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Pandey, G., S. Dhakal, A. Sadaula, G. KC, S. Subedi, KR Pandey, and IP Dhakal. "Status of tuberculosis in bovine animals raised by tuberculosis infected patients in Western Chitwan, Nepal." International Journal of Infection and Microbiology 1, no. 2 (January 20, 2013): 49–53. http://dx.doi.org/10.3126/ijim.v1i2.7407.
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INTRODUCTION: Bovine tuberculosis (bTB) is an important public health concern worldwide. This study was conducted to determine the status of bTB in animals raised by tuberculosis patients in Western Chitwan, Nepal. MATERIALS AND METHODS: This cross-sectional study was conducted from August, 2011 to January, 2012. A total of 100 bovines (cattle and buffalo) raised in 60 farms of tuberculosis patients were tested with single intradermal tuberculin test considering various animal factors. Well designed questionnaire survey was taken with 70 tuberculosis patients of same 60 families focusing knowledge, awareness and various practices related to bovine tuberculosis. RESULTS: Overall 15% bovines were positive for tuberculosis (13.6% cattle and 15.4% buffaloes). Age of animal was significantly associated with tuberculosis (p<0.05) while sex and species were not. 24% tuberculosis patients had raw milk consuming habit while very few of them (9%) were aware of zoonotic aspect of bovine tuberculosis. CONCLUSIONS: There is high chance of tuberculosis transmission form animals to humans or vice versa. Further detailed study is needed in large scale with stronger intersectoral collaboration of medical and veterinary health sector to determine the scale of problem and find out prevention and control strategies against zoonotic tuberculosis. DOI: http://dx.doi.org/10.3126/ijim.v1i2.7407 Int J Infect Microbiol 2012;1(1):49-53
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Bichha, R. P., K. K. Jha, V. S. Salhotra, A. P. Weerakoon, K. B. Karki, and Navneet Bichha. "An Epidemiological Study to Find out Risk Factors of Multi Drugs Resistance Tuberculosis in Nepal." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 14, no. 2 (March 13, 2018): 31–38. http://dx.doi.org/10.3126/saarctb.v14i2.19335.
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Introduction: Drug resistant tuberculosis is a threat to tuberculosis control worldwide. Previous anti- tuberculosis treatment is a widely reported risk factor for multi drug resistant tuberculosis (MDR-TB), whereas other risk factors are less well described. In Nepal National Tuberculosis Control Programme initiated DOTSPLUS Pilot project from September 2005 using standardized treatment regimen.Objective: To explore the risk factors for MDR-TB in Nepal.Methodology: Institution based matched case control study with a case: control ratio of 1:2 was carried out in three regions of Nepal. Fifty five cases and 110 controls were selected. Current MDR-TB patients on treatment from DOTS–Plus clinic were enrolled as cases. Controls were age, sex matched cured TB patients and who had completed treatment either from the same centre or any DOTS Centre adjacent to that DOTS Plus Centre. Data was collected by a trained research assistant using interviewer administered structured questionnaire. Matched analysis was done using SPSS 16 version. Confounding effects were controlled by using matching, matched analysis and regression analysis.Results: In matched analysis following were the significant risk factors for MDR-TB in Nepal.(1) HIV Sero positivity (OR 15.9, CI 1.9- 133.0) (2) Travel cost more than 50 NRs per day (OR 6.5, CI 2.4- 9.8) (3) Contact history of TB (OR 3.8, CI 2.2- 6.6) (4) Living in a nuclear family (OR 6.0, CI 2.6- 13.9)(5) Non adherence to DOTS (OR 18.6, CI 2.27- 151.0) (6) Distance to treatment centre more than 5 Km ( OR 3.9, CI 1.5- 10.) (7) Previous history of TB ( OR 12.0, CI 5.4 -26.5)(8) Living in a rural area (OR 4, CI 2.1- 8.5) (9) Unmarried (Crude OR 3.3,CI 1.6- 6.8) (10) Un-employment (OR 3.4,CI 1.6-7.6)(11) Living in a rented house (OR 3.5, CI 1.77- 3.67) (12) Single bed room (OR 2.8, CI 1.13- 6.9). Using muti-variate analysis except living in a rented house and single bed room other variables were positive significant predictors for MDR –TB in Nepal.Conclusions: Many risk factors were related to the DOTS. Strengthening of DOTS programme to tackle the identified risk factors can reduce the MDR –TB burden in Nepal.SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS, Vol. 14, No. 2, 2017, Page: 31-38
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Bahadur Nepali, Ram, and Damaru Prasad Paneru. "Compliance to Directly Observed Treatment Short Course (DOTS) Chemotherapy among the Patient of Pulmonary Tuberculosis in Banke District of Nepal." Journal of Health and Allied Sciences 3, no. 1 (November 24, 2019): 17–20. http://dx.doi.org/10.37107/jhas.45.
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Tubercular infection is still a pervasive public health problem in Nepal despite the massive efforts of National Health Service stakeholders. High bacterial infectivity, transmissibility, increasing drug resistance and non compliance to the therapy have been adding up challenges to prevention and control of tuberculosis. This study was conducted to observe the treatment compliance pattern among new pulmonary sputum smear positive cases of tuberculosis. A cross sectional study was carried out in the year 2009. The 114 new smear positive pulmonary tuberculosis patients registered in the six selected DOTS centres of the Banke Disrtict were randomly selected. Participants were selected from each DOTS centre by probability proportionate sampling methods. Data were analyzed by SPSS (11.0 Version) and P< 0.05 was considered as significant. Overall compliance to DOTS was 86.80 percent; of these, 57.00 percent showed excellent and regular compliance followed by nearly 30 percent good compliance. And 13.20 percent participants were non complaint to DOTS therapy. Positive Family behaviors were positively associated with compliance while alcohol consumption was found to be negatively associated with compliance however; age, sex and income were found to be non significant factors for compliance. Feeling of getting cure even before the course of DOTS therapy (feeling better after 2-3 months regular treatment) and drinking habits were found to be the major causes of non compliance. Supportive family behaviors and avoidance of alcohol consumption may promote the compliance. Excellent treatment compliance in the face of many odds is highly encouraging and the pattern can be useful in treatment despite little non compliances; furthermore compliance can be enhanced by acting on these causes of non compliances.
Key words: Pulmonary, Tuberculosis, DOTS, Banke, Nepal
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Tiwari, Bishnu Raj, Prakash Ghimire, Sarala Malla, Bimala Sharma, and Surendra Karki. "Intestinal parasitic infection among the HIV-infected patients in Nepal." Journal of Infection in Developing Countries 7, no. 07 (July 15, 2013): 550–55. http://dx.doi.org/10.3855/jidc.2785.
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Introduction: Intestinal parasitic infection has been a significant problem in HIV patients, worldwide. In this study, we aimed to measure the prevalence and identify the factors associated with intestinal parasitic infection in people infected with HIV and attending National Public Health Laboratory in Kathmandu, Nepal, for CD4 T-cell count. Methodology: An analytical cross-sectional study in 745 HIV-infected people attending for CD4 T-cell count was conducted. Results: The prevalence of intestinal parasitic infection was 22.4% (95% CI 19.5 to 25.5). In univariate analysis, age, sex, longer time since diagnosis of HIV, CD4 T-cell count of <200/µL, diarrhoea, marital status, and being under tuberculosis (TB) treatment were significantly associated with increased odds of intestinal parasite infection. However, in the logistic regression model, only the CD4 T-cell count of <200/µL (adjusted OR=4.2, 95% CI 2.5 to 7.0), diarrhoea (adjusted OR=2.8, 95% CI 1.8 to 4.3) and being under TB treatment (adjusted OR=2.9, 95% CI 1.8 to 4.6) remained as significant predictors. On stratification, CD4 T-cell count of <200/ µL was independently associated with higher odds of protozoal as well as helminthes infection. The parasites Cryptosporidium and Cyclospora were observed only in participants with CD4 T-cell counts <200/µL. Conclusions: Both protozoal and helminthic intestinal parasitic infections are common in HIV-infected people seeking care in healthcare facilities. The poor immune status as indicated by low CD4 T-cell count and TB may account for such a high risk of parasitic infection.
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Sapkota, Bishnu. "Sex trafficking in Nepal." Research Nepal Journal of Development Studies 1, no. 1 (October 5, 2018): 28–31. http://dx.doi.org/10.3126/rnjds.v1i1.21271.
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Extreme poverty, illiteracy, unemployment, poor law enforcement, and open border between India and Nepal are major factors for human trafficking. Due to the devastating earthquake that hit Nepal on April 25, 2015, which was followed by more than 400 aftershocks, about 3 million people were victimized. The earthquake victims- women and children, were more vulnerable to trafficking than before. Hence, it is vital to understand human trafficking, its form, factors, effects, and motives. The objective of this paper is to make intellectuals aware of the issue of sex trafficking, problems, and possible solutions in Nepal.Research Nepal Journal of Development Studies Vol.1(1) 2018 28-31
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Marahatta, S. B., J. Kaewkungwal, P. Ramasoota, and P. Singhasivanon. "Risk factors of Multidrug Resistant Tuberculosis in central Nepal: A pilot study." Kathmandu University Medical Journal 8, no. 4 (June 5, 2012): 392–97. http://dx.doi.org/10.3126/kumj.v8i4.6238.
