Jhapa District Research Articles

Debate of Ethnic Identity in Nepali Politics: An Examination of the debate from the Kisan Community of Eastern Nepal

The Kisan is an ethnic group of Nepal lived in Jhapa district only. It is a Tarai origin group with 773 populations which is traditionally organized under its own political organization, the Mahato system. The Mahato is a hereditary community head which is supported by Wokil (minister) and Sipahi (Police). These traditional authorities run a well functional community court which maintains peace and harmony in the community and works for the preservation of cultural practices. Along with the establishment of multiparty democracy, the community is exposed to external situations: political parties and economic organizations, advocacy groups, donor agencies and so on. A few literate Kisans seeking employment opportunities interfaced with the advocates of National Federations of Indigenous Nationalities and Action Aid Nepal after multiparty democracy. As a result, they had motivated and established a non-governmental organization for ethnic welfare. After establishment of the Kisan Community Development Academy (club in the Kisan language), the community is formally divided into two groups: the illiterate Kisans involved in community court under their traditional authorities and the literate Kisans involved in the newly established club. The club ran literacy and sanitation programs and constructed toilets and water taps. Mainly, it was involved in socio-cultural change and identity politics by the support of the above mentioned organizations. On the contrary, the traditional authorities involve in the preservation of community culture and maintain peace and harmony. The literate Kisans involved in identity politics are motivated for salaried jobs, not for cultural preservation for Kisan identity. DOI: http://dx.doi.org/10.3126/dsaj.v7i0.10441 Dhaulagiri Journal of Sociology and Anthropology Vol. 7, 2013; 157-172

Description on some rescued turtles and their translocation at Turtle Rescue and Conservation Centre (TRCC), Sanischare, Jhapa

The present paper deals with the brief introduction of Turtle Rescue and Conservation Centre (TRCC) and description of some rescued turtles. Nine specimens of turtles belonging to five genera were rescued and translocated to the centre till date including 9.3 kg male Indian Peacock soft-shelled turtle (Nilssonia hurum) for the first time from Jhapa district. The rescue operations were conducted for the translocation of turtles confiscated from the local market, censorial collectors, fisherman and public residence. The high resolution photographs of captured specimens, their necessary biometry and GPS coordinates of location were taken. Species identification was done with the help of and pictorial field guide and relevant literatures. Climatic data of study area were recorded from Gainde Irrigation Project, Maidhar, Jhapa. Interviews were taken during field visits with the help of structured questionnaire. Preliminary rescue data showed that the Indian flap-shelled turtle (Lissemys punctata) and Yellow bellied roofed turtle (Pangshura flaviventer) were the most overexploited species in the vicinities of the study area. The climatic condition of the rescue centre and water quality found suitable to support terrestrial and freshwater turtles and other various wetland flora and fauna. However, the rapid population growth and habitat destruction due to deforestation, unmanaged urbanization and expansion of agricultural land are found as the major threats to the survival of turtles and other wetland creatures at the study area and its vicinities. DOI: http://dx.doi.org/10.3126/bibechana.v11i0.10394 BIBECHANA 11(1) (2014) 141-148

Burden of Developmental and Behavioral Problems among Children - A Descriptive Hospital Based Study

The child development is a dynamic process that utilizes the genetic potential of the baby to achieve full potential within the context of available environment. Throughout the world, there are growing concerns about developmental, behavioural, social and emotional wellbeing of children. The management of these issues is possible only with an organized approach through a multidisciplinary team Objective: To estimate the prevalence of developmental and behavioral disorders in children. Method: Data were collected from primary caregivers of children presented to a developmental and behavioral pediatrics clinic over a period of 12 months. Standard screening and assessment tools like Strength and Difficulty Questionnaire (SDQ), Spence anxiety scale and Vanderbilt rating scale for ADHD were used. Cases were referred to the Psychiatrist, psychologist, speech therapist and physiotherapist for assessment and management when needed. Results: A total of 85 children with developmental problems presented to our clinic which gives clinic prevalence of 8.5%. There were 51 (60%) of male and 34 (40%) of female. The majority of these children were from Morang district 39 (46%), Sunsari district 13 (15%) and Jhapa District 9 (10.6%). The most common diagnosis were speech and language delay (22.4%), behavioral problems 21.2%, Anxiety disorders 18.8% , cerebral palsy 14.1% and Global developmental delay of 11.8% and several others. The highest number of children i.e 27 (31.8%), were referred to the psychologist/Psychiatrist followed by speech therapist 25 (29.4%) and physiotherapist 21(24.7%). Behavioral modification strategies and CBT were provided to children. DOI: http://dx.doi.org/10.3126/jonmc.v3i1.10054 Journal of Nobel Medical College Vol.3(1) 2014; 45-49

