Prevalence of multidrug resistant bacteria in causing community acquired urinary tract infection among the patients attending outpatient department of Seti Zonal Hospital, Dhangadi, Nepal

Involvement of multidrug resistant bacteria in causing community acquired infection is very serious public health issue. The main objective of our study was to determine the prevalence of multidrug resistant bacteria in causing community acquired urinary tract infection. In this study we cultured the 384 mid stream urine samples collected aseptically from the patients attending outpatient department of Seti zonal hospital and having no past history of hospitalization. The organisms isolated were identified by using conventional biochemical tests and antimicrobial susceptibility testing was performed by Kirby Bauer disc diffusion technique. Out of total 384 samples 98 (25.52%) samples showed significant bacterial growth. The most prevalent bacterium isolated was Escherichia coli. 42.86% of the bacteria isolated were found to be multidrug resistant (MDR). The involvement of such large numbers of multidrug resistant bacteria in causing community acquired urinary tract infection is very serious issue and cannot be neglected. And some abrupt initiatives should be taken by the responsible authorities to improve or at least avoid the further worsening of the situation.Nepal Journal of Biotechnology. Dec. 2015 Vol. 3, No. 1: 55-5

Road traffic injuries in Nepal during COVID-19 lockdown

Background: As the world is busy addressing COVID-19, road traffic injuries, another major cause of deaths is continuously killing people on the roads. In Nepal, there were frequent media reports of occurrences of road crashes, injuries, and deaths despite nationwide lockdown. This paper aims to describe the situation of road traffic crashes and casualties during the period of complete lockdown. Methods: This study used secondary data from two sources: Nepal Police and media reports between 24 March and 14 June 2020 (because the government lifted the nationwide lockdown from 15 June 2020). Available details of crashes, deaths, and injuries for this period were extracted from media reports and the summary data that was obtained from the Police. Narrative comparison is done between the data for the same period from both the sources, where possible. Results: Nepal Police recorded 1,801 incidents of road crashes during the 82 days of the COVID-19 lockdown with 256 deaths (on average 3.1 deaths daily) and 1,824 injuries (on average 22.2 injuries daily). Motorcycles comprised over 21% of all vehicles involved in crashes. Ambulances and other vehicles for essential services were also found to be involved in crashes. Speeding itself was the cause for almost a quarter of the incidents during the lockdown. Conclusions: Even when the movement restrictions were imposed in Nepal, the number of road crashes was not substantially reduced. Media reports were mainly found to be reporting the crashes where deaths occurred, but police records also included nonfatal injuries. The incidence of crashes in this period shows that it is important to work for road safety to save lives from road traffic crashes in Nepal

Global community child health

This special issue of IJERPH has published a range of studies in this developing field of Global Community Child Health research. A number of manuscripts submitted in response to our invitation describing ‘community-based interventions which impact on child health and wellbeing around the globe. In addition to rural community-based initiatives given that most children now live in cities we are also interested to hear about urban initiatives….’ We hope this issue will be of great interest to the researchers and practitioners as well as academia from the fields of Global Health as well as Global Child Health because it comprised of 14 articles representing all five continents. Physical activity appears a key component of the scientific community’s current conception of child well-being judging from the four papers published addressing this area. This issue also has papers on childhood obesity to rubella vaccination. Despite of the journal’s strive for reaching out to a wider global child health community, this issue missed contributions relating to child safeguarding and social determinants of urban health

Community-based child injury prevention in Nepal: A programme for female community health volunteers