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Introduction Tuberculosis is the most widespread infectious disease in Nepal and poses a serious threat to the health and development of the country. Incidences of drug resistant tuberculosis in Nepal are increasing and this tuberculosisis a major threat to successfully controlling tuberculosis . Objective The general objective of the study was to assess the risk factors of multi-drug resistant tuberculosis among the patients attending the National Tuberculosis Centre, Bhaktpur Nepal. Methods An observational study/ case-control study with a Atotal number of 55 multi-drug resistant tuberculosis cases and 55 controls. The study was conducted among the patient attending in the National Tuberculosis Centre , Bhaktpur Nepal for six months, between May–October 2010. sImulti-drug resistant tuberculosis wasThe collected data was analysed in SPSS 11.5 version. The association between categorical variables were analysed by chi-square tests, OR and their 95% CI were measured. Results The total number of patients used for the study was 110, of which among them 55 were cases and 55 were controls . Our study revealed that there were significant associations between history of prior TB MDR-TB OR =2.799 (95 % CI 1.159 to 6.667) (p=0.020); smoking habit OR =2.350 and (95%CI 1.071 to 5.159) (p=0.032); social stigma social stigma OR 2.655 (95%CI r 1.071 to 5.159) (p=0.013); knowledge on MDR-TB OR =9.643 (95% CI 3.339 to 27.846) (p < 0.001)and knowledge on DOTS Plus OR=16.714 (95% CI is ranging from 4.656 to 60.008) (p< 0.001). However, there was no association found between alcohol drinking habits and ventilation in the room. Conclusion Our study revealed that there were significant associations between history of prior tuberculosis, smoking habit social stigma social stigma, knowledge on multi-drug resistant tuberculosis and knowledge on DOTS Plus with multi-drug resistant tuberculosis However there was no association between alcohol drinking habit and ventilation in room with multi-drug resistant tuberculosis. http://dx.doi.org/10.3126/kumj.v8i4.6238 Kathmandu Univ Med J 2010;8(4):392-7
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Adhikari, Nilaramba, Ratna Bahadur Bhattarai, Rajendra Basnet, Lok Raj Joshi, Bhim Singh Tinkari, Anil Thapa, and Basant Joshi. "Prevalence and associated risk factors for tuberculosis among people living with HIV in Nepal." PLOS ONE 17, no. 1 (January 28, 2022): e0262720. http://dx.doi.org/10.1371/journal.pone.0262720.
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Background Worldwide tuberculosis (TB) takes more lives than any other infectious diseases. WHO estimates around 68,000 incident TB cases in Nepal. However, in 2018 only around 27,232 new TB cases were reported in the national system, resulting around 40,768 incident TB cases missing every year in Nepal. National Tuberculosis Control Center carried out this study in anti-retroviral therapy (ART) sites to estimate the prevalence of TB and identify the associated risk factors for TB among the people living with Human Immunodeficiency Virus (PLHIVs) in Nepal. Methods It was a cross-sectional institution-based study conducted between March and August 2018. Six ART sites with high caseloads of PLHIVs were selected. PLHIVs who were equal or above 18 years of age and were in ART program at the selected study sites were considered eligible for the study. Diagnosis of tuberculosis among PLHIVs who agreed to participate in the study was carried out as per the National Tuberculosis Management Guideline of National Tuberculosis Program of Nepal. Results Among 403 PLHIVs, tuberculosis was diagnosed in 40 (9.9%) individuals. Median age of the participants was 36 (30–43) years. Prevalence of TB was significantly higher among male PLHIVs than female PLHIVs (13.6% Vs 5.8%; P = 0.02) and Dalit ethnic group compared to Brahmin/Chettri (22.0%Vs5.9%, P = 0.01). The risk of developing TB was found significant among those with HIV stage progressed to WHO stage 3 and 4 (OR = 4.85, P<0.001) and with the family history of TB (OR = 4.50, P = 0.002). Conclusions Prevalence of TB among PLHIVs in Nepal was found 9.9%. Risk of developing TB was higher among PLHIVs who were male, Dalit, with HIV stage progressed to WHO stage 3 and 4 and with family history of TB. Hence, targeted interventions are needed to prevent the risk of developing TB among PLHIVs. Similarly, integrated, and comprehensive TB and HIV diagnosis and treatment services are needed for the management of TB/HIV co-infection in Nepal.
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Marahatta, S. B. "Prevalance of Tuberculosis and Risk Factors Assoicated with Multidrug Resistant Tuberculosis in Central Nepal." International Journal of Epidemiology 44, suppl_1 (September 23, 2015): i106. http://dx.doi.org/10.1093/ije/dyv096.059.
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Amgain, K., Dillee Prasad Paudel, DP Paneru, M. Dhital, and G. Amgain. "Gender Difference on Case Detection of Pulmonary Tuberculosis Among the Suspected Cases Attending in Jutpani Primary Health Centre of Chitwan, Nepal." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 10, no. 1 (September 15, 2013): 7–12. http://dx.doi.org/10.3126/saarctb.v10i1.8644.
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Introduction: Pulmonary tuberculosis is one of the World’s public health problems particularly in developing countries including Nepal. Every year, thousands of people suffered from active tuberculosis in Nepal; of whom 50 percent have infectious pulmonary tuberculosis. It is more common among men than women, and affects mostly adults of economically productive age. There is scantiness of such information in Nepal. Hence the study was carried out to identify the gender difference on case identifi cation of pulmonary tuberculosis in Chitwan district of Nepal. Methodology: Descriptive cross sectional study was carried out from July to December 2012 in Jutpani Village Development Committee of Chitwan, Nepal. All symptomatic cases attending in Jutpani Primary Health Center with the clinical history pulmonary tuberculosis were included. Microscopic examination of sputum samples of three consecutive days was done for AFB. Results were disseminated in tabular, graphical and narrative form using appropriate statistics. Results: Total 200 suspected cases of pulmonary tuberculosis were included in this study; among them 18 (9%) were found to be AFB positive. Sex ratio of diagnosed patients was 5:4 (male; 55.56% and female; 44.44%). Highest prevalence of TB infection (36.89%) was found in 30-40 years age. Highest number of cases 5 (27.78%) were reported in the ward number four (male female ratio; 3:2). One-third of cases were in July followed by 22.22% in each of the month; August and September. Conclusion: Males were found to be more likely to have pulmonary tuberculosis than females. Gender specifi c case identifi cation and preventive measure targeting to the most productive age group population will eventually supports to reduce the risk of pulmonary tuberculosis. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2013; X(1); 7-12 DOI: http://dx.doi.org/10.3126/saarctb.v10i1.8644
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Maharjan, Bijay, Hom Nath Chalise, and Mamta Thapa. "Tuberculosis and Diabetes Mellitus Comorbidity among the Ageing Population: A Threat to the Public Health System of Nepal." Journal of Nepal Health Research Council 16, no. 2 (July 5, 2018): 110–17. http://dx.doi.org/10.3126/jnhrc.v16i2.20294.
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Ageing population is attributable to the growing trend of diabetes mellitus. Diabetic patients are three times greater risk of developing tuberculosis. The review aims to describe the state of tuberculosis and diabetes mellitus comorbidity, risk factors for the comorbidity from the perspective of the ageing in Nepal. It is a systematic narrative review of literature in Google Scholar and Pubmed. At first, title and abstract of an article was reviewed for relevance, and then full article was reviewed for validity. The secondary data was retrieved from the Central Bureau of Statistics of Nepal and WHO, and analysed in the Ms-Excel. In Nepal, the population is ageing. The risk factors associated with diabetes are escalating. On the other hand, tuberculosis is endemic and about 45% of the Nepalese people are infected with tuberculosis bacteria. These circumstances have laid the foundation that fosters tuberculosis and diabetes co-epidemic in the future. The clinical management of patients with the comorbid condition is a difficult task because diabetes and tuberculosis interact with each other, one worsening the other. The upsurge of the co-morbidity needs the provision of more health services threatening the public health system of Nepal. It is fundamental to create a mechanism to integrate diabetes and tuberculosis program such as screening, diagnosis and management of the both diseases at the all levels of health service delivery. Furthermore, increase awareness of healthy lifestyle and the prevention of the risk factors for tuberculosis and diabetes could reduce the occurrence of the comorbidity in the future.
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BC, GB, and PL Basel. "Premarital Sex Behaviors Among College Youths of Kathmandu, Nepal." Kathmandu University Medical Journal 11, no. 1 (September 9, 2014): 27–31. http://dx.doi.org/10.3126/kumj.v11i1.11019.
