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Effect of knowledge and perception on adherence to iron and folate supplementation during pregnancy in Kathmandu, Nepal.

BACKGROUND: Adherence to iron and folate supplementation during pregnancy is considered key to prevention and control of iron deficiency anemia. Nepal-like other developing countries-faces problems with adherence vis-a-vis iron/folate supplementation. OBJECTIVE: This descriptive survey aimed to assess the effect ofknowledge and perception ofpregnant women on adherence to iron/folate supplementation in Kathmandu, Nepal. MATERIAL AND METHOD: The present study was conducted in Paropakar Maternity and Womens' Hospital in Kathmandu. Systematic random sampling was used to select 406 persons who we…

Prostate cancer screening in a healthy population cohort in eastern Nepal: an explanatory trial study.

BACKGROUND: Prostate cancer features a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in males. OBJECTIVE: To explore the situation of prostate cancer in a healthy population cohort in Eastern Nepal. MATERIALS AND METHODS: This study was conducted in the Department of General Surgery at B. P. Koirala Institute of Health Sciences, Dharan, Nepal from July 2010 to June 2011. Males above 50 years visiting the Surgical Outpatient Department in BPKIHS were enrolled in the study and screening camps were organized in fo…

Unsafe abortion after legalisation in Nepal: a cross-sectional study of women presenting to hospitals.

OBJECTIVE: To investigate abortion practices of Nepali women requiring postabortion care. DESIGN: Cross-sectional study. SETTING: Four tertiary-care hospitals in urban and rural Nepal. SAMPLE: A total of 527 women presenting with complications from induced abortion in 2010. METHODS: Women completed questionnaires on their awareness of the legal status of abortion and their abortion-seeking experiences. The method of induction and whether the abortion was obtained from an uncertified source was documented. Multivariable logistic regression was used to identify associated factors. MAIN OUTC…

Magnitude and determinants of refractive error among school children of two districts of Kathmandu, Nepal.

PURPOSE: The purpose of this study is to assess the magnitude and determinants of refractive error among school children of Lalitpur and Bhaktapur districts in Kathmandu Valley of Nepal. MATERIALS AND METHODS: A descriptive study was carried out in 2003 in four schools; two in each district. A detailed ocular examination was conducted of all children attending these schools and that included visual acuity testing, slit lamp examination, fundus evaluation, retinoscopy, cycloplegic refraction and subjective refraction. Myopia was defined as more than -0.5 D and hypermetropia was defined as erro…

Dengue virus and Japanese encephalitis virus epidemiological shifts in Nepal: a case of opposing trends.

We report on the changing epidemiology of two important flaviviruses in Nepal: Japanese encephalitis (JE) and dengue viruses. Morbidity and mortality in Nepal is in the thousands since JE was introduced in 1978. Nepal launched an extensive laboratory-based JE surveillance in 2004. Nepal experienced a remarkable reduction in disease burden after mass immunizations from 2005 to 2010, when 2,040 JE infections and 205 JE-related deaths were confirmed. With its emergence in 2006, dengue has become a significant challenge in the country, highlighted by a sudden outbreak in 2010 that resulted in 359 …

Epidemiology of Taenia solium in Nepal: is it influenced by the social characteristics of the population and the presence of Taenia asiatica?

The transmission of the zoonotic pork tapeworms Taenia solium and T. asiatica depends on a combination of specific risk factors, such as open defecation, backyard pig raising and the consumption of raw or undercooked pork and viscera. A community-based survey was conducted among 289 households in south-eastern Nepal to study the heterogeneity of these risk factor frequencies as a function of the social composition of the population. The frequency of open defecation, backyard pig raising and pork consumption differed significantly (P < 0.005) among the different coexisting caste and ethnic grou…

Suicidal ideation among students of a medical college in Western Nepal: a cross-sectional study.

