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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Impact of COVID-19 Pandemic on Tuberculosis Treatment Outcomes at a Tuberculosis Unit in Southern India: A Retrospective Observational Study
Correspondence Address :
Dr. Divyarajan Vinitha Kiruffi,
#24, 2nd Floor, 5nd Cross Road, SBM Colony, Brindavan Nagar, Mathikere, Bengaluru-560054, Karnataka, India.
E-mail: vinithakiruffi@gmail.com
Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic significantly affected both existing and undiagnosed Tuberculosis (TB) patients worldwide. The impact of the pandemic on the treatment outcomes of these patients in India remains unclear.
Aim: To assess the difference in TB treatment outcomes before and during the COVID-19 pandemic in an economically disadvantaged urban area in Southern India.
Materials and Methods: A retrospective observational study was conducted at a TB Unit in South Bangalore, Southern India, serving a population of 2,50,000 from January 2022 to December 2022. Purposive sampling was employed to select 516 patients who had registered for TB treatment during the years 2019 and 2020. The socio-demographic details and TB profiles of the patients were collected and tabulated. Treatment outcomes were classified according to World Health Organisation (WHO) definitions after a case record analysis. Data were entered into Microsoft Excel 2018 and analysed using Open Epi software. Descriptive statistics, such as mean and standard deviation, were used to report socio-demographic profiles, and the Chi-square test was utilised to evaluate the differences in treatment outcomes. A p-value <0.05 was considered statistically significant.
Results: The study included a total of 516 subjects. There were fewer cases registered in 2020 (n=202), especially after the first quarter, compared to the number registered in 2019 (n=314). The majority of the cases during both years were new instances of microbiologically confirmed pulmonary TB with no co-morbidities. Treatment success rates were 85.35% in 2019 and 88.61% in 2020, which was not statistically significant.
Conclusion: There was a noticeable reduction in the number of cases registered during 2020, indicating that the COVID-19 pandemic had a definite effect on TB case notification. However, treatment success rates increased during the COVID-19 pandemic. This increase in the treatment success rate from 85.35% to 88.61% could be attributed to the decrease in the number of registered cases during the pandemic. The study thus found no significant impact on TB treatment success rate due to the COVID-19 pandemic.
Coronavirus disease, Therapy, Tuberculosis outcome assessment
The TB, a disease known since ancient times, continues to be endemic in many South Asian countries and remains one of the leading causes of mortality in modern India (1),(2). The Indian government initially developed the National Tuberculosis Programme (NTP) in 1962 and established district TB centres to address the country’s TB burden. Since then, India’s approach to combating TB has evolved, embracing both contemporary developments and international principles (3). Following the implementation of the WHO-recommended Directly Observed Therapy Short course (DOTS) regimen, the programme was renamed the Revised National Tuberculosis Control Programme (RNTCP) in 1993 (4). More recently, in an effort to eliminate TB by 2025, India’s TB programme has integrated the goals of the “End TB Strategy”, endorsed by the WHO Assembly in May 2014 (5). On March 11, 2020, the WHO declared COVID-19 a public health emergency of international concern (6). India reported its first COVID-19 case on January 30, 2020; eight weeks later, the country’s total number of cases had surpassed 1,000 (7). The COVID-19 pandemic has posed a global health crisis, stretching health programmes to their limits, and affecting even established public health initiatives such as Tuberculosis Control Programmes (8). These national programmes have been actively involved in ensuring a rapid and effective response to COVID-19 while also maintaining essential TB services (9).
The pandemic has significantly impacted the delivery of services intended to tackle India’s TB burden, including diagnosis, surveillance, and management, thereby spelling ‘double trouble’ for the country’s health system (10),(11). Although India aims to eliminate TB by 2025, the current political and financial focus on COVID-19 could necessitate a reorientation of this goal, potentially creating adverse effects for existing and undiagnosed TB patients (12),(13),(14). While reviews and modelling studies predicted a noticeable decline in TB case notification, testing, and treatment coverage, few field studies have documented these effects. Furthermore, changes in treatment outcomes reported in these studies were less pronounced, and data in this regard were sparse (15),(16).
In this context, the present study was undertaken to determine the impact of the COVID-19 pandemic on TB case detection and treatment outcomes in an economically disadvantaged urban area in Southern India.
A retrospective observational study was conducted at a TB Unit in South Bangalore, Southern India, from January 2022 to December 2022, covering a population of 2,50,000. The study was conducted after obtaining clearance from the Institutional Review Board, Approval No. KIMS/IEC/A004/M/2022.
Inclusion criteria: All TB cases aged over 18 years registered for treatment from January 2019 to December 2020 at the study site were included in the study.
Exclusion criteria: Subjects under the age of 18 were excluded from the study.