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Backgroud Unhealthy premarital sex behavior leads to several health problems namely; sexually transmitted diseases (STDs), Human Immune Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS), unwanted pregnancies, abortions and maternal deaths. Unwanted pregnancies and unsafe abortions are rampant in Nepal despite introduction of legal provision for safe abortion since 2003. Lately, unsafe sex and sex without condoms and drinking before sex is increasing in trend in youth population. The primary aim of this study was to explore the factors associated with premarital sex behaviors. Objectives The main objective of the study was to identify the premarital sex behaviors and related factors among college youths in Kathmandu, Nepal. Methods Descriptive and explorative study of size 230 college youths aged between 18- 24 years. Data were collected by self-administered questionnaire from February 26 to March 15, 2012. The reliability of the questionnaire was ensured by using Cronbach’s alpha. Results Late youths of age 20-24 were more likely to experience premarital sex than early youths of age 18-19 years old. Urban youths were less involved in premarital sex behavior than rural youth. Youths having negative attitudes towards premarital sex were more likely to experience premarital sex than a positive attitude. Youths who had good relationship with their parents had less premarital sex experience than youths having poor relationship with their parents. Conclusion One fifth of college youth had premarital sex experience where alcohol drinker had higher premarital sex experience than non-drinker. Youths having good peer norms were significantly less likely to experience premarital sex behaviors than youths having poor peer norms. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11019 Kathmandu University Medical Journal Vol.11(1) 2013: 27-31
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Thapa, B., R. Paudel, P. Thapa, A. Shrestha, and AK Poudyal. "Prevalence of Diabetes among Tuberculosis Patients and Associated Risk Factors in Kathmandu Valley." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 12, no. 2 (October 25, 2016): 20–27. http://dx.doi.org/10.3126/saarctb.v12i2.15951.
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Introduction: Diabetes among tuberculosis patients is a growing concern. The prevalence of diabetes among tuberculosis patients in Nepal is not known. The objective of this study was to determine the prevalence of diabetes among tuberculosis patients and to identify the associated risk factors.Methodology: A descriptive, cross-sectional study was conducted in Kathmandu valley of Nepal. Face to face interviews using structured questionnaire were conducted to collect socio-demographic and behavioral risk factors. A random blood sugar test was carried out using glucometer. Measurements on height, weight and waist circumference were taken to obtain the anthropometric information.Results: Out of 407 tuberculosis patients recruited in the study, 37 (9.1%) were found to have diabetes. Among them 28 (6.9%) were self reported cases of diabetes while 9 (2.2%) were found with random blood sugar level >200mg/dl. Tuberculosis patients aged 50 years and above (OR 7.5; 95% CI 2.72-20.66), ever tobacco users (OR 3.5; 95% CI 1.19-10.74), high income status (OR 5.2; 95% CI 1.59-17.26) and self history of high blood pressure (OR 20.0; 95% CI 5.07-79.50) were found significantly associated with diabetes.Conclusion: Overall, the prevalence of diabetes among tuberculosis patients was 9.1%. Older age, tobacco use, high income status and history of high blood pressure were identified as associated risk factors.SAARC J TUBER LUNG DIS HIV/AIDS, 2015 XII (2), Page: 20-27
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Prasad Paudel, Dille. "Treatment Compliance of Tuberculosis and Factors Associated in Bhaktapur District in Nepal." Journal of Health and Allied Sciences 1, no. 1 (November 27, 2019): 38–43. http://dx.doi.org/10.37107/jhas.91.
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Kokiwar, Prashant Ramdas. "Risk factors of pulmonary tuberculosis: A community-based case control study." Indian Journal of Community Health 33, no. 2 (June 30, 2021): 391–93. http://dx.doi.org/10.47203/ijch.2021.v33i02.030.
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Studies on risk factors of tuberculosis help to focus on risk of tuberculosis and take appropriate policy action which help to eliminate tuberculosis. Hence present study was carried out to study risk factors of pulmonary tuberculosis. Community-based case-control studywas carried out among 78 age and sex matched cases and controls. Cases were incident cases of pulmonary tuberculosis aged 18-45 years of either sex. Data on housing condition was recorded with direct observation. Cases and controls were comparable for age, sex, presence of diabetes, HIV and immuno-compromised status. Mean body mass index was significantly low in cases as compared to controls (18.06 vs. 22.05; p<0.0001). On binomial logistic regression odds of tuberculosis was 5.544 (95%CI=2.513-12.232; P=0.000) among those exposed to indoor air pollution after controlling for other factors. We conclude that exposure to indoor air pollution was significantly associated with risk of pulmonary tuberculosis
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Kokiwar, Prashant Ramdas. "Risk factors of pulmonary tuberculosis: A community-based case control study." Indian Journal of Community Health 33, no. 2 (June 30, 2021): 391–93. http://dx.doi.org/10.47203/ijch.2021.v33i02.030.
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Studies on risk factors of tuberculosis help to focus on risk of tuberculosis and take appropriate policy action which help to eliminate tuberculosis. Hence present study was carried out to study risk factors of pulmonary tuberculosis. Community-based case-control studywas carried out among 78 age and sex matched cases and controls. Cases were incident cases of pulmonary tuberculosis aged 18-45 years of either sex. Data on housing condition was recorded with direct observation. Cases and controls were comparable for age, sex, presence of diabetes, HIV and immuno-compromised status. Mean body mass index was significantly low in cases as compared to controls (18.06 vs. 22.05; p<0.0001). On binomial logistic regression odds of tuberculosis was 5.544 (95%CI=2.513-12.232; P=0.000) among those exposed to indoor air pollution after controlling for other factors. We conclude that exposure to indoor air pollution was significantly associated with risk of pulmonary tuberculosis
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Laohasiriwong, Wongsa, Roshan Kumar Mahato, Rajendra Koju, and Kriangsak Vaeteewootacharn. "Delay for First Consultation and Its Associated Factors among New Pulmonary Tuberculosis Patients of Central Nepal." Tuberculosis Research and Treatment 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/4583871.
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Tuberculosis (TB) is still a major public health challenge in Nepal and worldwide. Most transmissions occur between the onset of symptoms and the consultation with formal health care centers. This study aimed to determine the duration of delay for the first consultation and its associated factors with unacceptable delay among the new sputum pulmonary tuberculosis cases in the central development region of Nepal. An analytical cross-sectional study was conducted in the central development region of Nepal between January and May 2015. New pulmonary sputum positive tuberculosis patients were interviewed by using a structured questionnaire and their medical records were reviewed. Among a total of 374 patients, the magnitude of patient delay was 53.21% (95% CI: 48.12–58.28%) with a median delay of 32 days and an interquartile range of 11–70 days. The factors associated with unacceptable patient delay (duration ≥ 30 days) were residence in the rural area (adj. OR = 3.10, 95% CI: 1.10–8.72;pvalue = 0.032) and DOTS center located more than 5 km away from their residences (adj. OR = 5.53, 95% CI: 2.18–13.99;pvalue < 0.001). Unemployed patients were more likely to have patient delay (adj. OR = 7.79, 95% CI: 1.64–37.00;pvalue = 0.010) when controlled for other variables.
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STRICKLAND, S. S., and V. R. TUFFREY. "PARENTAL INVESTMENT THEORY AND BIRTH SEX RATIOS IN NEPAL." Journal of Biosocial Science 29, no. 3 (July 1997): 283–95. http://dx.doi.org/10.1017/s0021932097002836.
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Parental investment theory postulates that where physical condition varies significantly then birth sex ratio will be correlated with social status. Application of this theory to man remains contentious. This study examines physique, wealth, and social status in relation to the sex of live births. It reports a female-biased sex ratio in high social and economic status Nepalese. Close consanguineous marriage, intended to conserve landed wealth within related lineages, and increased female work burdens accompanying larger farm size, are proximate factors which may underlie this finding. A differential payback hypothesis is one way of explaining this pattern.
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Subedi, Ranjeeta, Israt Jahan, and Pam Baatsen. "Factors Influencing Modern Contraceptive Use among Adolescents in Nepal." Journal of Nepal Health Research Council 16, no. 3 (October 30, 2018): 251–56. http://dx.doi.org/10.33314/jnhrc.v16i3.1258.
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In Nepal, contraceptive use among married adolescents is low and has remained nearly stagnant since 2006, while little information is available about contraceptive use among unmarried adolescents. Nepal is committed to improve sexual and reproductive health rights among all the adolescents. Promoting modern contraceptive use especially among married adolescents is one of the key approaches in practice, to prevent HIV or sexual transmitted infections, avoid unintended pregnancy and sub-sequent unsafe abortion. In spite of these efforts, modern contraceptive use among married adolescents is not increasing. In this study, we aimed to review the prevalence and trends as well as factors influencing modern contraceptive use among both married and unmarried adolescents in Nepal. A review of existing published and unpublished articles, documents, and reports were conducted. An adapted and modified socio-ecological model was used to explore the factors influencing contraceptive use.Contraceptive use is persistently low among adolescents. Various interrelated factors like socio-cultural norms and traditions, lack of comprehensive knowledge on contraceptive methods among adolescents, inadequate adolescent friendly Services and health workers not having the competencies to work with adolescents, are the major influential factors that limit adolescents to seek and use contraceptive services and information.A multilevel approach is required to address the interrelated factors and to create an enabling environment in which adolescent are fully informed and equipped to make use of contraceptives and related services. For this to happen, Government and NGOs working on sexual and reproductive health rights have to work towards translating the existing policies into practice. Involving adolescents, their families and communities; equipping teachers to provide comprehensive sex education within school and sex education programme for out of school and enhancing the competencies of health workers to provide adolescent friendly services – all in line with the written policy - is urgently needed.
Keywords: Adolescent; barriers; contraceptive; Nepal; SRHR.
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Subedi, Ranjeeta, Israt Jahan, and Pam Baatsen. "Factors Influencing Modern Contraceptive Use among Adolescents in Nepal." Journal of Nepal Health Research Council 16, no. 3 (November 2, 2018): 251–56. http://dx.doi.org/10.3126/jnhrc.v16i3.21419.
