SETTING: Adults interviewed during house-to-house surveys.
PARTICIPANTS: Women (15-45 years) and men (15-49 years) surveyed in four Nepal Demographic and Health Surveys done in 2001, 2006, 2011 and 2016.
OUTCOME MEASURE: Current tobacco use (in any form).
RESULTS: The prevalence of tobacco use for men declined from 66% in 2001 to 55% in 2016, and declined from 29% to 8.4% among women. Across both education and wealth quintiles for both men and women, the prevalence of tobacco use generally declines with increasing education or wealth. We found persistently larger absolute inequalities by education than by wealth among men. Among women we also found larger educational than wealth-related gradients, but both declined over time. For men, the Slope Index of Inequality (SII) for education was larger than for wealth (44% vs 26% in 2001) and changed very little over time. For women, the SII for both education and wealth were similar in magnitude to men, but decreased substantially between 2001 and 2016 (from 44% to 16% for education; from 37% to 16% for wealth). Women had a larger relative index of inequality than men for both education (6.5 vs 2.0 in 2001) and wealth (4.8 vs 1.5 in 2001), and relative inequality increased between 2001 and 2016 for women (from 6.5 to 16.0 for education; from 4.8 to 12.0 for wealth).
CONCLUSION: Increasing relative inequalities indicates suboptimal reduction in tobacco use among the vulnerable groups suggesting that they should be targeted to improve tobacco control.
METHODS: This hospital-based prospective cohort study included 346 pregnant women between 28-32 gestational weeks who were followed up after childbirth at Koshi Hospital in Nepal. The Malaysian antenatal risk stratification approach, which applies four color codes, was used: red and yellow denote high-risk women, while green and white indicate low-risk women based on maternal past and present medical and obstetric risk factors. The World Health Organization criteria were used to identify women with severe maternal morbidity. Multivariate confirmatory logistic regression analysis was performed to adjust for possible confounders (age and mode of birth) and explore the association between risk stratification and severe maternal morbidity.
RESULTS: The prevalence of high-risk pregnancies was 14.4%. Based on the color-coded risk stratification, 7.5% of the women were categorized red, 6.9% yellow, 72.0% green, and 13.6% white. The women with high-risk pregnancies were 4.2 times more likely to develop severe maternal morbidity conditions during childbirth.
CONCLUSIONS: Although smaller in percentage, the chances of severe maternal morbidity among high-risk pregnancies were higher than those of low-risk pregnancies. This risk scoring approach shows the potential to predict severe maternal morbidity if routine screening is implemented at antenatal care services. Notwithstanding, unpredictable severe maternal morbidity events also occur among low-risk pregnant women, thus all pregnant women require vigilance and quality obstetrics care but high-risk pregnant women require specialized care and referral.
METHODS: The study was conducted among 1010 women who were registered as migrant returnees at an organisation called Pourakhi Nepal. Secondary data were extracted from the records of the organisation covering the five-year period of July 2009 to July 2014.
RESULTS: The 1010 participants were aged 14 to 51 with a median age of 31 (IQR: 38-25) years. A quarter of respondents (24%) reported having experienced health problems while in the country of employment. Fever, severe illness and accidents were the most common health problems reported. Working for unlimited periods of time and not being able to change one's place of work were independently associated with a greater likelihood of health problems. Logistic regression shows that migrant women who are illiterate [OR = 1.56, 95% CI: 1.02 to 2.38, p = 0.042], who had changed their workplace [OR = 1.63, 95% CI: 1.14 to 2.32, p = 0.007], who worked unlimited periods of time [OR = 1.64, 95% CI: 1.44 to 1.93, p = 0.020], had been severely maltreated or tortured in the workplace [OR = 1.84, 95% CI: 1.15 to 2.92, p = 0.010], were not being paid on time [OR = 2.38, 95% CI: 1.60 to 3.55, p = 0.038] and migrant women who had family problems at home [OR = 3.48, CI 95%: 1.22 to 9.98, p = 0.020] were significantly associated with health problems in their host country in the Middle East.