Purposive sampling was employed to recruit 516 patients registered for TB treatment. Socio-demographic details of all subjects were collected from their treatment cards in person and through the NIKSHAY portal. Any additional information required was collected via telephone calls and patient interviews after obtaining verbal consent. Details of the patient’s TB profiles, such as the type of TB, prior treatment for TB, diagnostic tests used, and information on co-morbidities, including Human Immunodeficiency Virus (HIV) status and the presence of diabetes mellitus, were collected from the patients’ treatment cards. After performing a case record analysis of the enrolled cases, treatment outcomes were classified according to WHO Criteria, i.e., cured, lost to follow-up, not evaluated, treatment completed, death, and treatment failure (17). The treatment success rate was calculated using the appropriate formula:
Treatment Success Rate= subjects who completed treatment+subjects cured/Total number of subjects
Statistical Analysis
Data were entered into Microsoft Excel 2018 and analysed using Open Epi software. Descriptive statistics such as mean and standard deviation were used to report socio-demographic profiles, and the Chi-square test was used to determine the difference in treatment outcomes. A p-value <0.05 was considered statistically significant.
The present study involved a total of 516 subjects, with 314 (60.85%) registered during the pre-COVID-19 era (2019) and 202 (39.15%) during the COVID-19 pandemic (2020). The mean±SD age of the subjects was 35.78±16.58 years in 2019 and 36.31±16.43 years in 2020. Of the 314 subjects in 2019, 139 (44.27%) were females and 175 (55.73%) were males . In 2020, among the 202 subjects, 95 (47.03%) were females and 107 (52.97%) were males. A total of 257 (81.85%) cases in 2019 and 163 (80.69%) cases diagnosed during 2020 were new cases (Table/Fig 1). Additionally, the majority of the subjects, 183 (58.28%) in 2019 and 112 (55.45%) in 2020, had microbiologically confirmed pulmonary TB with no co-morbidities (Table/Fig 2).
During the first quarter of 2020, a total of 62 cases were registered, while the number of registered cases dropped to 48, 46, and 46 in the second, third, and fourth quarters, respectively (Table/Fig 3). The treatment outcome showed that 144 (45.86%) were cured in 2019, while in 2020, 93 (46.04%) were cured (Table/Fig 4). The treatment success rates were 85.35% in 2019 and 88.61% in 2020. There was no statistically significant difference in treatment success between the two years (p-value >0.05) (Table/Fig 5).
In the present study, a total of 516 TB patients were included as study subjects. During 2020, there was a reduction in the number of TB patients registered for treatment compared to 2019, yet treatment success rates improved in 2020. TB remains a significant public health issue and a leading cause of mortality in India, despite the availability of highly effective anti-TB drugs and easy access to treatment. The Government of India has exerted considerable efforts to control TB, with the ultimate goal of eliminating it by 2025. However, recent literature published during the pandemic suggests that the current political and economic focus on COVID-19 could divert attention from these priorities (4),(14). Published literature indicates that the COVID-19 pandemic has affected various national health programs in India, including the National Tuberculosis Elimination Programme, which provides services for TB prevention, control, and treatment (8),(9),(10).
The present study documented a decrease in the number of TB patients enrolling for treatment from the second quarter of 2020, subsequent to the declaration of the COVID-19 pandemic. This trend aligns with findings from Global TB reports, TB India reports, and other reviews (10),(12),(18),(19). Moreover, patients registered during the COVID-19 pandemic (2020) had a treatment success rate of 88.61%, higher than the rate for the state of Karnataka, where the study site is located, which stood at 81% for the same period. This pattern was observed even before the pandemic; the study site reported a treatment success rate of 85.35%, compared to the state’s 80% (1),(3).
This study is among the few efforts to compile data on the impact of COVID-19 on TB case notifications in the field. It provides a quantifiable indication of the anticipated decline in case notifications, as suggested by reviews and modelling studies. Furthermore, the findings from this study could act as a stimulus for future research that seeks to understand the specific weaknesses within the TB program and identify areas for optimisation.
Limitation(s)
As the present study was conducted at a single TB unit, the results cannot be generalised. Therefore, multicentric studies with a larger population are recommended.
The reduction in the number of cases registered during 2020, particularly after the second quarter, indicates that the COVID-19 pandemic has had a definitive effect on TB case notifications. Although treatment success rates increased in 2020 compared to 2019, the decrease in the total number of cases reported during the pandemic may have contributed to this increase. Therefore, it is clear that the COVID-19 pandemic has affected TB patients at the study site. Consequently, active case finding, treatment initiation, and case follow-up require heightened attention.
Authors would like to acknowledge the Indian Council of Medical Research (ICMR) for accepting the study as part of the Short Term Studentship programme 2022, District Tuberculosis Officer-BBMP, Bengaluru and associated personnel, and the staff of the Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India.
DOI: 10.7860/JCDR/2024/67038.19045
Date of Submission: Aug 15, 2023
Date of Peer Review: Oct 30, 2023
Date of Acceptance: Dec 28, 2023
Date of Publishing: Feb 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Aug 17, 2023
• Manual Googling: Dec 05, 2023
• iThenticate Software: Dec 26, 2023 (11%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com