An educational injury prevention programme, including basic first-aid training was developed for FCHVs and mother's group members. This included the discussion about child injury prevention in mother's group meeting; development of a mother's group facilitation manual; a picture book on child injuries and two education posters. Two hundred sixty mothers and thirty males were directly involved in the mother's group meetings. Twenty First-Aid kits were provided to 9 FCHVs, 10 mother's groups and a VDC facilitator. In total, the FHCVs and mothers identified 155 injured children in the VDC over a period of 7 months using the child injury data collection form. A report of the feasibility of delivering the materials through women’s groups in wards across the project VDC was prepared. An observation of their knowledge about child injuries before and after implementing this intervention found considerable increased awareness about child injuries. Each mother's group was able to establish a Child Injury Prevention Fund in their ward using a donation of about £6 per ward from the research study. Dissemination of the intervention and findings has been done through presentations at the South West Public Health Scientific Conference in February 2014 and IUHPE World Health Promotion Conference in Thailand in August 2013. An oral presentation is planned for the Faculty Research Conference at the University of the West of England in 2014. As stated in the proposal, preparation of articles for Peer Reviewed Journal and abstracts for International Conference is also planned. The following sections describe the results related to the process and programmatic part of the intervention

Epidemiology of unintentional child injuries in the makwanpur district of Nepal: A household survey

© 2015 by the authors; licensee MDPI, Basel, Switzerland. Secondary sources of information indicate that the proportion of child deaths due to injuries is increasing in Nepal. This study aimed to describe the epidemiology of unintentional injuries in children, explore risk factors and estimate the burden faced by families and the community in the Makwanpur district. We conducted a household survey in Makwanpur, covering 3441 households. Injuries that occurred during the 12 months before the survey and required treatment or caused the child to be unable to take part in usual activities for three or more days were included. We identified 193 cases of non-fatal unintentional child injuries from 181 households and estimated an annual rate of non-fatal injuries of 24.6/1000 children; rates for boys were double (32.7/1000) that for girls (16.8/1000). The rates were higher among the children of age groups 1–4 years and 5–9 years. Falls were the most common cause of non-fatal child injuries followed by burns in preschool children and road traffic injuries were the most likely cause in adolescence. Mean period of disability following injury was 25 days. The rates and the mechanisms of injury vary by age and gender. Falls and burns are currently the most common mechanisms of injury amongst young children around rural homes

Gender identity: Challenges to access social and health care services for lesbians in Nepal

Literature about same-sex love and sexuality in Nepal is rare. However, limited anecdotal evidence on these issues signals that the health and social care needs of lesbians in Nepal are high. This qualitative study explores the challenges faced by lesbians in Nepal in accessing health and social services. In-depth interviews carried out with fifteen lesbians found that Nepalese lesbians face many challenges from families and society which result in a stressful life, homelessness and forced and unwanted relationships and marriage, including self-harming behaviours. They often face discrimination and harassment when coming out at public administration and social institutions. Hence, most lesbians of Nepal prefer not to disclose their sexual identity due to the fear of becoming isolated and not getting quality health care services

Engaging Nepali journalists in good road safety reporting: Evaluation of the impact of training workshops

Most road traffic crash reports published in Nepali media provide little information about their causes, impacts, or preventability. Three workshops involving 31 journalists from diverse media platforms were held using published World Health Organisation resources, to provide training in good road safety reporting. Participants were invited to complete a survey exploring their motivation for participation and knowledge gained. Thirteen (42%) participants responded, reporting the acquisition of new knowledge for content generation, finding facts, active application of learning, and purposeful communication, and an intention to apply the skills learned in their work. A before and after assessment of 94 media outputs from workshop participants found an improvement in the use of story angles and ideas recommended in WHO resources. The study suggests that journalists are interested in developing their road safety reporting skills and that running such workshops has the potential to improve responsible reporting and the promotion of road safety