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In Nepal, contraceptive use among married adolescents is low and has remained nearly stagnant since 2006, while little information is available about contraceptive use among unmarried adolescents. Nepal is committed to improve sexual and reproductive health rights among all the adolescents. Promoting modern contraceptive use especially among married adolescents is one of the key approaches in practice, to prevent HIV or sexual transmitted infections, avoid unintended pregnancy and sub-sequent unsafe abortion. In spite of these efforts, modern contraceptive use among married adolescents is not increasing. In this study, we aimed to review the prevalence and trends as well as factors influencing modern contraceptive use among both married and unmarried adolescents in Nepal. A review of existing published and unpublished articles, documents, and reports were conducted. An adapted and modified socio-ecological model was used to explore the factors influencing contraceptive use. Contraceptive use is persistently low among adolescents. Various interrelated factors like socio-cultural norms and traditions, lack of comprehensive knowledge on contraceptive methods among adolescents, inadequate adolescent friendly Services and health workers not having the competencies to work with adolescents, are the major influential factors that limit adolescents to seek and use contraceptive services and information. A multilevel approach is required to address the interrelated factors and to create an enabling environment in which adolescent are fully informed and equipped to make use of contraceptives and related services. For this to happen, Government and NGOs working on sexual and reproductive health rights have to work towards translating the existing policies into practice. Involving adolescents, their families and communities; equipping teachers to provide comprehensive sex education within school and sex education programme for out of school and enhancing the competencies of health workers to provide adolescent friendly services – all in line with the written policy - is urgently needed.
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Shaw, Sophie, and Kevin Purdy. "Sex Bias in Tuberculosis in the Developing World." American Journal of Undergraduate Research 15, no. 4 (March 24, 2019): 61–70. http://dx.doi.org/10.33697/ajur.2019.007.
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Tuberculosis (TB), the most deadly global single organism infectious disease, kills nearly twice as many men as women. Understanding the factors that drive this bias in TB mortality is an important aspect of the global effort to reduce the enormous burden of this disease in the developing world. One third of the world’s population is estimated to be infected TB, with Low and Middle Income Countries (LMIC) bearing the greatest disease burden. In LMIC sex bias in TB is influenced by sociocultural, behavioural as well as biological factors, with dynamic interactions between reporting variables, other confounding variables and physiological mechanisms, which each influence one another to produce the male-biased sex ratio observed in TB transmission, prevalence and mortality. While confounding factors are addressed in the existing global drive to tackle TB it is the biological aspects of sex bias in TB that present specific challenges for diagnosis and treatment in men and women as they potentially influence future immunological-based interventions to treat TB.
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Kakchapati, Sampurna, Sumina Oli, and Dikshika Bhandari. "Sexual Risk Behavior among Youths of Nepal: Further analysis of Nepal Demographic Health Survey." Health Prospect 20, no. 1 (June 12, 2021): 8–14. http://dx.doi.org/10.3126/hprospect.v20i1.30211.
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Background: The period of youth is the time of major physical changes in the body that precedes psychosocial maturity. The curious mind of youths predisposes them to practice sexual risk behaviors. The aim of this study is to identify the sexual risk behavior and factors associated with sexual behaviors among youths of Nepal.
Methodology: This was a retrospective analysis of 6524 youths aged 15-24 years using data obtained from the Nepal Demographic and Health Survey for the year 2016. The outcome was sexual behaviors and the determinants were socio-demographic characteristics and smoking. Statistical analysis was done using chi-square tests to assess statistically significant associations between determinants and outcome. In order to identify the most important determinants with the outcome, significant predictors in the univariate analysis were then included in logistic regression.
Results: The prevalence of premarital sex among the youths was 5.2%, nearly half of them were sexually active and 5.5% had multiple sex partners. Variables that were significantly associated with premarital sex in the presence of other variables included male gender (AOR=6.3,95% CI=4.3,13.2) and smoker (AOR=2.4, 95%CI=1.8,3.16). Variables that were significantly associated with recent sexual activity in the presence of other variables included female gender (AOR=1.36,95%CI=1.18,1.58), age group (AOR=8.3,95% CI= 7.3,9.3), rural residence (AOR=1.4, 95% CI=1.26,1.62), illiterate youths (AOR=4.34,95% CI=3.27,5.76), poor wealth index (AOR=0.6, 95% CI=0.5,0.68) and smoker (AOR=3.38,95% CI=2.57,4.46). Variables that were significantly associated with multiple sexual partners in the presence of other variables included male gender (AOR=5.5, 95% CI=2.58,7.05) and smoker (AOR=2.2,95% CI=1.6,3.05).
Conclusion: The male and smoker youths were more likely to practice all forms of sexual risk behaviors. This study recommends the need for further studies to understand the factors responsible for sexual risk behavior among youths. Furthermore, it is imperative to provide comprehensive sexuality education for youths.
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Adhikari, Nilaramba, Ratna Bhattarai, Rajendra Basnet, Bhim Singh Tinkari, Badri Nath Gyawali, and Lok Raj Joshi. "Prevalence of Human Immunodeficiency Virus Infection among Tuberculosis Patients in Nepal." Journal of Nepal Health Research Council 17, no. 01 (April 28, 2019): 15–20. http://dx.doi.org/10.33314/jnhrc.v17i01.1768.
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Background: National Tuberculosis Program has envisioned to provide human immunodeficiency virus testing for all tuberculosis patients. However, human immunodeficiency virus testing coverage among notified tuberculosis patients is very low in Nepal. Hence, it is difficult to reflect the prevalence of human immunodeficiency virus infection among Tuberculosis patients based on the information available from the routine system. Hence National Tuberculosis Program carried out sentinel surveillance to assess the prevalence of human immunodeficiency virus infection among tuberculosis patients and its associated factors in Nepal.Methods: This study is cross-sectional study type conducted at six sentinel sites across the country. This study lasted for six months starting from March 2017 to August 2017. The sample size was calculated using Epiinfo STATCAL application assuming confidence interval at 95%, 85% power and 5% non-response rate. The required sample size was 1672 tuberculosis patients. Ethical approval was obtained from Nepal Health Research Council. All types of tuberculosis patients who were equal or above 15 years were included in the study. Human immunodeficiency viruse testing was performed among tuberculosis patients as per the testing algorithm recommended by national guideline.Results: The study was carried out among 1664 tuberculosis patients registered for tuberculosis treatment during the study period. More than two thirds of tuberculosis patients (67%) were male. The median age of tuberculosis patients was found 32 years. During human immunodeficiency virus testing, 41 out of 1664 tuberculosis patients were found human immunodeficiency virus positive resulting human immunodeficiency virus infection seroprevalence among tuberculosis patients to 2.5%. Prevalence of human immunodeficiency virus infection was significantly associated with age (P=0.002), caste/ethnicity (P=0.025), religion (P=0.015) and occupation (P=0.014) of tuberculosis patients.Conclusions: Prevalence of human immunodeficiency virus infection among tuberculosis patients was found 2.5%. Information and access to tuberculosis/human immunodeficiency virus services needs to be increased toaddress tuberculosis-human immunodeficiency virus co-infection in Nepal.Keywords: HIV; prevalence; TB; TB-HIV coinfection.
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Marahatta, S. B., J. Kaewkungwal, P. Ramasoota, and P. Singhasivanon. "P2-447 Risk factors of multi-drug resistant tuberculosis (MDR TB) in Nepal." Journal of Epidemiology & Community Health 65, Suppl 1 (August 1, 2011): A344—A345. http://dx.doi.org/10.1136/jech.2011.142976l.76.
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Pahari, Santosh, and Chiranjivi Adhikari. "Premarital Sexual Behaviours of College Youth of Tanahun District, Nepal." Journal of Health and Allied Sciences 11, no. 1 (August 18, 2021): 30–37. http://dx.doi.org/10.37107/jhas.259.
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Introduction: youth are at risk of numerous health problems as they progress towards adulthood, which affect their quality of life. While sexuality remains a morality on one side, an increasing prevalence of premarital sexual activities is being reported among Nepalese youth on omit other side. This study aimed to assess the premarital sexual behaviors of college-going youth in the Tanahun district.
Methods: An institution-based cross-sectional study was carried out using a pre-tested structured self-administered questionnaire among 721 youth of six undergraduate colleges of Tanahun district. The association between premarital sexual behaviours and the explanatory variables was assessed using the chi-square test and stepwise logistic regression.
Results: More than one-tenth (13.17%) of total youth reported that they had had premarital sex preceding the survey. The study also showed that substantial proportion of college youth had indulged in risky sexual behaviours. Nearly threefourths (73.21%) of sexually active youth had their sexual debut before the age of 20 and about half (46.15%) of them did not use a condom. Similarly, more than one-third (34.62%) of sexually active respondents had multiple sex partners. Males were almost three times as likely (AOR=2.64, 95% CI; 1.26-5.51) to be involved in premarital sex compared to their counterparts. Similarly, youth having dating experience were six-fold more likely (AOR=6.4, 95% CI; 3.37-12.30) and youth who had an unmarried close friend with sexual experiences were four times more likely (AOR=3.9, 95% CI; 2.1-7.24) to indulge in premarital sex compared to their counterparts.
