Medicine and Health Sciences Commons^™

Predicting Factors Of Health-Related Quality Of Life Among End-Stage Renal Disease Patients Receiving Hemodialysis At A Tertiary Level Hospital In Nepal., Jyoti Gahatraj, Poolsuk Janepanish Visudtibhan, Tiraporn Junda, Nipaporn Butsing

Journal of Health Research

Background: End-stage renal disease (ESRD) puts tremendous burdens upon affected patients and their support persons in Nepal. The health-related quality of life (HRQoL) among Nepalese persons with hemodialysis-dependent ESRD is not well understood. This study aimed to examine HRQoL and its predicting factors among persons undergoing hemodialysis in Nepal.

Methods: A purposive sampling was applied to recruit 106 persons with ESRD receiving hemodialysis at a tertiary hospital in Nepal between October and December 2021. The structured questionnaires included personal information, the World Health Organization Quality of Life instruments (WHOQOL-BREF), the fatigue assessment scale (FAS), the Hamilton depression rating scale (HDRS), …

National Health Insurance Program In Nepal: Early Experiences And Its Effect On Health Service Utilization, Rajani Bharati

Dissertations and Theses

Introduction: Nepal initiated the Health Insurance program in 2016 to achieve Universal Health Coverage by 2030. However, the enrollment rate is low, and people are already starting to drop out. Therefore, this study aimed to explore the demand and supply side (service providers) experiences with Nepal's National Health Insurance Program and its effect on insurance enrollment and health service utilization.

Methods: We employed a mixed-method design. Ethnographic methods were used to explore the rich holistic insights into people's views and actions. We conducted 14 focus group discussions and 20 key informant interviews, mainly in Kailali and Baglung districts. …

Nepal's Response To Contain Covid-19 Infection, Rano Mal Piryani, Suneel Piryani, Jay Narayan Shah

Community Health Sciences

Nepal is a landlocked country bordering two most populous countries, India and China. Nepal shares open border with India from three sides, east, south and west. And, in north with China, where the novel coronavirus infection (CVOVID-19) began in late December 2019. The first confirmed imported case in Nepal was reported in 2nd week of January 2020. The initial response of Nepal to COVID-19 were comparably slow but country geared efforts after it was declared a 'global pandemic' by WHO on 11 March, 2020. Government of Nepal's steps from 18 March, 2020 led to partial lock down and countrywide lockdown …

Social, Economic, And Political Events Affect Gender Equity In China, Nepal, And Nicaragua: A Matched, Interrupted Time-Series Study, Tuan T. Nguyen, Ashley Darnell, Amy Weissman, Edward A. Frongillo Jr., Roger Mathisen, Karin Lapping, Timothy D. Mastro, Mellissa Withers

Faculty Publications

: Progress in gender equity can improve health at the individual and country levels.: This study's objective was to analyze recent trends in gender equity and identify historical and contextual factors that contributed to changes in gender equity in three countries: China, Nepal, and Nicaragua.: To assess gender equity trends, we used the Gender Gap Index (GGI) from the World Economic Forum's Global Gender Gap Report (2006-2017). The GGI incorporated data on economic participation, educational attainment, health, and political empowerment for almost 150 countries. We selected China, Nepal, and Nicaragua because of their major changes in GGI and diversity in …

Risk And Resilience Pertaining To Mental Health Of Youth Attending A College In Kathmandu Who Were Exposed To The 2015 Earthquakes During Their Adolescence: A Mixed Method Study, Vinita Sharma

USF Tampa Graduate Theses and Dissertations

Background: Adverse mental health outcomes have been previously reported among survivors of natural disasters. Available studies mostly focus on risk factors and not resilience. In 2015, a series of earthquakes caused massive loss of lives and livelihood in Nepal. Epidemiological data pertaining to youth mental health in Nepal is limited. Information about the post-earthquake mental health of youth who were exposed to earthquakes during their adolescence in Nepal is scarce.