Modification of Delivery Practice in Rajbanshi Mothers of Nepal

Introduction: This is a cross-sectional study with the objective of identifying modification in delivery practice in Rajbanshi mothers of Nepal. Methodology: Both qualitative and quantitative tools were used. Semi-structured questionnaires covering 375 samples of its resident districts Morang, Jhapa and Sunsari districts and check lists for in-depth interview were used in the study. Results: People were adopting both traditional and modern care practices concurrently. Among 375 households; 40% adopted local clinic/ hospital/ traditional healer concurrently. Similarly 31.20% adopted local clinic/ traditional healer/ hospital, 10.67% adopted hospital/traditional healer. There were 11.47% (urban 0.54% and rural 10.93%) respondents were having traditional care system as a first choice. During first delivery among 375 mothers 265 (70.67%) had traditional home delivery and 110 (29.33%) had hospital delivery. During last delivery, this was 115 (30.67%) in traditional home delivery and 260 (69.33%) in hospital delivery. Therefore trend of hospital delivery was increasing whereas trend of traditional home delivery was decreasing. It was statistically highly significant (p=<0.0001). There was also remarkable increased in using trained Health Worker/Nurse/Doctor at hospitals is 66.4% during last delivery which was only 6.13% during first delivery. It is statistically highly significant (p= <.0001). Conclusion: Trend of hospital delivery was increasing (from 30.67% to 69.33%) and trend of home delivery was decreasing (from 69.33% to 29.23%) in between first and last child delivery. There was remarkable increased in using trained HW/Nurse/Doctor at hospitals is 66.4% during last delivery which was only 6.13% during first delivery. Traditional care was more practiced in rural than in urban population. DOI: http://dx.doi.org/10.3126/jonmc.v3i1.10047 Journal of Nobel Medical College Vol.3(1) 2014; 10-15

Delivery Practices among Rajbanshi

This is a cross-sectional study with the objective of uncovering home and hospital delivery practices among Rajbansi of Nepal. Quantitative tools semi-structured questionnaires, check lists were used covering 375 samples of its resident districts Morang, Jhapa and Sunsari districts. Among Rajbanshi population 69.33% has done hospital delivery and 30.67% has home delivery. Home delivery is practiced by economic condition very poor (18.87%), poor (8.8%) and rich (4%). Hospital delivery is practiced by economic condition very poor (20.53%), poor (20.27%) and rich (28.53%). Similarly, home delivery is higher by occupation labour (24.27%), by education illiterate (10.67%), by geography rural (34.28%). Hospital delivery is increasing and home delivery is decreasing in trend. Status of hospital delivery of Rajbanshi is better than the levels of Morang district and country Nepal, but which is significantly lower among very poor, illiterate, labour and rural Rajbanshi population. DOI: http://dx.doi.org/10.3126/researcher.v1i2.9886 Researcher 1(2) 2013: 63-71

Study on knowledge and practice of water and sanitation application in Chandragadhi VDC of Jhapa District

Background: Poor hygiene practices and inadequate sanitary conditions play major roles in the increased burden of communicable diseases within developing countries. Objectives: To know the knowledge and practice of the people about the diseases related to water and sanitation and to know the pattern of water related diseases in last one year in that area. Methods: The crosssectional study was conducted from 16th March to 30th March 2008 in Chandragadhi VDC where 203 households were taken as subjects. Convenient purposive sampling technique was applied. Semi-structured questionnaire was used and face to face interview was conducted. Chisquare test was applied to find out the significant difference between various diseases and related to water and sanitation system of the study areas. Results: People drinking untreated water suffered from diarrhea (38.46%) followed by dysentery (9.89%) respectively. People who devoid of latrine facilities suffered from diarrhea (40.74%) followed by dysentery (12.03%) respectively. Almost (38%) of the population under study gets rid of the excreta of their children in the river nearby and (32.5%) throw in the same latrine they use. Almost (66%) people wash their hands with soap water after defecation. Conclusion: A majority of people with knowledge of safe water and sanitation used soap and water for hand washing before meal and after defecation. People drinking untreated water showed significant with water related diseases ie diarrhoea followed by dysentery. DOI: http://dx.doi.org/10.3126/hren.v11i3.9639 Health Renaissance 2013;11(3):241-245

Re: First isolation of dengue virus from the 2010 epidemic in Nepal.

