Digital Commons Network^™

Roadside Exposure And Inflammation Biomarkers Among A Cohort Of Traffic Police In Kathmandu, Nepal, Kabindra M. Shakya, Richard E. Peltier, Yimin Zhang, Basu D. Pandey

Environmental Health Sciences Faculty Publication Series

Air pollution is a major environmental problem in the Kathmandu Valley. Specifically, roadside and traffic-related air pollution exposure levels were found at very high levels exceeding Nepal air quality standards for daily PM_2.5. In an exposure study involving traffic police officers, we collected 78 blood samples in a highly polluted spring season (16 February 2014–4 April 2014) and 63 blood samples in the less polluted summer season (20 July 2014–22 August 2014). Fourteen biomarkers, i.e., C-reactive protein (CRP), serum amyloid A (SAA), intracellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1), interferon gamma (IFN-γ), interleukins (IL1-β, IL-2, IL-4, …

Delays In Antiretroviral Therapy Initiation Among Hiv-Positive Individuals: Results Of The Positive Living With Hiv Study, Krishna C. Poudel, David R. Buchanan, Kalpana Poudel-Tandukar

Health Promotion and Policy Faculty Publication Series

Background: Lack of early initiation of antiretroviral therapy (ART) remains a major health concern due to increased risk of premature mortality and further HIV transmission. This study explored CD4+ cell count monitoring in relation to delays in ART initiation among HIV-positive individuals in the Kathmandu Valley, Nepal, where ART coverage was only 23.7% in 2011.

Design: We recruited a total of 87 ART-naïve, HIV-positive individuals aged 18 to 60 years through the networks of five non-government organizations working with HIV-positive individuals. We collected data on the history of ART initiation, CD4+ cell count monitoring, socio-demographic variables, perceived family …

Perceived Family Support And Antiretroviral Adherence In Hiv-Positive Individuals: Results From A Community-Based Positive Living With Hiv Study, Krishna Poudel, David Buchanan, Rachel Amiya, Kalpana Poudel-Tandukar

Elaine Marieb College of Nursing Faculty Publication Series

The purpose of this study was to examine the association between perceived family support, either positive or negative, and adherence to antiretroviral medication regimens among HIV-positive individuals in the Kathmandu Valley, Nepal. We measured past 3-month antiretroviral adherence among 233 HIV-positive individuals, in relation to perceived family support, both positive (in terms of emotional and instrumental support) and negative (in the form of negative interactions), using the 10-item Nepali Family Support and Difficulty Scale. Medium and high levels of perceived emotional support from family were associated with reduced risk of antiretroviral nonadherence, compared with low levels of perceived emotional support …

Serum Zinc Concentration And C-Reactive Protein In Individuals With Human Immunodeficiency Virus Infection: The Positive Living With Hiv (Polh) Study, Krishna Poudel, Elizabeth Bertone-Johnson, Kalpana Poudel-Tandukar

Elaine Marieb College of Nursing Faculty Publication Series

Low zinc levels and chronic inflammation are common in individuals infected with human immunodeficiency virus (HIV). Zinc deficiency may promote systemic inflammation, but research on the role of zinc in inflammation among HIV-positive individuals taking account of antiretroviral therapy is lacking. We assessed the association between serum zinc and C-reactive protein (CRP) concentration in a cohort of HIV-positive individuals. A cross-sectional survey was conducted among 311 HIV-positive individuals (177 men and 134 women) aged 18–60 years residing in Kathmandu, Nepal. High-sensitive or regular serum CRP concentrations were measured by the latex agglutination nephelometry or turbidimetric method, and zinc concentrations were …

Perceived Family Support And Depression Among People Living With Hiv/Aids In The Kathmandu Valley, Nepal, Sadhana Shrestha, Krishna Poudel, Kalpana Poudel-Tandukar, Jun Kobayashi, Basu Dev Pandey, Junko Yasuoka, Keiko Otsuka, Masamine Jimba

Elaine Marieb College of Nursing Faculty Publication Series

Background: Depression is emerging as a highly prevalent psychiatric condition among people living with HIV/AIDS (PLWHA). Perceived family support (PFS) buffers depression among chronic disease patients. However, a similar relationship among PLWHA is unexplored. Objective: To examine the relationship between PFS and depression among PLWHA in the Kathmandu Valley, Nepal. Methods: In this cross-sectional study, depression was measured by Beck Depression Inventory Ia. Perceived family support was measured by Nepali Family Support and Difficulties Scale. The status of depression was compared between 208 PLWHA and 208 HIV-negative participants. The relationship between PFS and depression was examined only among PLWHA. Results: …

Coinfection With Hepatitis C Virus Among Hiv-Positive People In The Kathmandu Valley, Nepal, Krishna Poudel, Paula Palmer, Masamine Jimba, Tetsuya Mizoue, Jun Kobayashi, Kalpana Poudel-Tandukar