Purpose: The purpose of this study was to address risk and resilience factors related to mental health among college-attending Nepali youth (18-20 years) exposed to the 2015 earthquake during their …

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

Krishna C. Poudel

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

Krishna C. Poudel

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 …

Understanding The Mechanisms Linking Gendered Intrahousehold Bargaining Power And Child Nutrition In Rural Nepal, Shibani Kulkarni

Theses and Dissertations

Child undernutrition is a serious issue in Nepal as 36% of children below five years of age are chronically undernourished. Reducing child undernutrition is an important priority to prevent adverse effects through the life course that perpetuate the cycle of undernutrition and poverty.

Women’s intra-household bargaining power is an important determinant of child nutrition. Intra-household bargaining power is an individual’s relative social and economic position within the household to access and control resources, and influence decision-making. In our research, we use women’s intra-household bargaining power as a resource for care, which enables women to be exposed to nutrition information, gain …

Nepal : Healthcare And Sanitation Issues Resulting From Frequent Natural Disasters In Nepal, Jake Lauderdale

Global Public Health

This Public Health Brief calls to attention the issues plaguing Nepal as a result of both frequent natural disasters and poor healthcare infrastructure. The geographic characteristics of Nepal are shown to be a major factor in the damage and aftermath of natural disasters such as earthquakes. Due to its status as a poor and economically weakened country, Nepal must rely heavily on outside aid in order to alleviate the pressure of frequently occurring natural disasters. Despite work being done by several Non-Governmental Organizations, Nepal has a long way to go before they are able to independently manage the outcomes of …

Risk Factors For Pre-Eclampsia And Eclampsia In Nepal, Population Council

Reproductive Health

Each day around the world, 830 women die from pregnancy- and childbirth-related causes. The second most common cause (after postpartum hemorrhage) is a hypertensive disorder during pregnancy, such as pre-eclampsia and eclampsia (PE/E)—life-threatening, pregnancy-induced high blood pressure and excess protein in urine—which can lead to seizures and other fatal complications. One in four preterm infants dies as a result of its mother’s PE/E. These deaths are preventable, yet essential medicines and tools to treat this disorder are often unavailable in low-resource settings. This factsheet provides a graphic overview of the data surrounding this issue with a specific focus on Nepal.

Caste-Ethnic Disparity In Vaccine Use Among 0- To 5-Year-Old Children In Nepal: A Decomposition Analysis, Satis Devkota, Christopher Butler

Economics & Management Publications

Objectives To examine what factors, if any, could account for caste/ethnic disparities in vaccine utilization between upper caste and indigenous, and upper caste and low caste (Dalit) groups in Nepal.

Methods Using the Institute of Medicine (IOM) approach to calculate disparity, we estimate the disparity between upper caste and indigenous, and between upper caste and Dalit 0- to 5-year-old children in Nepal. Then we use Fairlie’s non-linear regression-based decomposition technique to account for those disparities in immunization.

Results Using nationally representative data (the Nepal Living Standard Survey II and III), we construct a pooled cross-sectional series and calculate the disparity …

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 …

A Cross-Sectional Study On Patients' Access To Healthcare In A Developing Nation, Pawan Bhandari

All Graduate Theses, Dissertations, and Other Capstone Projects

The objective of this research study was to gauge the current status of patients' access to health care services in a developing nation or least-developed country (as defined by the World Bank and United Nations), Nepal. Many patients are not privileged to have a hospital at a close proximity in Nepal. They are also forced to travel and wait for long hours due to their inability to pay for services offered by private healthcare institutions. A survey questionnaire was developed to get a snapshot of how long patients travel to get to a public hospital for an outpatient service. The …

Perceived Family Support And Antiretroviral Adherence In Hiv-Positive Individuals: Results From A Community-Based Positive Living With Hiv Study (International Quarterly Of Community Health Education), Krishna C. Poudel, David R. Buchanan, Rachel Amiya, Kalpana Poudel-Tandukar

Kalpana Poudel-Tandukar

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

Kalpana Poudel-Tandukar

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 …

Understanding Factors Influencing Adverse Sex Ratios At Birth And Exploring What Works To Achieve Balance: The Situation In Selected Districts Of Nepal, Mahesh Puri, Anand Tamang

