Economic Burden of HIV/AIDS upon Households in Nepal: A Critical Review

Thousands of people are infected with HIV/AIDS in Nepal and most of them are adults of working age. Therefore, HIV/AIDS is a big burden in Nepal. This review was conducted to find the existing knowledge gap about the economic burden of HIV/AIDS at the household level in Nepal, the extent of economic burden exerted by the disease, and to provide policy recommendations. It is concluded that there was a considerable knowledge gap about the issue, and the economic burden exerted by HIV/AIDS was big enough to push the affected households into poverty. It is suggested that more studies need to be conducted to fill the knowledge gap. Similarly, Government of Nepal and other organisations working in the field of HIV/AIDS need to provide economic supports (e.g.- support for travel costs) to the HIV positive people and need to increase the awareness level among general population for reducing stigma and discrimination, and reducing economic burden on them

Agro-morphological Diversity of High Altitude Bean Landraces in the Kailash Sacred Landscape of Nepal

Many varieties of bean are widely grown across diverse agro-ecological zones in Nepal. And opportunities exist for improving the crops and enhancing their resilience to various biotic and abiotic stressors. In this context, an experiment was conducted from June to October 2016 in Khar VDC of Darchula district to study the phenotypic traits of nine landraces of bean (Phaseolus vulgaris L.). The bean landraces were planted using randomized complete block design in three sites (Dhamidera, Dallekh and Sundamunda villages), with three replications in each site for their comparative analysis. The study considered the following phenotypic traits: days to emergence, days to 50% flowering, days to 90% pod maturity, number of nodes, pod length, pod width, number of pods, number of seeds per pod and weight and grain yield for 100 seeds. Kruskal-Wallis test showed significant differences in the landraces both within and among locations. KA-17-08-FB and KA-17-04-FB were late  flowering (63 and 65 days respectively) compared to other landraces whereas KA-17-07-FB flowered earliest (within 42 days). In all three sites, three landraces namely KA-17-07-FB, KA-17-04-FB and KA-17-06-FB were found to be relatively more resistant to pest and diseases than other landraces. Eight out of nine landraces in Dhamidera and Dallekh villages and seven out of nine in Sundamunda village produced seeds greater than 1.0 t/ha. Among the nine varieties KA-17-02-FB was the highest yielding variety, with an average yield of 3.8 t/ha. This study is useful for identifying suitable landraces for future promotion based on their maturity, grain yield, diseases resistance and other qualitative and quantitative characteristics

Prevalence of underweight, overweight and obesity and their associated risk factors in Nepalese adults: Data from a nationwide survey, 2016

INTRODUCTION:Over the past few decades, the total population of Nepal has increased substantially with rapid urbanization, changing lifestyle and disease patterns. There is anecdotal evidence that non-communicable diseases (NCDs) and associated risk factors are becoming key public health challenges. Using nationally representative survey data, we estimated the prevalence of underweight, overweight and obesity among Nepalese adults and explored socio-demographic factors associated with these conditions. MATERIALS AND METHODS:We used the Nepal Demographic Health Survey 2016 data. Sample selection was based on stratified two-stage cluster sampling in rural areas and three stages in urban areas. Weight and height were measured in all adult women and men. Body mass index (BMI) was calculated using Asian specific BMI cut-points. RESULTS:A total of 13,542 adults aged 18 years and above (women 58.19%) had their weight and height measured. The mean (±SD) age was 40.63±16.82 years (men 42.75±17.27, women 39.15±16.34); 41.13% had no formal education and 60.97% lived in urban areas. Overall, 17.27% (95% CI: 16.64-17.91) were underweight; 31.16% (95% CI: 30.38-31.94) overweight/obese. The prevalence of both underweight (women 18.30% and men 15.83%, p<0.001) and overweight/obesity (women 32.87% and men 28.77%, p<0.001) was higher among women. The older adults (≥65 years) (aOR: 2.40, 95% CI: 1.92-2.99, p<0.001) and the adults of poorest wealth quintile (aOR: 2.05, 95% CI: 1.62-2.59, p<0.001) were more likely to be underweight. The younger age adults (36-45 years) (aOR: 3.05, 95% CI: 2.61-3.57, p<0.001) and women (aOR: 1.53, 95% CI 1.39-1.68, p<0.001) were more likely to be overweight or obese. Also, all adults were twice likely to overweight/obese (p<0.001). No significant difference was observed for overweight/obesity by ecological regions and place of residence (urban vs. rural). CONCLUSION:These findings confirm co-existence of double burden of underweight and overweight/obesity among Nepalese adults. These conditions are associated with increased risk of developing NCDs. Therefore, effective public health intervention approaches emphasizing improved primary health care systems for NCDs prevention and care and using multi-sectoral approach, is essential

