (86%) were following modern medicine system for treatment. Health insurance was availed by 26.6 % of the study participants. Most common reported morbidity was combination of hypertension, diabetes mellitus, and hypercholesterolemia. The total median out of pocket expenditure for chronic diseases was found to be 5000 Indian Rupees. It was found that 41.6% of the total income of study participants was spent for health care of chronic diseases which indicate catastrophic health expenditure.Conclusions: The burden of chronic disease is high and the private hospitals are approached more by the study population for treatment rather than government hospitals. Health insurance coverage is low, and social assistance availed for treatment is marginal. These factors lead to high out of pocket expenditure amounting to catastrophic health expenditure.

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Background: Rapid unplanned industrialization is creating serious problems for the human environment. Worse and directly affected in this process are the industrial workers. The purpose of the study is to assess the health profile of workers in an Industrial area of Thrissur district and to compare the morbidity profile of industrial workers from native Kerala and migrants.Methods: A cross-sectional study was conducted in the industrial area of Thrissur district for a period of six months. Cluster sampling was done. Among the total industries in the industrial area of Thrissur, one industry was selected using the lottery method. All the workers in that industry were included in the study. After establishing a rapport, data was collected using a semi-structured interview schedule from the participant using questionnaires.Results: Among 246 workers interviewed, 79.3% were males. 43.9% of participants were from Kerala, 37.4% Orissa, 10.4% Bihar and the rest from other states of India. 30.9% of participants were obese, 17.9% overweight and 8.5% underweight. Other morbidities were refractory error (46.7%) and hypertension (30.5%). Overweight and obesity were significantly more among workers from native Kerala compared to migrants (p=0.001). History of injuries was reported by 10.6% of workers.Conclusions: The high proportion of obesity and hypertension detected among workers was alarming. Interventions at various levels (host, vector, and environment) are likely to produce a lasting impact on industrial worker's health.