Poverty, Gender, and Youth

The goal of this study is to identify programs and sociocultural factors underlying disparities in sex ratios at birth in some parts of Nepal, by comparing the situation in districts with high and normal sex ratios at birth and among under-5 children. Findings are expected to inform the design of programs intended to raise the value of girls in general and counter the practice of gender-biased sex selection in particular. The study was conducted in two adjoining hill districts of the western development region of Nepal, namely Kaski (where sex ratios are adverse) and Tanhaun (where sex ratios are normal). …

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 …

Utilization Of Anc And Pnc Services In Nepal : A Multivariate Analysis Based On Nepal Demographic Health Survey 2001 And 2006, Gehendra Mahara, Collins Asweto, Kai Cao, Ali M. Alzain, Andrea Sebastian, Jill Barr, Xiuhua Guo, Wei Wang

Research outputs 2014 to 2021

Background: Maternal Mortality is a public health problem in Nepal, which was highest in 1990 among the South Asian countries. Associated factors of maternal mortality are various; among them maternal health sevices such as antenatal (ANC) and postnatal care (PNC) services are the main. Methods: A multivariate secondary data analysis out based on Nepal Demographic Health Surveys 2001 and 2006. Logistic regression models was performed to compare the utilization of the ANC and PNC services, with background characteristics of women aged between 15 to 49 years old. Results: A total of 8913 reproductive aged groups (15-49) women were taken f …

Prevalence And Determinants Of High Risk Human Papillomavirus (Hpv) Among Wives Of Migrant Workers - A Study In Far - West Nepal, Derek Johnson

All ETDs from UAB

This dissertation research focuses on the risk factors associated with high-risk HPV infection (HR-HPV) and abnormal cervical cytology in Nepali women residing in Nepal’s Far-West district of Achham. The first part of this dissertation assesses the HR-HPV test concordance of self-collected vs. clinician-collected cervico-vaginal specimens. Of 261 women with both clinician- and self-collected cervical samples, 25 tested positive for HR-HPV, resulting in an overall HR-HPV prevalence of 9.6% (95% Confidence Interval [CI]: 6.3 – 13.8). The overall Kappa value for clinician- and self-collected tests was 0.64 (95% CI: 0.48 – 0.84), indicating a “good” level of agreement. The second part …

Highlights From The Unicef Adolescent Development And Participation Baseline Study, Sajeda Amin, Ashish Bajracharya, Michelle Chau, Mahesh Puri

Poverty, Gender, and Youth

This document presents highlights from the UNICEF Adolescent Development and Participation (ADAP) Baseline Study in Nepal, which aims to ensure the systematic, ethical, meaningful, and regular participation of adolescents and focuses on vulnerable and disadvantaged groups. The program aims to empower adolescents, especially girls, to initiate and sustain activities and interventions that create positive transformation in their families, communities, and society, and bring about realization of their rights. The Population Council and partners led a study to develop a research design and implement a baseline survey to inform UNICEF’s ADAP program. The primary aim is to inform the program with …

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: …

25 Years After Vi Typhoid Vaccine Efficacy Study, Typhoid Affects Significant Number Of Population In Nepal, Deepak Bajracharya, M. Imran Khan, Alfred Pach Iii, Parisha Shrestha, Nilesh Joshi, Shyam R. Upreti, Thomas Wierzba, Mahesh Puri, Sushant Sahastrabuddhe, R. Leon Ochiai

Centre of Excellence in Women and Child Health

Salmonella Typhi, first isolated in 1884, results in infection of the intestines and can end in death and disability. Due to serious adverse events post vaccination, whole cell killed vaccines have been replaced with new generation vaccines. The efficacy of Vi polysaccharide (ViPS) vaccine, a new generation, single-dose intramuscular typhoid vaccine was assessed in Nepal in 1987. However, despite the availability of ViPS vaccine for more than 25 years, Nepal has one of the highest incidence of typhoid fever. Therefore we collected information from hospitals in the Kathmandu Valley from over the past five years. There were 9901 enteric fever …

