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Article: An Evaluation of Malaria Surveillance System in Punjab, India, 2020.

Sharma, Sahil / Goel, Kapil / Kaushal, Kanica / Grover, Gagandeep S / Dikid, Tanzin / Singh, Gurinder B

Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine

2023 Volume 48, Issue 3, Page(s) 407–412

Abstract: Background: India accounted for 6% of global burden of malaria with 95% population residing in malaria endemic areas. However, Punjab is in the malaria elimination phase with annual parasite incidence (API) <1/1000 population.: Objectives: We ... ...

Abstract	Background: India accounted for 6% of global burden of malaria with 95% population residing in malaria endemic areas. However, Punjab is in the malaria elimination phase with annual parasite incidence (API) <1/1000 population. Objectives: We evaluated malaria surveillance system in Punjab using CDC's updated guidelines for evaluating public health surveillance systems to provide recommendations for strengthening the existing system and to overcome the challenges in the path of malaria free Punjab. Methods: We chose two districts of Punjab, Amritsar (lowest API) and Mansa (highest API), interviewed stakeholders, and performed a retrospective desk review. We evaluated the overall usefulness of the system and assessed seven attributes at state, district, health facility, and village level during July-August 2020. Results: In Punjab, there was progressive decline in the malaria cases from 2,955 cases in 2009 to 1,140 in 2019 and no malaria deaths since 2011. Regarding various attributes, overall score for flexibility was good (85.9%); average for simplicity (77%), acceptability (74%), data quality (74%), and timeliness (70%); and poor for representativeness (59%) and stability (57%). Conclusions: Malaria surveillance system was useful in analyzing the trends of morbidity and mortality and for generating data to drive policy decisions. To improve stability, representativeness, and acceptability, surveillance staff should not be engaged in supplemental work, and reports from private sector must be ensured. Supportive supervision and regular trainings should be carried out regarding reporting formats, guidelines, and timely epidemiological investigations to improve timeliness, data quality, and simplicity.
Language	English
Publishing date	2023-05-30
Publishing country	India
Document type	Journal Article
ZDB-ID	2085330-0
ISSN	1998-3581 ; 0970-0218
ISSN (online)	1998-3581
ISSN	0970-0218
DOI	10.4103/ijcm.ijcm_305_22
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Evaluation of Scrub Typhus Surveillance, Alwar District, Rajasthan, India, July-August 2020.

Prajapati, Surendra M / Kaushal, Kanica / Tiwari, Simmi / Shewale, Ajit / Nale, Tushar / Dikid, Tanzin

Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine

2023 Volume 48, Issue 1, Page(s) 177–182

Abstract: Introduction: Scrub typhus is one of the most underreported and fatal illnesses accounting for 23% of all febrile illness. Rajasthan reported cases during 2018-2019 in state reporting system but did not report any case to central Integrated Disease ... ...

Abstract	Introduction: Scrub typhus is one of the most underreported and fatal illnesses accounting for 23% of all febrile illness. Rajasthan reported cases during 2018-2019 in state reporting system but did not report any case to central Integrated Disease Surveillance Programme (IDSP) unit. We evaluated the Scrub typhus surveillance system in Alwar district, Rajasthan, with the objective of describing and evaluating the system and providing evidence-based recommendations to identify gaps. Material and methods: In cross-sectional study, we reviewed records and conducted key informant interviews at district- and block-level health facilities. Using US Centers for Disease Control guidelines, we evaluated the system by framing indicators for selected attributes for a defined reference period. Overall performance was ranked as outstanding (90-100%), excellent (80-89%), very good (70-79%), good (60-69%), and poor (<60%). Results: Line list of confirmed cases was sent from district to block level for additional active case search (ACS) to implement control measures. We conducted 26 key informant interviews and reviewed records and calculated simplicity as 79%, flexibility 100%, data quality 46%, acceptability 92%, representativeness 48%, timeliness 43%, and stability 79%. Conclusions: Epidemiological surveillance (active and passive) is a core intervention under scrub typhus surveillance system. Lab reports were incompletely uploaded on IDSP portal. Surveillance reports should be updated after each ACS. Reporting format under IDSP should be uploaded timely, and lab reports from state should be sent within 48 hours of diagnosis so that case investigation is not delayed.
Language	English
Publishing date	2023-02-01
Publishing country	India
Document type	Journal Article
ZDB-ID	2085330-0
ISSN	1998-3581 ; 0970-0218
ISSN (online)	1998-3581
ISSN	0970-0218
DOI	10.4103/ijcm.ijcm_385_22
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Article ; Online: An evaluation of malaria surveillance system in Punjab, India, 2020

