| 1. |
- Aryal, Umesh R., 1973, et al.
(författare)
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Establishing a health demographic surveillance site in Bhaktapur district, Nepal : initial experiences and findings
- 2012
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Ingår i: BMC Research Notes. - : BioMed Central. - 1756-0500. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A health demographic surveillance system (HDSS) provides longitudinal data regarding health and demography in countries with coverage error and poor quality data on vital registration systems due to lack of public awareness, inadequate legal basis and limited use of data in health planning. The health system in Nepal, a low-income country, does not focus primarily on health registration, and does not conduct regular health data collection. This study aimed to initiate and establish the first HDSS in Nepal.RESULTS: We conducted a baseline survey in Jhaukhel and Duwakot, two villages in Bhaktapur district. The study surveyed 2,712 households comprising a total population of 13,669. The sex ratio in the study area was 101 males per 100 females and the average household size was 5. The crude birth and death rates were 9.7 and 3.9/1,000 population/year, respectively. About 11% of births occurred at home, and we found no mortality in infants and children less than 5 years of age. Various health problems were found commonly and some of them include respiratory problems (41.9%); headache, vertigo and dizziness (16.7%); bone and joint pain (14.4%); gastrointestinal problems (13.9%); heart disease, including hypertension (8.8%); accidents and injuries (2.9%); and diabetes mellitus (2.6%). The prevalence of non-communicable disease (NCD) was 4.3% (95% CI: 3.83; 4.86) among individuals older than 30 years. Age-adjusted odds ratios showed that risk factors, such as sex, ethnic group, occupation and education, associated with NCD.CONCLUSION: Our baseline survey demonstrated that it is possible to collect accurate and reliable data in a village setting in Nepal, and this study successfully established an HDSS site. We determined that both maternal and child health are better in the surveillance site compared to the entire country. Risk factors associated with NCDs dominated morbidity and mortality patterns.
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| 2. |
- Beal, Jacob, et al.
(författare)
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Robust estimation of bacterial cell count from optical density
- 2020
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Ingår i: Communications Biology. - : Springer Science and Business Media LLC. - 2399-3642. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data.
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| 3. |
- Choulagai, Bishnu, et al.
(författare)
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Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal: 2012 follow-up survey and use of skilled birth attendants
- 2015
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9880 .- 1654-9716. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Estimates of disease burden in Nepal are based on cross-sectional studies that provide inadequate epidemiological information to support public health decisions. This study compares the health and demographic indicators at the end of 2012 in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) with the baseline conducted at the end of 2010. We also report on the use of skilled birth attendants (SBAs) and associated factors in the JD-HDSS at the follow-up point. Design: We used a structured questionnaire to survey 3,505 households in the JD-HDSS, Bhaktapur, Nepal. To investigate the use of SBAs, we interviewed 434 women who had delivered a baby within the prior 2 years. We compared demographic and health indicators at baseline and follow-up and assessed the association of SBA services with background variables. Results: Due to rising in-migration, the total population and number of households in the JD-HDSS increased (13,669 and 2,712 in 2010 vs. 16,918 and 3,505 in 2012). Self-reported morbidity decreased (11.1% vs. 7.1%, respectively), whereas accidents and injuries increased (2.9% vs. 6.5% of overall morbidity, respectively). At follow-up, the proportion of institutional delivery (93.1%) exceeded the national average (36%). Women who accessed antenatal care and used transport (e.g. bus, taxi, motorcycle) to reach a health facility were more likely to access institutional delivery. Conclusions: High in-migration increased the total population and number of households in the JD-HDSS, a peri-urban area where most health indicators exceed the national average. Major morbidity conditions (respiratory diseases, fever, gastrointestinal problems, and bone and joint problems) remain unchanged. Further investigation of reasons for increased proportion of accidents and injuries are recommended for their timely prevention. More than 90% of our respondents received adequate antenatal care and used institutional delivery, but only 13.2% accessed adequate postnatal care. Availability of transport and use of antenatal care was associated positively with institutional delivery.
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| 4. |
- Oli, Natalia, et al.