Unicef Nepal Adolescent Development And Participation (Adap) Baseline Study: Final Report, Sajeda Amin, Ashish Bajracharya, Michelle Chau, Mahesh Puri

Poverty, Gender, and Youth

The Adolescent Development and Participation (ADAP) program is UNICEF Nepal’s endeavor to inform the design and implementation of an evidence-based program for adolescents. This ADAP Baseline Study Final Report documents the first comprehensive study of the lives of adolescents in 15 districts of Nepal with high levels of child deprivation where UNICEF is focusing its intervention. The ADAP Baseline Study is aligned with the National Plan of Action for Holistic Development of Adolescents launched in 2013, and highlights the sociocultural and behavioral aspects of adolescents in six domains: Education and Skills; Livelihoods and Financial Literacy; Enabling and Protective Environment; Gender …

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

Kalpana Poudel-Tandukar

Household Wealth And Neurocognitive Development Disparities Among School-Aged Children In Nepal., Shivani A Patel, Laura E Murray-Kolb, Steven C Leclerq, Subarna K Khatry, James M. Tielsch, Joanne Katz, Parul Christian

Global Health Faculty Publications

BACKGROUND: Wealth disparities in child developmental outcomes are well documented in developed countries. We sought to (1) describe the extent of wealth-based neurocognitive development disparities and (2) examine potential mediating factors of disparities among a population-based cohort of children in rural Nepal.

METHODS: We investigated household wealth-based differences in intellectual, executive and motor function of n = 1692 children aged between 7 and 9 years in Nepal. Using linear mixed models, wealth-based differences were estimated before and after controlling for child and household demographic characteristics. We further examined wealth-based differences adjusted for three sets of mediators: child nutritional status, home …

Better Learning In Schools To Improve Attitudes Toward Abstinence And Intentions For Safer Sex Among Adolescents In Urban Nepal, Rachana Manandhar Shrestha, Keiko Otsuka, Krishna C. Poudel, Junko Yasuoka, Medin Lamichhane, Masamine Jimba

Krishna C. Poudel

Background: School-based sex education is an effective medium to convey health information and skills about preventing sexually transmitted infections (STIs) and unwanted pregnancies among adolescents. However, research on school-based sex education is limited in many developing countries, including Nepal. This study thus had two main objectives: (1) to assess students’ evaluation of school-based sex education, and (2) to examine the associations between students’ evaluations of school-based sex education and their (a) attitudes toward abstinence and (b) intentions for safer sex. Methods: This cross-sectional study was conducted among 634 students from six schools in the Kathmandu Valley during May–June 2010. We …

Improved Quality Of Life After Surgery For Pelvic Organ Prolapse In Nepalese Women, Rolina Dhital, Keiko Otsuka, Krishna C. Poudel, Junko Yasuoka, Ganesh Dangal, Masamine Jimba

Krishna C. Poudel

Background: Pelvic organ prolapse (POP) is a common gynecological condition that can affect quality of life (QOL) in women. In Nepal, the prevalence of POP is high, but many affected women are still deprived of treatment. Vaginal hysterectomy with pelvic floor repair is one of the common treatment options for advanced POP. However, QOL outcomes after surgery have not been reported in low-income countries. Thus, we aimed to examine changes in QOL among Nepalese women with POP after such surgery. Methods: This longitudinal study was conducted in the selected central and peripheral hospitals in Nepal where vaginal hysterectomy was being …

Health-Related Quality Of Life, Depression, And Self-Esteem In Adolescents With Leprosy-Affected Parents: Results Of A Cross-Sectional Study In Nepal, Nobuko Yamaguchi, Krishna C. Poudel, Masamine Jimba

Krishna C. Poudel

Better Learning In Schools To Improve Attitudes Toward Abstinence And Intentions For Safer Sex Among Adolescents In Urban Nepal, Rachana Manandhar Shrestha, Keiko Ostuka, Krishna C. Poudel, Junko Yasuoka, Medin Lamichhane, Masamine Jimba

Krishna C. Poudel