Health Issue In Nepal Research Articles

Drowning Prevention should be a Public Health Issue in Nepal

Nepal is prone to a range of natural disasters; earthquakes being the most widely recognised one. However, many people are at risk of drowning as the floodings in the autumn of 2024 showed, but this is not recognised enough as a serious public health risk in Nepal. Drowning relates to everyday activities such as bathing and swimming and should be treated as a social and public health problem. The United Nations, particularly the World Health Assembly, has called its member states for accelerating action on drowning prevention. This mini review paper considered literature covering drowning in children in Nepal and Bangladesh over the past decade. It outlines some of the key drowning risks and the need for active prevention with reference to some tested drowning prevention interventions in neighbouring countries in South Asia. Many of such interventions have been designed and implemented in Bangladesh, a densely populated countries with a load of water. It has one of the highest rates of drowning, especially among children in the world. Next, the paper highlights some on-going research in this field, especially our newly started research project in Bangladesh, which is aimed at the prevention of drowning in children under two. Finally, the paper concludes with some of the lessons Nepal can learn in this area from its neighbours.

Intimate partner violence in Nepal: Analysis of Nepal Demographic and Health Survey 2022.

Intimate partner violence (IPV) is a major public health issue in Nepal. IPV has social and economic impacts on women, family, and the wider society. In this study, we aimed to determine factors associated with IPV among currently partnered women aged 15-49. We conducted a secondary data analysis of the Nepal Demographic and Health Survey (NDHS) 2022. The study examines the lifetime prevalence of IPV. IPV was measured in three domains: experience of physical violence, emotional violence, and sexual violence. Weighted univariate and multivariable logistic regression analysis were applied to determine factors associated with IPV. The results of logistic regression were presented as crude odds ratio (COR) and adjusted odds ratio (AOR) and their 95% confidence interval (CI). Of 3853 women, 27.2% had experienced any form of IPV. The lifetime prevalence of physical violence, emotional violence, and sexual violence were 23.2%, 12.8%, and 7.1%, respectively. Higher odds of physical violence were reported among women aged 35-49 years (AOR: 2.13, 95% CI: 1.58-2.87), women without formal education (AOR: 1.51, 95% CI: 1.10-2.06), and women who justified wife-beating (AOR: 1.23, 95% CI: 1.00-1.52). Women from poor households (AOR: 1.61, 95% CI: 1.12-2.35) and women with uneducated partners (AOR: 1.66, 95% CI: 1.08-2.58) were at higher risk of experiencing sexual violence. Women with unemployed husbands reported a higher risk of physical violence (AOR: 2.72, 95% CI: 1.45-5.06) and emotional violence (AOR: 1.61, 95% CI: 1.12-2.35). Almost one in three currently partnered women experienced some form of IPV in their lifetime. Various sociodemographic, partner-related, and women's empowerment-related factors were associated with experiencing IPV. Acknowledging and addressing these factors is essential to mitigating the high rates of IPV among reproductive aged women.

Parental knowledge and communication with their adolescent on sexual and reproductive health issues in Nepal.

Parental knowledge about sexual and reproductive health issues and adequate communication with their adolescent on these issues are crucial in promoting adolescent sexual and reproductive health. Although there are evidence on adolescent perceptions of their sexual health issues, research on parental perspectives of adolescent sexual health and parent-adolescent communication about sexual health issues in Nepal remains unexplored. Therefore, this study aimed to assess parental knowledge and communication practice about sexual and reproductive health with their adolescent children in Lalitpur Metropolitan City of Nepal. A community-based cross-sectional study was conducted between January and March 2019 among randomly selected 308 parents of adolescents (aged 10-19 years) residing in Lalitpur Metropolitan City of Nepal. Face-to-face interviews using structured questionnaires were conducted to collect the data. The collected data were entered into EpiData software v3.1, and data analysis was performed using IBM SPSS Statistics for Windows Version 21.0 (IBM Corp. Armonk, NY, USA). The statistical significance was considered at a p-value <0.05 and a 95% confidence interval (CI). Of 308 parents, one-third of parents were found to have correct knowledge about safe abortion, menstrual hygiene and management, modern contraceptives, prevention of sexually transmitted infections, wet dreams among male adolescents, abstaining from sexual intercourse during the fertile period, and the possibility of a male adolescent to impregnate a girl. In addition, only 40.9% of parents were found to have communicated with their adolescent children about sexual and reproductive health issues. Parents who have knowledge about puberty (aOR = 2.2, 95% CI: 1.2-3.9), belong to Bharamin/Chhetri ethnic group (aOR = 1.2, 95% CI: 1.1-2.2), self-employed (aOR: 2.4, 95% CI: 1.3-4.0), having two or more adolescent children (aOR = 2.0, 95% CI: 1.1-3.6), and whose adolescent children were staying in school hostel (aOR = 1.7, 95% CI:1.0-3.0) were more likely to have parental communication about sexual and reproductive health with their adolescent children. Most parents do not communicate with their adolescent children on sexual health topics, although they feel sexual health education is essential to adolescents. The majority of parents were found inadequately aware of adolescent sexual health issues. It is crucial to have contextual interventions that would encourage parent-adolescent communication on sexual health matters in an integrated way to promote adolescent sexual and reproductive health.