We compliment the team of investigators from Kathmandu, Nepal for their meticulous serologic and molecular investigations of patients suspected with dengue virus (DENV) infection during the large 2010 epidemic in Nepal [1]. Several measures are needed to address the rapid emergence of DENV infection in different regions of Nepal. Recently, DENV infection was reported in Chitwan with a large number of patients presenting in the Chitwan Medical College Teaching Hospital and other privately-run clinics and nursing homes in Bharatpur [2]. Furthermore, in Jhapa district, 17 people, including 13 from Mechinagar Municipality alone, were found to be infected with the disease. Dengue cases were found in Kakadvitta and its adjoining areas, while 12 patients were receiving treatment in various hospitals in Parsa district and 13 had returned home after treatment [3]. In Nepal, diagnosis of DENV infections was based on serologic testing for IgM antibody at different centres in Kathmandu and Mahendranagar, Kanchanpur and Kuhsibu employing IgM-capture ELISA [4]. Molecular investigations were performed at the National Institute of Infectious Diseases, Tokyo, Japan [1]. Rather than relying on a multi-step capture ELISA, it would be convenient to opt for point-of-care, rapid diagnostics in different heath care centres across Nepal. Such assay formats involve 1–2 steps, are user friendly and require minimum equipment. Neither sophisticated laboratory facilities nor highly trained technologists are needed. A concurrent testing for NS1, IgM and IgG is ideal since it would address even cases with atypical presentations. During the 2006–2007 outbreak of DENV in Malaysia, the molecular and serologic response in in ten adults with a fatal outcome was remarkable. DENV infection was confirmed in all ten cases by serological tests. Seven were both IgM and IgG positive while three were IgM negative and IgG positive. Eight of the patients (two were unavailable) tested positive for dengue NS1 while DENV-1 was isolated from one case. Consequently, the presence of anti-dengue IG anybody with dengue NS1 antigen confirmed the secondary infection in all eight patients [5]. Screening for DENV antigenemia among international travellers at different ports of entry could be introduced to detect persons infected with the virus who could be bitten by DENV vectors during their stay in different regions of Nepal. After viral amplification in mosquitoes, a secondary dissemination of the disease could occur. Furthermore, even prospective international travellers from Nepal to DENV endemic areas should be asked to protect themselves against the mosquito bites while away on any business or pleasure trip. It is important to educate the community about otherwise ignored basic facts about of the mosquito and protection from bites. The mosquitoes of Aedes genus, A. aegypti and A. albopictus are responsible for multiplication and dissemination of dengue Virus, chikungunya virus and yellow fever virus. Both A. aegypti and A. albopictus are day-biters but will bite at night if there is sufficient artificial lighting. A. aegypti is particularly fond of ankles when searching for a good spot to bite a human being [6]. A. albopictus is a very aggressive day-time biter, with peaks occurring during early morning and late afternoon. Both are container-inhabiting species that lay eggs in domestic and peri-domestic clean water-containing receptacles. Anti-mosquito measures are practiced universally at night when insecticides and mosquito repellents and mosquito nets are used. In spite of such meticulous night-time care taking, one could still be exposed to bites from mosquitoes of the genus Aedes as they are mostly day-biters [6]. The public should be advised to wear full-length clothes to cover their arms and legs during day-time as well as in the evenings if they go outdoors. As a final suggestion, fashion designers in Nepal and elsewhere should be urged to create attractive formal and informal clothing for both sexes that would not protect against mosquito bites but also is attractive and suited to the local customs each region. Prominent public personalities like film stars, actors, athletes should wear such clothes during their appearance in public. School children should avoid use of skirts or shorts while in school. local governments should declare an exemption of such garments from sales local taxes.

