Mangaluru City Research Articles

Assessing Knowledge and Practices of E-Waste Management Among Consumers in Mangaluru City

Assessing Knowledge and Practices of E-Waste Management Among Consumers in Mangaluru City

Evaluation of Knowledge, Awareness, and Attitude Towards Management of Displaced Tooth from Socket (Avulsion) Amongst Nursing Fraternity in Mangaluru City: A Cross-Sectional Study

Abstract Introduction The aim of this study was to evaluate knowledge, awareness, and attitude in the management of displaced tooth from socket (avulsion) amongst nursing fraternity in Mangaluru City. Materials and Methods A 20-item questionnaire regarding knowledge, awareness toward management of avulsed tooth was administered to 150 nursing interns. Results Among 150 participants, 47% demonstrated awareness of the storage media for an avulsed tooth. About half of the respondents did not know regarding handling of avulsed tooth. The majority of participants responded positively about attending workshop on dental trauma management. Conclusion Given the frequent encounter with emergencies, it is imperative for nurses to possess sufficient knowledge regarding management of traumatic dental injuries.

Decadal changes in land use and land cover: impacts and their influence on urban ecosystem services

Abstract The steady growth of cities alters the urban environmental pattern and functions, posing significant challenges to urban ecological as well as environmental governance. Under this setting, analyzing the relationship between urban growth and ecological services is critical for management and policy-related sustainable urban development. The primary goal of this research is to analyse the dynamic urbanization and its influence on urban ecosystem services via changes in LULC of Mangaluru city agglomeration, India. For five decades (1980,1990, 2000, 2010, and 2022), the ecosystem service values (ESVs) are analysed using remote sensing data and Geographic Information System (GIS) techniques corresponding with the global value coefficient (VC) to estimate total ecosystem service values (ESVt) and individual ecosystem service function change. The study shows that ecosystem service values (ESVs) declined by US$ 116.89 million to US$ 85.14 million due to 9.54 and 63.44% decreases in agricultural land and wasteland/shrubland between 1980 and 2022. In terms of individual ecosystem service functions, regulating services increased from 1980 to 2022, with nutrient cycling (45.64%), raw material (15.59%), and erosion control (12.13%) contributing the most. The loss in total and certain individual ESV in the study landscape necessitates immediate action to improve urban ecosystem sustainability via proper planning and policy.

Isolation of Bacterial Pathogens Associated with Commercially Available Spices in Mangaluru City, India

Spices are important sources of natural flavouring, colouring and antimicrobial agents in food and medicine. In India, spices are widely produced, consumed and exported across the world. Like many other agricultural commodities, spices are exposed to a wide range of bacterial contamination during their harvesting, processing and transportation causing foodborne illnesses. Spices in their desiccated form offer an environment conducive to the survival of many pathogenic bacteria which becomes challenging for spice manufacturers to control or mitigate any bacterial contamination. The present study aimed at the isolation, phenotypic and genotypic identification of bacterial pathogens namely Salmonella spp., Bacillus cereus, Staphylococcus aureus and Escherichia coli associated with spices collected in and around Mangaluru, Karnataka. Isolation of bacterial pathogens was performed using a modified standard FDA BAM methodology. A total of 140 spice samples inclusive of pepper, clove, cumin, red chillies, turmeric, coriander, clove and fennel in whole and powdered form were screened for pathogens. No targeted bacterial pathogens were present in the samples collected. It can be inferred that good agricultural, manufacturing and hygienic practices were maintained in the commercial supply of spices. The absence of bacteria could also be attributed to the inherent antimicrobial properties of spices.

Assessment of Hydrogeochemical Characteristics and Seawater Intrusion in Coastal Parts of Mangaluru City, Karnataka, India

Assessment of Hydrogeochemical Characteristics and Seawater Intrusion in Coastal Parts of Mangaluru City, Karnataka, India

AN ANALYSIS OF EMERGING TRENDS IN ONLINE SHOPPING DURING AND POST COVID-19 WITH SPECIAL REFERENCE TO THE CONSUMERS OF MANGALURU CITY: A PERSPECTIVE STUDY

