Aditya Prasad Sarkar

Suspected anthrax outbreak: Investigation in a rural block of west Bengal and public health response

Anthrax is one of the top 10 diseases reported in India and also one of the major causes of death in livestock. This study was conducted to confirm the outbreak of suspected anthrax, determine the transmission mechanism, and implement control measures in Bhatar block of Burdwan district, West Bengal, India. A cross-sectional descriptive study was conducted through house-to-house visits in Oregram and Kathaldanga villages during the period from May 30, 2013 to June 8, 2013. Out of the 93 persons exposed to anthrax, 11 persons had history of slaughtering, while 82 consumed the meat. All of the 7 cases of suspected anthrax were male (mean age 41.14 ± 10.04 years) and involved in slaughtering the animal. Most cases presented with papule and vesicle over the upper extremity and the trunk. One patient among the suspected cases died. The outbreak was labeled as a suspected anthrax outbreak. A health awareness camp was organized to improve awareness of anthrax among villagers.

Correlation among perceived stress, emotional intelligence, and burnout of resident doctors in a medical college of West Bengal: A mediation analysis

Background: Perceived stress and burnout are by-products of powerless responsibility imposed on resident doctors. Emotional intelligence (EI) works as an adapting and coping tool. Objective: The objective of this study is to find out the role of work-related perceived stress on burnout and influence of EI on it. Methods: A descriptive cross-sectional study was conducted from February to April 2016 among 63 resident doctors of different departments of Bankura Sammilani Medical College and Hospital. Data were collected through a self-administered questionnaire for background characteristics and work-related variables. Cohen perceived stress scale, Trait EI, and Shirom-Melamed burnout questionnaire were applied for measuring perceived stress, EI, and burnout, respectively. Statistical analysis was done with of SPSS version 22.0, and for mediation analysis, Andrew F. Hyne’s SPSS macro was adopted. Nonparametric bootstrapping was done assuming small sample. Results: Out of complete responses, 67%, 22.9%, and 9.8% were from clinical, paraclinical, and preclinical specialties, respectively. Burnout had a significant positive correlation with perceived stress and in negative correlation with EI-well-being and positive correlation with EI-self-control and sociability. Physical fatigue factor of burnout had a significant positive correlation with EI-emotionality. Perceived stress had a negative correlation with EI-well-being. On mediation analysis, assuming EI as a mediator, total, direct, and indirect effects of perceived stress on burnout were significant (<0.05). Mediation was proved to act with percent mediation of 0.07. Conclusion: There was definite mitigating effect of EI on burnout by perceived stress among resident doctors. This necessitates more attention by decision-makers toward this burning problem for the sake of care of caregivers.

Directly observed therapy and repeat house-to-house visit: pincer movement for mass drug administration in West Bengal, India

Objective The aim of this study was to assess the effect of directly observed therapy (DOT) on coverage, the compliance of mass drug administration (MDA), and to find out correlates of noncompliance. Background MDA for the elimination of lymphatic filariasis (LF) by 2015 in West Bengal (WB) has been criticized for undercoverage and mere distribution of antifilarial medicines for unsupervised consumption. To overcome these shortcomings, the government of WB adopted DOT for MDA. Participants and methods A cross-sectional survey was conducted in three villages of three blocks and two wards of one municipality of Bankura district, WB, India, selected randomly. Information was collected by interviewing inhabitants of randomly selected households. Results Overall, appropriate medicine distribution and consumption were 71.31 and 53.21%, respectively. Multivariate analysis revealed that medicine consumption was higher among the following: participants who belonged to the Hindu religion; people of poor socioeconomic status; those who were distributed medicine by a routine health worker acting as drug administrators;; those whose consumption was supervised and those who had complied to MDA previously. Almost three-fourth consumptions were unsupervised. 58.73% respondents knew about LF and 42% knew about transmission; 50.79% had heard about MDA and 39.68% stated that MDA is to avoid LF. Noncompliance to the distributed medicines might be due to lack of awareness about LF and MDA. The reasons for noncompliance were as follows: ′fear of adverse reaction′ (63.72%), ′didn′t know why to consume′ (23.89%), and ′healthy′ (20.35%) were causes of noncompliance. Conclusion Despite DOT and repeat house visit coverage of MDA, we fell short of target. Mass mobilization with effective supervision is the need of hour for universal coverage of MDA with supervised consumption of tablets.

Taking stocks of antimalarial activities: A study on knowledge and skill of health personnel at primary care setting in the state of West Bengal, India

Background: Early diagnosis and effective treatment are the key areas in malaria control in India. Objective: The present study was carried out to assess the knowledge and skill of health personnel at primary care level and the logistic support related to the program at subcenter (SC) level. Methods: A cross-sectional, descriptive study was conducted among medical and paramedical personnel working at primary health-care institutions in two districts of West Bengal. Knowledge was assessed using a structured questionnaire while diagnostic skill and logistic support were assessed with structured checklists. Clinical skill was assessed with case vignettes. Results: Requisite knowledge on diagnostic procedure was found in two-third to three-fourth of health personnel while only 26.7% and 12.4%, respectively, knew the correct treatment of Plasmodium vivax and Plasmodium falciparum malaria. Median standardized score for knowledge was 50.0 while the scores for skill of preparing blood slide and for rapid diagnostic test were 70.0 and 57.1, respectively. Education and work experience were related to diagnostic skill but had little effect on knowledge. In clinical skill, medical personnel scored 50% or more in investigation and treatment aspects only. In another case vignette, health workers excelled over medical officers and other staff in all axes other than history taking and clinical examination although their performance was also suboptimal. Formal training on malaria did not show any bearing on median knowledge and skill score. Supply of diagnostics and drugs was insufficient in majority of SCs. Conclusion: Renewed efforts are needed to create competent workforce and ensure adequate logistic supply.