Old Women Care Situation in Rural Nepal : A Reflection from Professional Perspective

Master in social science - Nord university, 201

Impact of air pollution on global burden of disease in 2019

Air pollution consisting of ambient air pollution and household air pollution (HAP) threatens health globally. Air pollution aggravates the health of vulnerable people such as infants, children, women, and the elderly as well as people with chronic diseases such as cardiorespiratory illnesses, little social support, and poor access to medical services. This study is aimed to estimate the impact of air pollution on global burden of disease (GBD). We extracted data about mortality and disability adjusted life years (DALYs) attributable to air pollution from 1990 to 2019. The extracted data were then organized and edited into a usable format using STATA version 15. Furthermore, we also estimated the impacts for three categories based on their socio-demographic index (SDI) as calculated by GBD study. The impacts of air pollution on overall burden of disease by SDI, gender, type of pollution, and type of disease is estimated and their trends over the period of 1990 to 2019 are presented. The attributable burden of ambient air pollution is increasing over the years while attributable burden of HAP is declining over the years, globally. The findings of this study will be useful for evidence-based planning for prevention and control of air pollution and reduction of burden of disease from air pollution at global, regional, and national levels

Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal:perspectives of stakeholders

BACKGROUND: Nepal adopted the Multisectoral Action Plan for the Prevention and Control of Non-Communicable Diseases (MSAP) in 2014. Implementation of the plan has been challenging, with limited participation from non-health sectors. OBJECTIVES: The overall aim of the study was to gain the perspectives of key stakeholders involved in the Nepal MSAP on the barriers and facilitators to its implementation, through the participation of relevant sectors in the plan. METHODS: We held face-to-face semi-structured interviews with 12 stakeholders working in sectors involved in the MSAP. These sectors included the Office of the Prime Minister and Council of Ministries; Ministry of Health and Population (MOHP); Ministry of Education, Science and Technology; Ministry of Forest and Environment; academia; and professional organizations. Thematic analysis of transcripts was used to identify themes on awareness of NCDs, awareness of the MSAP, and barriers and facilitators to participation in the MSAP. RESULTS: Participants recognised NCDs as a growing and major burden in Nepal. However, a number of participants were not familiar with the MSAP, identifying a lack of leadership and poor dissemination. Political and systemic transformation, since the adoption of the MSAP, was seen as a key barrier to implementation. International commitments to develop multisectoral action made by the Government of Nepal were identified as drivers. The recent establishment of a separate section for NCDs and Mental Health within the Department of Health Services of MOHP and the promotion of a Health in All Policies (HiAP) approach in recent national documents, were both considered to support implementation. CONCLUSIONS: The establishment of permanent multisectoral or multistakeholder mechanisms has been challenging despite strong political calls for their development. Moving beyond 2020, multisectoral action plans should engage with stakeholders from federal, provincial and local governments in order to develop costed action plans with specific roles and responsibilities for each sector

An Open-Source Platform for Real-Time Preliminary Diagnosis amongst Adults using Data Analytics

Depression can be defined as a mental health disorder characterized by persistently depressed mood, loss of interest in activities, causing significant impairment in daily life.  Technical intervention to screen depression in non-clinical population which records, classify depression on the basis of severity and provide features or predictors that discriminate the classification of depression among non-clinical population comprising of college students is the main area of the study. Beck Depression Inventory – II (BDI-II), as per Diagnostic and Statistical manual of Mental disorder (DSM IV) is used to screen depression and its severity. Indicators are determined on the basis of how well the features or predictors can discriminate the classes of depression severity.  Providing quality indicators which help in supporting the process can be considered as symptoms for screening depression.  Descriptive analytics is used in order to find the underlying pattern of the responses captured, factor analysis groups variables on the basis of correlation between patterns of the responses to reduce dimension.  The approach for supervised descriptive analysis method that takes BDI-II questions as features and refine the features using information gain and linear discriminant analysis as feature selection algorithm. The classification of severity of depression is done using Support vector machine (SVM).

Nepal Urgently Needs a National Evidence Synthesis Centre

Evidence synthesis is a powerful research process that allows researchers to combine and analyse all relevant data from multiple studies and draw conclusions based on the most up-to-date evidence available. The science to synthesize research evidence has developed considerably in recent years. Evidence-based health care has undergone a revolution over two decades. Several global organizations produce, support and use evidence synthesis, including: the Cochrane Collaboration, the Campbell Collaboration, the Health Evidence Network WHO, Evidence Synthesis International, and several others have been preparing high quality summaries of research about the effectiveness of drugs, interventions and health care in general.1 Many policymakers, clinicians and health managers are drawing on these reliable reviews in their decision making. There is increasing trend of scientific publications on health research in Nepal, therefore this is the right time to assess the quality of published articles and evidence synthesis for evidence-informed decision-making

Hypertension screening, awareness, treatment, and control: a study of their prevalence and associated factors in a nationally representative sample from Nepal