(författare)
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Changes in children’s diet and physical activity as perceived by their mothers : Impact of a health promotion intervention for mothers in a sub-urban area of Nepal
- 2018
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Ingår i: Journal of Kathmandu Medical College. - Kathmandu : Kathmandu Medical College (KMC). - 2091-1785 .- 2091-1793. ; 7:4, s. 140-146
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Tidskriftsartikel (refereegranskat)abstract
- Background:Unhealthy diet and physical inactivity contribute to the growing burden of cardiovascular diseases in Nepal. Lifestyle is formed in childhood and in the Nepalese context influenced mainly by mothers, it is to date unknown how influential mothers are.Objectives:To assess changes in children’s diet and physical activity as perceived by their mothers after a health promotion intervention.Methodology:The Heart-Health Associated Research, Dissemination and Intervention in the Community is a community trial conducted in the Jhaukhel-Duwakot Health Demographic Surveillance site, in Bhaktapur district of Nepal. We conducted a health promotion intervention on diet and physical activity targeted at mothers with children aged one to nine years old in August-November 2016. Duwakot was randomized as the intervention site and Jhaukhel as the control. We conducted a follow-up study after three months to determine the outcome of the intervention. Nine trained enumerators conducted door-to-door visits to all households with eligible mothers. We calculated mean, frequency and percent changes for children’s behavior.Results:As responded by mothers, children in Duwakot consumed more healthy snacks after the intervention compared to Jhaukhel. Children in Duwakot increased consumption of water and milk. Children’s consumption of packet juices and soft drinks was decreased by 30% and 4% respectively. There was 21% increment in the duration of outdoor playing among the children at Duwakot during follow-up.Conclusion:The Heart-Health Associated Research, Dissemination and Intervention in the Community that focused on mothers showed indirect positive impact on their young children’s diet and physical activity behavior. In future, the longterm effects of such intervention should be assessed.
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| 5. |
- Oli, Natalia, et al.
(författare)
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Experiences and perceptions about cause and prevention of cardiovascular disease among people with cardiometabolic conditions: findings of in-depth interviews from a peri-urban Nepalese community
- 2014
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9880 .- 1654-9716. ; 7:Article Number: 24023
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nepal currently faces an increasing burden of cardiovascular disease (CVD). Earlier studies on health literacy and the behavior dimension of cardiovascular health reported a substantial gap between knowledge and practice. Objective: This qualitative study aimed to deepen understanding of the community perspective on cardiovascular health from the patients' viewpoint. Design: We conducted in-depth interviews (IDIs) with 13 individuals with confirmed heart disease, hypertension, or diabetes mellitus. All participants provided verbal consent. We used an IDI guide to ask respondents about their perception and experiences with CVD, particularly regarding causation and preventability. We manually applied qualitative content analysis to evaluate the data and grouped similar content into categories and subcategories. Results: Respondents perceived dietary factors, particularly consumption of salty, fatty, and oily food, as the main determinants of CVD. Similarly, our respondents unanimously linked smoking, alcohol intake, and high blood pressure with cardiac ailments but reported mixed opinion regarding the causal role of body weight and physical inactivity. Although depressed and stressed at the time of diagnosis, respondents learned to handle their situation better over time. Despite good family support for health care, the financial burden of disease was a major issue. All respondents understood the importance of lifestyle modification and relied upon health professionals for information and motivation. Respondents remarked that community awareness of CVD was inadequate and that medical doctors or trained local people should help increase awareness. Conclusions: This study provided insight into the perceptions of patients regarding CVD. Respondents embraced the importance of lifestyle modification only after receiving their diagnosis. Although better health care is important in terms of aiding patients to better understand and cope with their disease, interventions should be tailored to improve the community's cardiovascular health literacy and preventive practices.
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| 6. |
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| 7. |
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| 8. |
- Vaidya, Abhinav, et al.