“Augmenting the referral pathway for retinal services among diabetic patients at Reiyukai Eiko Masunaga Eye Hospital, Nepal: a non-randomized, pre-post intervention study”

BackgroundDiabetic Retinopathy (DR) is an important public health issue in Nepal. Despite the availability of retinal services, people may not access them because of the lack of knowledge about DR and poor referral systems. DR screening uptake was low at Reiyukai Eiko Masunaga Eye Hospital(REMEH) since retina services were started. Scheer Memorial Hospital is a multispeciality hospital near to REMEH. It has no eye department but has been running a regular diabetic clinic. This was a site for referring diabetic patients for DR screening. Improving DR awareness among general physicians has the potential to address these challenges.MethodsThe aim of our study was to investigate the effectiveness of providing health education to selected health personnel and establish a referral pathway on the attendance of diabetic patients for retinal screening at REMEH. This was a non-randomized, pre-post intervention study design. Total of three health education sessions were provided to the health care professionals of Scheer on diabetic retinopathy using Power Point presentations, posters, pamphlets and videos. The study period was 16 months (2020 June –2021 September) and divided into 8 months pre-intervention(baseline data collection) and 8 months post intervention period. The proportional increase in number of diabetes attendance pre and post intervention was calculated by Z test. The change in knowledge of health care personnels pre and post intervention was scored and evaluated through a questionnaire and calculated by paired- t test. Data was analyzed using Excel and Epi Info 7.The Protocol was published on August 21, 2021, in JMIR Publications.ResultsThe proportional increase in number of referrals of diabetes attendance post intervention increased from 50 to 95% and was statistically significant (p < 0.001, 95% CI: 0.214–0.688). The mean score of knowledge gained by physicians on DR awareness was more at post intervention (8.8 ± 1.32) than pre intervention (6.4 ± 1.51). It was statistically significant (p < 0.001).ConclusionThis study shows that a well-planned health education intervention changes the knowledge in physicians about DR. There is an increase in the number of referrals and attendance of patients for DR screening with the change in knowledge and referral mechanism.Trial RegistrationClinical Trials.gov NCT04829084; https://clinicaltrials.gov/ct2/show/NCT04829084:02/04/2021.

Implications from the health belief model concerning zoonoses‐related threat perceptions held by livestock farmers in Nepal

AbstractDiseases that can be spread from animals to humans (zoonoses) are neglected health issues in Nepal. Due to professional exposure, livestock farmers are highly vulnerable to zoonoses. However, since there are limited studies, we have virtually no actual evidence on perception and practices toward prevention and response to zoonoses by livestock farmers in Nepal. This study examines the association between zoonoses preventive practices and the threat perceptions held by livestock farmers in Nepal based upon applications of health belief model (HBM) constructs. A descriptive cross‐sectional quantitative interview‐based survey was conducted with 380 livestock farmers randomly selected from three districts in Nepal. Results show that livestock farmers held primarily strong beliefs about zoonoses based on key constructs from the Health Belief Model (susceptibility, severity, benefits, and barriers with 91.5%, 93.7%, 91.1%, and 41.0%, respectively). However, they described low levels of participation in zoonoses preventive practices, such as handwashing with soap and water (52%–59%), following prescribed sick animal consumption practices (6.6%–17.7%), raw meat consumption practices (1.6%–6.3%), engaging in vaccination practices for livestock (33.9%–38.2%), and maintaining distance between home and shed (2.1%–13%). Based upon these findings, we strongly recommend enacting strategies to minimize the gaps between zoonoses preventive practices and perceptions through targeted communication interventions that include optimal educational sessions to reinforce applications from the constructs of HBM in farming communities.