Conclusion: One in each 10 college youth involved in premarital sex though risky sexual behaviours were prominent. Being male, having dating experience and unmarried close friend with sexual experience were the risk factors for premarital sex. These factors have to be warranted in sex education interventions.
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Iwaki, Yoko, Santosh Kumar Rauniyar, Shuhei Nomura, and Michael C. Huang. "Assessing Factors Associated with TB Awareness in Nepal: A National and Subnational Study." International Journal of Environmental Research and Public Health 18, no. 10 (May 12, 2021): 5124. http://dx.doi.org/10.3390/ijerph18105124.
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Tuberculosis (TB) has still remained a serious global health threat in low- and middle-income countries in recent years. As of 2021, Nepal is one of the high TB burden countries, with an increasing prevalence of cases. This study evaluates factors associated with TB awareness in Nepal. This study uses data from the Nepal Demographic and Health Survey, a cross-sectional survey carried out from June 2016 to January 2017. Multilevel logistic regression is performed to examine the association of demographic and socioeconomic factors with TB awareness. Our findings show a high level of TB awareness in all seven provinces of Nepal. Province 5 has the highest level of awareness (98.1%) among all provinces, followed by provinces 3 and 4, while province 6 has the lowest awareness level (93.2%) compared to others. Socioeconomic factors such as wealth, education and owning a mobile phone are significantly associated with TB awareness. Socioeconomic determinants are influential factors associated with TB awareness in Nepal. The wide variation in the proportion of awareness at a regional level emphasizes the importance of formulating tailored strategies to increase TB awareness. For instance, the use of mobile phones could be an effective strategy to promote TB awareness at a regional level. This study provides valuable evidence to support further research on the contribution of information and communication technology (ICT) usage to improving TB awareness in Nepal.
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Talbot, Elizabeth A., Thomas A. Kenyon, Themba L. Moeti, Gary Hsin, Laura Dooley, Shenaaz El-Halabi, and Nancy J. Binkin. "HIV risk factors among patients with tuberculosis — Botswana 1999." International Journal of STD & AIDS 13, no. 5 (May 1, 2002): 311–17. http://dx.doi.org/10.1258/0956462021925126.
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To identify factors associated with HIV in Botswana, a standardized questionnaire was administered to 135 tuberculosis patients with known HIV status. HIV-positive patients were more likely than HIV-negative patients to: be female (45% vs 26% (adjusted prevalence odds ratio (aPOR)=3.8, 95% confidence interval (CI)=1.1-12.7)); be 26-35 years old (50% vs 19% (aPOR=2.7, CI=0.7-10.7)); be unmarried (91% vs 71% (aPOR=13.3, CI=2.5-72.7)); have higher income (24% vs 10% (aPOR=8.2, CI=1.6-42.9)); report separation from spouse/partner for work (63% vs 52% (aPOR=1.8, CI=0.5-6.2)); have 2 sex partners other than their regular partner (82% vs 67% (aPOR=1.8, CI=0.5-7.5)); and state that they or their partner drank alcohol before sex (77% vs 55% (aPOR=6.8, CI=1.9-24.1)). Only 22% of respondents used condoms during all of their past 10 sexual encounters. These data provide information for HIV prevention strategies.
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Joshi, Ranjila, Pernille Tanggaard Andersen, Subash Thapa, and Arja R. Aro. "Sex trafficking, prostitution, and increased HIV risk among women during and after the 2015 Nepal earthquake." SAGE Open Medicine 8 (January 2020): 205031212093828. http://dx.doi.org/10.1177/2050312120938287.
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Women might be at increased risk of HIV infection after a disaster situation due to several interlinked environmental and social factors, such as increased sex trafficking and prostitution, in resource-limited settings. However, this information has not been clearly understood. Based on the review of available gray and peer-reviewed evidence, the present debate paper summarizes potential factors for increasing women’s HIV risk during/after two earthquakes that hit Nepal in 2015. Poverty and socio-economic crisis, displacement and reduced social capital, increased rate of sex trafficking and prostitution, and poor access to health care seem to be the factors to increase women’s HIV risk in the earthquake-affected areas of Nepal. There is a lack of essential empirical evidence on environmental and social factors (e.g. increased sex trafficking and prostitution) that are linked with women’s HIV risk in the post-disaster phase. Therefore, the factors and interactions discussed should be further studied potentially in disaster-affected areas so that locally and culturally salient and sustainable relief and reconstruction strategies, which include strategies for preventing HIV risk in post-disaster situations, can be developed.
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Paudel, Sagun, Retna Siwi Padmawati, Ashmita Ghimire, Choden Lama Yonzon, and Yodi Mahendradhata. "Feasibility of Find cases Actively, Separate safely and Treat effectively (FAST) strategy for early diagnosis of TB in Nepal: An implementation research." PLOS ONE 16, no. 10 (October 26, 2021): e0258883. http://dx.doi.org/10.1371/journal.pone.0258883.
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Introduction Tuberculosis is one of the leading causes of death worldwide. Diagnosing TB in an early stage and initiating effective treatment is one of the best ways to reduce the burden of tuberculosis. Feasibility of Find cases Actively, Separate safely and Treat effectively (FAST) Strategy helps to improve the early diagnosis of tuberculosis cases among inpatient settings as well as out patient department patients and prevent TB transmission in hospital. This study aimed to assess the feasibility of the FAST strategy, organizational factors, technical factors, barriers and enablers for the proper implementation of the FAST strategy in Nepal. Methods A qualitative study was conducted from April 2019 to August 2019. Data was collected by using focus group discussion, key informant interviews, and client exit interviews. A retrospective research was conducted in different hospitals in Nepal where FAST strategy was implemented. The patients, health care workers, province, district, and National level stakeholders were interviewed. Thematic analysis was used to assess the feasibility as well as barriers and enablers of the FAST strategy. Results Study identified that the ‘current setting’ of implementation and service delivery arrangement at hospitals were not well arranged as per requirements. The research findings showed hospital ownership is crucial for mobilizing staff and proper space management inside hospitals. Study identified that unavailability of a separate room, limited capacity of GeneXpert machine, irregular supply of GeneXpert cartridge, and insufficient human resources for screening and counseling are the major barriers of FAST implementation in Nepal. Conclusion FAST strategy is feasible to implement in healthcare settings in Nepal although the technical and organizational factors should be managed to ensure effective function of the strategy as per the approach. Hospital ownership is essential to mobilize health workers, improve client flow system and proper space management for FAST services.
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Jaiswal, Saroj Kumari, Chandni Jaishwal, Shumneva Shrestha, Sudish Jaiswal, Aabhushan Bikram Mahara, Amar Suwal, and Randhir Sagar Yadav. "FACTORS ASSOCIATED WITH RELAPSE, DEFAULTER AND TREATMENT FAILURE IN TUBERCULOSIS TREATMENT IN EASTERN NEPAL." International Journal of Current Advanced Research 7, no. 05 (May 28, 2018): 12905–11. http://dx.doi.org/10.24327/ijcar.2018.12911.2286.
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Xie, Yi, Jing Han, Weili Yu, Junping Wu, Xue Li, and Huaiyong Chen. "Survival Analysis of Risk Factors for Mortality in a Cohort of Patients with Tuberculosis." Canadian Respiratory Journal 2020 (September 7, 2020): 1–9. http://dx.doi.org/10.1155/2020/1654653.
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Identify the treatment effects and risk factors for mortality in patients with pulmonary tuberculosis receiving antituberculosis treatment under the Directly Observed Treatment Short-Course (DOTS) program to reduce the mortality rate of tuberculosis. A retrospective cohort analysis was conducted on the outcomes of antituberculosis treatment of 7,032 patients with tuberculosis in the DOTS program, in the Tuberculosis Management Information System from 2014 to 2017 in Tianjin, China. The Kaplan–Meier method and multifactor Cox proportional risk regression model were used to analyze the risk factors for mortality during antituberculosis treatment under DOTS. The success rate of antituberculosis treatment was 90.24% and the mortality rate was 4.56% among 7,032 cases of tuberculosis in Tianjin. Cox regression analysis showed that advanced age, male sex, human immunodeficiency virus (HIV) positivity, first sputum positivity, retreated tuberculosis, and a delayed visit (≥14 days) were risk factors for mortality in patients with pulmonary tuberculosis receiving antituberculosis treatment under DOTS. The treatment effects in patients with pulmonary tuberculosis during antituberculosis treatment under DOTS were positive in Tianjin. Advanced age, male sex, HIV positivity, first sputum positivity, retreated tuberculosis, and a delayed visit (≥14 days) increased the risk for mortality during antituberculosis treatment.
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Shrestha, Dhan Bahadur, and Sunil Dhungel. "Prevalence and Risk Factors of Hypertension in Hansposa VDC of Sunsari District, Nepal." Medical Journal of Shree Birendra Hospital 15, no. 2 (April 23, 2017): 48–53. http://dx.doi.org/10.3126/mjsbh.v15i2.15406.