Many studies have been conducted in the developed countries to know the magnitude and factors influencing suicidal ideation among medical students, but such data are sparse in developing countries. This cross-sectional study was therefore conducted to find out the prevalence of suicidal ideation and factors influencing such ideation among students of a medical college in Western Nepal. A total of 206 students were selected using random sampling and questioned about their socio-demographic factors, other risk factors and suicidal ideation using a preformed validated questionnaire. The data were…

Implementation of legal abortion in Nepal: a model for rapid scale-up of high-quality care.

Unsafe abortion's significant contribution to maternal mortality and morbidity was a critical factor leading to liberalization of Nepal's restrictive abortion law in 2002. Careful, comprehensive planning among a range of multisectoral stakeholders, led by Nepal's Ministry of Health and Population, enabled the country subsequently to introduce and scale up safe abortion services in a remarkably short timeframe. This paper examines factors that contributed to rapid, successful implementation of legal abortion in this mountainous republic, including deliberate attention to the key areas of policy…

Will visceral leishmaniasis be eliminated from Nepal? A review of recent (1994-2006) control efforts.

The Visceral Leishmaniasis (VL) control program in Nepal launched in 1993 includes provision of free diagnostic test, treatment along with vector control by indoor residual spraying. However, even after 14 years the disease is far from being controlled. Elimination of VL by 2015 has recently been identified as a regional priority with high level of political commitment. We analyzed the VL control effort in Nepal over the period 1994-2006 and tried to formulate recommendations for the VL elimination initiative. To document performance of the VL control program in Nepal we used literature review…

Клинические и прогнозные особенности детей с острым энцефалитным синдромом в Непале; ретроспективное исследование.

КОЛИЧЕСТВО: Синдром острого энцефалита (AES) часто встречается у госпитализированных детей Непала. Примерно четверть случаев приходится на японский энцефалит (JE). Несмотря на то, что были выявлены плохие прогнозы в отношении ДЖЭ и даны руководящие указания в отношении управления, относительно мало сообщается об остальных трех четвертях случаев СЭЗ. МЕТОДЫ: В период с 2006 по 2008 год в двух больницах Катманду были выявлены дети, имеющие AES (n = 225). По отдельности анализировались пациенты, не имеющие результатов поясничных проколов (n = 40) или инфекция бактерий или плазмодия (n = 40). Оста

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BACKGROUND: Acute encephalitis syndrome (AES) is commonly seen among hospitalized Nepali children. Japanese Encephalitis (JE) accounts for approximately one-quarter of cases. Although poor prognostic features for JE have been identified, and guide management, relatively little is reported on the remaining three-quarters of AES cases. METHODS: Children with …

Population genetics of Vibrio cholerae from Nepal in 2010: evidence on the origin of the Haitian outbreak.

Cholera continues to be an important cause of human infections, and outbreaks are often observed after natural disasters, such as the one following the 2010 earthquake in Haiti. Once the cholera outbreak was confirmed, rumors spread that the disease was brought to Haiti by a battalion of Nepalese soldiers serving as United Nations peacekeepers. This possible connection has never been confirmed. We used whole-genome sequence typing (WGST), pulsed-field gel electrophoresis (PFGE), and antimicrobial susceptibility testing to characterize 24 recent Vibrio cholerae isolates from Nepal and evaluate …

Perinatal characteristics and outcome of VLBW infants at NICU of a developing country: an experience at eastern Nepal.

OBJECTIVE: To evaluate the perinatal chracteristics and mortality pattern as well as to correlate mortality with perinatal characteristics in very low birth weight (VLBW) infants. METHODS: This was a retrospective study. Chi square tests, Fisher Exact tests, Log rank tests and Pearson correlation coefficient were used for analysis of different parameters using SPSS 10.0 statistical software. RESULTS: Among 125 VLBW infants, 76 survived. Survival improved with increasing birth weight (BW) and gestational age (GA). Most deaths occurred within 5 days. Duration of hospital stay increased with de

Prenatal micronutrient supplementation and intellectual and motor function in early school-aged children in Nepal.