COVID-19\ Novel Corona virus disease has changed the normality of the world as it had earlier. The rapid dissemination of the contagious viral infection among the social community has shaken the basic composition of working operations in numerous business sectors. Online Shopping\ E-shopping is an emerging trend in the field of E-Commerce over the recent years. The purchasing of goods electronically has helped the customers to fulfill their needs of procurement with more convenience and discomforts. After the outburst of the pandemic, the purchase of products via online has assumed greater attention and significance in view of controlling the spread of virus in traditional buying at the physical stores\shops. The proportion of placing E-orders for the commodities has increased immensely in the post epidemic scenario. The customers tend to buy more items digitally rather than resorting to in-personal shopping in the actual shops as a precautionary measure. In this regard, an attempt has been made to analyse the emerging trends in e-shopping during and Post COVID-19 era by collecting the primary data from the selected consumers (respondents) living in Mangaluru City. KEYWORDS: COVID-19, Consumers, Emerging Trends, E-Purchases, Online Shopping, Post pandemic,

Evaluation of the Effectiveness of an Educational Intervention Program on Knowledge, Attitude and Practice among School Teachers Regarding Management of Traumatic Dental Injuries in Mangaluru City

Background Traumatic dental injuries can have an adverse effect on a childrsquos psychological functional and aesthetic well-being.Aim To assess school teachers knowledge attitude and practice KAP with reference to emergency management of traumatic dental injuries before and after an educational intervention.Method The current study was a questionnaire-based interventional study conducted in three phases among 300 school teachers of government state and CBSE schools in Mangaluru. Total 20 self-structured questions were included in the survey which was given in both English and a regional language. Kannada. Following a baseline survey an informative lecture on dental trauma and its management was given in the second phase and a follow-up survey was conducted after six months to assess the outcome.Results During the preliminary phase teachers from all schools showed a dearth of KAP regarding dental trauma and its management. Significant growth in the mean knowledge p0.000 attitude p0.000 and practice p0.000 scores was observed after the intervention as compared to knowledge scores at baseline in all the schools.Conclusion There is a lack of knowledge among teachers with reference to emergency management of dental trauma and educational programs must be implemented to improve knowledge.

Awareness of the Influence of Periodontitis on Systemic Health among Medical Professionals: A Questionnaire Study

Abstract Background Periodontitis is a chronic inflammatory disease of the periodontium, characterized by progressive destruction of supporting periodontal structures. However, the periodontal infection can enter into the systemic circulation and affect different organs in the body, and systemic diseases may be aggravated by periodontal disease. Aim The aim of this study is to evaluate the knowledge of medical professionals regarding periodontal disease and its correlation with systemic disease. Materials and Methods The survey was conducted in different government/private hospitals in and around Mangaluru city, Karnataka, India. The online survey form was circulated among various medical practitioners between June and August 2019. There was a total of 10 questions in the questionnaire, and the respondents were asked to mark their appropriate choices. Using SPSS version 16, the data collected were compiled and analyzed. Results A total of 186 general practitioners were involved in the study. About 75.4% of practitioners were aware of periodontal disease and 73.7% of practitioners were aware of the association between periodontitis and cardiovascular diseases. Moreover, 88.1% have referred their patients to a dentist. Among the medical doctors practicing in and around Mangaluru city, this survey showed that knowledge about the relationship between oral health and general health was good. Conclusion This study emphasizes on increasing the awareness regarding periodontal and systemic interrelationships among physicians and more comprehensive and collective efforts by both the general physicians and dental surgeons to improve overall health through improving oral health.

A rare occurrence of multidrug-resistant environmental Acinetobacter baumannii strains from the soil of Mangaluru, India.

Over the last decade, Acinetobacter baumannii has emerged as one of the main causes of infections acquired in the hospital setting. Outbreaks associated with this pathogen are caused mainly due to contamination and transmission in hospital territories. However, the natural habitats of A. baumannii of clinical significance still remain unclear. In this study, we highlight the isolation and identification of multidrug-resistant environmental strains of A. baumannii from the soil of Mangaluru city. All the recovered isolates were biofilm formers, and two isolates were multidrug-resistant and showed resistance to fluoroquinolone, aminoglycosides, sulfonamide, tetracycline, and carbapenems. In addition, they exhibited protease activity, and produced phospholipase C and siderophore. To the best of our knowledge, this is the first study to isolate and identify drug-resistant strains of A. baumannii from the soil.