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Introduction: Hypertension is defined as a systolic blood pressure (SBP) of 140 millimeter of mercury (mm of Hg) or more and a diastolic blood pressure (DBP) of 90 mm of Hg or more, or taking antihypertensive medication. Hypertension causes an increased work load on the heart and can cause damage to the blood vessels. The public awareness about hypertension in the villages of Nepal is low and no studies have been conducted earlier to elaborate the risk factors and prevalence of Hypertension in Hansposa village of Nepal. The aim of this study was to identify the prevalence of Hypertension and the risk factors associated with it in this village.Methods: A cross sectional survey (study) was carried out from September 25, 2014 to October 25, 2014 in order to know the prevalence and risk factor(s) of hypertension among people of Hansposa Village Development Committee (VDC), Sunsari, Nepal. Data were collected from both sexes by asking demographic details, habits like alcohol intake, smoking, exercise and education and examination of blood pressure, weight and height. The association of hypertension with age, sex, education, tobacco, alcohol consumption and body mass index (BMI) were estimated according to WHO standard criteria.Results: On analysis, the prevalence of hypertension was 37 % [95% CI=31-42(M: 55.1%; F: 26.7%)]. The prevalence of tobacco, alcohol consumption, and overweight/obesity was 31.3% (including past and present), 36.1%, and 31.9% respectively. Further analysis showed that there is significant association between hypertension and age, sex, alcohol consumption and physical inactivity (P<0.05) i.e. there is increasing trend in the prevalence of hypertension with increasing age [ χ2(chi square) for linear trend P = 0.000].Conclusion: There is high prevalence of hypertension among people of Hansposa VDC; especially isolated diastolic blood pressure and is associated with age, sex, alcohol consumption and physical inactivity.
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Kharel, R. K., R. Sultana, R. P. Bichaa, R. P. Pant, A. P. Weerakoon, and K. B. Karki. "The Prevalence and Determinants of Active Tuberculosis among Diabetes Patients in Tertiary Care Hospitals of Nepal 2018." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 17, no. 2 (December 31, 2019): 22–28. http://dx.doi.org/10.3126/saarctb.v17i2.49111.
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Introduction: Researches implicated diabetes as independent risk factor for multi-drug resistant tuberculosis and unfavorable outcome of treatment. There is no data to address the association between diabetes mellitus (DM) and tuberculosis (TB) in Nepal. Thus we assessed the burden and demographics of active tuberculosis among diabetic patients attending tertiary care hospitals in Nepal.
Methods: A cross-sectional study was conducted in adult DM patients attending seven tertiary care hospitals representing five development region of the country. Relevant data were collected and participants were screened for active TB (symptom screening and microbiological diagnosis).
Results: Among the 520 enrolled DM patients screened, 23 had active TB. The prevalence was 4.42% (CI 2.96 - 6.54). The positive cases had older age group with the mean age of 59.73 ± 17.36 years with male predominance of 78% (18/23). Among the 23 positive cases, only two (8.69 %) had extra pulmonary TB. Diabetic control had significant (p=0.006) relationship to develop Tuberculosis. The comorbid conditions e.g., Hypertension (OR 13, 95% CI: 4.54 to 37.14); diabetic nephritis (OR 9.25, 95% CI: 2.03 to 42.20); and Diabetic neuropathy (OR 26.66, 95% CI: 5.16 to 137.71) are significant risk factors to develop tuberculosis among the diabetes patients. There were no significant differences in occupation, literacy rate, tobacco or alcohol consumption, HbA1c levels between TB and non-TB participants.
Conclusion: The prevalence of tuberculosis among diabetic patients is low in Nepal. This is the result of tertiary care hospital outdoor patients only, thus representativeness was compromised. Thus to assess the magnitude of comorbidities, mandatory screening in all level were recommended.
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Bhusal, Durga. "Age and Sex: The Demographic Factors Matter in Sight Care Treatment Decision in Nepal." Butwal Campus Journal 5, no. 1 (December 14, 2022): 56–64. http://dx.doi.org/10.3126/bcj.v5i1.50180.
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Even though existing philosophy advocating patients should be active partakers in treatment decision-making about their care, the literature suggests that patients require be informing but not involving. Eyesight treatment-decision of the participants involving free Eye-Care-Camp in a one-day free Eye-Care-Camp organized by Krim Samaj with the technical support of Tamnagar Chasma Ghar were considered with 91 responses. Two technical officers checked up the eye conditions. On the Treatment Decision-Making, they overwhelmingly wished to be performed by the technical officers. Near and free service was a most influencing factor for the treatment decision. Age significant result regarding eyesight care treatment-decision was appeared in the study. Although the treatment decisions of patients were autonomous up to the participation in free eye care camp, few wishes to hand over the treatment decision-making control to their technical personalities. The findings suggested that choices are not free but controlled under the technical officer, and household decision. Hidden serious eye problems not exhibited in household got the chance to disclose and the patients got the idea what to do further.
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Cobelens, Frank, Nico Nagelkerke, and Helen Fletcher. "The convergent epidemiology of tuberculosis and human cytomegalovirus infection." F1000Research 7 (March 6, 2018): 280. http://dx.doi.org/10.12688/f1000research.14184.1.
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Although several factors are known to increase the risk of tuberculosis, the occurrence of tuberculosis disease in an infected individual is difficult to predict. We hypothesize that active human cytomegalovirus infection due to recent infection, reinfection or reactivation plays an epidemiologically relevant role in the aetiology of tuberculosis by precipitating the progression from latent tuberculosis infection to disease. The most compelling support for this hypothesis comes from the striking similarity in age-sex distribution between the two infections, important because the age-sex pattern of tuberculosis disease progression has not been convincingly explained. Cytomegalovirus infection and tuberculosis have other overlapping risk factors, including poor socio-economic status, sexual contact, whole blood transfusion and solid organ transplantation. Although each of these overlaps could be explained by shared underlying risk factors, none of the epidemiological observations refute the hypothesis. If this interaction would play an epidemiologically important role, important opportunities would arise for novel approaches to controlling tuberculosis.
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Cobelens, Frank, Nico Nagelkerke, and Helen Fletcher. "The convergent epidemiology of tuberculosis and human cytomegalovirus infection." F1000Research 7 (April 30, 2018): 280. http://dx.doi.org/10.12688/f1000research.14184.2.
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Although several factors are known to increase the risk of tuberculosis, the occurrence of tuberculosis disease in an infected individual is difficult to predict. We hypothesize that active human cytomegalovirus infection due to recent infection, reinfection or reactivation plays an epidemiologically relevant role in the aetiology of tuberculosis by precipitating the progression from latent tuberculosis infection to disease. The most compelling support for this hypothesis comes from the striking similarity in age-sex distribution between the two infections, important because the age-sex pattern of tuberculosis disease progression has not been convincingly explained. Cytomegalovirus infection and tuberculosis have other overlapping risk factors, including poor socio-economic status, solid organ transplantation and, possibly, sexual contact and whole blood transfusion. Although each of these overlaps could be explained by shared underlying risk factors, none of the epidemiological observations refute the hypothesis. If this interaction would play an epidemiologically important role, important opportunities would arise for novel approaches to controlling tuberculosis.
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Sah, Shiv Kumar, Pramod Raj Bhattarai, Anjana Shrestha, Deepak Dhami, Deepa guruwacharya, and Renu Shrestha. "Rifampicin-resistant Mycobacterium tuberculosis by GeneXpert MTB/RIF and Associated Factors Among Presumptive Pulmonary Tuberculosis Patients in Nepal." Infection and Drug Resistance Volume 13 (August 2020): 2911–19. http://dx.doi.org/10.2147/idr.s263795.
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SHAKYA, KUSHUM, and CHRISTINE McMURRAY. "NEONATAL MORTALITY AND MATERNAL HEALTH CARE IN NEPAL: SEARCHING FOR PATTERNS OF ASSOCIATION." Journal of Biosocial Science 33, no. 1 (January 2001): 87–105. http://dx.doi.org/10.1017/s0021932001000876.
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This study explores the factors associated with neonatal mortality and maternal health care in Nepal. The subjects were 4375 births reported in the 1996 Nepal Family Health Survey. Maternal and child health care was found to have a significant association with neonatal mortality, although preceding birth interval and sex of child had stronger effects. Four aspects of maternal care were found to be highly associated with region, household ownership of assets, mother’s education and father’s education. This indicates that accessibility, affordability and availability of maternal health care are important factors to consider in future research on neonatal mortality.
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Yadav, D., D. K. Yadav, and R. K. Yadav. "Prevalence of multi-drug resistance and its risk factors among tuberculosis patients in Kaski, Nepal." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 16, no. 2 (December 31, 2018): 1–7. http://dx.doi.org/10.3126/saarctb.v16i2.23336.
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Introduction: Multidrug-resistant tuberculosis is an intense and feared problem, difficult to control and has shown a trend of increase worldwide. MDR-TB poses a therapeutic and infection control challenge with significantly higher rates of morbidity and mortality. Hence, this study was conducted with objective to assess prevalence of multidrug resistance and its risk factors among Tuberculosis patients in Kaski district.
Methods: The main component of the study comprised institutional based cross sectional study design which was conducted in directly observed treatment short course (DOTS) centers in Kaski district. The study period was from July 2016 to December 2016. The sample size for the study was 175 participants. Data collection was done through interview with used interview schedule, and review of patient treatment cards. Data were entered in Epidata software and analyzed by using SPSS 20 version software.
Results: The prevalence of multidrug resistance in Kaski district was 5.7 per cent. Variables such as TB history in past, TB treatment in past, and cured in past are found statistically significant (p<0.005). People with prior history of TB were shown to be 19 times more likely to get MDR TB than those with no prior history (OR=19.056, CI: 4.522-80.294). People with complete TB treatment in past were 0.2 times less likely to get MDR TB than those with incomplete TB treatment in past (OR=0.182, CI: 0.075-0.441).