A prospective study of snakebite in a tertiary care hospital in south-western Nepal.

Snakebite is a neglected public health issue in Nepal. We aimed to characterize patients with snake envenoming admitted to hospital in south-western Nepal. This was a prospective cohort study of 476 snakebite patients admitted to Bheri Hospital from May to December 2017. Data were collected on patient demographics, bite circumstances, snake type, treatment-seeking behavior, clinical effects, complications and treatment. There were 139/476 (29%) patients with clinical features of envenomation and 10 deaths (8%), of which six were prehospital deaths; 325/476 (68%) patients used non-recommended prehospital first aid, including 278 (58%) who applied a tourniquet and 43 (9%) consulting traditional healers. Median time to hospital arrival was 1.5 (IQR: 0.8-4) h. Also, 127 envenomated patients (91%) developed neurotoxicity and 12 (9%) hemotoxicity, while 124 patients (89%) received antivenom, with a median dose of 10 (4-30) vials. Three patients developed anaphylaxis following antivenom administration; 111 of 139 (80%) cases were admitted to the ICU and 48 (35%) were intubated. Median length of hospital stay for all cases was 0.5 (IQR: 0.5-1.2) d, but it was 2.2 (IQR: 1.5-3.8) d for envenomated cases. The majority of snakebite patients used non-recommended first aid or attended traditional healers. Almost one-third of patients developed systemic envenomation and required antivenom. The case fatality rate was high, but many died prior to arriving in hospital.

News Media Coverage of Snakebite Incidence in Nepal during 2010–2022

Background: Despite snakebite being a medical emergency, it is still a neglected health issue in Nepal. Further, there exists gap of knowledge on snakebite epidemiology. Therefore, an analysis of incidence of snakebites reported in news is essential to understand snakebite epidemiology in Nepal and fill up existing knowledge gap in some extent. Objectives: We aimed analysing incidence of snakebites reported in the news media to know whether news-based incidence of snakebite is comparable to the similar incidence reported most comprehensively by Nepal Government, know the snakebite distribution patterns across its geo-climatic regions, provinces, and districts, understand supra-annual variations of snakebite incidence, and measure association between incidences of snakebites with the respective districts’ human population density. Methods: We retrospectively searched and analyzed incidence of snakebites reported in news articles published between 2010 and 2022. Using line graphs and plotted maps, we compared the annual patterns of snakebites with the national data of snakebites reported by Department of Health Services of Nepal Government. Further, we used non-parametric inferential statistics to know representativeness of our dataset and association of snakebite incidence with population density of snakebite prone districts. Results: Snakebites were reported from 53 out of 77 districts of Nepal. People inhabiting 50 out of 53 districts were affected by snakebite envenoming (with 11% of collective envenoming rate) that resulted in deaths of people inhabiting 43 districts (with 15% of collective case fatality rate). The most of envenomings and deaths occurred in the lowlands of Nepal along the northern border of India. We deemed at least 10,339 snakebites, 2,113 envenomings, and 101 deaths annually in Nepal. Conclusions: The incidences of snakebites were high in flood affected areas, terai regions as well as some districts in the hills and mountains. Therefore, improvement of the snakebite risk map released by Nepal Government is essential to ensure prevention and control of snakebite envenoming in these high affected areas. Inclusion of urban areas in terai regions of this country is essential while designing the next more representative community-based study

Status of Health Literacy and associated factors among Type 2 Diabetes Mellitus in Nepal

