Exploring the Sociodemographic Factors and Consequences related to Alcohol Consumption among Older Indigenous Community of a District in Nepal: A Qualitative Study.

INTRODUCTION: Alcoholism is a major global public health concern associated with numerous health conditions. Alcohol use has been a cultural part of several ethnic groups in Nepal. This study aimed to explore the qualitative dimension of alcohol use, its promoting factors, and consequences in Nepalese communities. METHODS: Qualitative study was conducted among 20 older adults belonging to the Magar community of Mathagadhi Rural Municipality, Lumbini Province, Nepal after acquiring ethical approval from Institutional Review Committee of CiST College (Reference number: 179/078/079). The data were analyzed using inductive thematic analysis, and themes were identified based on participants' responses to explore promoting factors for alcohol consumption along with its consequences. RESULTS: Traditional beliefs, cultural practices, and socioeconomic factors were the major contributors to alcohol misuse. Increased alcohol consumption during old age was perceived to be associated with body pain, tension, painful life events, and loneliness. CONCLUSIONS: A conflicting perception was observed, where some of the participants expressed the need to promote alcohol use as a part of their culture while some shared the view that the use of alcohol as a cultural practice should be limited. This study highlights the need for culturally appropriate interventions to address alcohol misuse among indigenous communities. Interventions should focus on addressing traditional beliefs and cultural practices that normalize alcohol consumption and the social and economic problems associated with alcohol misuse.

Cyberbullying victimisation and its association with depression, anxiety and stress among female adolescents in Deumai Municipality, Nepal: a cross-sectional survey.

OBJECTIVE: To estimate the prevalence of cyberbullying and its association with depression, anxiety and stress among female adolescents attending higher secondary schools in Deumai Municipality, Nepal. DESIGN: Cross-sectional survey study. SETTING: The survey was conducted at all available higher secondary schools of Deumai Municipality, Ilam District, Nepal, from February to April 2022. PARTICIPANTS: A total of 501 female adolescents enrolled in grades 11 and 12 were included in the study. All eligible participants available on the day of data collection were approached until the calculated sample size was reached. OUTCOME MEASURES: The study assessed the prevalence of cyberbullying victimisation, along with the prevalence of depression, anxiety and stress and their associated factors. The level of psychological distress was explored using the Depression Anxiety Stress Scale-21. Pearson's χ2 test and multivariate logistic regression analysis were applied to determine the association between psychological distress and related variables, including cyberbullying victimisation, at 95% CI and 5% level of significance. RESULTS: Nearly a third (32.5%) of the female adolescents included in the study had experienced cyberbullying. The overall prevalence of depression, anxiety and stress was 46.5%, 52.7% and 34.9%, respectively. Cyberbullying victims were observed to have increased odds of experiencing depression (adjusted OR (aOR): 1.64, 95% CI 1.11 to 2.42), anxiety (aOR: 2.49, 95% CI 1.67 to 3.70) and stress (aOR: 2.59, 95% CI 1.74 to 3.86) in comparison with non-victims. CONCLUSION: Cyberbullying victims are significantly more likely to experience psychological distress. There is an urgent need to strengthen cybersecurity and to have strong legislative measures to address cyberbullying in order to safeguard the mental health of adolescents in the digital age.

Risky sexual behaviour and its determinants among undergraduate students residing in hostels of Kathmandu Metropolitan City, Nepal: a cross-sectional study.