CONCLUSION: Female migrant workers face various work-related health risks, which are often related to exploitation. The Government of Nepal should initiate awareness campaigns about health risks and rights in relation to health care services in the host countries. Recruiting agencies/employers should provide information on health risks and training for preventive measures. Raising awareness among female migrant workers can make a change in their working lives.
METHODS: A total of 61 individuals clinically diagnosed to have thalassemia were genotyped with multiplex amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Twenty-one major mutations were investigated using allele-specific primers grouped into six different panels.
RESULTS: The most common mutations found (23%) were IVS 1-5 (G-C) and Cd 26 (G-A) (HbE), followed by 619 deletion, Cd 8/9 (+G), Cd 16 (-C), Cd 41/42 (-TTCT), IVS 1-1 (G-T), Cd 19 (A-G), and Cd 17 (A-T) at 20%, 12%, 8%, 6%, 4%, 3%, and 1%, respectively.
CONCLUSION: The results of this study revealed that Nepal's mutational profile is comparable to that of its neighboring countries, such as India and Myanmar. This study also showed that thalassemia could be detected across 17 Nepal's ethnic groups, especially those whose ancestors originated from India and Central Asia.
METHODS: A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and gestational age were enrolled. Key inclusion criteria were pragmatic and management markers of NNM and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0.
RESULTS: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI) 2.07-9.84) and no formal education (aOR 2.16; 95% CI 1.12-4.14) had a positive association with NNM, while multiparity (aOR 0.52; 95% CI 0.32-0.86) and caesarean section (aOR 0.44; 95% CI 0.19-0.99) had negative associations with NNM.
CONCLUSIONS: Maternal characteristics and complications were associated with NNM. Healthcare providers should be aware of the impact of obstetric factors on newborn health and provide earlier interventions to pregnant women, thus increasing survival chances of newborns.
METHODS: A descriptive cross-sectional study was used to collect information from 502 Nepalese migrant workers in the arrival section of Tribhuvan International Airport from May to June 2019 using purposive sampling. Workers with a minimum work experience of 6 months and above were included in the study. A structured questionnaire with socio-demographic items was used along with the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and WHO (five) wellbeing scale for measuring the subjective psychological wellbeing and screening for depression.
RESULTS: The mean age of the respondents was 32.97 years. Majority (41.8%) of the respondents had work experience in Qatar and 63.7% had work experience of 1-5 years. The results suggested that 14.4% had mild to severe depression while 4.4% had a moderate level of anxiety. The WHO5 wellbeing index score suggested that 14.1% of the respondents had a score below 13, which is suggestive of poor psychological wellbeing. Further, the country of work (p = 0.043), sleeping hours (p = 0.001), occupation (p = 0.044), working hours (p = 0.000), water intake (p = 0.010) and anxiety level (p = 0.000) were found to be significantly associated with depression score. Similarly, sleeping hours (p = 0.022), occupation (p = 0.016), working hours (p = 0.000), water intake (p = 0.010), and anxiety level (0.000) were significantly associated with the WHO5 wellbeing score.
CONCLUSIONS: Nepalese migrant workers in the Gulf countries (United Arab Emirates, Saudi Arabia, Qatar, Oman, Kuwait, Bahrain) and Malaysia bear an important burden of psychological morbidities. This highlights the need to prioritize the migrant worker's mental health by Nepal as well as Gulf countries and Malaysia.
METHODS: We selected 1500 refugee records from 14 states from March 2013 through July 2015 to determine whether overseas vaccination records were available at the US postarrival health assessment and integrated into the Advisory Committee on Immunization Practices schedule. We assessed number of doses, dosing interval, and contraindications.
RESULTS: Twelve of 14 (85.7%) states provided data on 1118 (74.5%) refugees. Overseas records for 972 (86.9%) refugees were available, most from the Centers for Disease Control and Prevention's Electronic Disease Notification system (66.9%). Most refugees (829; 85.3%) were assessed appropriately for MMR vaccination; 37 (3.8%) should have received MMR vaccine but did not; 106 (10.9%) did not need the MMR vaccine but were vaccinated.
CONCLUSIONS: Overseas documentation was available at most clinics, and MMR vaccinations typically were given when needed. Further collaboration between refugee health clinics and state immunization information systems would improve accessibility of vaccination documentation.