Knowledge and attitude on HIV-AIDS and Practice of Sexual Behavior among Female Sex Workers: a pilot study in Jhapa, Nepal

Acquired Immune Deficiency Syndrome (AIDS) remains a public health problem of major significance in most parts of the world. The first HIV infection was detected in 1988 in Nepal. Since then HIV and AIDS epidemic has evolved from low to concentrated among “High risk groups” i.e. Injecting Drug Users (IDUs), Female Sex Workers (FSWs), Men having Sex with Men (MSM) and Seasonal labor Migrants. The objective of this study was to find out knowledge, attitude on HIV-AIDS among the respondents and assess the types of behavior that places them at risk of contracting HIV_AIDS in Jhapa district of Nepal. This was the cross sectional descriptive study carried out among High risk behavior group (FSWs, and Clients of FSWs) who come for treatment at VCT centre of Jhapa district. Multi stage purposive and random sampling was adopted and data were collected using a pre-tested interview schedule. Maximum no. of respondents (98.9 %) had heard about HIV and (100.0 %) had heard about AIDS, (100.0 %) using condom, among which (82.2%) used consistently. About half of the respondents (50.1%) had thought that they have chances of contracting HIV/AIDS. Sex at an early age was the prevalent practice among the study population as (46 .6 %) of them reported to have initiated before the age of 15 years. As the age at first sex increases RTI problems decreases (p=0.018) and vice versa. Less than half of the respondents (71.2%) had used alcohol during sexual activity, among which, (59.6%) had neglected to use condom. Knowledge about HIV-AIDS and condom was high. More than half of the respondent perceived their high risk to HIV/AIDS infection, judging from their present sexual behavior. The frequency of condom use was unsatisfactory (82.2%). Alcohol use and negligence to use condom during sexual activity was high.

Constraint and opportunity of raw jute production : A case study of eastern Terai, Nepal

Area and production of raw jute has decreased, though there is a high demand of raw jute in the country. In order to assess production constraints, a survey was carried out in 2005/06 in Jhapa, Morang and Sunsari districts. The study revealed that unstable or low price of raw jute, unavailability of quality jute seed, limited irrigation water at sowing period, diseases complex (wilt), labor shortage during peak season, weed problem, lack of retting water/retting pond were the main constraints in jute production and processing. The study indicates that the maximum production cost has involved in fiber extraction (16.9%) and weeding (16.33%). Jute productivity ranged from 1788 to 2260 kg per hectare. JRO-524 variety of jute has been widely grown across the region due to its wider adaptability, high yield potential and quality fiber. Jute area has been replaced by sugarcane due to its high yield potential and high profit margin. It is observed that the cost of production of jute is high as compared to other crops in the season. Average cost of production of fiber was estimated to be Rs.1563/quintal. For the promotion of jute cultivation in the eastern Terai, it would be better to provide subsidies on seeds and fertilizer to jute growers as practiced in neighboring countries thereby profit margin becomes high and will encourage growers in producing more raw jute within the country for the fulfillment of raw jute requirement of local jute industries. Cost effective technologies have to be developed in jute production and processing aspects for lowering the production cost and increasing the profit margin. Popular genotypes JRO- 524 which was widely adopted needs to be recommended officially for the general cultivation in this region. Being an eco-friendly crop, promotion is required to adapt climate change effect and maintaining the soil properties in jute growing areas. Agronomy Journal of Nepal (Agron JN) Vol. 3. 2013, Page 117-122 DOI: http://dx.doi.org/10.3126/ajn.v3i0.9013

Seroprevalence of Hepatitis B among blood donors in Jhapa, Nepal

Background: Blood donation saves life of millions. However unsafe transfusion is also putting blood receivers in risk of Hepatitis B infections and window period is potential cause of transmission. Objectives: The objective of the study was to find out the seroprevalence of hepatitis B among blood donors. Materials and Methods: During the study period from July 2008 to April 2009, a total of 2277 donated blood samples from Nepal Red Cross Society Jhapa Branch and Damak Sub-branch were analyzed for present of hepatitis B surface antigen (HBsAg) on serum by using Hepacard, a rapid diagnostic chromatographic test kit. Results: On the study HBsAg seroprevalence were 7 out of 1340 (0.52%) and 6 out of 937(0.64%) in Bhadrapur and Damak respectively. The Hepatitis B Virus (HBV) prevalence among male at Bhadrapur was found 7 out of 1172 (0.59%) and 6 at Damak out of 760 (0.79%) were positive. The overall seroprevalence of male blood donors in Jhapa district was 12 out of 1932 (0.62%). Among the 168 female blood donors only one female was seen positive at Bhadrapur with 0.59% of seroprevalence and overall seroprevalence of hepatitis B surface antigen among female in Jhapa district was 1 out of 345 (0.29%). Conclusion: Hepatitis B infection is a most important threat associated with unscreened blood donations. It.s a great importance to perform and confirm donated blood by sensitive and specific tests. It is essential to prevent the transmission of hepatitis B virus from blood donors. DOI: http://dx.doi.org/10.3126/stcj.v1i1.8659 Sunsari Technical College Journal Vol.1(1) 2012 33-37

