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- 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. |
- Shakya-Vaidya, Suraj, et al.
(författare)
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Do non-communicable diseases such as hypertension and diabetes associate with primary open-angle glaucoma? : Insights from a case-control study in Nepal
- 2013
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Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 6, s. 22636-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Non-communicable diseases (NCDs) such as hypertension and diabetes are rapidly emerging public health problems worldwide, and they associate with primary open-angle glaucoma (POAG). POAG is the most common cause of irreversible blindness. The most effective ways to prevent glaucoma blindness involve identifying high-risk populations and conducting routine screening for early case detection. This study investigated whether POAG associates with hypertension and diabetes in a Nepalese population.METHODS: To explore the history of systemic illness, our hospital-based case-control study used non-random consecutive sampling in the general eye clinics in three hospitals across Nepal to enroll patients newly diagnosed with POAG and controls without POAG. The study protocol included history taking, ocular examination, and interviews with 173 POAG cases and 510 controls. Data analysis comprised descriptive and inferential statistics. Descriptive statistics computed the percentage, mean, and standard deviation (SD); inferential statistics used McNemar's test to measure associations between diseases.RESULTS: POAG affected males more frequently than females. The odds of members of the Gurung ethnic group having POAG were 2.05 times higher than for other ethnic groups. Hypertension and diabetes were strongly associated with POAG. The overall odds of POAG increased 2.72-fold among hypertensive and 3.50-fold among diabetic patients.CONCLUSION: POAG associates significantly with hypertension and diabetes in Nepal. Thus, periodic glaucoma screening for hypertension and diabetes patients in addition to opportunistic screening at eye clinics may aid in detecting more POAG cases at an early stage and hence in reducing avoidable blindness.
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| 3. |
- Shakya-Vaidya, Suraj, et al.
(författare)
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Understanding and living with glaucoma and non-communicable diseases like hypertension and diabetes in the Jhaukhel-Duwakot Health Demographic Surveillance Site: a qualitative study from Nepal
- 2014
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9880 .- 1654-9716. ; 7, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Primary open-angle glaucoma (POAG) is one of the most common causes of irreversible blindness. A possible association between POAG and non-communicable diseases such as hypertension and diabetes suggests that the incidence of POAG may increase. People with POAG in Nepal usually present late to hospital and have poor knowledge of glaucoma. Objectives: Anticipating a knowledge gap regarding these diseases, this study aimed to explore the knowledge of POAG, hypertension, and diabetes in the community and barriers to health care. Design: We conducted this qualitative study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS), a peri-urban community near Kathmandu, a capital city of Nepal. To study how disease influences knowledge, we conducted focus group discussions separately for men and women with and without pre-existing POAG, hypertension, and diabetes. Data were analyzed using the framework analysis approach. Results: Although people suffering from POAG, hypertension, and/or diabetes exhibited adequate knowledge of hypertension and diabetes, they lacked in-depth knowledge of POAG. People believed mostly in internal health locus of control. Perception of disease consequences and impact of disease on daily life was influenced by pre-existing POAG, hypertension, and/or diabetes but only in men. Gender disparity was observed regarding health literacy, health perception, and health barriers, which put women in a more difficult situation to tackle their health. We also revealed a gap between knowledge, attitude, and practice of health among women and healthy men. Conclusion: Although people in JD-HDSS exhibited adequate knowledge regarding hypertension and diabetes, they lacked in-depth knowledge about POAG. This study demonstrated gender difference in health literacy and access to health care, making women more vulnerable towards disease. We also demonstrated a gap between knowledge, attitude, and practice of health. However, tailored health literacy programs may bring changes in the health status in the community.
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| 4. |
- Shakya-Vaidya, Suraj, et al.
(författare)
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Visual status in primary open-angle glaucoma: a hospital-based report from Nepal
- 2014
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Ingår i: Journal of Kathmandu Medical College. - : Nepal Journals Online (JOL). - 2091-1785 .- 2091-1793. ; 3:2, s. 49-57
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Tidskriftsartikel (refereegranskat)abstract
- Background: Primary open-angle glaucoma (POAG) is the commonest cause of irreversible blindness. Most hospitals in Nepal are carrying out opportunistic glaucoma screening for those attending hospitals for any eye consultation. However, there are no reports detailing the visual damage at the time of diagnosis confi rming the early detection of cases. Objectives: This study aimed to investigate the clinical features and visual status at the time of diagnosis of POAG in the Nepalese population. Methods: We evaluated 173 newly diagnosed consecutive cases of POAG from three hospitals across Nepal. Glaucoma evaluation was carried out detailing the findings of visual acuity and visual fields. Continuous data were presented as means and standard deviations (SD) and categorical data as proportions (95% CI). Unpaired t-tests compared continuous variables with p value set at a 5% level of signifi cance. Results: Out of total patients, 82.1% were diagnosed incidentally while they visited the hospital for symptoms not expected to be for glaucoma. Only 9.8% of cases were aware of them being at risk of developing glaucoma and thus attended hospitals for regular check-up. Visual field examination revealed mean scores of mean deviation (MD) as low as -13.24 dB and pattern standard deviation of 7.34 dB. Glaucoma hemifield test was outside normal limits in 61.5% of eyes tested. Additionally, 4.7% patients were blind. Conclusion: POAG cases presented late with signifi cant visual damage. Existing opportunistic screening for glaucoma in Nepal needs to be combined with community-based glaucoma awareness programs to bring more people to hospital at the early stage of the disease.
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| 5. |
- Vaidya, Abhinav, et al.
(författare)
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Obesity Prevalence in Nepal : Public Health Challenges in a Low-Income Nation during an Alarming Worldwide Trend
- 2010
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 7:6, s. 2726-2744
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Forskningsöversikt (refereegranskat)abstract
- The future toll of the obesity epidemic will likely hit hardest in low- and middle-income countries. Ongoing urbanization promotes risk factors including sedentary lifestyle and fat- and sugar-laden diets. Low-income countries like Nepal experience a double disease burden: infectious diseases as well as rising incidence of noncommunicable diseases (e.g., cardiovascular disease and diabetes mellitus) frequently characterized by obesity. Nepal currently directs efforts towards curing disease but pays little attention to preventive actions. This article highlights obesity prevalence in Nepal, delineates the challenges identified by our pilot study (including low health literacy rates), and suggests strategies to overcome this trend.
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