AIMS: The aim of this study was to establish the feasibility, and to investigate the impact, of community pharmacy-based educational intervention on knowledge, practice, and disease management of patients with hypertension in Western Nepal.
METHOD: A single-cohort pre-/post-intervention study was conducted from August 2012 to April 2013. The participants included in the study were patients diagnosed with hypertension attending a pharmacist-led hypertension clinic. The educational intervention was conducted by pharmacists, was individualised, and consisted of three counselling sessions over a period of six months. The patients' knowledge of hypertension, their practice of lifestyle modification and non-pharmacological approaches concerning hypertension management, and blood pressure were assessed at baseline and again after nine months by using a pre-validated questionnaire.
RESULTS: Fifty patients met the inclusion criteria and were enrolled in the study. The median (IQR) knowledge score changed from 6 (4) to 13 (0) after the intervention (p<0.01) with the median (IQR) practice score changing from 7 (4) to 16 (2) (p<0.01). The mean (SD) systolic BP changed from 150.1 (7.8) to 137.7 (9.9) (p<0.01) and the mean (SD) diastolic BP from 104 (9.5) to 94.5 (7.8) after the intervention (p< 0.01).
CONCLUSION: A simple, educational intervention by community pharmacists had improved patients' disease knowledge, practice, and management of their hypertension. Evidence suggests Nepalese community pharmacists need could play an important role in the management of chronic diseases like hypertension through simple interventions such as providing educational support for patients.
Methods: A systematic search was conducted in PubMed, Web of Science, Google Scholar, Scopus and Nepal Journal Online (NepJOL) databases. 'Adverse Drug Reactions' or 'ADRs' or 'ADR' or 'Adverse drug reaction' or 'AE' or 'Adverse Event' or 'Drug-Induced Reaction' or 'Pharmacovigilance' or 'PV' and 'Nepal'. The search covered 15 years (January 2004 to December 2018) of study on ADRs and PV in Nepal. Only articles retrieved from databases were included, whereas published/unpublished drug bulletins, pharmacy newsletters and thesis were excluded. The articles thus retrieved were recorded, and thereafter analyzed. Word count code was used for the analysis of keywords used in the retrieved articles.
Results: A total of 124 articles were retrieved, with the highest rate of publications in 2006 and 2007, with 16 papers each. Among the articles, 10 (8.1%) were published in Kathmandu University Medical Journal (KUMJ). Single papers were published in 38 different journals. Brief reports (1.6%), case reports (31.2%), case series (0.8%), education forums (0.8%), letters to the editor (5.6%), original research articles (41.9%), review articles (9.7%), short communications and short reports (8.1%) on ADRs and PV were recorded. Out of 124 papers, 52 (41.9%) were original research publications. The majority (74.1%) of research was done in the category of ADR incidence, types, prevention, and management, followed by policy and suggestions for strengthening national and regional pharmacovigilance centers of Nepal (14.5%).
Conclusions: During the study years, there was an increase in scientific publications on drug safety. A total of 124 published articles were found during bibliometric analysis of ADRs and PV research activities in Nepal.
Objective: The aim of this study was to determine knowledge, awareness and preparedness regarding coronavirus disease 2019 among CPPs working in Kathmandu, Nepal.
Methods: A cross-sectional study was conducted using a convenience sampling method from 10 February to 25 March 2020. Data were analysed descriptively, and one-sample independent t-test and one-way analysis of variance were used to compare scores among different subgroups of respondents (p
METHODS: Seven psychiatrists from seven countries reviewed recent published and ongoing research in psychiatry in their respective nations, with respect to themes, as well as any barriers or challenges faced by mental health researchers.
RESULTS: While the seven nations included in this review vary in terms of research capabilities and economic development level, they share many similarities both in terms of research direction, and with regards to challenges faced. Limitations in the form of sociocultural differences from the West, and a lack of funding were some of the barriers identified.
DISCUSSION: Mental health research in the region has been progressing well. However, more varied research in the form of qualitative or economic studies are lacking, as are multi-center studies. The similar issues that nations face with regards to research could perhaps benefit from collaborative efforts and initiatives for the furtherance of research in the region.