Post Partum Depression among Rajbansi Women in Nepal

This is a cross-sectional and descriptive study which uncovered and described Postpartum Depression and its contributing factors among Rajbansi mothers in Nepal. Methodology: quantitative tools semi-structured questionnaires, check lists used covering 375 samples of Morang, Jhapa and Sunsari districts of Nepal. Findings: Prevalence of Postpartum Depression (PPD) was 12.27% in Rajbansi mothers. PPD was associated with sleeplessness (p= <0.0001) in the study. Mental stress was associated with sleeplessness (p= <0.0001). Habit of alcohol use by husband was associated with sleeplessness in wife or mothers (p= <0.0001). Habit of tobacco use or smoking by husband was associated with sleeplessness in wife or mothers (p= 0.005). Conclusion: Economic conditions, education, habits of husband were associated with mental stress in mothers and mental stress in mothers was also associated with Postpartum Depression of mothers in Rajbansi was statistically significant. Mothers with labour occupation or very poor, uneducated and those wives of alcohol taking and smoking husbands were vulnerable to PPD. DOI: http://dx.doi.org/10.3126/researcher.v1i1.8374 Researcher: A Research Journal of Culture and Society Vol.1(1) 2013

Climate Change and Malaria in Jhapa District of Nepal: Emerging Evidences from Nepal

Climate change is an escalating issue of concern especially towards health. Malaria, as one of the major public health problems in Jhapa district of Nepal, is one of the sensitive diseases related to climate change. This study has been carried out to assess the relationship between climatic variables and malaria and to find out the range of non-climatic factors that can confound the relationship of climate change and human health. This was a retrospective study in which data of past 10 years relating to climate and disease (malaria) variables were analyzed. The occurrence of malaria in Jhapa was seen almost throughout the year with seasonal fluctuations. With mean annual temperature increase (0.04°C/year), the increase in malaria cases in the district was observed with correlation of 0.284 (p <0.01) and 0.338 (p <0.001) with maximum and minimum temperature, respectively. Rainfall pattern was observed to be decreasing at an average rate of 7.1 mm/year but the malaria cases appeared mostly during the heavy rainfall season/period and had significant correlation between the two variables. On the contrary, Relative Humidity had no significant correlation with malaria occurrence. Climatic variables (except Relative Humidity) were found to be correlated with malaria occurrence but were not the significant predictors when time-series analysis was conducted.

Separating climate resilient crops through screening of drought tolerant rice land races in Nepal

Many studies have shown that local landraces are found to be better adapted to changing climatic conditions. The screening of local land races is one of important processes to detect drought tolerant behavior of crop species to further verify in similar field situation and genomic/molecular level studies. In 2009 for main season rice, a study was done to identify different land races of rice in Jhapa and Kailali districts to know their performance on drought stressed conditions by field techniques. Among the 22 rice land races studied, Kataush showed maximum drought tolerant efficiency (DTE) of 192.8% and minimum drought susceptibility index (DSI) of -0.88% followed by Guthanisaro (DTE=181% and DSI= -0.77%). Likewise, in the cluster analysis, these genotypes formed a cluster with two highest DTE and minimum DSI. Hence, these two land races could be used for drought stressed breeding program in the future to include drought resistant genes for variety impovement. Also, it was recorded that these land races could be used as the most drought tolerant variety in Terai region similar to Jhapa and Kailali, Nepal. These varieties could play important role in climate extreme situations, where farmers can adopt them as climatic resilient rice genotypes. DOI: http://dx.doi.org/10.3126/ajn.v1i0.7546 Agronomy Journal of Nepal (Agron JN) Vol. 1: 2010 pp.80-84

Choice of health-care facility after introduction of free essential health services in Nepal.

