Sources of information on dengue fever.

<p>Error bars represent 95% confidence intervals.</p

Correlation between knowledge, attitude and practice scores.

<p>All <i>P</i>-values are based on Fisher's R- to- Z transformation of correlation coefficients in highland and lowland categories.</p><p>r_s: Spearman rank correlation coefficients.</p><p>CI: Confidence intervals.</p

Univariate logistic regression analysis showing predictors of knowledge, attitude and practice levels (good vs. poor).

<p>OR: Odds ratio.</p><p>CI: Confidence intervals.</p><p>NRS: Nepalese Rupees.</p

Multiple logistic regression analysis showing predictors of attitude and practice levels (good vs. poor).

<p>OR: Odds ratio.</p><p>aOR: Adjusted odds ratio.</p><p>CI: Confidence intervals.</p

Key characteristics of study sites.

a<p>based on national population and housing census 2011.</p><p><b>*</b>Taken as proxy from district indicator of census data 2011.</p>#<p>Includes tap/piped water supply and tube-well/hand pump.</p><p>All <i>P</i>-values are based on chi-square analysis of numbers in each category.</p><p>NA means not available/applicable.</p

Attitudes towards dengue fever (DF).

<p>All <i>P</i>-values are based on chi-square analysis of numbers in highland and lowland categories except those indicated by an asterisk (<b>*</b>) which are based on Fisher's exact test. Responses in bold font indicate correct answer. DENV means dengue virus.</p><p>Note: None of the participants strongly disagreed with statements or questions in our study.</p

Preventive measures against dengue fever (DF).

<p>All <i>P</i>-values are based on chi-square analysis of numbers in highland and lowland categories except those indicated by an asterisk (<b>*</b>) which are based on Fisher's exact test. Responses in bold font indicate correct answer.</p

Knowledge of dengue fever (DF) transmission.

<p>All <i>P-</i>values are based on chi-square analysis of numbers in highland and lowland categories except those indicated by an asterisk (*) which are based on Fisher's exact test. Responses in bold font indicate correct answer.</p

Knowledge on symptoms and signs of dengue fever (DF).

<p>All <i>P-</i>values are based on chi-square analysis of numbers in highland and lowland categories except those indicated by an asterisk (*) which are based on Fisher's exact test. Responses in bold font indicate correct answer.</p

The Burden and Determinants of Non Communicable Diseases Risk Factors in Nepal: Findings from a Nationwide STEPS Survey

<div><p>Background</p><p>World Health Organization (WHO) estimates for deaths attributed to Non Communicable Diseases (NCDs) in Nepal have risen from 51% in 2010 to 60% in 2014. This study assessed the distribution and determinants of NCD risk factors among the Nepalese adult population.</p><p>Methods and Findings</p><p>A nationally representative cross-sectional survey was conducted from Jan to June 2013 on the prevalence of NCD risk factors using the WHO NCD STEPS instrument. A multistage cluster sampling method was used to randomly select the 4,200 respondents. The adjusted prevalence ratio (APR) was used to assess the determinants of NCD risk factors using a Poisson regression model. The prevalence of current smoking (last 30 days) was 19% (95%CI:16.6-20.6), and harmful alcohol consumption (≥60 g of pure alcohol for men and ≥40 g of pure alcohol for women on an average day) was 2% (95%CI:1.4-2.9). Almost all (99%, 95%CI:98.3-99.3) of the respondents consumed less than five servings of fruits and vegetables combined on an average day and 3% (95%CI:2.7-4.3) had low physical activity. Around 21% (95%CI:19.3-23.7) were overweight or obese (BMI≥25). The prevalence of raised blood pressure (SBP≥140 mm of Hg or DBP≥90 mm of Hg) and raised blood glucose (fasting blood glucose ≥126 mg/dl), including those on medication were 26% (95%CI:23.6-28.0) and 4% (95%CI:2.9-4.5) respectively. Almost one quarter of respondents, 23% (95%CI:20.5-24.9), had raised total cholesterol (total cholesterol ≥190 mg/dl or under current medication for raised cholesterol). he study revealed a lower prevalence of smoking among women than men (APR:0.30; 95%CI:0.25-0.36), and in those who had higher education levels compared to those with no formal education (APR:0.39; 95%CI:0.26-0.58). Harmful alcohol use was also lower in women than men (APR:0.26; 95%CI:0.14-0.48), and in Terai residents compared to hill residents (APR:0.16; 95%CI:0.07-0.36). Physical inactivity was lower among women than men (APR:0.55; 95%CI:0.38-0.80), however women were significantly more overweight and obese (APR:1.19; 95%CI:1.02-1.39). Being overweight or obese was significantly less prevalent in mountain residents than in hill residents (APR:0.41; 95%CI:0.21-0.80), and in rural compared to urban residents (APR:1.39; 95%CI:1.15-1.67). Lower prevalence of raised blood pressure was observed among women than men (APR:0.69; 95%CI: 0.60-0.80). Higher prevalence of raised blood glucose was observed among urban residents compared to rural residents (APR:2.05; 95%CI:1.29-3.25). A higher prevalence of raised total cholesterol was observed among the respondents having higher education levels compared to those respondents having no formal education (APR:1.76; 95%CI:1.35-2.28).</p><p>Conclusion</p><p>The prevalence of low fruit and vegetable consumption, overweight and obesity, raised blood pressure and raised total cholesterol is markedly high among the Nepalese population, with variation by demographic and ecological factors and urbanization. Prevention, treatment and control of NCDs and their risk factors in Nepal is an emerging public health problem in the country, and targeted interventions with a multi-sectoral approach need to be urgently implemented.</p></div