Background: Diabetes is an iceberg disease and a major public health issue in Nepal. The prevalence and incidence of type 2 diabetes have occurred globally, especially affecting societies in economic transition, mostly newly industrialized and developing countries. Health literacy has become crucial to develop skills and knowledge of a person to access, understand and use the information and understand health determinants to make health and health care decisions and implement healthy behaviors. Objectives: The study aimed to assess health literacy level and associated factors among type 2 diabetes patients. Methods: A community-based cross-sectional study was conducted from August 2019 to January 2020. Health literacy level was measured using the European health survey questionnaire. This study used the SPSS version 16 on the received data sets to perform statistical analysis. Univariate logistic regression and multivariate logistic regression models were carried out to identify the independent factors related to health literacy. Results: The study showed that majority (86.3 %) of the diabetes patients had adequate health literacy. Gender, marital status, educational status, occupational status, and hospitalization were found statistically significant with health literacy. Marital Status (AOR = 0.18, 95% CI: 0.04-0.71, p = 0.001), educational status (AOR = 7.06, 95% CI: 2.13-23.36, p = 0.001), hospitalization (AOR = 8.38, 95% CI: 1.85-37.92, p = 0.001) and treatment compliance (AOR = 4.28, 95% CI: 1.57-11.63, p = 0.001) were found to be predictors for the health literacy. Conclusion: The study findings indicated more than a fourth-fifth of the respondents had adequate health literacy. Health Literacy plays a vital role in the prevention and management of the disease, so, the government should emphasize on uplift the education level and provide health counseling during diagnosis and treatment.

Poisoning among Patients Presenting to the Department of Emergency Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Poisoning is one of the major public health problems worldwide. The World Health Organization has estimated 0.3 million deaths a year due to various poisoning agents; pesticides being the leading one. Poisoning is one of the leading causes of emergency room visits. It has become a significant public health issue in Nepal. This study aimed to find out the prevalence of poisoning among patients presenting to the Department of Emergency Medicine of a tertiary care centre. A descriptive cross-sectional study was done in the Department of Emergency Medicine of a tertiary care centre from 24 June 2022 to 6 July 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 11/2022). Data from 765 patients were collected from the hospital records. The patient's history and clinical examination were used to make the diagnosis of poisoning. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Among 765 patients visiting the emergency department, 8 (1.04%) (0.99-1.09, 95% Confidence Interval) patients were of poisoning. The most common poison used was organophosphates which was consumed by 2 (25%) patients and benzodiazepines by 2 (25%) patients. The prevalence of poisoning among patients presenting to the Department of Emergency Medicine was similar when compared to other studies conducted in similar settings. Although agricultural poisons were commonly used, cases of drug poisoning seems to be on the rise nowadays. emergency department; poisoning; prevalence.

Development of a scale to evaluate negative menstrual attitudes among Nepalese women

BackgroundMenstrual attitudes include negative and positive perceptions of menstruation and are associated with reproductive health, underscoring the importance of its evaluation in women. Given that social and cultural factors affect menstrual attitudes, developing evaluation methods specific to distinct societal cultures is necessary.MethodsWe developed a scale based on the menstrual attitude questionnaire, which is the most widely used measure of menstrual attitudes, to evaluate negative menstrual attitudes among Nepalese women in consideration of Nepalese cultural backgrounds and literacy. In total, 352 Nepalese women aged 20–45 years living in urban or suburban areas in Nepal were enrolled in the study. Participants were randomly divided into two groups using the permuted block method. Using the prototype, Group 1 (n = 176) was evaluated with an exploratory factor analysis to develop a reliable scale, and Group 2 (n = 176) was evaluated with a confirmatory factor analysis to confirm the structure of negative menstrual attitudes. Further, we preliminarily examined the relationship of negative menstrual attitudes with the frequency of traditional menstrual practices and intensity of menstrual pain, which are significant reproductive health issues in Nepal, in Group 2.ResultsWe developed a 15-item, 3-factor scale to evaluate negative menstrual attitudes among Nepalese women using exploratory factor analysis. The first, second, and third factors were “Natural event” (α = 0.82), “Debilitating event” (α = 0.76), and “Bothersome event” (α = 0.69), respectively. Confirmatory factor analysis revealed that negative menstrual attitudes comprised a 3-factor structure. Participants who performed three traditional menstrual practices (“stay in their own house”, “go to public spaces”, and “contact with others generally”) demonstrated significantly higher scores for negative menstrual attitudes than did non-performers. Negative menstrual attitudes were positively correlated with the intensity of menstrual pain (r = 0.558).ConclusionsThis study is the first to evaluate menstrual attitudes and analyse its factor structure among Nepalese women. In the future, the relationship between accurately evaluated negative menstrual attitudes and reproductive health issues should be examined more comprehensively.

Use of Psychoactive Substance and its Associated Factors among School Adolescents in Rupandehi District of Nepal.