Conclusion: Present of previous TB infection and prior treatment outcome (to be defaulted or failed in treatment) were also identified as the risk factors for developing MDR TB. Proper surveillance system is to be established in terms of complete treatment to all TB patients that leads the prevention from MDRTB and prevent potent expensive costs from medical care for MDRTB patients.
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Yogi, Belpatra Nath. "Factors Associated with Early Marriage in Rural Mid-Western Nepal." Journal of Health Promotion 8 (November 22, 2020): 63–72. http://dx.doi.org/10.3126/jhp.v8i0.32986.
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Early (or child) marriage is a global public health issue influenced by a complex web of factors including socio-demographic conditions of the people. The present paper aims to examine factors associated with early marriageamong the people in rural communities of Nepal. A cross-sectional end-line study was carried out among 155 married respondents selected through cluster cum convenience sampling from six clusters of two rural districts of Mid-western Nepal. The mean age at first marriage was 18.4 years (SD=3.83). Two-third of them had an early marriage and the proportion of early marriage was remarkably higher among women than men (77.8% vs. 42.6%). The prevalence of early marriage was the most common among those of women, age-group of 35-44 years, illiterate and basic literate ones, nuclear and small families, and Janajatis. Sex and educational status of the respondents had a statistically significant association with their marital age (p < 0.05) and were major factors associated with early marriage but other socio-demographic factors such as age, caste/ethnicity, family type, family size and source of income were notfound directlyassociated with early marriage for the sample. Future research efforts should prioritize gender-transformative interventions to recognize and confront inequitable gender norms and actions.
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Kumar, Gaurav, N. Jha, SR Niraula, DK Yadav, S. Bhattarai, and PK Pokharel. "Gender Based Barriers In Accessing Tuberculosis Treatment: A Qualitative Study From Eastern Nepal." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 10, no. 2 (January 28, 2014): 15–20. http://dx.doi.org/10.3126/saarctb.v10i2.9708.
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Introduction: Previous studies have demonstrated longer length of delays in diagnosis and treatment among men and women, especially among women experiencing longer duration of delay in accessing tuberculosis treatment. So, the study was conducted to explore responsible factors among men and women affecting longer duration in accessing tuberculosis treatment. Methodology: Qualitative approach with FGD sessions among people from community, DOTS providers and pulmonary tuberculosis patients were conducted separately in between March 2012 to May 2012. Results: The perception of fear, hiding symptoms, social stigmas and traditional beliefs were common among women. The study revealed that social and cultural barrier, ignorance of symptoms, home remedies, fear of stigma, access to health centre from rural areas, poor knowledge of TB signs and symptoms, beliefs on traditional healers were the common reason for the longer delays in diagnosis. Conclusions: The fi ndings suggested that knowledge, information, perception regarding TB among men and women were lacking, especially among females. This warrants awareness for early diagnosis and control of disease. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2013; X(2); 15-20 DOI: http://dx.doi.org/10.3126/saarctb.v10i2.9708
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Mahato, R. K., W. Laohasiriwong, and R. P. Koju. "Prevalence and Determinants of Type 2 Diabetes among the Pulmonary Tuberculosis Cases in Nepal: A Cross Sectional Study." Kathmandu University Medical Journal 19, no. 4 (December 31, 2021): 474–80. http://dx.doi.org/10.3126/kumj.v19i4.49764.
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Background Since prehistoric time to the earlier 20th century, diabetes was accounted as comorbidity among tuberculosis patients, which is reducing the treatment efficiency.
Objective To investigate the prevalence and determinants of type 2 diabetes mellitus among tuberculosis patients in central development region of Nepal.
Method An analytical cross-sectional study was conducted by using structured questionnaire. Face to face interview as well as reviewing of the medical records of the tuberculosis cases has been performed during September 2018 - February 2019. The systematic random sampling was applied to select 306 tuberculosis cases. Then the respondents were examined for blood glucose level as well as Glycated haemoglobin (HbA1c) level to identify TB with Diabetes Mellitus. The proportion of respondents with fasting blood glucose level ≥ 126 mg/dl or a random blood glucose ≥ 200 mg/dl was considered as Tuberculosis with Diabetes Mellitus cases. Similarly, haemoglobin A1C ≥ 7% was accessed as amplified risk for tuberculosis. Multiple logistic regression was performed to analyse the factors associated with Tuberculosis with Diabetes Mellitus by using STATA. P value < 0.05 was taken as statistically significant.
Result A total of 306 tuberculosis patients were included in the study. The mean ± standard deviation of age of participants was 36.82±15.94 years. The proportion of male slightly exceeded than that of female with a ratio of 1.73:1. The prevalence of TBDM was 17.32% (95% CI: 13.05-21.58) of all diagnosed tuberculosis cases. Our multivariable analysis identified the factors those were associated with TBDM were age ≥ 45 years (adj.OR=3.97, 95% CI 1.81-8.71, p value 0.001), patients residing in the urban areas (adj.OR=9.75, 95% CI 1.99-47.6, p value 0.005), had Body Mass Index (BMI) <18.5 Kg/m2 (adj.OR=3.20, 95% CI 1.58-6.51, p value 0.001), had diastolic blood pressure ≥ 80 mmHg (adj.OR=2.34, 95% CI 1.17-4.66, p value 0.015) and patients who were treated with Cat II and Cat III tuberculosis treatment regimens (adj.OR=2.65, 95% CI 1.22-5.73, p value 0.013).
Conclusion The prevalence of type 2 diabetes mellitus among tuberculosis patients was higher than prevalence of diabetes in general population of Nepal and it was higher among male, urban residents, patients with low BMI and the older aged tuberculosis patients.
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Dhungel, Kshitiz Upadhyay, and Agya K.C. "Hypertension and Associated Demographic Factors among Chepang Adults in Nepal." Janaki Medical College Journal of Medical Science 8, no. 2 (December 31, 2020): 25–31. http://dx.doi.org/10.3126/jmcjms.v8i2.33974.
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Background and Objectives: Hypertension is one of the leading health problems globally. In developing countries like Nepal, the prevalence of hypertension is increasing yearly. This study aims to find the prevalence of hypertension and associated demographic factors among Chepang people, an indigenous ethnic group also known as one of the isolated tribal groups of Nepal.
Material and Methods: It is a descriptive cross-sectional study performed in total of 324 respondent living in chepang community of Majbang-09 of Kalika Municipality. Semi structured questionnaire including socio-demographic, anthropometric measurement, 24 hour diet recall, and food frequency to explore dietary diversity information. Data entry and analysis was done using SPSS 20. Chi-Square test was used to measure the association between variables and was considered significant at p <0.05.
Results: According to the study the 35.5% of the respondent were hypertensive and 50.3% of were pre-hypertensive. More than half of the respondent (58.3%) had normal BMI followed by (26.9%) of the respondent were overweight, (9.0%) of the respondent were under nutrition and (5.9%) of the respondent were obese. Among the respondent who had hypertension (60.7%) were above 60 years and the lowest (21.3%) were below 40 years.
Conclusion: The socio demographic variables like age, sex, educational status, annual income and marital status were found to be significantly associated with hypertension.
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Limbu, Ben, Grant Moore, Amir H. Marvasti, Mariel E. Poole, and Rohit Saiju. "Work Related Ocular Injury: Nepal." Nepalese Journal of Ophthalmology 10, no. 1 (November 20, 2018): 47–56. http://dx.doi.org/10.3126/nepjoph.v10i1.21689.
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Introduction: Occupational eye injuries comprise a major source of ocular trauma. Knowledge of the epidemiology of occupational eye injuries is essential to formulate viable safety strategies.Objectives: To evaluate the demographics, patterns of protective eye wear use, and patterns of occupational eye injury among workers in Hetauda, Nepal.Materials and methods: Community based cross-sectional prospective survey was carried out from September 2010 to July 2011. Survey included all workers irrespective of their age and those who are willing to participate in survey by filling details on structured questioners and comprehensive eye examination at community level.Results: 1236 surveys were collected. 38.3% (473) of workers surveyed reported experiencing a work-related eye injury. Over two-thirds [68.3% (844)] of workers surveyed reported never wearing safety eyewear while at work. There was a positive correlation between male sex (P<0.001), reported previous work-related injury (P<0.001), and attending school (P=0.016) and use of personal protective equipment (PPE).Conclusions: The population studied demonstrates a significant level of work related injury. There are potentially modifiable factors that could lead to increased use of eye protection.
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NP, Shah. "Prevalence of and Risk Factors for Latent Tuberculosis Infection among Healthcare Workers of Directly Observed Tuberculosis Treatment Centers of Kathmandu, Nepal." American Journal of Biomedical Science & Research 13, no. 5 (July 23, 2021): 495–501. http://dx.doi.org/10.34297/ajbsr.2021.13.001901.
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Beaujolais, Brieanne, Marissa Kaloga, Sharvari Karandikar, Lindsay B. Gezinski, Pradipta Kadambari, and Kipa Maskey. "Client-Perpetrated Violence Toward Female Sex Workers in Kathmandu." Violence Against Women 26, no. 2 (March 7, 2019): 249–67. http://dx.doi.org/10.1177/1077801219832117.
