Challenges in Contact Tracing and Sampling in Three Districts of Western Rajasthan during the COVID-19 Pandemic

Introduction: Contact tracing commenced in districts of Western Rajasthan in March 2020 to control the spread of Covid-19.It was an ongoing process involving isolation and sampling of contacts. Multi department Quick and Rapid response teams (Q/RRT) worked continuously as the pandemic passed through different stages. The objectives of the study was to compare the challenges faced during contact tracing and document good practices in place. Methods: A cross –sectional study was done among contact tracers using a semi structured questionnaire in Google forms in three districts of Pali, Jodhpur and Barmer. Keeping power of study at 80%, 5% error and 95% confidence interval, assuming 50% prevalence of effective contact tracing and 10 % non-response total 400, i.e 133 participants from each district. Results: Major challenges faced by tracers were resistance to contact sampling (64%)lack of training (49%), and random sampling workload (47%). Overall 36% of contacts had downloaded the Aarogya setu app but among them only 68% were using the app. Trainings, workload distribution and inter-sectoral coordination was best in Jodhpur, Barmer and Pali respectively. Conclusions: Trainings helped in better field management of resistance to sampling among contacts. Excessive workload of lab technicians lead to errors in reporting. Transport for sampling of contacts was a challenge in remote areas. The Aarogya setu app was not used by all contacts. Regular feedback meetings by local administration helped in effective contact tracing.