Barriers towards reporting and response of anthrax outbreaks in Simdega District, Jharkhand, India,2021-A mixed method approach

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India has a well-established nation-wide surveillance system called integrated disease surveillance programme (IDSP) since 2004.As per IDSP outbreak investigation should be completed within 48 hours of onset. During 2014-2019 there have been delays of over a week in reporting anthrax outbreaks. The study aims to describe the knowledge and practices regarding anthrax outbreak reporting and response among various cadres of public health workforce (Health Department and animal husbandry department) and to describe community perceptions and practices of anthrax and their perceived barriers towards health and veterinary services.

We conducted a cross-sectional mixed method study from March-June 2021.We did thematic analysis of the qualitative interview and calculated proportions from the quantitative data. We did a cross sectional survey involving 215 respondents, six focus group discussions (FGD) from field level workers and 15 in depth interview from health, animal husbandry and general administrative department officers at block, district and state level. We did six FGD in the community which was purposively selected based on reports of previous anthrax outbreaks.

Over 50% posts were vacant in different public health cadres in the district.121 (52.3%) of 215 public health respondents stated that they were trained. Only 19 (8.8%) of 215 respondents has good knowledge about anthrax and also in identifying the disease.68 (31.6%) of 215 respondents did not know whether the disease was zoonotic or not. Regarding qualitative part major theme emerged were inter-departmental coordination, livestock vaccination, surveillance network, laboratory facilities, occupational risks, cultural practices, norms, and belief.

The knowledge of the participants regarding anthrax disease was low. The participants did not receive any consistent training regarding the disease. Inadequate public health work force and their involvement in several health programmes has also impacted the outbreak reporting and responding system.

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