Choice of health-care services depends on patients' characteristics and the features of health-care facilities available. In Nepal, a significant proportion of health care is provided through the private sector, despite the introduction of free essential health care for all citizens in 2008. We sought to determine whether people chose private or public facilities in the first instance for acute health problems. We also assessed the reasons for their choice. A cross-sectional survey was done by use of a questionnaire administered to 400 household heads in Jhapa district, Nepal. 272 (68%) respondents sought treatment from public health-care facilities in the first instance. On adjusted analysis, illiterate people were more likely to choose public facilities than people with higher secondary education (OR 5.47, P = 0.002). Similarly, lower-caste and religious-minority respondents were more likely to choose public facilities than disadvantaged janajati (OR 2.33, P = 0.01). Among respondents who used public facilities, 174 (64.0%) and 109 (40.0%) stated that that their choice was based on financial accessibility and physical accessibility, respectively. Among respondents who used private facilities, 65 (50.7%) and 54 (42.1%) said their choice was based on adequacy of resources/services and health-care delivery, respectively. A substantial portion of respondents used public health-care facilities in the first instance, mainly because of financial and physical accessibility rather than adequacy of resources or better health-care delivery. These results may indicate a positive impact of removal of user fees for public health-care facilities in Nepal, especially for impoverished people.

Knowledge and practices regarding tuberculosis among people living with HIV/AIDS

Background: Tuberculosis is a serious public health problem in many developing countries. More than 2 billion people are infected with TB bacilli and annually around 9 million become infected, 1.7 million die due to this disease. TB is the most common opportunistic infection, leading to the mortality of people living with HIV.Objective: To assess the knowledge and practices of tuberculosis among people living with HIV/AIDS.Method: This study was carried out in Sunsari, Morang and Jhapa district of Eastern Nepal. Face to face interview was performed using convenience sampling technique. Data was collected from people living with HIV/AIDS, related to information on socio-demographic profile, knowledge, practices and risk taking behavior with the help of pretested semi-structured questionnaire. The generated data were entered into Microsoft Excel and SPSS 15.0 and Chi-square was applied for test of significance.Results- The total of 242 subjects were enrolled in the study. Out of them, 75.2% were males and 24.8% females, the age of the respondents varied from 14-65 years. Among them 53.3% were Intra Venus drug users, followed by 17.4% clients of commercial sex workers and housewives (17.4%). Around half (48.8%) of the study population were in the 30-39 yrs age group. The knowledge of tuberculosis disease was satisfactory but in depth knowledge of symptoms was not adequate. Regarding symptoms of TB, it was found that 85% were aware that cough for more than 2 weeks was suggestive of TB, 54% knew of chest pain and 84% knew of haemoptysis. Over the years, perception about tuberculosis has changed, which was shown by our finding, 93% of the respondents knew that TB is curable and 75% knew that anti-tuberculosis drugs provided free of cost under directly observed treatment short course (DOTS). Regarding knowledge of consequences of incomplete treatment, it was found that 17% answered the disease may attack again, and very few (2%) knew that incomplete or discontinued treatment would develop Multi drug resistantance.Conclusion- Our study revealed that knowledge and practices of people living with HIV/AIDS is not adequate. Their knowledge regarding consequences of treatment, and multi drug resisistance was very poor. Thus there is a need for an awareness program regarding tuberculosis - its signs and symptoms, treatment regimen and drug compliance through advocacy, communication and social mobilization.DOI: http://dx.doi.org/10.3126/hren.v10i2.6578 Health Renaissance 2012; Vol 10 (No.2); 118-125

Patient Delay in Leprosy Treatment in Jhapa District Nepal

Introduction Leprosy remains a public health problem in Nepal with prevalence rate of 3.04 per 10,000 population. Jhapa district has the highest case detection rate of 8.27 per 10,000 as compared to other districts of Nepal. For achieving the elimination of leprosy and reducing the impact on society, early case detection is of utmost priority. Understanding the magnitude of patient delay and factors associated with such delay can provide evidence for making policies and designing programmes aimed at reducing delay. Objectives The objectives of the study were to measure magnitude of patient delay in leprosy treatment and to establish a link of the delay with other variables so that appropriate intervention measures could be taken. Methods The design of the study was cross-sectional, a field survey with a detailed questionnaire for 78 patients and in-depth interview with 7 patients. Structured questionnaire and guidelines were used to obtain quantitative data and for in-depth interviews. Results After adjusting with education, knowledge, perception and type of contact, patient delay in leprosy treatment was found significantly associated with travel time to the diagnostic facilities (p=0.03). The information obtained through questionnaire interview and in-depth interview reveal that patients perceive the disease as curable through medication. Findings suggest that there is still an appreciable level of stigma attached to the disease thus hindering the prompt treatment seeking and social integration. Conclusion Majority of patients are delayed by more than 180 days for seeking care of leprosy. The factors playing significant role in making delayed health seeking are knowledge, accessibility to diagnostic health facility, level of education and perception of patients towards the symptoms of the disease.

