Health problems among migrant construction workers: A unique public–private partnership project

Background: Construction sector is a booming industry and involves many hazardous activities. Migrant labor in the industry is susceptible to various health and occupational hazards. In a unique public-private partnership project, a medical team from a public sector teaching hospital in Mumbai provided comprehensive on-site health care services to the construction workers of a private construction company. Objective: To study socio-demographic profile and morbidity pattern of construction workers. Setting and Design: A cross-sectional study at construction site Vidyavihar (West), Mumbai, was carried out over the period of May to November 2010. Materials and Methods: A medical team provided comprehensive on-site health care services, and a Health Card was devised to maintain the record of socio-demographic, occupational details, and complete physical examination findings of the workers who participated in the study. Statistical Analysis Used: Statistical analysis was done using SPSS 15.0. Results: Of the 1337 workers (all males) examined, 1289 (96.4%) belonged to 15-45 years age group. The mean age of the workers was 26.25 ± 8.49 years. A third of the migrants belonged to West Bengal. The average number of health problems in the workers was 1.41. Regular consumers of tobacco and alcohol were 50.48 and 14.65%, respectively. Nearly one-fifth of the workers had febrile illness, of which 20.71% had suspected malaria; 12.6% had respiratory infections, while 3.4% were found to have hypertension. There was a statistically significant association (P < 0.05) between type of occupation and morbidity status

SARS-CoV-2 antibody response following COVID-19 vaccination, a longitudinal study

Background: The objective was studying the antibody response following immunization with COVID-19 vaccines. Material and Methods: It was a longitudinal study of healthcare workers (HCWs). Two groups were taken, Group 1 had taken first dose of the COVID-19 vaccine, at least 3 weeks have passed. Group 2 had taken two doses of COVID-19 vaccine and at least 2 weeks have passed. A quantitative test for antibodies to SARS-CoV-2 spike protein was done. Follow-up of both groups was done after 3 months of collection of the first sample. Results: The antibody titre of the 57 HCWs in Group 1, decreased significantly 125 days after the first dose [median = 2,013 U/ml] as compared to the titre 30 days after the first dose of Covishield vaccine[median = 9,965.26 U/ml]. The median interval between two doses of vaccine was 34 days. In Group 2, the antibody titre of the 60 HCWs in Group 2, decreased significantly 114 days after second dose[median = 1,411 U/ml] as compared to the titre 19.5 days after second dose of Covishield vaccine [median = 2,377.5]. There was no significant difference in the antibody titre in follow-up samples of HCWs with and without side effects. Conclusion: The antibody titre decreases after 13 to 17 weeks post the second dose of Covishield vaccination. The decision of the Government of India to increase the interval between two doses of Covishield is justified. Low antibody titre can be the reason for breakthrough infections. The antibody titre was not related to side effects post-vaccination

Alarming levels of drug-resistant tuberculosis in HIV-infected patients in metropolitan Mumbai, India.

BACKGROUND: Drug-resistant tuberculosis (DR-TB) is a looming threat to tuberculosis control in India. However, no countrywide prevalence data are available. The burden of DR-TB in HIV-co-infected patients is likewise unknown. Undiagnosed and untreated DR-TB among HIV-infected patients is a major cause of mortality and morbidity. We aimed to assess the prevalence of DR-TB (defined as resistance to any anti-TB drug) in patients attending public antiretroviral treatment (ART) centers in greater metropolitan Mumbai, India. METHODS: A cross-sectional survey was conducted among adults and children ART-center attendees. Smear microscopy, culture and drug-susceptibility-testing (DST) against all first and second-line TB-drugs using phenotypic liquid culture (MGIT) were conducted on all presumptive tuberculosis patients. Analyses were performed to determine DR-TB prevalence and resistance patterns separately for new and previously treated, culture-positive TB-cases. RESULTS: Between March 2013 and January 2014, ART-center attendees were screened during 14135 visits, of whom 1724 had presumptive TB. Of 1724 attendees, 72 (4%) were smear-positive and 202 (12%) had a positive culture for Mycobacterium tuberculosis. Overall DR-TB was diagnosed in 68 (34%, 95% CI: 27%-40%) TB-patients. The proportions of DR-TB were 25% (29/114) and 44% (39/88) among new and previously treated cases respectively. The patterns of DR-TB were: 21% mono-resistant, 12% poly-resistant, 38% multidrug-resistant (MDR-TB), 21% pre-extensively-drug-resistant (MDR-TB plus resistance to either a fluoroquinolone or second-line injectable), 6% extensively drug-resistant (XDR-TB) and 2% extremely drug-resistant TB (XDR-TB plus resistance to any group-IV/V drug). Only previous history of TB was significantly associated with the diagnosis of DR-TB in multivariate models. CONCLUSION: The burden of DR-TB among HIV-infected patients attending public ART-centers in Mumbai was alarmingly high, likely representing ongoing transmission in the community and health facilities. These data highlight the need to promptly diagnose drug-resistance among all HIV-infected patients by systematically offering access to first and second-line DST to all patients with 'presumptive TB' rather than 'presumptive DR-TB' and tailor the treatment regimen based on the resistance patterns