The COVID-19 pandemic and mental health outcomes – A cross-sectional study among health care workers in Coastal South India [version 4; peer review: 2 approved]

Background: Frontline health care workers (HCWs) are at increased risk of developing unfavourable mental health outcomes and burnout, especially during the COVID-19 pandemic. Recognizing the early warning signs of mental distress is very important to ensure the provision of quality patient care. Methods: In this facility-based cross-sectional study, HCWs of the teaching hospitals affiliated to Kasturba Medical College, Mangalore were assessed regarding their mental health status using a semi-structured questionnaire. All doctors and nurses who were willing to participate from these teaching hospitals were included in the study. Data was collected over a period of four months (1st March -30th June 2021) till the required sample size was reached and analysed using IBM SPSS and expressed using mean (standard deviation), median (interquartile range), and proportions. Univariate analysis was done to identify the factors associated with mental health outcomes among the HCWs and the corresponding unadjusted odds ratio and 95% confidence interval were reported. Results: A total of 245 HCWs [52.2% (n=128) doctors and 47.8% (n=117) nurses] were included in our study. The proportion of participants with depressive symptoms, anxiety, and insomnia assessed using PHQ-9, GAD-7, and ISI-7 scales were 49% (n=119), 38% (n=93), and 42% (n=102) respectively. Depression, anxiety, and insomnia were more likely to be experienced by HCWs aged > 27 years, females, and involved in COVID-19 patient care. (p>0.05) Conclusions:  Our findings that 38% of the examined HCWs had clinically relevant anxiety symptoms and 49% had clinically relevant depression symptoms draws attention to the importance of systematically tracking the mental health of HCWs during this ongoing pandemic. HCWs should monitor their stress reactions and seek appropriate help both on a personal and professional level. Appropriate workplace interventions including psychological support should be provided to HCWs, to ensure provision of uncompromised quality patient care

Adherence to isoniazid preventive therapy and its determinants among people living with HIV

Aims: To determine adherence levels to Isoniazid preventive therapy (IPT) and the factors influencing it in people living with HIV (PLHIV). Materials and Methods: An institution based descriptive longitudinal study was conducted from September 2017 to June 2019 to assess the level of adherence to IPT and its determinants among HIV patients. A total of 320 participants were included from the associated ART centres. Adherence was defined as completion of the 6-month course of treatment with 80% pills taken and was measured by self -report of intake of tablets. Proforma and a semi-structured questionnaire was used to collect all the relevant information. Questionnaire covered aspects on TB treatment and care, HIV related stigma, medical provider relations, social support and socioeconomic status. Data was analysed using SPSS version 11.5. Results/ Discussion: IPT Adherence rate was 83.75 %. Of the 320 patients, 268 were adherent. Isoniazid related side effects were reported by 50 people, 33 of whom were withdrawn. Prior history of TB was noted in 43 people. Patients cited counselling and physician’s advice on IPT intake as one of the main reasons for good adherence. Forgetfulness was the most common reason for missed pills.&nbsp

PERCEPTION AND PRACTICES OF STANDARD PRECAUTIONS AMONG HEALTH CARE PROFESSIONALS AT TERTIARY CARE HOSPITALSIN COASTAL SOUTH INDIA

Objectives: Health care professionals are constantly exposed to blood and other body fluids in the course of their work. Standard precautions are a simple set of effective practices designed to protect health workers and patients from infections. Hence, the present study was undertaken to know the extent of occupational exposure, perception and the reasons for noncompliance towards practice of standard precautions among the health care professionals.Methods: A cross sectional study was done among health care professionals working in four tertiary care teaching hospitals. A semi-structured questionnairewas used to collect information related to socio demographic details, history related to occupational exposure to blood/ body fluids, risk perception, perception and practice of standard precautions and the reasons for non-compliance of standard precautions. Data analysis was done by using SPSS Version 11.5 and results obtained were expressed in proportions. Chi square test was used to compare the perception, practices and reasons for non-compliance of standard precautions among doctors and nurses. P value <0.05 was considered as statistically significant.Results:The perception regarding standard precautions was generally observed to be good among health care professionals in the study and the application of this knowledge however, in day to day practice was considerably lower. The most common reason for non-compliance towards practice of standard precautions among healthcare professionals was prioritizing the patient's need in emergency conditions and their busy work schedule. Conclusion:Non-compliance to standard precautions despite of the knowledge of the possibility of acquiring hazardous infections is a serious cause of concern. Keywords Perception and practices; Standard precautions; Health care professionals: South Indi

How familiar are our doctors towards Rabies prophylaxis- A study from coastal south India

<div><p>Background</p><p>Rabies, a 100% fatal disease claims more than 59,000 human lives every year globally. One human life is lost every 15 minutes due to this deadly preventable disease. Timely initiation of post exposure prophylaxis following an animal exposure can result in 100% preventability of this fatal disease.</p><p>Methodology</p><p>This facility based study was conducted among clinical fraternities of teaching hospitals. A semi structured questionnaire was used for collection of data. Institutional Ethics Committee approval was sought. The study investigators visited the workplace of the participants and distributed the questionnaire. SPSS Ver 16 (Chicago, IL, USA) was used to analyse the data.</p><p>Findings</p><p>Most of the participants knew that veterinary groups and zoo-keepers should be given pre-exposure prophylaxis. Many participants knew about the Intra Muscular schedule of anti-rabies vaccine and its site of administration for pre exposure prophylaxis. It was observed that most participants had knowledge regarding correct intramuscular regimen of anti-rabies vaccine for post-exposure prophylaxis but less than half were able to differentiate between the intramuscular and intradermal regimens. Less than half of participants were aware of the fact that local administration of anti-rabies serum is useful.</p><p>Conclusion</p><p>The knowledge regarding WHO categorisation of animal exposure and recommended post exposure prophylaxis according to type of exposure observed to be minimal among clinical fraternity.</p></div

Distribution of study participants according to their awareness regarding pre-exposure prophylaxis.

<p>Distribution of study participants according to their awareness regarding pre-exposure prophylaxis.</p

Distribution of study participants according to their knowledge regarding epidemiological determinants of rabies.

<p>Distribution of study participants according to their knowledge regarding epidemiological determinants of rabies.</p

Baseline characteristics of the study participants (n = 96).

<p>Baseline characteristics of the study participants (n = 96).</p