Sahil Sharma / Kapil Goel / Kanica Kaushal / Gagandeep S Grover / Tanzin Dikid / Gurinder B Singh

Indian Journal of Community Medicine, Vol 48, Iss 3, Pp 407-

2023 Volume 412

Abstract	Background: India accounted for 6% of global burden of malaria with 95% population residing in malaria endemic areas. However, Punjab is in the malaria elimination phase with annual parasite incidence (API) <1/1000 population. Objectives: We evaluated malaria surveillance system in Punjab using CDC's updated guidelines for evaluating public health surveillance systems to provide recommendations for strengthening the existing system and to overcome the challenges in the path of malaria free Punjab. Methods: We chose two districts of Punjab, Amritsar (lowest API) and Mansa (highest API), interviewed stakeholders, and performed a retrospective desk review. We evaluated the overall usefulness of the system and assessed seven attributes at state, district, health facility, and village level during July–August 2020. Results: In Punjab, there was progressive decline in the malaria cases from 2,955 cases in 2009 to 1,140 in 2019 and no malaria deaths since 2011. Regarding various attributes, overall score for flexibility was good (85.9%); average for simplicity (77%), acceptability (74%), data quality (74%), and timeliness (70%); and poor for representativeness (59%) and stability (57%). Conclusions: Malaria surveillance system was useful in analyzing the trends of morbidity and mortality and for generating data to drive policy decisions. To improve stability, representativeness, and acceptability, surveillance staff should not be engaged in supplemental work, and reports from private sector must be ensured. Supportive supervision and regular trainings should be carried out regarding reporting formats, guidelines, and timely epidemiological investigations to improve timeliness, data quality, and simplicity.
Keywords	evaluation ; india ; malaria ; punjab ; surveillance ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Rapid Decline of SARS-CoV-2 Viral Load in Single vs. Double-Dose (Short-Interval <6 Weeks) ChAdOx nCoV-19 Vaccinated Health-Care Workers.

Ghosh, Arnab / Kanta, Poonam / Ramola, Manisha / Mohindra, Ritin / Goyal, Kapil / Kishore, Roop / Suri, Vikas / Lakshmi, P V M / Chauhan, Chanderkanta / Sharma, Manisha / Rakshit, Partha / Ponnusamy, Kalaiarasan / Dikid, Tanzin / Singh, Mini P

Current microbiology

2024 Volume 81, Issue 4, Page(s) 95

Abstract: The present work was carried out during the emergence of Delta Variant of Concern (VoC) and aimed to study the change in SARS CoV-2 viral load in Covishield vaccinated asymptomatic/mildly symptomatic health-care workers (HCWs) to find out the optimum ... ...

Abstract	The present work was carried out during the emergence of Delta Variant of Concern (VoC) and aimed to study the change in SARS CoV-2 viral load in Covishield vaccinated asymptomatic/mildly symptomatic health-care workers (HCWs) to find out the optimum isolation period. The SARS CoV-2 viral load was carried out in sequential samples of 55 eligible HCWs which included unvaccinated (UnV; n = 11), single-dose vaccinated (SDV, n = 20) and double-dose vaccinated [DDV, n = 24; short-interval (<6 weeks)] subjects. The mean load of envelope (E) gene on day 5 in SDV [0.42 × 10
MeSH term(s)	Humans ; ChAdOx1 nCoV-19 ; SARS-CoV-2/genetics ; Viral Load ; COVID-19/prevention & control
Chemical Substances	ChAdOx1 nCoV-19 (B5S3K2V0G8)
Language	English
Publishing date	2024-02-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	134238-1
ISSN	1432-0991 ; 0343-8651
ISSN (online)	1432-0991
ISSN	0343-8651
DOI	10.1007/s00284-023-03603-7
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Article: Foodborne Disease outbreak associated with eating

Vardhan, Vaishali / Dikid, Tanzin / Yadav, Rajesh / Patil, Ramakant / Awate, Pradip

Indian journal of public health

2021 Volume 65, Issue Supplement, Page(s) S10–S13

Abstract: Background: A foodborne disease outbreak among wedding attendees from Makunsar village, Palghar district, Maharashtra state, India, was reported on February 18, 2018.: Objectives: The outbreak investigation was conducted to find out the epidemiology ... ...