Prevalence of Allergic Rhinitis Among Students in the Age Group of 16-20 Years in a South Indian City

ABSTRACT Introduction: Allergic Rhinitis (AR) is often viewed as a trivial disease but it can significantly affect the quality of life by causing fatigue, headache, sleep disturbances, cognitive impairment. According to World Health Organization (WHO) report (2007), the global burden of allergic rhinitis was estimated to be 400 million, and the prevalence among adults ranges between 10% and 32% in the Asia Pacific region. The prevalence of allergic rhinitis and other allergic diseases has increased globally in the last three decades. Despite the high burden, there is a paucity of community-based studies in India, determining the burden of allergic rhinitis. Hence we undertook this study to determine the prevalence of allergic rhinitis among students (16-20 Years) of age. Materials and Methods: Students of age group 16-20 years of age, both Girls and boys in and around Mangaluru city, Dakshina Kannada district were included in the study. This was a questionnaire based cross sectional study. A standardized questionnaire (adopted from ISAAC) was prepared and was administered to students of 12 different colleges. The sample size was calculated after carefully analyzing previous Indian studies on the prevalence of allergic rhinitis. Considering an 8% prevalence rate and a 10% allowable error, sample size was estimated as N= 4600. Purposive sampling, among students of various colleges in Mangaluru city was done. The diagnosis of allergic rhinitis was done clinically as per ARIA guidelines. Students were interviewed in their class room for one hour. First the study objectives and the questionnaire was explained to the students. Then each student was given the questionnaire to fill. Informed consent was taken from each student. The statistical analysis was performed by Frequency and percentage method to calculate the prevalence. Chi-square test, odds ratio (OR), and 95% confidence interval (95%CI) were used to measure the association between the variables, and a p-value of <0.05 was considered to be significant. Results: In our study group, the age distribution was from 16-20 years. 961(20.8%) students were 16 years of age, 1196(26.0%) students were 17 years of age, 905(19.7) were 18years of age, 697(15.2%) 19 years of age & 841(18.3%) students were 20 years of age. The prevalence of allergic rhinitis among students (16-20) years of age was 11.9%. The prevalence was higher among girls (12.0%) compared to boys (11.7%). The prevalence of allergic rhinitis was more among students of 20 years of age. The prevalence of allergic rhinitis was more in girls (12.0%) compared to boys (11.7%). Smokers were found to be 2.6 times more prone to develop eczema. Statistically significant correlation between bronchial asthma with allergic rhinitis and eczema was found. Incidence of allergic rhinitis among asthma patients was 5.7times more compared to normal subjects. A significant association of asthma was observed with the incidence of eczema. Incidence of asthma among the people who have a family history of asthma was 7.08 times more compared to other population. Incidence of allergic rhinitis among the people who had a family history of asthma was 2.63 times compared to other population. Incidence of eczema among the people who have a family history of asthma is 11 times compared to other population. Conclusions: The prevalence of allergic rhinitis among students (16-20) years of age was 11.9%. The prevalence was slightly higher among girls (12.0%) compared to boys (11.7%).

AN EVALUATION OF FINANCIAL PERFORMANCE OF MUNICIPAL CORPORATIONS IN KARNATAKA WITH REFERENCE TO MYSURU AND MANGALURU CITY CORPORATIONS

The research study attempts to evaluate the financial performance of Mysuru and Mangaluru City Corporations in Karnataka. The study is based on secondary data, which will be collected through secondary sources of financial statements of Mysuru and Mangaluru city corporation. The data so collected will be tabulated appropriately to achieve the objectives set. Required statistical tools will also be used to test the hypotheses formulated in the study. The per capita income and per capita expenditure were increased in all selected Municipal corporations during the study period 2010-11 to 2019-20. There is no significant difference in per capita income between Mysuru CC and Mangaluru CC, which means per capita income is almost equal in selected Municipal Corporations. The per capita expenditure is also equivalent to Mysuru CC and Mangaluru CC. It also found that the expenditure of selected Municipal Corporation is high compared to their income, which means the selected Municipal Corporation depends on State Government grants and loans. There is a significant difference between the development and non -development expenditure on revenue account of both Mysuru and Mangaluru City Corporations. The Mysuru CC had the highest development expenditure in 2017-18 and became 262.64 crores and lowest by 50.04 crores of Mangaluru CC in 2012-13. The Mysuru CC has the highest non-development expenditure in 2019-20 and became 199.52 crores and lowest by 16.73 crores of Mangaluru CC in 2010-11.

