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Context: Even in this era of epidemiologic transition communicable disease is still a major public health problem. Surveillance and timely prevention and control activities are the key to the reduction of morbidity and mortality of communicable diseases. Identifying the trend in communicable diseases and pattern of mortality for a period of ten years will be an insight into the ongoing surveillance. Aim: In this study we have analysed data from 2013 to 2022 to evaluate the trend and mortality pattern of communicable diseases in a teaching institution in Kerala. Settings and Design: A retrospective record‑based cross‑sectional study conducted at the Department of Community Medicine, Government Medical College, Kottayam. Methods and Material: All confirmed communicable disease cases reported from 2013 to 2022 were included in this study except COVID‑19‑positive cases. The communicable diseases were grouped as: airborne, waterborne, vector‑borne, zoonosis, bloodborne diseases and others. SPSS version 20.0 software, Microsoft Word, and Excel were used in data handling and analysis. Results: Total cases reported were 48124. The majority of the morbidity was due to airborne diseases (17585,37%) followed by waterborne diseases (6381, 13%). The total number of deaths reported was 1842. Airborne and zoonotic diseases together accounted for more than 50% of the mortality. Case fatality rate of zoonosis (20.2%) was the highest followed by bloodborne diseases (10.2%). Conclusions: Communicable diseases still continue as a public health problem contributing to morbidity and mortality. Airborne diseases and zoonotic diseases constitute the maximum mortality. [ABSTRACT FROM AUTHOR]

Byline: Neethu. Parambil, Sairu. Philip, Jaya. Tripathy, Phinse. Philip, Karthickeyan. Duraisamy, Satheesan. Balasubramanian INTRODUCTION: Community based programs can assist in early detection and improved survival of breast cancer. AIMS: To [...]

Background: Physical activity is defined as any bodily movement produced by skeletal muscles which results in energy expenditure above the resting level. For children and young people, physical activity includes play, games, sports, physical education, or planned exercise, in the context of family, school or the community. Lack of physical activity is already a global health hazard and is a rapidly increasing problem among adolescents due to changes in lifestyle, the availability and constant use of newer technologies and devices. Preventive interventions addressing physical inactivity should begin early in life for lifelong benefits and these should target the adolescents at the right time to change the age of inactivity to an age of opportunity. Materials and methods: A cross sectional study was conducted among adolescents in higher secondary schools in a block panchayat area in Kerala using a self-administered semi structured questionnaire. The Global Physical Activity Questionnaire (GPAQ) was used to assess the pattern of physical activity among adolescents. The statistical significance of association was tested using Pearson Chi square test for qualitative variables and binary logistic regression analysis was used to find out the independent predictors of physical inactivity. Results: The prevalence of inadequate physical activity which is one of the risk factors for lifestyle diseases was 42.4% and the prevalence was higher in girls. Significant association was found between female gender, mother being employed, studying in government aided schools and inadequate physical activity. Conclusion: Physical activity needs to be emphasised as a protective behaviour during adolescence to halt the progression of chronic diseases. Adolescence provides a key opportunity where risk and protective factors can be modified altering the health trajectory into adulthood. [ABSTRACT FROM AUTHOR]

Context: Information on the pattern of mortality among alcohol users is important for advocacy and planning. The proportion of deaths attributed to alcohol is often underestimated. Aim: We determined the risk of mortality among alcohol using adult males compared with adult male nonalcohol users. Settings and Design: Cohort study was conducted in the population registry of lifestyle diseases cohort in a rural block in Kerala, India. Materials and Methods: During 2002-2007, trained fi eld workers conducted interviews, and underlying cause of death was coded by local physicians trained in verbal autopsy. Statistical Analysis: Risk ratios of death among men using alcohol and not using alcohol were calculated. Risk ratio of alcohol for various causes of mortality across various age groups was also determined. Log-rank test was done to compare the mortality of adult men using and not using alcohol. Results: Risk ratios of all-cause mortality in alcoholic men were 1.87 (1.45, 2.4) in 20-44 age group, 1.3 (1.07, 1.57) for 45-59 age group. Relative risks of alcohol use status for coronary heart disease mortality were 2.91 (1.67, 5.05) among 20-44 years and 1.49 (1.09, 2.03) among 45-59 years. Conclusion: Young and middle-aged male alcohol users (20-59 years) showed signifi cantly increased risk ratio of death. Alcohol users have a higher risk of coronary artery disease mortality and mortality from injuries. The results support a restrictive alcohol policy and screening for coronary artery disease in men using alcohol seeking care in treatment facilities. [ABSTRACT FROM AUTHOR]