Abstract	Background: A foodborne disease outbreak among wedding attendees from Makunsar village, Palghar district, Maharashtra state, India, was reported on February 18, 2018. Objectives: The outbreak investigation was conducted to find out the epidemiology of the outbreak and to identify the etiologic agent and risk factors. Methods: A case-control study was carried out, where cases (patients), controls, and food handlers were interviewed and leftover foods were collected for culture. A case was defined as a person having vomiting or diarrhea (i.e., ≥3 loose stools within 24 h) who attended the wedding ceremony at Makunsar village, Palghar district, Maharashtra, on February 18, 2018. Attack rate and odds ratio (OR) were calculated with 95% confidence intervals (CIs). Results: Out of 75 cases, 63% were female. Altogether, forty-two (56%) cases were hospitalized, and later on, all of them were discharged from hospital without any mortality. About 93%, 68%, 43%, and 41% of the cases reported with vomiting, nausea, abdominal pain, and diarrhea, respectively. The median incubation period was found to be 4 h (range: 2-8 h). Eating gaajar halwa (carrot pudding) was significantly associated with illness (OR: 12.8; 95% CI: 3.5-46). Gaajar halwa is prepared with khoa, a perishable milk product. The gaajar halwa culture yielded no growth. Conclusion: The case-patients' clinical presentation and incubation period were consistent with enterotoxin-producing Staphylococcus aureus as the probable etiologic agent. The epidemiologic investigation identified the probable etiologic agent and food source in a low-resource community setting. Community food handlers were educated on food preparation hygiene and safe storage measures to prevent future outbreaks.
MeSH term(s)	Case-Control Studies ; Disease Outbreaks ; Female ; Foodborne Diseases/epidemiology ; Gastroenteritis/epidemiology ; Humans ; India/epidemiology ; Male
Language	English
Publishing date	2021-04-27
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	800737-8
ISSN	2229-7693 ; 0019-557X
ISSN (online)	2229-7693
ISSN	0019-557X
DOI	10.4103/ijph.IJPH_1099_20
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Article: Evaluation of point of entry surveillance for COVID-19 at Mumbai international airport, India, July 2020.

Aroskar, Khyati / Sahu, Rajesh / Choudhary, Sushma / Pasi, Achhelal R / Gaikwad, Pragati / Dikid, Tanzin

Indian journal of public health

2022 Volume 66, Issue 1, Page(s) 67–70

Abstract: India started Point of entry (PoE) surveillance at Mumbai International Airport, screening passengers returning from coronavirus disease (COVID-19)-affected countries using infrared thermometers. We evaluated in July 2020 for March 1-22 with the Centers ... ...

Abstract	India started Point of entry (PoE) surveillance at Mumbai International Airport, screening passengers returning from coronavirus disease (COVID-19)-affected countries using infrared thermometers. We evaluated in July 2020 for March 1-22 with the Centers for Disease Control and Prevention evaluation framework. We conducted key informant interviews, reviewed passenger self-reporting forms (SRFs) (randomly selected) and relevant Airport Health Organization and Integrated Disease Surveillance Programme (IDSP) records. Of screened 165,882 passengers, three suspects were detected and all were reverse transcription-polymerase chain reaction negative. Passengers under-quarantine line-listing not available in paper-based PoE system, eight written complaints: 6/8 SRF filling inconvenience, 3/8 no SRF filling inflight announcements, and standing in long queues for their submission. Outside staff deployed 128/150 (85.3%), and staff: passenger ratio was 1:300. IDSP reported 59 COVID-19 confirmed cases against zero detected at PoE. It was simple, timely, flexible, and useful in providing information to IDSP but missed cases at PoE and had poor stability. We recommended dedicated workforce and data integration with IDSP.
MeSH term(s)	Airports ; COVID-19 ; Humans ; India/epidemiology ; Mass Screening ; Quarantine
Language	English
Publishing date	2022-04-05
Publishing country	India
Document type	Journal Article
ZDB-ID	800737-8
ISSN	2229-7693 ; 0019-557X
ISSN (online)	2229-7693
ISSN	0019-557X
DOI	10.4103/ijph.ijph_1487_21
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Article ; Online: Evaluation of point of entry surveillance for COVID-19 at Mumbai international airport, India, July 2020