Awareness and usage of personal protective equipment among construction workers and their hearing assessment by pure tone audiometry; A cross-sectional study in South India.

Context:Occupational hazards at the building construction workplace are enormous. Good compliance to the use of personal protective equipment (PPE) alongside other safety measures is critical in reducing the hazards. Occupational hearing loss is one such occupational hazard among construction workers.Aims:This study was conducted for determining the awareness of the benefits of PPE and its usage among construction workers along with hearing assessment.Settings and Design:A cross-sectional study was conducted among construction workers in a building project in Mangaluru city in Dakshina Kannada district in South India.Methods and Material:After obtaining informed written consent, 110 construction workers were recruited by simple random sampling method. Basic information, awareness, and use of PPE were collected using a semistructured questionnaire through personal interviews. Hearing assessment was done by pure tone audiometry.Statistical Analysis Used:Data collected was analyzed. Chi-square test and Fischer’s exact probability test were used to test the association between variables.Results:Majority (85.5%) of the construction workers are working for duration of 15 years or less. Difficulty in hearing was reported by 9.6% of them. Awareness regarding benefits of using personal protective devices like helmets, masks, and earplugs/muffs were 58.2%, 56.4%, and 14.5%, respectively. The utilization of at least one PPE among them was 58.1%. The presence of sensory neural hearing loss (SNHL) in both/either ears was detected among 14.5% of the workers. There was a statistically significant association of SNHL among workers and their duration of construction work.Conclusion:The current study highlights that awareness and usage of PPE was low and a proportion of them had a hearing impairment. Occupational health and safety training along with a periodic examination of construction workers need to be focused so as to detect and manage occupational health hazards early.

Urban expansion quantification from remote sensing data for sustainable land-use planning in Mangaluru, India

Urban growth is indispensable in developing countries, particularly in the context of rapid economic development and growing urban population. The idea of managing urban growth is often restricted exclusively to large metropolis; ignoring small and emerging cities from the requirement of having sustainable urban growth strategies. India, experiencing a rapid pace of urban growth is expected to host its future urban population in its small and medium-sized cities. In this context, the dynamics of urban growth in numerous small and medium-sized cities must be studied and urban policies must be reoriented to ensure sustainable urbanisation in future. However, the nonavailability of geospatial data for generating information database and models to support decision making processes on a local scale pose challenges in developing countries. The remote sensing technology offers cost-effective, timely, and efficient technology to collect urban spatial data, to generate urban physical and socioeconomic information using various GIS and statistical models. In this study, the spatial pattern, dynamics and goodness of urban growth in Mangaluru city were studied in the context of its implications for future sustainable development using the techniques of remote sensing, GIS and statistical models. The urban land is delineated from the Landsat series of satellites then, the statistical models were applied to study the trend of urban growth. The built-up land in Mangaluru has increased significantly by more than 400 % during 1972–2018. Further, subtleties of urban growth were studied by extracting land-use expansion modes, UEI Index, UED Index, Pearson's Chi-square and Shannon's entropy. Finally, the goodness of urban growth was measured to identify the sustainability of urban growth. The findings suggest that the urban expansion mode was dominated by leapfrogging and edge expansion at the peri-urban area during initial periods which eventually gave way to infilling and edge-expansion. Also, a rapid expansion in urban land was expected in the southern and south-eastern part of the city. The study confirms the prevalence of the highly unsustainable nature of urban growth in the study area and therefore advocates participatory urban planning in managing and for achieving a sustainable urban growth.

Respiratory Muscle Strength in Healthy Indian Children of Age 7-17 Years: A Cross-Sectional Study.

PurposeAs the values of respiratory muscle strength vary according to race, ethnicity, and geographical area, there is a wide-ranging difference among different populations. Thus, the available reference values may not have an application for use in the Indian paediatric population, creating a need for generating values which will be appropriate for the Indian paediatric context.Materials and MethodsAssessment of respiratory muscle strength was carried out by assessing maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) and synthesising predictive formulas using anthropometric variables like height, gender and age, which will be suitable for Indian children.ResultsWe calculated MIP and MEP of 320 (boys=160 and girls= 160) children in the age range of 7 years to 17 years of Mangaluru city, India. Results stated that mean MIP and MEP for boys were 72.5±32.8 cm H2O and 73±33.2 cm H2O, while for the girls it was 67±30.2 cm H2O and 68±30.1 cm H2O, respectively.ConclusionThis study concluded that there is a difference in respiratory pressure values of Indian children with respect to those of other countries. Age, gender, height and BMI have a significant role in determining respiratory muscle strength. Boys demonstrated higher MIP and MEP. As age, height, weight and BMI increases, so does MIP and MEP.