Background: The growing burden of hypertension is emerging as one of the major healthcare challenges in low- and middle-income countries (LMICs), such as Nepal. Given that they are struggling to deliver adequate health services, some LMICs have significant gaps in the cascade of hypertension care (including screening, awareness, treatment, and control). This results in uncontrolled hypertension, placing a high burden on both patients and healthcare providers. Objective: The objective of this study was to quantify the gaps in hypertension screening, awareness, treatment, and control in the Nepalese population. Methods: We used the data from a pooled sample of 9682 participants collected through two consecutive STEPwise approach to Surveillance (STEPS) surveys conducted in Nepal in 2013 and 2019. A multistage cluster sampling method was applied in the surveys, to select nationally representative samples of 15- to 69-year-old Nepalese individuals. Prevalence ratios were calculated using multivariable Poisson regression. Results: Among the hypertensive participants, the prevalence of hypertension screening was 65.9% (95% CI: 62.2, 69.5), the prevalence of hypertension awareness was 20% (95% CI: 18.1, 22.1), the prevalence of hypertension treatment was 10.3% (95% CI: 8.8, 12.0), and the prevalence of hypertension control was 3.8% (95% CI: 2.9, 4.9). The unmet need of hypertension treatment and control was highest amongst the poorest individuals, the participants from Lumbini and Sudurpaschim provinces, those who received treatment in public hospitals, the uninsured, and those under the age of 30 years. Conclusions: The gaps in the cascade of hypertension care in Nepal are large. These gaps are particularly pronounced among the poor, persons living in Lumbini and Sudurpaschim provinces, those who sought treatment in public hospitals, those who did not have health insurance, and young people. National- and local-level public health interventions are needed to improve hypertension screening, awareness, treatment, and control in Nepal

Non-linear effect of temperature variation on childhood rotavirus infection: A time series study from Kathmandu, Nepal

Available online 30 July 2020Introduction: This study aimed to investigate the effects of temperature variability on rotavirus infections among children under 5 years of age in Kathmandu, Nepal. Findings may informinfection control planning, especially in relation to the role of environmental factors in the transmission of rotavirus infection. Methods: Generalized linear Poisson regression equationswith distributed lag non-linearmodelwere fitted to estimate the effect of temperature (maximum,mean and minimum) variation onweekly counts of rotavirus infections among children under 5 years of age living in Kathmandu, Nepal, over the study period (2013 to 2016). Seasonality and long-term effects were adjusted in the model using Fourier terms up to the seventh harmonic and a time function, respectively. We further adjusted the model for the confounding effects of rainfall and relative humidity. Results: During the study period, a total of 733 cases of rotavirus infection were recorded, with amean of 3 cases per week. We detected an inverse non-linear association between rotavirus infection and average weekly mean temperature, with increased risk (RR: 1.52; 95% CI: 1.08–2.15) at the lower quantile (10th percentile) and decreased risk (RR: 0.64; 95% CI: 0.43–0.95) at the higher quantile (75th percentile). Similarly, we detected an increased risk [(RR: 1.93; 95% CI: 1.40–2.65) and (RR: 1.42; 95% CI: 1.04–1.95)] of rotavirus infection for both maximum and minimum temperature at their lower quantile (10th percentile). We estimated that 344 (47.01%) cases of rotavirus diarrhoea among the children under 5 years of age were attributable to minimum temperature. The significant effect of temperature on rotavirus infectionwas not observed beyond lag zero week. Conclusion: An inverse non-linear association was estimated between rotavirus incidence and all three indices of temperature, indicating a higher risk of infection during the cooler times of the year, and suggesting that transmission of rotavirus in Kathmandu, Nepal may be influenced by temperature.Dinesh Bhandari, Peng Bi, Meghnath Dhimal, Jeevan Bahadur Sherchand, Scott Hanson-Ease

Has COVID-19 suppressed dengue transmission in Nepal?

Following the report of the first COVID-19 case in Nepal on 23 January 2020, three major waves were documented between 2020 and 2021. By the end of July 2022, 986 596 cases of confirmed COVID-19 and 11 967 deaths had been reported and 70.5% of the population had received at least two doses of a COVID-19 vaccine. Prior to the pandemic, a large dengue virus (DENV) epidemic affected 68 out of 77 districts, with 17 932 cases and six deaths recorded in 2019. In contrast, the country's Epidemiology and Disease Control Division reported 530 and 540 dengue cases in the pandemic period (2020 and 2021), respectively. Furthermore, Kathmandu reported just 63 dengue cases during 2020 and 2021, significantly lower than the 1463 cases reported in 2019. Serological assay showed 3.2% positivity rates for anti-dengue immunoglobulin M antibodies during the pandemic period, contrasting with 26.9-40% prior to it. Real-time polymerase chain reaction for DENV showed a 0.5% positive rate during the COVID-19 pandemic which is far lower than the 57.0% recorded in 2019. Continuing analyses of dengue incidence and further strengthening of surveillance and collaboration at the regional and international levels are required to fully understand whether the reduction in dengue incidence/transmission were caused by movement restrictions during the COVID-19 pandemic