Khyati Aroskar / Rajesh Sahu / Sushma Choudhary / Achhelal R Pasi / Pragati Gaikwad / Tanzin Dikid

Indian Journal of Public Health, Vol 66, Iss 1, Pp 67-

2022 Volume 70

Abstract	India started Point of entry (PoE) surveillance at Mumbai International Airport, screening passengers returning from coronavirus disease (COVID-19)-affected countries using infrared thermometers. We evaluated in July 2020 for March 1–22 with the Centers for Disease Control and Prevention evaluation framework. We conducted key informant interviews, reviewed passenger self-reporting forms (SRFs) (randomly selected) and relevant Airport Health Organization and Integrated Disease Surveillance Programme (IDSP) records. Of screened 165,882 passengers, three suspects were detected and all were reverse transcription-polymerase chain reaction negative. Passengers under-quarantine line-listing not available in paper-based PoE system, eight written complaints: 6/8 SRF filling inconvenience, 3/8 no SRF filling inflight announcements, and standing in long queues for their submission. Outside staff deployed 128/150 (85.3%), and staff: passenger ratio was 1:300. IDSP reported 59 COVID-19 confirmed cases against zero detected at PoE. It was simple, timely, flexible, and useful in providing information to IDSP but missed cases at PoE and had poor stability. We recommended dedicated workforce and data integration with IDSP.
Keywords	airports ; centers for disease control and prevention u.s ; covid-19 ; india ; surveillance ; Public aspects of medicine ; RA1-1270
Subject code	380
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Investigation of a cluster of acute-onset seizures and deaths among children, Sirohi District, Rajasthan, April 2022

Anurag Dhoundiyal / Dr Sushma Choudhary / Dr Tanzin Dikid / Praveen Aswal / Ravi Prakash Sharma / Dr Saurabh Goel

Global Biosecurity, Vol

2023 Volume 5

Abstract: Background: Following reports of seven deaths among children with seizure and vomiting in the village of Sirohi, Rajasthan in April 2022, an epidemiological investigation was conducted. Methods: We established a hospital-based surveillance and did active ...

Abstract	Background: Following reports of seven deaths among children with seizure and vomiting in the village of Sirohi, Rajasthan in April 2022, an epidemiological investigation was conducted. Methods: We established a hospital-based surveillance and did active case finding. A case was defined as vomiting and acute onset seizure or altered sensorium in <18 years old in Verafalli village. We conducted verbal autopsy and collected information on food, behaviours and health-seeking. Food samples, cerebrospinal fluid (CSF) and blood specimens were collected for testing biochemical, bacterial and viral markers. Environmental surveys were conducted around cases’ houses for presence of poisonous vegetation and potential vectors. Results: Among 11 cases (median age 7 years (2-16 years), females 27%), all had vomiting, new-onset seizure was present in 73% and altered sensorium in 27%; 33% were hospitalized. Case fatality was 64%. No new cases were identified after April 2022. Median time between symptom onset and death was 9 hours (2-54 hours). Among deaths 28% (2/7) were hospitalized. Two deaths had low weight-for-age, blood glucose <25 mg/dl (refractory hypoglycemia) and elevated liver enzymes (SGPT >8000 IU/L). Lab results for food and CSF samples were inconclusive for bacterial and viral markers. Toxicology screen of one death was negative for organophosphates. In 25% (2/8), tick pools tested positive for rickettsia. All cases had houses in vicinity or within fennel crop area. Conclusions: This acute health event cluster presenting as acute seizures with rapid progression among children in a rural setting was likely due to environmental toxin consumption; high fatality may result from uncorrected metabolic derangement. Aflatoxin is commonly known to infect fennel crops. We recommend early identification and case management to prioritize metabolic derangement correction; continued surveillance and a systematic epidemiological investigation to evaluate the role of environmental toxins particularly aflatoxin as the ...
Keywords	outbreak ; acute encephalopathy ; toxin ; outbreak investigation ; aflatoxin ; Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	University of New South Wales
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Foodborne illness outbreak linked to a rural community kitchen in a rural area of Patiala District, Punjab, India, 2018.

Kumar, Akshay / Grover, Gagandeep Singh / Dikid, Tanzin / Kaur, Suneet / Patil, Amol

Indian journal of public health

2021 Volume 65, Issue Supplement, Page(s) S41–S45

Abstract: Background: In December 2018, an acute gastroenteritis outbreak was reported from Faridpur-Gujjran village, Patiala district, Punjab, India.: Objective: The objective of this study was to describe the epidemiology and risk factors of the outbreak and ...