(författare)
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Disparities in fruit and vegetable intake by socio-demographic characteristics in peri-urban Nepalese adults: findings from the Heart-Health Associated Research and Dissemination in the Community (HARDIC) Study, Bhaktapur, Nepal
- 2013
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Ingår i: Journal of Kathmandu Medical College. - : Kathmandu Medical College (KMC). - 2091-1785 .- 2091-1793. ; 2:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Inadequate fruit and vegetable intake and other adverse dietary habits – along with tobacco and alcohol abuse and sub-optimal physical activity - make up the four most important behavioural risk factors of non-communicable diseases. Low fruit and vegetable intake is particularly associated with burden of high cardiovascular disease. It has received more attention in the last decade, with studies that explore disparities and determinants in their intake, as well as interventions that attempt to improve the intake. Objectives: Our study aimed to determine fruit and vegetable consumption in a peri-urban community of Nepal and to compare this intake in relation to various socio-demographic variables. Methods: This cross-sectional study was conducted as a part of the HARDIC (Heart-Health Associated Research and Dissemination in the Community) study in the Jhaukhel-Duwakot Health Demographic Surveillance Site in the Bhaktapur district of Nepal during September-December 2011. Adults from six randomly selected clusters were interviewed by 12 trained interviewers after taking informed consent. WHO-STEPS questions were used to elicit information on fruit and vegetable intake. Results: Fruit and vegetable intake in the community was low with 2.1 percent of the study population consuming the WHO-recommended fi ve servings per day. There were differences in the intake according to the various socio-demographic factors. Conclusions: Our study reaffi rms low fruit and vegetable intake as a public health problem in the Nepalese context. Health-promotional activities aimed at specific target groups are essential. Multi-sectoral coordination of health and other health-related sectors is therefore vital in addressing the issue.
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| 9. |
- Vaidya, Abhinav, et al.
(författare)
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High prevalence of prehypertension in mothers of young children in peri-urban Nepal
- 2016
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Ingår i: Journal of Kathmandu Medical College. - : Kathmandu Medical College (KMC). - 2091-1785 .- 2091-1793. ; 5:2, s. 52-60
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prehypertension is clinically defined as a level of blood pressure between normal and hypertension, i.e. elevated systolic blood pressure between 120-139 or diastolic blood pressure between 80-89 mm Hg. Prehypertension remains neglected as a public health problem, and has not been explored in mothers with small children in Nepal.Objectives: We aimed to study prehypertension and its related factors including obesity-related parameters among mothers with children aged 1-7 years in Duwakot and Jhaukhel communities of Bhaktapur district, Nepal.Methods: We prepared a sampling frame of all the eligible mothers, and interviewed 962 mothers. The trained enumerators also measured their blood pressure, body weight, height, waist and hip circumferences. We analysed data with SPSS version 22. We received ethical approval from the Nepal Health Research Council to conduct the study, and obtained informed verbal consent from the participating mothers.Results: About one-third (31.8%) of the mothers had prehypertension. It was more common among Newars and those aged 30-34 years. Multivariate analysis did not reveal significant association with sociodemographic variables except for education. We found positive correlations between blood pressure and obesity parameters. Overweight and obese participants were 2.24 (95% confidence interval: 1.06-4.73) and 4.65 (95% confidence interval: 1.92-11.23) times, respectively, more likely to have prehypertension than underweight mothers.Conclusions: Our study demonstrated a high prevalence of prehypertension, coupled with high obesity parameters, among young mothers of peri-urban Nepal. Primordial preventive efforts at community level are needed not only for the mothers themselves, but for heart-health of their offspring as well.
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| 10. |
- Vaidya, Abhinav, et al.
(författare)
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Is health promotion the starting point of primary cardiovascular care in low- and middle-income countries like Nepal?
- 2012
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Ingår i: Health promotion practice. - : SAGE Publications. - 1524-8399 .- 1552-6372. ; 13:3, s. 412-5
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Tidskriftsartikel (refereegranskat)abstract
- Cardiovascular diseases (CVDs) are on the rise in low- and middle-income countries (LMICs) but have not received adequate priority. With a lack of concrete policy and programs, the present emphasis of CVD management in most LMICs is on curative aspects. Nepal is a prototype in this trend as it is treatment centric, particularly in urban areas. A major drawback of cure-centrism is that it requires both larger funds and more skilled manpower--both of which are limited in Nepal and other LMICs.
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