Psychoactive substance use among adolescents has been identified as an important health issue in Nepal. Therefore, this study examined the psychoactive substance use and factors associated with its use among adolescent students in the Rupandehi district of Nepal. A school-based cross-sectional study was conducted from December 2017 to July 2018 with 460 school students aged between 15 to 19 years across sampled public and private schools in the Rupandehi district of Nepal. Structured interview schedule was used to collect information on psychoactive substance use. The generalized estimating equation was used to identify the factors associated with the use of psychoactive substances. Over a quarter (27.4%) of school-going adolescents used at least one type of psychoactive substance. Commonly used psychoactive substance included tobacco products (59.3%) followed by cannabis (55.6%), marijuana (35.8%), hashish (23.5%), alcohol (22.2%), heroin (18.5%), nitrogen tablets (14.8%), sulfa (13.6%) and opium (13.6%), respectively. Being male (AOR=2.0, 95% CI: 1.19-3.36), having peers (AOR=1.8, 95% CI: 1.13-3.03) or family members (AOR=2.2, 95% CI: 1.40-3.54) that used psychoactive substances and father's education level (AOR=2.5, 95% CI: 1.05-5.78) were significantly associated with the psychoactive substance use. This study identified that over a quarter of school-going adolescents reported the use of at least one illegal psychoactive substance. This study provided details on the extent of behaviours, and can be used to develop a comprehensive prevention and control program. Such programs should address the socio-cultural factors that enable substance use and address gaps in knowledge to prevent and control of psychoactive substance use.

A qualitative study to understand drivers of psychoactive substance use among Nepalese youth.

BackgroundPsychoactive substance use among youth is an emerging public health issue in Nepal. This exploratory study aimed to better understand the drivers of psychoactive substance use among Nepalese youth in Rupandehi district of Nepal.Materials and methodsThis study used a qualitative approach for data collection. Both in-depth interviews (IDI, seven participants) and focus group discussions (FGD, 13 participants) were conducted among study participants who self-reported as psychoactive substance users or had history of psychoactive substance use. Participants for IDI were aged between 11 and 24 years and between 18 and 35 years old for FGDs. Semi-structured interview guides were prepared separately for IDIs and FDGs. Interviews were conducted in Nepali language and were audio recorded, which were there transcribed and translated into English for coding and analyses. In addition, interviews notes were taken by two research assistants. An inductive thematic analysis was used to analyze the data.ResultsThis study identified a range of drivers of psychoactive substances use among Nepalese youths. Themes included (i) socio-cultural factors, (ii) individual factors, (iii) academic environment, (iv) physical environment and the (v) influence of media. The socio-cultural factors were categorized into sub-themes of family relationships, ethnic identity and psychoactive substance use and lack of social acceptance. Individual factors included peer pressure, stress relief and coping with financial challenges. Accessibility and availability of psychoactive substances in the surrounding environment and lack of monitoring and reinforcement of rules/ law and regulations were other drivers to psychoactive substance use among this Nepalese youth cohort.ConclusionOur study identified several important drivers of psychoactive substance use among youth in the Rupandehi district of Nepal. Future works are anticipated to further explore youth initiation and use of psychoactive substances and support the design of interventions that address these risk factors to reduce and prevent subsequent harms.

Assessment Of Occupational Burnout And Its Correlates Among Medical Doctors in Nepal during COVID-19 pandemic: A cross-sectional study

Introduction: The current COVID-19 pandemic has increased emotional and physical toll on healthcare workers. The burnout among doctors could be another psychological outcome due to this. Considering the dearth of literature we planned this study with an aim to explore burnout and its correlates among medical doctors of Nepal.&#x0D; Material And Method: An online survey using a cross-sectional design and purposive sampling was conducted during the lock-down due to COVID-19 pandemic in Nepal. The tools used were basic proforma, Copenhagen Burn out Inventory (CBI) and Perceived Stress Scale (PSS). Descriptive and inferential statistical analysis (bivariate analysis followed by multiple linear regression) was performed with an objective to study prevalence of burnout and its correlates among the medical doctors.&#x0D; Results: The average age of participants was 30.44 years with the majority being male. All the study participants reported moderate to severe level of perceived stress. Around half of them reported moderate to high burnout. The multiple linear regression analyses showed that perceived stress, and working in surgical department were significant correlates for personal and work-related burnout among medical doctors. Additionally, being front-line worker was a significant correlate for client-related burnout.&#x0D; Conclusion: The burden and severity of burnout and perceived stress reported by the medical doctors during COVID-19 pandemic in the present study, suggests it to be an important mental health issue in Nepal. Suitable interventions for targeting this urgent issue of effectively reducing the burnout are warranted.