Digitized smart surveillance and micromanagement using information technology for malaria elimination in Mangaluru, India: an analysis of five-year post-digitization data

BackgroundMalaria control system (MCS), an Information technology (IT)-driven surveillance and monitoring intervention is being adopted for elimination of malaria in Mangaluru city, Karnataka, India since October 2015. This has facilitated ‘smart surveillance’ followed by required field response within a timeline. The system facilitated data collection of individual case, data driven mapping and strategies for malaria elimination programme. This paper aims to present the analysis of post-digitization data of 5 years, discuss the current operational functionalities of MCS and its impact on the malaria incidence.MethodsIT system developed for robust malaria surveillance and field response is being continued in the sixth year. Protocol for surveillance control was followed as per the national programme guidelines mentioned in an earlier publication. Secondary data from the malaria control system was collated and analysed. Incidence of malaria, active surveillance, malariogenic conditions and its management, malariometric indices, shrinking malaria maps were also analysed.ResultsSmart surveillance and subsequent response for control was sustained and performance improved in five years with participation of all stakeholders. Overall malaria incidence significantly reduced by 83% at the end of 5 years when compared with year of digitization (DY) (p < 0.001). Early reporting of new cases (within 48 h) was near total followed by complete treatment and vector control. Slide positivity rate (SPR) decreased from 10.36 (DY) to 6.5 (PDY 5). Annual parasite incidence (API) decreased from 16.17 (DY) to 2.64 (PDY 5). There was a negative correlation between contact smears and incidence of malaria. Five-year data analyses indicated declining trends in overall malaria incidence and correlation between closures by 14 days. The best impact on reduction in incidence of malaria was recorded in the pre-monsoon months (~ 85%) compared to lower impact in July–August months (~ 40%).ConclusionMCS helped to micromanage control activities, such as robust reporting, incidence-centric active surveillance, early and complete treatment, documentation of full treatment of each malaria patient, targeted mosquito control measures in houses surrounding reported cases. The learnings and analytical output from the data helped to modify strategies for control of both disease and the vector, heralding the city into the elimination stage.

Iron Content as an Indicator for Legionella Species in Artificial Water Systems

Background: Legionella have emerged as a pathogenic group due to increased use and poor maintenanceof artificial water environments. World Health Organization considers Legionella associated diseases tobe underestimated, especially in developing countries due to difficulty in detection. The aim of this studywas isolation and culture of Legionella spp. from artificial water systems and to test the importance of ironconcentration which can be developed as a reliable chemical marker.Method: Thirty samples each were collected from drinking water coolers, cooling towers and shower headsfitted in different houses of Mangaluru city. Isolation and identification of the bacteria were carried out as perthe standard protocols followed by determination of iron content prescribed by IS 3025 (Part 53).Conclusion: Our study shows that concentrations of iron, is an important factor that increases the likelihoodof Legionella spp. Statistically, a concentration of 300 mg Fe/L shows a positive correlation with Legionellapresence. Therefore, monitoring suspect sites for iron concentration and chelation of available iron, canbe developed as respective assays for identifying Legionella spp. Furthermore, we show that PCR baseddetection of Legionella is a more robust method than the classical 3-plate method, especially for virulentstrains.

Acquired antibody responses against merozoite surface protein-119 antigen during Plasmodium falciparum and P.vivax infections in South Indian city of Mangaluru.