A systematic review of current knowledge of HIV epidemiology and of sexual behaviour in Nepal

OBJECTIVE: To systematically review information on HIV epidemiology and on sexual behaviour in Nepal with a view to identifying gaps in current knowledge. METHODS: Systematic review covering electronic databases, web-based information, personal contact with experts and hand searching of key journals. RESULTS: HIV-1 seroprevalence has been rising rapidly in association with high-risk behaviours, with current levels of 40% amongst the nation's injecting drug users and approaching 20% amongst Kathmandu's female commercial sex workers (FCSWs). HIV seroprevalence remains low in the general population (0.29% of 15–49 year olds). There are significant methodological limitations in many of the seroprevalence studies identified, and these estimates need to be treated with caution. There are extensive migration patterns both within the country and internationally which provide the potential for considerable sexual networking. However, studies of sexual behaviour have focused on FCSWs and the extent of sexual networks within the general population is largely unknown. CONCLUSIONS: Whilst some of the ingredients are present for an explosive HIV epidemic in Nepal, crucial knowledge on sexual behaviour in the general population is missing. Research on sexual networking is urgently required to guide HIV control in Nepal. There is also a need for further good-quality epidemiological studies of HIV seroprevalence

Adapting Livestock Production Systems to Climate Change in Nepal: Challenges and Opportunities

To assess climate change impacts and identify challenges and opportunities for livestock climate change adaption, we conducted a comprehensive study in the Thulokhola watershed of Nuwakot district in Nepal from June 1, 2011 to January 31, 2013. We established nine community livestock groups (CLGs) consisting of 51 members and trained the CLG members in daily livestock record keeping and monitoring surface water quality. Monthly fecal samples from 50 cattle, 50 goats, and 50 buffaloes were collected for the determination of gastrointestinal parasites. Soil and fodder samples were also collected and analyzed. Group discussions, Participatory Rural Appraisals, and full-fledged household survey of 97 households were done. A survey of 41 water sources in the watershed was also conducted. While 85.3 % of the water sources have either dried up or decreased in flow in recent years, drought conditions had great toll on agricultural production. Prevalence rates of helminthes on goats, cattle, and buffalo was 53.8%, 31.32%, and 23.52%, respectively, and animal deaths were remarkably high. Declining pregnancy rates on livestock along with waning supply of fodder and forages and poor soil quality were additional major problems. Although local communities have undertaken several measures including adding new breed, destocking, purchasing fodder and forages, and planting grasses for livestock climate change adaptation, the problems of animal health, breeding conditions, soil fertility, forest degradation, increasing women workload, and water shortages were largely unaddressed. Opportunities for livestock climate change adaptation in Nepal include agroforestry intervention, groundwater utilization, rainwater harvesting, enhancing feed efficiency, and community capacity-building

Quantitative Trait Loci for Freezing Tolerance in a Lowland x Upland Switchgrass Population