Factors Associated with Chronic Obstructive Pulmonary Diseases in Nepal: Evidence from a Nationally Representative Population-Based Study.

BackgroundThe Global Burden of Diseases Study 2017 predicted that chronic obstructive pulmonary disease (COPD) is the second leading cause of death, the fourth leading cause of premature death, and the third cause for DALYs lost in Nepal. However, data on the population-based prevalence of COPD in Nepal are very limited. This study aims to assess the prevalence of COPD and factors associated with the occurrence of COPD in Nepal.MethodsFrom a nationally representative, population-based cross-sectional study on chronic non-communicable diseases, the prevalence of COPD and its associated factors was determined. Of 12,557 participants aged over 20 years, 8945 participants completed a questionnaire and spirometry. Eligible participants were also asked to answer a COPD diagnostic questionnaire for screening COPD cases, and if needed underwent pre-bronchodilator and post-bronchodilator spirometry. COPD was defined as a post-bronchodilator FEV1/FVC (forced expiratory volume in 1 s/forced vital capacity) ratio of <0.70. Multivariate logistic regression was performed to identify factors associated with COPD. Sampling weights were used for all data analyses.ResultsThe prevalence of COPD in Nepal was 11.7% (95% CI: 10.5% to 12.9 %), which increased with age, and higher in those with a low educational level, those who had smoked ≥50 pack-years, persons having a low body mass index (BMI), and residents of Karnali province. Multivariate analysis revealed that being aged 60 years and above, having a low BMI, low educational status, having smoked more than 50 pack-years, provincial distribution, and ethnicity were independent predictors of COPD.ConclusionCOPD is a growing and serious public health issue in Nepal. Factor such as old age, cigarette smoking, low educational attainment, low BMI, ethnicity, and locality of residence (province-level variation) plays a vital role in the occurrence of COPD. Strategies aimed at targeting these risk factors through health promotion and education interventions are needed to decrease the burden of COPD.

Epidemiologic Pattern of Cancer in Kathmandu Valley, Nepal: Findings of Population-Based Cancer Registry, 2018.

PURPOSEAlthough cancer is an important and growing public health issue in Nepal, the country lacked any population-based cancer registry (PBCR) until 2018. In this study, we describe the establishment of the PBCR for the first time in Nepal and use the registry data to understand incidence, mortality, and patterns of cancer in the Kathmandu Valley (consisting of Kathmandu, Lalitpur, and Bhaktapur districts), which comprises 10.5% of the estimated 29 million population of Nepal in 2018.MATERIALS AND METHODSThe PBCR collects information from facilities and communities through the active process. The facilities include cancer or general hospitals, pathology laboratories, hospice, and Ayurvedic centers. In the communities, the field enumerators or female community health volunteers collected the data from the households. In addition, the Social Security and Nursing Division under the Department of Health Services, which provides subsidy for cancer treatment of underprivileged patients, was another major source of data. The collected data were verified for residence, accuracy, and completeness and then entered and analyzed using CanReg5 software.RESULTSIn the Kathmandu Valley, the PBCR registered 2,156 new cancer cases with overall age-adjusted incidence rate for all cancers of 95.7 per 100,000 population (95.3 for males and 98.1 for females). The age-adjusted mortality rate for males was 36.3 (n = 365) and for females 27.0 (n = 305) per 100,000 population. We found that the commonest cancers in males were lung and stomach, whereas in females, they were breast and lung cancer. Gallbladder cancer was among the top five common cancers in both sex.CONCLUSIONThese findings provide a milestone to understand the cancer burden in the country for the first time using the PBCR and will be helpful to develop and prioritize cancer control strategies.

Adsorption of Inorganic As(III) from Aqueous Solutions by Iron-Manganese Oxide

Arsenic contamination in water is well noted public health issue in Nepal and elsewhere. Adsorbents are important chemical means to purify the arsenic contaminated water. In this study the adsorption of As(III) on iron manganese oxide has been investigated as a function of different parameters. Herein, two iron based adsorbents, iron-manganese oxide-1 (Fe-Mn oxide-1) and iron-manganese oxide-2 (Fe-Mn oxide-2) were prepared by oxidation and co-precipitation methods. Adsorbents were characterized by powder X-ray diffraction (XRD) and scanning electron microscope (SEM). Within 4 hours of reaction time, 90% of the arsenic was removed by both Fe-Mn oxides and removal efficiency of the Fe-Mn oxide-1 was obtained higher than that of Fe-Mn oxide-2. Pseudo-second order model was well fitted to describe adsorption kinetic (R2 =0.99) for both adsorbents. Removal efficiency of the absorbents decreased with increase in the pH value and increased with increase in the concentration of adsorbent in the suspension. Based on the result, the synthesized Fe-Mn oxides have significant potential applications in the inorganic arsenic treatment in the water.