Modeling of malaria incidence in Nepal.

Malaria is a major cause of morbidity and mortality in Nepal. The magnitude of malaria across the country is alarming and varies with location. Therefore, the present study aimed to model malaria incidence rates during 1998 to 2009 in Nepal. Data for the study were obtained from Health Management Information System (HMIS), Ministry of Public Health. A negative binomial model was used to fit malaria incidence rates as a function of year and location and provided a good fit, as indicated by residual plots. In total, 83,345 cases of malaria were reported from 1998 to 2009. The mean incidence rate was 0.30 per 1000 population. The models show trends and spatial variations in disease incidence. There was decreasing trend in the incidence rates of malaria (1998-2004), followed by a more moderate upward trend until 2008, when the rate decreases again. Zero malaria incidences occurred in six districts including Humla, Jajarkot, Manang, Kathmandu, Bhakthapur and Solukhumbu districts for over twelve years. Higher incidence occurred in Kanchanpur, Kailali, Bardiya, Kavre, and Jhapa districts for the study period. Malaria is still a public health problem in Nepal. This study showed a steady decreasing trend in malaria incidence but the numbers of cases are still very high. Higher rates were observed in Terai Region and border areas. These findings highlight the need for more systematic and effective malaria control measures on malaria burden areas of Nepal.

Feminisation of Agriculture as an Effect of Male Out-migration: Unexpected Outcomes from Jhapa District, Eastern Nepal

In Nepal, male out-migration is an important factor to contribute to GDP through regular remittances. This paper looks at the effects of male out-migration on the women left behind in relation to labour participation and decision-making in agriculture. The literature speaks of feminisation of agriculture as a positive development for women’s empowerment. A distinction is made between labour feminisation and managerial feminisation. As the two concepts indeed refer to two different roles, power positions and managerial practices, the paper separately explores these practices and actors involved. Data were collected for a doctoral study in Jhapa District, Eastern Nepal; a lowland area from where much male out-migration is taking place. The study shows a higher level of feminisation in a situation where de-facto autonomous female heads-of-household are decision makers and less in case of women who stay within the patrilineal household of their parents-in-law. Moreover, feminisation in the first case has the unexpected outcome that women seem to be moving away from agriculture. An interdisciplinary approach using anthropological in-depth interviews and demographic survey data shows that a concept like feminisation of agriculture needs to be considered and understood in the wider social and cultural context of an expanding rural space

Vegetation Analysis of Namuna Community Forest of Salbari, Sanischare VDC in Jhapa District, Eastern Nepal

Vegetation study was carried out in an afforested land called Namuna Community Forest in Salbari, Sanischare, VDC, Jhapa, District. Random samplings for estimation of density, frequency, basal area and IVI were carried out by laying quadrates (10m x 10 m) at different sites of forest, three times and mean value was calculated. Nine tree species were recorded during field study. Total density of 10,410 pl/ha and total basal area of 33.956 m2/ha of tree species were recorded. The value of density (1790 pl/ha), basal area (31.45m2/ha) and IVI (130.63) were found highest for Shorea robusta, which is ecologically successful species in this forest. Lower value of basal area showed that this forest is young and regenerating. Other tree species had comparatively lower value of density, basal area and IVI due to regular human inte rference. Therefore an example of establishing forest community so as to initiate the conservation of local biodiversity has been discussed in this article.Key words: Community forest; conservation; IVI estimation; regenerating; Shorea robustaJournal of Natural History Museum Vol. 23, 2008 Page 12-15

Assessment of Therapeutic Efficacy of Anti-Malarial Drugs Against Uncomplicated Plasmodium Falciparum Malaria in the Indo-Nepal Border Jhapa District (Nepal) & Darjeeling District, West Bengal (India)

Assessment of Therapeutic Efficacy of Anti-Malarial Drugs Against Uncomplicated Plasmodium Falciparum Malaria in the Indo-Nepal Border Jhapa District (Nepal) & Darjeeling District, West Bengal (India)