Merozoite surface protein-1 (MSP-1) of malaria parasites has been extensively studied as a malaria vaccine candidate and the antibody response to this protein is an important indicator of protective immunity to malaria. Mangaluru city and its surrounding areas in southwestern India are endemic to malaria with Plasmodium vivax being the most widespread and prevalent species although P. falciparum also frequently infects. However, no information is available on the level of protective immunity in this population. In this regard, a prospective hospital-based study was performed in malarial patients to assess antibody responses against the 19-kDa C-terminal portion of P. vivax and P. falciparum MSP-1 (MSP-119). Serum samples from 51 healthy endemic controls and 267 infected individuals were collected and anti-MSP-119 antibody levels were analyzed by ELISA. The possible association between the antibody responses and morbidity parameters such as malarial anemia and thrombocytopenia was investigated. Among the 267 infected cases, 144 had P. vivax and 123 had P. falciparum infections. Significant levels of anti-MSP-119 antibody were observed both in P. vivax (123/144; 85.4%) and P. falciparum (108/123; 87.9%) infected individuals. In both type of infections, the major antibody isotypes were IgG1 and IgG3. The IgG levels were found to be increased in patients with severe anemia and thrombocytopenia. The antibody levels were also higher in infected individuals who had several previous infections, although antibodies produced during previous infections were short lived. The predominance of cytophilic anti-MSP-119 IgG1 and IgG3 antibodies suggests the possibility of a dual role of Pv MSP-119 and Pf MSP-119 during malarial immunity and pathogenesis.

CSR practices in state bank of india and its impact on creating loyal customers: A study in Mangaluru city; Karnataka

The objective of this research paper is to study the perception of customers towards CSR practices and its impact on creating loyal customers. The study found that all the respondents are having moderately positive perception towards the CSR practices of the Bank and the independent impacting variable of customer satisfaction and ethics are significantly influencing on the dependent variable that is customer loyalty. The findings of the study can assist the bankers to concentrate more on CSR practices, so that customers will be having positive approach towards the bank and they will be loyal. The study can assist the scholars in upcoming studies related to CSR and customer loyalty.

Internet addiction and psychological well-being among high school students of Mangaluru city, Karnataka, India

Background: Despite the controversies on the effects of Internet usage, the habit of Internet usage is increasing in all ages and rampant among the young ages making it critical to understand its relationship with psychological well-being (PWB). Objectives: The study was conducted to determine the relation of Internet addiction with PWB among school students aged 12–16 years. Materials and Methods: A cross-sectional study was conducted among high school students in Mangaluru city. A total of 654 students participated in the study. Data on Internet usage and PWB were obtained using Young's Internet Addiction Scale and Ryff's Psychological Well-being Scale, respectively. The relation between Internet addictions with PWB was analyzed using correlation statistics. Results: The mean age of the respondents was 14.3 ± 1.007 years, and 62.7% were males. There was a weak negative correlation between PWB of the high school students and Internet addiction scores (r = −0.255, P

Indigenously developed digital handheld Android-based Geographic Information System (GIS)-tagged tablets (TABs) in malaria elimination programme in Mangaluru city, Karnataka, India

BackgroundUnder-reporting, delayed diagnosis, incomplete treatment and inadequate vector management are few among many factors responsible for uninterrupted transmission of malaria in India. Information technology (IT) and mobile apps can be utilized effectively to overcome these hurdles. Indigenously developed digital handheld geographic information system (GIS)-tagged Android-based tablets (TABs) has been designed especially for implementation of digitization protocol. This has changed the effectiveness of malaria surveillance and intervention strategies in a malaria endemic area of Mangaluru city, Karnataka, India.MethodsA software was developed and implemented for control measures to create a digital database of each malaria case. Secondary data analyses were carried out to determine and compare differences in malariometric indices between pre- and post-digitization years. With the introduction of this software active surveillance, information education and communication (IEC), and anti-vector measures were made ‘incidence-centric’. This means that the entire control measures were carried out in the houses where the malaria cases (index cases) were reported and also in surrounding houses.ResultsAnnual blood examination rate (ABER) increased from 13.82 to 32.8%. Prompt reporting of new cases had improved (36% within 24 h and 80% within 72 h). Complete treatment and parasite clearance time were documented in 98% of cases. In the second post-digitization year untraceable cases reduced from 11.3 to 2.7%; contact blood smears collection also increased significantly (p < 0.001); Slide Positivity Rate (SPR) decreased from 15.5 to 10.48%; malaria cases reduced by 30%.ConclusionsIT is very useful in translation of digitized surveillance to core interventions thereby effectively reduce incidence of malaria. This technology can be used effectively to translate smart surveillance to core interventions following the ‘1-3-7-14’ strategy.