Identifying research priorities for road safety in Nepal: A Delphi study

OBJECTIVE: To identify and prioritise the research needed to help Nepali agencies develop an improved road safety system. DESIGN: Delphi study.Nepal. PARTICIPANTS: Stakeholders from government institutions, academia, engineering, healthcare and civil society were interviewed to identify knowledge gaps and research questions. Participants then completed two rounds of ranking and a workshop. RESULTS: A total of 93 participants took part in interviews and two rounds of ranking. Participants were grouped with others sharing expertise relating to each of the five WHO 'pillars' of road safety: (1) road safety management; (2) safer roads; (3) safer vehicles; (4) safer road users and (5) effective postcrash response. Interviews yielded 1019 research suggestions across the five pillars. Two rounds of ranking within expert groups yielded consensus on the important questions for each pillar. A workshop involving all participants then led to the selection of 6 questions considered the most urgent: (1) How can implementing agencies be made more accountable? (2) How should different types of roads, and roads in different geographical locations, be designed to make them safer for all road users? (3) What vehicle fitness factors lead to road traffic crashes? (4) How can the driver licensing system be improved to ensure safer drivers? (5) What factors lead to public vehicle crashes and how can they be addressed? and (6) What factors affect emergency response services getting to the patient and then getting them to the right hospital in the best possible time? CONCLUSIONS: The application of the Delphi approach is useful to enable participants representing a range of institutions and expertise to contribute to the identification of road safety research priorities. Outcomes from this study provide Nepali researchers with a greater understanding of the necessary focus for future road safety research

The prevention of‑ and first response to‑ injuries in Nepal: A review of policies and legislation

Background: Injuries, the cause of an estimated 4.5 million deaths annually and many more disabilities worldwide each year, are the predictable outcome of particular circumstances. One of the most effective ways to prevent injuries is through policy and legislation. The aim of this research study was to identify and critically review all policy and legislation in Nepal that had the potential to prevent injuries. Methods: We identified legislation and policy that met inclusion criteria through a stakeholder meeting, networks and contacts, and websites and electronic resources. Each included document was critically reviewed to identify areas of strength and opportunities for improvement. We compared the included documents against WHO’s recommendations of known effective interventions. Results: Sixty-two documents met the inclusion criteria for this review. Of these, 24 (38.7%) were exclusively related to road injuries, 11 (17.7%) to occupational injuries, 6 (9.7%) to injuries in the home and 5 (8.1%) to injuries at school; 30 (48.4%) documents included text related to the first response to injuries. Of 127 strategic recommendations by WHO that provided an area for policy or legislative focus, 21 (16.5%) were considered adequately met by Nepali policy and legislation, 43 (33.9%) were considered partially met and 63 (49.6%) were not met. Conclusion: We drew five conclusions from this critical policy review, which we have related to recommendations as follows: widening the scope of legislation and policy for injury prevention to emphasize injuries occurring at home or school; addressing the causes of injuries and promoting proven preventive measures; greater clarity on both individual and institutional roles and responsibilities; trustworthy data and quality evidence to inform decision-making; and financial investment and capacity-strengthening for injury prevention and first response. The current system of federal governance in Nepal has potential for strengthening injury prevention and first response at the central, provincial and local levels

Diabetes prevention and management in South Asia

Background: Globally, the number of people living with Diabetes Mellitus (DM) has increased four-fold since 1980. South Asia houses one-fifth of the world’s population living with diabetes, and it was the 8th leading cause of deaths in 2013 for South Asians.Aim: To review and discuss the context of diabetes in South Asia, with a particular focus on, a) contributing factors and impact; b) national health policies around non-communicable diseases in the region, and c) to o er recommendations for prevention and management of diabetes.Method: We assessed relevant publications using PubMed, Scopus and OvidSP. Similarly, the World health Organization (WHO) and relevant ministries of each South Asian country were searched for reports and policy documents.Results: Emerging evidence supports that the prevalence of diabetes (ranging from 3.3% in Nepal up to 8.7% in India) in South Asia follows the global trend over the past decades. Urban populations in the region demonstrate a higher prevalence of diabetes, although is also a public health concern for rural areas. Changes in the pattern and types of diet, together with increasingly sedentary, lifestyles are major causes of diabetes. The overall agenda of health promotion to prevent diabetes has not yet been established in the region, and the majority of the countries in the region are inadequately prepared for the therapeutic services for diabetes.Conclusions: The early onset of the diabetes, longevity of morbidity and early mortality may have a significant impact on people’s health expenditure and health systems, as well as on the region’s demographic composition. There is an urgent need to reduce the prevalence of diabetes in the region through evidence-based interventions ranging from prevention and early detection to appropriate treatment and care. We suggest that a multi-sectorial collaboration across all stakeholders is necessary to raise awareness about diabetes, its prevention, treatment and care in the region