Knowledge, Attitude and Practice of Mothers regarding Diarrhoeal Illness in Children under Five Years of Age: A Cross Sectional Study in an Urban Slum of Delhi, India

Diarrhoea is one of the lead killers of children worldwide. This study was done with an aim to determine the knowledge, attitude and practice regarding diarrhoeal illness, its prevention and management in mothers of under- five children. A descriptive cross- sectional study; 125 mothers were randomly selected from an urban slum of Delhi and were interviewed using a structured questionnaire. 96% mothers defined diarrhoea appropriately. Most common perceived causes of diarrhoea were contaminated food and drinking water (80%). Though 83% mothers believed that clean drinking water prevents diarrhoea, yet water treatment was practiced by only 36%. Most mothers believed in (90%) and practiced (88%) hand washing with soap post-defecation to prevent diarrhoea. While only 31% had knowledge on importance of use of latrine, fewer (19%) accepted that safe disposal of stool was very important and just 58% reported practicing it. Less than a third of the mothers recognized critical signs of dehydration. 79% mothers recognized importance of increased fluid requirement and 70% practiced it for management of diarrhoea. Though 76% mothers used ORS, only 26% considered it as the mainstay treatment of diarrhoea. Also, 42% mothers had incomplete knowledge regarding proper preparation of ORS. Though only 22% were aware of the role of breastfeeding in prevention of diarrhoea, a positive attitude towards (74%) and healthier practice (90%) of exclusive breast-feeding was observed. Thus, we conclude that though the community knowledge, attitude and practices on diarrhoeal illness and its prevention is marginally satisfactory, the poor knowledge regarding signs of dehydration and relevance of ORS as primary management component is a matter of concern for child survival

IJCM_223A: Assessment of the Tuberculosis Surveillance System in Amethi district of Uttar Pradesh, India, 2023

Background: Tuberculosis (TB) continues to be one of the leading global causes of death. In 2022, globally 10.6 million TB cases were estimated, 28% from India. Uttar Pradesh (UP) has TB incidence rate of 210 per 100,000 population. Amethi district has a population of 21 lakhs and 10 TB units. We assessed the TB surveillance system in Amethi for its attributes and to provide recommendations for improvement. Objective: To describe and evaluate tuberculosis surveillance system in Amethi (UP) Recommendation to strengthen TB surveillance system. Methodology: We evaluated the timeliness and completeness of surveillance data of Amethi from the January to June 2023 through the online Nikshay portal. We assessed the timeliness for treatment started within three days of diagnosis and flow of monthly reports at every level. We assessed the data quality by completeness of information of the enrolled patients. We interviewed the Frontline Health Workers (FLW) from each blocks as per their availability during the time of filed visit regarding the knowledge about TB, symptoms, modes of spread and treatment selected. Results: Nikshay portal data had 1500 patient entries for Amethi during Jan- June 2023. The median age of the patients was 37 (range: Conclusion: The Amethi TB surveillance has a good timeliness and completeness in initiating TB treatment to those diagnosed; however, requires improvement for health workers awareness and reporting in the blocks. We recommended district to conduct yearly capacity building of FLW and conduct monthly review

IJCM_234A: Malaria Surveillance System Assessment in Jashpur district, Chhattisgarh State, India, January - March 2023

Background: Globally in 2021, 247 million malaria cases were reported from 84 malaria endemic countries. India is committed to eliminate malaria by year 2030. India reported >160,000 malaria cases in 2021 and 2022; 65% cases from four states-West Bengal, Chhattisgarh, Orrisa and Jharkhand. Objectives: We assessed malaria surveillance system in Jashpur district to describe epidemiology of reported malaria cases, for its strengths and weaknesses and to provide evidence-based recommendations. Methodology: We analyzed surveillance data for the year 2022. We assessed timeliness and completeness attributes of the system using US CDC guidelines for evaluating the surveillance system of the five randomly selected reporting units (RUs) for January-March 2023. We reviewed surveillance data reporting portal, hospital records and interviewed key informants. We analyzed data using MS Excel and calculated frequencies and proportion Results: Jashpur reported 269 cases in 2022; 51% female, 58% among tribal community, 89% above 15 years and 90% were of plasmodium falciparum. The maximum number of cases were reported during July to November with peak in the month of August. The annual parasite index (API) per 1000 population was 0.3 for the district, however two blocks had API of >0.5. All the five RUs submitted monthly reports timely. Of the ten reporting formats reviewed, 48% critical blank fields were not filled. Conclusion: Malaria surveillance system in Jashpur detected cases largely among tribal community, identified high burden blocks with good timeliness but require improvement in complete information. We recommended district to focus preventive public health measures in high burden blocks and orient the laboratory technicians for complete data entry in line list of cases

IJCM_292A: Chikungunya Outbreak Investigation at Village Bolasa, Petlawat, Jhabua, Madhya Pradesh, India, September 2023

Background: Chikungunya, a resurging vector-borne disease caused by chikungunya virus, remains a global health challenge. In 2023, globally 4.4 lakhs suspected cases and 365 fatalities were estimated; India accounting for 21% of the global burden. On 5 September 2023, suspected outbreak of chikungunya was reported at Bolasa village, Jhabua, Madhya Pradesh by local newspaper. Objective: We investigated to confirm the outbreak, describe the epidemiology and provide evidence-based recommendations. Methodology: We compared past three years Integrated Disease Surveillance System (IDSP) data to confirm the outbreak. We defined a suspect case as fever with arthralgia in a resident of Bolasa village, during 20 August-30 October 2023, searched cases by reviewing patients register from health-care-facilities and house-to-house in Bolasa village. Cases were interviewed using semi- structured questionnaire prepared by modifying WHO chikungunya toolbox and data analyzed using Microsoft-Excel. We conducted environmental survey at domestic and peri-domestic areas and serum samples collected for laboratory confirmation. Results: No chikungunya case was reported in the last three years. We identified 117 suspected cases (56% females) with median age of 40 years (range 27-52 years). Other than fever and arthralgia, the other symptoms included bodyache (78%) and headache (67%). Overall attack rate (AR) was 8%; highest AR in Tadvifaliya of 18% followed by Harijan and Patidar faliya with 12% each. Among the cases, 76% stored water in containers without cover, mosquito larvae were found in the containers in the house or nearby place of 60% cases. Of the 20 serum samples tested, nine were positive for chikungunya IgM-antibody. Conclusion: We detected a confirmed chikungunya outbreak in a rural setting with vector breeding sites identified in a community. Outbreak investigation led to vector control by eliminating breeding sites and community sensitization on water storage practices. We recommended early case reporting, periodic entomological surveys and source reduction