CONTEXT: Iron and zinc are important for the development of both intellectual and motor skills. Few studies have examined whether iron and z … andomized controlled trial of prenatal micronutrient supplementation between 1999 and 2001 in rural Nepal. Study children were also in the placebo group of a subsequent preschool iron and zinc supplementation trial. INTERVENTIONS: Women whose children were followed up had been randomly assigned to receive daily iron/folic acid, iron/folic acid/zinc, or …

Pattern and quality of scientific communications on drug safety produced by a regional pharmacovigilance center in Nepal.

UNLABELLED: Analyzing the pattern and quality of scientific communications on pharmacovigilance can help the regional centers in Nepal and other developing countries to develop approaches for communicating effectively medicine safety issues. This kind of research is lacking in developing countries. OBJECTIVES: To analyze the pattern and quality of scientific communications on drug safety produced by the regional pharmacovigilance center at western Nepal. METHODOLOGY: Various conference abstracts and journal publications produced by the center during its initial four years of establishment (1…

Pattern of occurrence of leukemia at a teaching hospital in eastern region of Nepal - a six year study.

INTRODUCTION: Pattern of leukemia is known to vary widely throughout the world. The characterization of distribution patterns of different subtypes of leukemia in Nepal needs further study. We wanted to study the leukemia pattern in our institute. METHODS: A retrospective study of 196 cases of leukemia, diagnosed at BPKIHS, between January 1997 to December 2002 was done. We analyzed the pattern of leukemia at BPKIHS by morphological subtype, gender, age at diagnosis, time period of diagnosis (seasonality), and geographic distribution. RESULTS: Morphological sub typing showed that 121 cases w…

Testing a scalable community-based approach to improve maternal and neonatal health in rural Nepal.

OBJECTIVE: The aim of the study was to determine the feasibility of improved maternal-neonatal care-seeking and household practices using an approach scalable under Nepal's primary health-care services. STUDY DESIGN: Impact was assessed by pre- and post-intervention surveys of women delivering within the previous 12 months. Each district sample comprised 30 clusters, each with 30 respondents. The intervention consisted primarily of community-based antenatal counseling and dispensing and an early postnatal home visit; most activities were carried out by community-based health volunteers. RESU…

Homeless street children in Nepal: use of allostatic load to assess the burden of childhood adversity.

As challenges to child well-being through economic disadvantage, family disruption, and migration or displacement escalate world wide, the need for cross-culturally robust understanding of childhood adversity proportionately increases. Toward this end, developmental risk was assessed in four contrasting groups of 107 Nepali children ages 10-14 years that represent distinctive, common conditions in which contemporary children grow up. Relative cumulative burden (allostatic load) indexed by multiple dimensions of physical and psychosocial stress was ascertained among homeless street boys and thr…

Environmental hazards in Nepal: altitude illness, environmental exposures, injuries, and bites in travelers and expatriates.

BACKGROUND: Adventure travel necessarily places travelers at risk of environmental hazards. We assessed the burden of "environmental" hazards among a cohort of travelers and expatriates presenting to a large travel clinic in Nepal. METHODS: Data on travelers and expatriates seen at the Canadian International Water and Energy Consultants (CIWEC) clinic in Kathmandu were prospectively collected and entered into the GeoSentinel Surveillance Network database. Data on individuals receiving predefined diagnoses related to environmental hazards were extracted and analyzed. RESULTS: Of 10,499 travel…

Incidence of megaloblastic anaemia and its correction in leishmaniasis--a prospective study at BPKIHS hospital, Nepal.

Fifty (50) cases of Leishmaniasis were included in a prospective study after making the diagnosis based on the demonstration of L D Bodies on bone marrow aspirate. Hemoglobin (Hb) and total leucocyte count (TLC) were less than 10 gm/dl and 4000 per/ml respectively in 22 out of 50 cases. Among 50 cases, 30 showed macrocytic red cell and hypersegmented neutrophils on peripheral blood smear as features of megaloblastic anemia. Out of 30 cases of leishmaniasis with megaloblastic anemia, 10 cases showed decreased reticulocyte count. Bone marrow aspiration cytology showed megaloblastic maturation in