Elaine Marieb College of Nursing Faculty Publication Series

Background: Previous research has studied the rate of hepatitis C virus (HCV) coinfection among HIV-positive people regardless of their antiretroviral therapy (ART) status. Our objectives were to measure the seroprevalence of HCV both in HIV-positive people receiving ART and in those not receiving ART and to describe the characteristics of coinfected people in the Kathmandu Valley, Nepal. Methods: We conducted a cross-sectional survey of 319 HIV-positive people residing in the Kathmandu Valley, Nepal. We screened the participants’ serum samples for HCV antibodies using the Latex Photometric Immunoassay based on third-generation assay. Results: A total of 138 (43.3%) participants were HCV …

Correlates Of Sharing Injection Equipment Among Male Injecting Drug Users In Kathmandu, Nepal, Krishna Poudel, Kalpana Poudel-Tandukar, Junko Yasuoka, Anand Joshi, Masamine Jimba

Elaine Marieb College of Nursing Faculty Publication Series

Background: HIV prevalence is high and risky injection practices occur frequently among injecting drug users (IDUs) in Nepal. We explored the correlates of sharing injection equipment (having injected with a needle or syringe previously used by another) among male IDUs in Kathmandu, Nepal. Methods: From August to September 2007, we anonymously interviewed 296 male IDUs in Kathmandu, Nepal, using a structured questionnaire. We performed bivariate and multivariable logistic regression analysis and identified variables associated with sharing injection equipment. Results: Over half (n = 152) of the participants reported injecting drugs with a needle or syringe previously used by another in …

Unsafe Sexual Behaviors Among Hiv-Positive Men In Kathmandu Valley, Nepal, Krishna Poudel, Shinji Nakahara, Kalpana Poudel-Tandukar, Junko Yasuoka, Masamine Jimba

Elaine Marieb College of Nursing Faculty Publication Series

We assessed unsafe sexual behaviors of the Nepalese HIV-positive men and their knowledge about the consequences of unsafe sex. We interviewed 167 participants recruited conveniently in the Kathmandu Valley, Nepal. Of total, 125 participants (75%) had sex in the past 6 months, 47% of whom with multiple partners. Fiftyseven (46%) of 123 participants who had sex did not always use condoms; unsafe sex was common in seroconcordant or serodiscordant relationships or in serounknown relationships. Only 41% (50/123) participants knew about the possibility of HIV superinfection. Our results suggest the urgent need of HIV prevention interventions for the Nepalese HIV-positive men.

Relationship Between Mechanisms And Activities At The Time Of Pedestrian Injury And Activity Limitation Among School Adolescents In Kathmandu, Nepal, Kalpana Poudel-Tandukar, Shinji Nakahara, Masao Ichikawa, Krishna Poudel-Tandukar, Susumu Wakai

Elaine Marieb College of Nursing Faculty Publication Series

This study assessed the relationship between pedestrian activity at the time of injury, the type of vehicle involved and resulting activity limitation among school adolescents in the Kathmandu and Lalitpur districts of Nepal. A cross-sectional study of 1557 students in grades 6–8 across 14 schools was conducted using a self-administered questionnaire from August to September 2003. Twenty-three percent of adolescents reported pedestrian injuries, 38% were from urban and 21% from semi-urban areas. Adolescents were commonly injured by motorcycles and motor vehicles while crossing the road; however, while walking and playing, they were commonly injured by bicycles and motorcycles. Bicycles and …

Reaching Hard-To-Reach Migrants By Letters: An Hiv/Aids Awareness Programme In Nepal, Krishna Poudel, Masamine Jimba, Kalpana Poudel-Tandukar, Susume Wakai

Elaine Marieb College of Nursing Faculty Publication Series

We assessed the impact of an HIV/AIDS programme for Nepalese migrants to India that involved writing letters. The programme created opportunities for sending HIV/AIDS-related messages to the migrants in India, and encouraging them practicing safer sex. Initially, they received the messages only from the programme, but later from their colleagues, spouses or other family members. They discussed the messages in groups, disseminated them, and sought more knowledge in their destinations. These findings indicated that using letters could be an effective way to reach inaccessible migrants at their destinations, and help them to improve their HIV/AIDS-related knowledge, and safer sex practices.

Factors Influencing Women’S Use Of Health Services For Sexually Transmitted Infections In Eastern Nepal, Kalpana Poudel-Tandukar, Krishna Poudel, Colin Macdougall

Elaine Marieb College of Nursing Faculty Publication Series

This paper explores low levels of women’s health service utilization for Sexually Transmitted Infections (STIs) in Nepal.We interviewed 120 women individually and 53 in focus groups. Predictors of lower utilisation were self-medication, consultation with faith healers, inadequate knowledge of STIs, beliefs about causes, fear, social taboos and stigmatisation, women’s secondary status, and presence of male health professionals. Results indicate the importance of people’s beliefs in their decisions about health care. Strategies to improve access to health services in Nepal shouldsystematically investigate the role of all these factors to improve access to and utilisation of health services for STIs.