Noncommunicable disease risk factors among older adults aged 60-69 years in Nepal: findings from the STEPS survey 2013.

Both the noncommunicable diseases (NCDs) burden and the population of older adults are increasing in Nepal. This study aims to estimate the prevalence of behavioral and biological risk factors of common NCDs among Nepali older adults aged 60-69 years. A subsample analysis of data from the 2013 Nepal STEPwise approach to Surveillance (STEPS) survey was conducted with 526 older adults aged 60-69 years. STEPS sample weighting and domain analyses were used to include the entire sample for variance estimation and to obtain prevalence estimates and corresponding 95% confidence intervals (CI) for our selected population of older adults. All participants had at least one risk factor for NCDs; about one-fourth had four. Of the eight examined risk factors, inadequate fruit/vegetable intake (98.6%, 95% CI: 96.9-100.0), hypertension (57.2%, 95% CI: 51.0-63.4), and hypercholesterolemia (37.9%, 95% CI: 30.8-44.9) were ranked the three most prevalent risk factors while physical inactivity (2.5%, 95% CI: 1.0-4.0) was least prevalent. Prevalence of smoking was 31% (95% CI: 24.9-37.2), overweight/obesity was 19% (95% CI: 13.1-25.2), alcohol use was 18% (95% CI: 12.2-23.5), diabetes was 15% (95% CI: 8.5-21.4), and 36% (95% CI: 30.9-42.0) of the older participants suffered discomfort due to oral health problems. Several risk factors, including current alcohol consumption, daily servings of fruit/vegetable intake, and overweight/obesity showed signficant variation in prevalence by gender, ethnicity, and place of residence, urban vs. rural. Epidemiological and demographic transitions are two emerging public health issues in Nepal. The baseline information provided by this study on the prevalence of NCD risk factors among Nepali older adults aged 60-69 years can inform policies and programs that focus on maximizing the health and well-being of older adults.

Baseline Study of Sputum Microscopy for Diagnosis of Tuberculosis in Western Region of Nepal

Introduction: Tuberculosis is a major health issue in Nepal. Early detection of tuberculosis is essential to identify the case which limits the transmission of tuberculosis and builds an effective approach of tuberculosis control policy. Therefore, the present study is aimed to assess the case of tuberculosis by sputum smear examination.Methods: A prospective study was conducted in a tertiary care hospital of Western Nepal. Two sputum samples were collected from each suspect – spot specimen on the first day and one early morning specimen on the second day. The standard protocol of Ziehl Neelsen stain was applied to detect the acid fast bacilli.Results: Out of 280 smears from suspected patients, only 30 showed smear positivity (10.7%). Among the total identified positive case of tuberculosis (30/280), the highest rate was observed in the age group of 56-65 years. Males (56.7%) were highly affected by tuberculosis than females (43.3%). The minimum age of the suspects was two years and maximum age was of 105 years with mean age of 53.6 years.Conclusions: It is concluded that prevalence of tuberculosis is high in patients attending tertiary care hospital in Western region of Nepal, which is slightly higher than the annual report of National Tuberculosis Program 2017. Incidence of pulmonary tuberculosis is higher in males as compared to females.

Malnutrition in Children: A Serious Public Health Issue in Nepal

DOI: http://dx.doi.org/10.3126/hprospect.v11i0.7439 Health Prospect 2012;11:61-62

Infertility: An Emerging Public Health Issue in Nepal

Infertility is one of the major health care problems worldwide, including Nepal. An increasing trend of infertility has been noticed recently in Nepal however, exact prevalence rate is still unknown. Male and female factors, lifestyle factors and pesticides exposures are the main causes of infertility. In Nepal, particulary migration of fertile age group abroad for job and its consequences may be the main causes of infertility. Due to lack of knowlege regarding the prevalnce and exact causes of infertility in Nepal, nationwide study is required.