MONITORING OF MEASLES RUBELLA VACCINATION SESSIONS AT SCHOOLS IN PUNE CITY

Introduction: India with the support of WHO launched one of the world's largest vaccination campaigns against measles and rubella on 5 February 2017. The campaign was launched to vaccinate children in the age group of 9 months to 15 years with measles and rubella vaccine. In Maharashtra state the campaign started from 27th November 2018. All eligible children were vaccinated at the following session sites: Schools, Health sub-centers, Anganwadi centers, xed outreach sessions and mobile posts in villages and urban areas, Government health facilities will vaccinate on all days of campaign. Aim and objectives: To monitor vaccination injection practices, cold chain maintenance and safe needle disposal at measles rubella vaccination sessions at schools in Pune city. Material and methods: Study was a cross sectional study. 5 schools in each 5 Wards (Bibewadi, Kondwa, Hadapsar, Wanowri, and Dhankawadi) out of the 15 wards of Pune Municipal Corporation were MR vaccination campaign session will take place will be studied in 2nd week of the campaign. After obtaining permission from the WHO surveillance medical ofcer The above mentioned sites were visited on vaccination day. A structured Performa based on WHO checklist were lled on observation of all the sites selected. Results: 92% of the vaccinators have attended training sessions, 16% of the vaccinators were wearing gloves, Swabbing of the skin done by 52% , 80% of the vaccinators were administering vaccine through subcutaneous route, cold chain were maintained to 100% perfection and Safe needle disposal practices were maintained to 100%. Conclusion: Need for better training to healthcare workers about safe practices and proper implementation of vaccination campaign.

A case report of Nocardia spp. infective endocarditis in an injection drug user

Background Nocardia-related endocarditis is rare. Intravenous drug use with nonsterile injection practices is a potential risk factor for nocardia infection. Disseminated nocardiosis with endovascular involvement is rarely reported in immunocompetent individuals. Case presentation A 54-year-old male was diagnosed with infective endocarditis due to Nocardia asteroides with septic emboli in the brain and spleen. The use of a matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) rapid diagnostic system was beneficial in identifying the causative organism. He was empirically treated with combination therapy consisting of three antibiotics. Antimicrobial susceptibility testing indicated that all three antibiotics had favorable minimum inhibitory concentrations (MICs). Due to his clinical status, he was not a surgical candidate. Patient passed away after discharge to hospice. Conclusions This case demonstrates unique challenges in the identification, diagnosis, and management of Nocardia-related infective endocarditis. A detailed history of injection practices should guide clinicians in assessing the risk for environmental pathogens. Valvular surgery and combination antibiotic therapy should be recommended for all eligible patients to improve the chances of survival.

Injections and infections: understanding syringe service program utilization in a rural state

Background Increasing rates of injection drug use (IDU) associated-infections suggest significant syringe service program (SSP) underutilization. Our study objective was to assess practices of safe injection techniques and to determine predictors of SSP utilization in a rural state. Patients and methods This was a fifteen-month cross-sectional study of participants hospitalized with IDU-associated infections in Maine. Data were collected through Audio Computer-Assisted Self-Interview survey and medical record review. Descriptive analyses were performed to characterize demographics, health characteristics, and injection practices. The primary outcome was SSP utilization, and the main independent variable was self-reported distance to SSP. Logistic regression analyses were performed to identify factors associated SSP utilization, controlling for gender, homelessness, history of overdose, having a primary care physician and distance to SSP. Results Of the 101 study participants, 65 participants (64%) reported past 3 month SSP utilization, though only 33% used SSPs frequently. Many participants (57%) lived more than 10 miles from an SSP. Participants who lived less than 10 miles of an SSP were more likely to use an SSP (adjusted odds ratio 5.4; 95% CI 1.9–15.7). Conclusions Our study highlights unsafe injection practices and lack of frequent SSP utilization among people admitted with IDU-associated infections in a rural state. Especially given increasing stimulant use, these results also highlight the need for SSP access. Particularly in rural areas where patients may live more than 10 miles from an SSP, expansion of harm reduction services, including mobile units, should be a priority.

Gamifying the Infection Control Curriculum: The Impact on Nursing Students’ Knowledge, Exam Performance, and Course Perception

Background: Unlike passive didactic teaching, the introduction of innovative active-learning approaches to university nursing curricula aims to address the educational content in an interactive learning environment, improving in turn the learning process and problem-solving skills indispensable for future infection control professionals. One such strategy is the use of educational games, which can motivate students and enhance the degree of their engagement. We appraised the effectiveness of introducing an interactive game based on a popular television quiz show “Who Wants to be a Millionaire?” for educational attainment, exam performance, and course perception in nursing students. Methods: A whole generation of second-year undergraduate nursing students (126 female and 27 male participants; age range, 19–41 years) from a public university in Croatia (University Centre Varazdin, University North) were divided into 2 groups by cluster randomization; one group had received additional hours of game play after core training curriculum in a “Hygiene and Epidemiology” course, while the other had not. Game play was accomplished by employing ‘edutaining’ interactive multimedia approach, and covered primarily hand hygiene, cough etiquette, the use of personal protective equipment, sterilization and disinfection, and safe injection practices. Quantitative results of multiple-choice exams were used to evaluate any differences in the knowledge level of respective groups. A satisfaction opinion survey was used to gauge attitudes of students attending the course. Statistical significance was defined as P < .05 (2-tailed). Results: The mean baseline examination score was 28.30±5.79 points for the game group and 24.65±5.94 points for the control group, demonstrating improved knowledge retention when the interactive game was introduced into the curriculum. The statistically significant improvement in knowledge was observed in the domains of personal protective equipment and safe injection practices. There was no statistically significant difference in the overall scores between male and female students. Students who were subjected to game play expressed more agreement on a Likert scale regarding course enjoyment and innovativeness, albeit they did not differ from control group when assessing the educational merit of the course. Conclusions: Introducing interactive games to university courses that cover infection control may boost student enjoyment and enhance long-term retention of information, as confirmed by this study. Nonetheless, extra care should be taken when specific games that have not been assessed objectively are implemented. Further research in this field will elucidate how this increased knowledge retention in infection control principles translates to quotidian practice, for the benefit of students and (ultimately) patients.Funding: NoDisclosures: None

Trends in homelessness and injection practices among young urban and suburban people who inject drugs: 1997-2017

BackgroundAmong young people who inject drugs (PWID) homelessness is associated with numerous adverse psychosocial and health consequences, including risk of relapse and overdose, psychological distress and suicidality, limited treatment access, and injection practices that increase the risk of HIV and hepatitis C (HCV) transmission. Homeless PWID may also be less likely to access sterile syringes through pharmacies or syringe service programs.MethodsThis study applied random-effects meta-regression to examine trends over time in injection risk behaviors and homelessness among young PWID in Chicago and surrounding suburban and rural areas using data from 11 studies collected between 1997 and 2017. In addition, subject-level data were pooled to evaluate the effect of homelessness on risk behaviors across all studies using mixed effects logistic and negative binomial regression with random study effects.ResultsThere was a significant increase in homelessness among young PWID over time, consistent with the general population trend of increasing youth homelessness. In mixed-effects regression, homelessness was associated with injection risk behaviors (receptive syringe sharing, syringe mediated sharing, equipment sharing) and exchange sex, though we detected no overall changes in risk behavior over time.ConclusionsIncreases over time in homelessness among young PWID highlight a need for research to understand factors contributing to youth homelessness to inform HIV/STI, HCV, and overdose prevention and intervention services for this population.