Low-temperature related abiotic stress is an important factor affecting winter survival in lowland switchgrass when grown in northern latitudes in the United States. A better understanding of the genetic architecture of freezing tolerance in switchgrass will aid the development of lowland switchgrass cultivars with improved winter survival. The objectives of this study were to conduct a freezing tolerance assessment, generate a genetic map using single nucleotide polymorphism (SNP) markers, and identify QTL (quantitative trait loci) associated with freezing tolerance in a lowland × upland switchgrass population. A pseudo-F2 mapping population was generated from an initial cross between the lowland population Ellsworth and the upland cultivar Summer. The segregating progenies were screened for freezing tolerance in a controlled-environment facility. Two clonal replicates of each genotype were tested at six different treatment temperatures ranging from −15 to −5°C at an interval of 2°C for two time periods. Tiller emergence (days) and tiller number were recorded following the recovery of each genotype with the hypothesis that upland genotype is the source for higher tiller number and early tiller emergence. Survivorship of the pseudo-F2 population ranged from 89% at −5°C to 5% at −15°C with an average LT50 of −9.7°C. Genotype had a significant effect on all traits except tiller number at −15°C. A linkage map was constructed from bi-allelic single nucleotide polymorphism markers generated using exome capture sequencing. The final map consisted of 1618 markers and 2626 cM, with an average inter-marker distance of 1.8 cM. Six significant QTL were identified, one each on chromosomes 1K, 5K, 5N, 6K, 6N, and 9K, for the following traits: tiller number, tiller emergence days and LT50. A comparative genomics study revealed important freezing tolerance genes/proteins, such as COR47, DREB2B, zinc finger-CCCH, WRKY, GIGANTEA, HSP70, and NRT2, among others that reside within the 1.5 LOD confidence interval of the identified QTL

Optical conductivity and vibrational spectra of the narrow-gap semiconductor FeGa3_3

Intermetallic narrow-gap semiconductors have been intensively explored due to their large thermoelectric power at low temperatures and a possible role of strong electronic correlations in their unusual thermodynamic and transport properties. Here we study the optical spectra and vibrational properties of $\mathrm{FeGa_3}$ single crystal. The optical conductivity indicates that $\mathrm{FeGa_3}$ has a direct band gap of $\sim 0.7$\,eV, consistent with density functional theory (DFT) calculations. Most importantly, we find a substantial spectral weight also below 0.4~eV, which is the energy of the indirect (charge) gap found in resistivity measurements and ab initio calculations. We find that the spectral weight below the gap decreases with increasing temperature, which indicates that it originates from the impurity states and not from the electronic correlations. Interestingly, we did not find any signatures of the impurity states in vibrational spectra. The infrared and Raman vibrational lines are narrow and weakly temperature dependent. The vibrational frequencies are in excellent agreement with our DFT calculations, implying a modest role of electronic correlations. Narrow M\" ossbauer spectral lines also indicate high crystallinity of the sample

Collaborative care model for depression in rural Nepal: A mixed-methods implementation research study

Introduction Despite carrying a disproportionately high burden of depression, patients in low-income countries lack access to effective care. The collaborative care model (CoCM) has robust evidence for clinical effectiveness in improving mental health outcomes. However, evidence from real-world implementation of CoCM is necessary to inform its expansion in low-resource settings. Methods We conducted a 2-year mixed-methods study to assess the implementation and clinical impact of CoCM using the WHO Mental Health Gap Action Programme protocols in a primary care clinic in rural Nepal. We used the Capability Opportunity Motivation-Behaviour (COM-B) implementation research framework to adapt and study the intervention. To assess implementation factors, we qualitatively studied the impact on providers' behaviour to screen, diagnose and treat mental illness. To assess clinical impact, we followed a cohort of 201 patients with moderate to severe depression and determined the proportion of patients who had a substantial clinical response (defined as ≥50% decrease from baseline scores of Patient Health Questionnaire (PHQ) to measure depression) by the end of the study period. Results Providers experienced improved capability (enhanced self-efficacy and knowledge), greater opportunity (via access to counsellors, psychiatrist, medications and diagnostic tests) and increased motivation (developing positive attitudes towards people with mental illness and seeing patients improve) to provide mental healthcare. We observed substantial clinical response in 99 (49%; 95% CI: 42% to 56%) of the 201 cohort patients, with a median seven point (Q1:-9, Q3:-2) decrease in PHQ-9 scores (p<0.0001). Conclusion Using the COM-B framework, we successfully adapted and implemented CoCM in rural Nepal, and found that it enhanced providers' positive perceptions of and engagement in delivering mental healthcare. We observed clinical improvement of depression comparable to controlled trials in high-resource settings. We recommend using implementation research to adapt and evaluate CoCM in other resource-constrained settings to help expand access to high-quality mental healthcare