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This qualitative study explores the experiences of client-perpetrated violence toward female sex workers in Kathmandu, Nepal. Individual interviews were conducted with 30 female sex workers. Data were analyzed using qualitative coding methods and thematic development. Two main themes emerged. Contexts in which client-perpetrated violence corresponded with (a) conditions associated with exchange of services, and (b) alcohol use. The first theme involved five factors: negotiating condom use, number of clients, requesting payment, length of service time, and negotiating sex acts. Alcohol use by clients and/or sex workers exacerbated violence. Implications for practice and research are discussed.
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Thapa, R., G. Paudyal, M. K. Shrestha, R. Gurung, and S. Ruit. "Age-Related Macular Degeneration in Nepal." Kathmandu University Medical Journal 9, no. 3 (June 11, 2012): 165–69. http://dx.doi.org/10.3126/kumj.v9i3.6298.
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Background The Age–related Macular Degeneration (AMD) is a common cause of visual impairment and blindness worldwide in elderly. Objective This study aimed to explore the demographic characteristics, pattern and risk factors for AMD at a tertiary referral eye centre in Nepal. Methods This is a hospital-based prospective study, conducted at Tilganga Institute of Ophthalmology, Nepal from September 2008 to May 2009. All the consecutive cases of AMD diagnosed at the institute were included. Results A total of 141 patients (266 eyes) with AMD recruited for the study. The mean age was 69.5 years (9.1SD) with three fifth males (58.9%). Housewives and occupations like agriculture comprised of 38.3% and 42.5% respectively. Three fourth (75.6%) of the patients were illiterate. The proportion of dry and wet AMD were found in 62.4% and 37.6% respectively. Bilateral involvement was seen in 88.7% of the subjects. Three fourth (71.4%) of the AMD eyes had presenting visual acuity less than 6/18. History of smoking was found in 69.9% of patients. Hypertension was the predominant systemic problem (45.4%) followed by diabetes mellitus (12.8%). Conclusion AMD is correlated with ageing in our study as well. Dry AMD is more in age groups 45-64 years and wet AMD at 65 years and older. Bilateral involvement with one eye dry and fellow eye wet AMD is more predominant (44%). Smoking and occupations like agriculture and housewife are significant risk factors for AMD. Likewise male sex, illiteracy and hypertension are other risk factors for AMD in hospital settings.DOI: http://dx.doi.org/10.3126/kumj.v9i3.6298 Kathmandu Univ Med J 2011;9(3):165-9
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Shrestha, Gambhir, Rahul Kumar Thakur, Rajshree Singh, Rashmi Mulmi, Abha Shrestha, and Pranil Man Singh Pradhan. "Cancer burden in Nepal, 1990–2017: An analysis of the Global Burden of Disease study." PLOS ONE 16, no. 8 (August 3, 2021): e0255499. http://dx.doi.org/10.1371/journal.pone.0255499.
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Introduction Cancer is the second leading cause of death and a major public health problem in the world. This study reports the trend and burden of cancer from 1990 to 2017 along with its risk factors in Nepal. Methods This study used the database of the Institute of Health Metrics and Evaluation’s Global Burden of Diseases on cancer from Nepal to describe the most recent data available (2017) and trends by age, gender, and year from 1990 to 2017. The data are described as incidence, prevalence, disability-adjusted life years (DALY), and percentage change. Results In 2017, the age-standardized cancer incidence and mortality rates were 101.8/100,000 and 86.6/100,000 respectively in Nepal. Cancer contributed to 10% of total deaths and 5.6% of total DALYs in Nepal. The most common cancers were the breast, lung, cervical, stomach and oral cavity cancers. The number of new cancer cases and deaths in Nepal have increased from 1990 to 2017 by 92% and 95% respectively. On the other hand, age-standardized incidence and mortality rates decreased by 5% and 7% respectively. The leading risk factors of cancer were tobacco use, dietary factors, unsafe sex, air pollution, drug use, and physical inactivity. Conclusions This study highlighted the burden of cancer in Nepal, contributing to a significant number of new cancer cases, deaths and DALY. A comprehensive approach including prevention, early diagnosis and treatment, and rehabilitation should be urgently taken to reduce the burden of cancer.
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Prakash Shah, Naveen, Anil Regmi, Aakash Acharya, Jwala K.C., Bidur Khatiwada, and Meera Hada. "Sputum Smear Non-conversion at the End of Intensive Phase of Tuberculosis Treatment at a Tertiary Center: A Descriptive Cross-sectional study." Journal of Nepal Medical Association 59, no. 243 (November 15, 2021): 1090–93. http://dx.doi.org/10.31729/jnma.7020.
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Introduction: Sputum non-conversion is smear positive tuberculosis despite anti-tubercular therapy. Various factors may lead to sputum non-conversion including resistance to anti-tubercular drugs, age, gender, disease severity, non-compliance, drugs unavailability etc. Little is known and studied about the contribution of these individual factors. Our study sought to determine the prevalence of sputum smear non-conversion in patients at the end of intensive phase of tuberculosis treatment visiting a tertiary-level institution in Nepal. Methods: A descriptive cross-sectional study was conducted among recorded data of patients undergoing sputum Acid Fast Bacilli staining at the end of intensive phase at National Tuberculosis Control Center from April 2018 to April 2020. The study was approved by Nepal Health Research Council (Registration no: 76012020 P). The convenient sampling method was adopted. The data were analyzed using Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Our study found that out of 830 samples that were tested by Acid Fast Bacilli stain at the end of intensive phase, 40 (4.82%) (3.37-6.28 at 95% Confidence Interval) were sputum smear non-converters. The mean age of sputum non-converters was 41.25±15.543 years. Conclusions: The study shows that a significant proportion of patients remain acid-fast stain positive despite the treatment. However, the proportion is low compared to other similar studies around the globe. This study provides program managers with evidence to support the development of more tailored tuberculosis care and need to conduct more intensive studies about various factors that may lead to non-conversion.
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Marahatta, SB. "Knowledge on HIV/AIDS amongst bus drivers of Dhulikel, Nepal." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 9, no. 1 (October 18, 2012): 35–38. http://dx.doi.org/10.3126/saarctb.v9i1.6963.
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Introduction: One of the growing epidemics in the world today is HIV/AIDS. In the cities with high mobility, bus drivers and transport workers are considered as the risk group for HIV/AIDS. In Kavre district, the increased mobility along with Araniko highway and Banepa Bardibas highways has drastically increased the vulnerabilities of younger populations in particularly to HIV/AIDS and STDs. Most of these young people do not have access to information, condoms, supportive services which enable them to have safer sex. Methodology: A descriptive cross sectional study was done to assess knowledge about HIV/AIDS among bus drivers of Dhulikhel. Results: After the analysis and interpretation of the data, study revealed that majority of the respondents i.e. 38% (n=19) were between age 20-24 years. Among them vast majority of the respondents i.e 82% (n=41) have heard from media (radio, Television and newspapers). Regarding transmission of HIV/AIDS 90% (n=45) of the respondents mentioned that unsafe sex is the means of transmission. Still 24% (n=12) believe that sharing clothes and 2% (n=1) believe that kissing can transmit HIV/AIDS. As per prevention measures 90% (n=5) have the knowledge that using condom during sexual intercourse can prevent HIV/ AIDS. 8% (n=4) of the respondents still believe that HIV/AIDS is curable and rest of them i.e. 92% (n=46) of the respondents knew that HIV/AIDS is not curable. Conclusion: The present study strongly recommends that there is immediate need of program to create awareness of public motor drivers and co-workers, vulnerable youths and other high risk groups of people including migrant populations. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS 2012; IX (1) 35-38 DOI: http://dx.doi.org/10.3126/saarctb.v9i1.6963
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Bhattarai, Manjula, Jagat Bahadur Baniya, Nirmal Aryal, Bimal Shrestha, Ramanuj Rauniyar, Anurag Adhikari, Pratik Koirala, et al. "Epidemiological Profile and Risk Factors for Acquiring HBV and/or HCV in HIV-Infected Population Groups in Nepal." BioMed Research International 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/9241679.
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HBV and HCV infections are widespread among the HIV-infected individuals in Nepal. The goals of this study were to investigate the epidemiological profile and risk factors for acquiring HBV and/or HCV coinfection in disadvantaged HIV-positive population groups in Nepal. We conducted a retrospective study on blood samples from HIV-positive patients from the National Public Health Laboratory at Kathmandu to assay for HBsAg, HBeAg, and anti-HCV antibodies, HIV viral load, and CD4+ T cell count. Among 579 subjects, the prevalence of HIV-HBV, HIV-HCV, and HIV-HBV-HCV coinfections was 3.62%, 2.93%, and 0.34%, respectively. Multivariate regression analysis indicated that spouses of HIV-positive migrant labourers were at significant risk for coinfection with HBV infection, and an age of >40 years in HIV-infected individuals was identified as a significant risk factor for HCV coinfection. Overall our study indicates that disadvantaged population groups such as intravenous drug users, migrant workers and their spouses, female sex workers, and men who have sex with HIV-infected men are at a high and persistent risk of acquiring viral hepatitis. We conclude that Nepalese HIV patients should receive HBV and HCV diagnostic screening on a regular basis.