Abstract	Background: In December 2018, an acute gastroenteritis outbreak was reported from Faridpur-Gujjran village, Patiala district, Punjab, India. Objective: The objective of this study was to describe the epidemiology and risk factors of the outbreak and recommend prevention measures. Methods: We conducted a descriptive study and a retrospective cohort study in the village. We defined a case as vomiting or ≥3 loose feces in 24 h plus abdominal pain and/or fever in a resident of the village during December 23-28, 2018. To find cases, we conducted a house-to-house survey; to identify risk factors, we conducted a retrospective cohort study. Fecal specimens were tested for enteric pathogens; water samples were tested for fecal contamination. We also interviewed food handlers. We compared attack rates by level of exposure. From the cohort study, we calculated risk ratios with 95% confidence intervals. Results: From the 261 residents of the village, we identified 116 cases (attack rate 44%) and no deaths. The median age of affected persons was 27.5 years (range 0.5-80 years). The illness was associated with eating in a community kitchen of a temple during December 23-24, 2018. Eating mixed vegetables was associated with illness. We found no pathogens in fecal specimens. All three water samples showed coliform contamination. Cooked food had been left at room temperature before serving. Conclusion: Improper storage practices might have led to microbial proliferation of the food served. Our findings will help guide the enforcement of food safety policies for community kitchens.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cohort Studies ; Disease Outbreaks ; Foodborne Diseases/epidemiology ; Humans ; India/epidemiology ; Infant ; Middle Aged ; Retrospective Studies ; Rural Population ; Young Adult
Language	English
Publishing date	2021-03-22
Publishing country	India
Document type	Journal Article
ZDB-ID	800737-8
ISSN	2229-7693 ; 0019-557X
ISSN (online)	2229-7693
ISSN	0019-557X
DOI	10.4103/ijph.IJPH_1112_20
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Article: Shellfish poisoning outbreaks in Cuddalore District, Tamil Nadu, India.

Velayudhan, Anoop / Nayak, Janardhan / Murhekar, Manoj V / Dikid, Tanzin / Sodha, Samir V

Indian journal of public health

2021 Volume 65, Issue Supplement, Page(s) S29–S33

Abstract: Background: Two suspected shellfish poisoning events were reported in Cuddalore District in Tamil Nadu, India, between January and April 2015.: Objectives: The study was conducted to confirm the outbreaks and to identify the source and risk factors.!# ...

Abstract	Background: Two suspected shellfish poisoning events were reported in Cuddalore District in Tamil Nadu, India, between January and April 2015. Objectives: The study was conducted to confirm the outbreaks and to identify the source and risk factors. Methods: For both outbreaks, a case was defined as a person with nausea, vomiting, or dizziness. Sociodemographic details and symptoms were noted down. Data were also collected in a standard 3-day food frequency questionnaire, along with a collection of clam samples. A case-control study was initiated in the April outbreak. Stool samples were collected from cases, and clam vendors were interviewed. Results: In an outbreak that happened in January, all the twenty people reported to be consumed clams were diagnosed as cases (100% attack rate, 100% exposure rate). In the April outbreak, we identified 199 cases (95% attack rate). In both outbreaks, the clams were identified as genus Meretrix meretrix. The most common reported symptoms were dizziness and vomiting. The clams heated and consumed within 30-60 min. No heavy metals or chemicals were detected in the clams, but assays for testing shellfish toxins were unavailable. All 64 selected cases reported clam consumption (100% exposure rate) as did 11 controls (17% exposure rate). Illness was associated with a history of eating of clams (odds ratio = 314, 95% confidence interval = 39-512). Of the six stool samples tested, all were culture negative for Salmonella, Shigella, and Vibrio cholerae. The water at both sites was contaminated with garbage and sewage. Conclusion: Coordinated and timely efforts by a multidisciplinary team of epidemiologists, marine biologists, and food safety officers led to the outbreaks' containment.
MeSH term(s)	Case-Control Studies ; Disease Outbreaks ; Humans ; Incidence ; India/epidemiology ; Shellfish Poisoning/epidemiology
Language	English
Publishing date	2021-03-22
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	800737-8
ISSN	2229-7693 ; 0019-557X
ISSN (online)	2229-7693
ISSN	0019-557X
DOI	10.4103/ijph.IJPH_1070_20
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