Context: Even in this era of epidemiologic transition communicable disease is still a major public health problem. Surveillance and timely prevention and control activities are the key to the reduction of morbidity and mortality of communicable diseases. Identifying the trend in communicable diseases and pattern of mortality for a period of ten years will be an insight into the ongoing surveillance., Aim: In this study we have analysed data from 2013 to 2022 to evaluate the trend and mortality pattern of communicable diseases in a teaching institution in Kerala., Settings and Design: A retrospective record-based cross-sectional study conducted at the Department of Community Medicine, Government Medical College, Kottayam., Methods and Material: All confirmed communicable disease cases reported from 2013 to 2022 were included in this study except COVID-19-positive cases. The communicable diseases were grouped as: airborne, waterborne, vector-borne, zoonosis, bloodborne diseases and others. SPSS version 20.0 software, Microsoft Word, and Excel were used in data handling and analysis., Results: Total cases reported were 48124. The majority of the morbidity was due to airborne diseases (17585,37%) followed by waterborne diseases (6381, 13%). The total number of deaths reported was 1842. Airborne and zoonotic diseases together accounted for more than 50% of the mortality. Case fatality rate of zoonosis (20.2%) was the highest followed by bloodborne diseases (10.2%)., Conclusions: Communicable diseases still continue as a public health problem contributing to morbidity and mortality. Airborne diseases and zoonotic diseases constitute the maximum mortality., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Introduction: Engaging the private sector effectively has been considered as the single most important intervention required for Revised National TB Control Program (RNTCP) to achieve the overall goal of universal access and early detection. This study attempts to identify the barriers and facilitators in the involvement of private practioners in signed schemes of RNTCP., Materials and Methods: Six focus group discussions - four among private sector doctors and two among RNTCP TB key workers and 10 key informant interviews were conducted. Themes were divided into private sector involvement in RNTCP, barriers for private sector involvement, facilitators for private sector involvement and suggestions for better PPP., Results: General feel was that private sector involvement in RNTCP was increasing. Public sector at ground level has not really understood the need to engage the private sector. Lack of capacity for public sector staff to understand and deal with private sector, power relations and not taking hospital managements to trust emerged as important barriers for engagement while private sector doctors expressed concerns over patient confidentiality and patient choices, apprehension of losing patients, inability of program to keep commitments and timely payments, poor recognition to private sector, bureaucratic hurdles and cumbersome formalities. Building locally customised partnership schemes, behaviour change for PPP, building managerial capacity of Public sector to deal with private sector, presence of an interphase agency and quality control through a participatory body were important suggestions for improvement of PPP., Conclusion: Strategies have to be formulated to customise partnership for private sector doctors using the flexibilities of the program. Strengthening PPP will be possible in presence of strong administrative will and the understanding that personal relationships are the best key to Public Private Partnerships., Competing Interests: There are no conflicts of interest.

Dengue fever, a mosquito-borne viral infection, causes significant morbidity and has become endemic in the Indian subcontinent. Virus strains currently circulating in many parts of the country are not well studied at the molecular level. In the present study, genetic characterization of virus strains from a dengue outbreak that occurred in and around a tertiary care hospital in Ernakulam, Kerala in the year 2008 has been reported. By reverse transcription polymerase chain reaction (RT-PCR), 37 out of 75 (49.3%) clinically suspected cases were positive for dengue viral RNA. Among these, 21 (56.8%) samples showed concurrent infection with multiple serotypes of the virus. Majority of the combined infections were caused by dengue serotype 2 and 3. Co-infections with type 1 and 2 in two patients, and type 1, 2 and 3 in one patient were also observed. The core-pre-Membrane (CprM) junction nucleotide sequencing and phylogenetic analysis revealed that the type 1 strains were related to the viral strains reported from Delhi-2001 and Gwalior-2002 dengue outbreaks, while the type 2 strains were related to the strains from Gwalior-2001 epidemic. Sequences of type 3 strains did not show clear relation to any of the previous Indian isolates, and in the phylogenetic analysis, they formed a distinct lineage within the Indian type 3 strains. This study indicates hyperendemicity of dengue in the region with the presence of multiple serotypes and high rates of co-infection, and local genomic evolution of the viral strains involved in this outbreak.

Background: Effectiveness of intermittent Short Course Chemotherapy for Neuro Tuberculosis has not been well studied. There are only few reported studies on this issue in the world literature under filed conditions. Neurologists all over India are reluctant to accept Directly Observed Treatment Short course for neuro tuberculosis since its introduction in India., Aim: Assessing effectiveness of Revised National TB Control Programme (RNTCP-DOTS) regimens among neuro tuberculosis patients registered under the programme., Methods: All the neuro tuberculosis patients referred to RNTCP for treatment were included in the study. Study population included only those patients diagnosed at higher centre and referred to RNTCP during the period Jan - Dec 2002, Alappuzha District. Diagnostic Algorithm as per RNTCP guidelines was strictly followed and treatment outcome and follow-up status were taken from tuberculosis register. No pediatric age group was included in the study., Results: A total of 32 cases registered for DOTS regimen were included in the study, of whom 29 completed the treatment and all were asymptomatic at the end of treatment (85%). All patients received treatment as DOTS, but only 70% received actual DOTS. All patients were given nine months intermittent regimen as per RNTCP guidelines. Five patients died during the treatment (14%). This result shows that DOTS under field programme conditions are efficient in curing Neuro Tuberculosis., Conclusion: Good result was obtained with intermittent short course chemotherapy under programme conditions in neurotuberculosis.