OBJECTIVES: To assess the prevalence of risky sexual behaviour (RSB) and its associated factors among Nepalese undergraduates residing in hostels of Kathmandu Metropolitan City, Nepal. DESIGN: Cross-sectional study SETTING: Hostels operating inside Kathmandu Metropolitan City were taken as the study setting. PARTICIPANT: A total of 361 undergraduate students residing in hostels in the Metropolitan City OUTCOME MEASURES: RSB was the outcome measure assessed using nine questions able to trace any risky sexual practice practiced by the participants within the past year prior to data collection. The question included participants' engagement in sexual activity before the age of consent, having unprotected vaginal sex even when pregnancy is not intended, engaging in vaginal sex with strangers without a condom, risky oral sex with a stranger and/or intimate partner, risky condom use, having multiple sex partners, having sex under the influence of alcohol and having sex with commercial sex workers. A positive response to any of these nine questions was considered indicative of RSB. Pearson's χ2 test and multivariable logistic regression analysis were performed to determine factors associated with RSB at the 5% level of significance. RESULTS: The prevalence of RSB was found to be 35.7% (95% CI: 30.2 to 40.2). RSB was found to be associated with higher age (≥25 years) (aOR: 3.938; 95% CI: 1.707 to 8.673), male gender (aOR: 3.233; 95% CI: 1.623 to 6.439), being in relationships in the past/current (aOR: 3.914, 95% CI: 2.099 to 7.012), lower education of mother (aOR: 3.655; 95% CI: 1.189 to 9.237) and peer pressure to have a sexual relationship (aOR: 2.356; 95% CI: 1.260 to 4.349). Notably, bivariate analysis illustrated problematic pornographic consumption to have a statistical relation with RSB, which was weakened and became non-significant after accounting for other factors in the adjusted model (aOR:1.213, 95% CI: 0.331 to 4.442). CONCLUSION: RSB is a concerning behaviour among undergraduate students and is linked with age, gender, relationship status, parental education and peer pressure. There is a need for comprehensive sex education programmes that equip students with the knowledge and skills needed to navigate healthy relationships, make safe choices and embrace responsible sexual practices.

Depressive symptoms and its associated factors among secondary school adolescents of Birtamod Municipality, Jhapa, Nepal.

Depression is a rising public health concern affecting adolescents' mental health throughout the world. This cross-sectional study aimed to assess the prevalence of depressive symptoms and its associated factors among adolescents from urban Nepal. The depressive symptoms among 271 randomly selected secondary school adolescents of Britamod Municipality were assessed using Center for Epidemiologic Studies Depression Scale (CES-D). The chi-square test and multivariable logistic regression were executed to assess the statistical relationship between potential risk factors and depressive symptoms at 5% level of significance. The prevalence of depressive symptoms was 42.8% (95% CI: 37.3-49.1%). Multiple logistic regression revealed that female adolescents (aOR: 2.309, 95% CI: 1.233-4.325), adolescents enrolled in higher grades i.e. 10th grade (aOR: 4.576, 95% CI: 1.482-9.128), studying at private school (aOR: 2.302, 95% CI: 1.184-4.476), not sharing their problems with their friends (aOR: 3.022, 95% CI: 1.477-6.186), presence of perceived academic stress (aOR: 2.388, 95% CI: 1.263-4.518), dissatisfaction with current academic performance (aOR: 2.278, 95% CI: 1.141-4.518), lower perceived family support (aOR: 3.440, 95% CI: 1.276-9.275), and lower self-esteem (aOR: 2.139, 95% CI: 1.061-8.708) had higher odds of experiencing depressive symptoms. There is a high prevalence of depression among Nepalese adolescents. The findings highlight the need for health promotion interventions focusing on mental health awareness, enhancing social support systems, and implementing stress reduction strategies within schools to mitigate the burden of depression among Nepalese adolescents.

Social and mental health impact of COVID-19 pandemic among health professionals of Gandaki Province, Nepal: A mixed method study.

BACKGROUND: The frontline health workers are the key players in the fight against the COVID-19 pandemic, however, several incidences of attacks, stigmatization, and discrimination towards them have been reported throughout the world during the peak of infection. The social impact experienced by health professionals can alter their efficiency and also lead to mental distress. This study aimed to examine the extent of social impact experienced by health professionals currently working in Gandaki Province, Nepal along with the factors associated with their depression status. METHODS: This was a mixed-method study where a cross-sectional online survey was executed among 418 health professionals followed by in-depth interviews with 14 health professionals of Gandaki Province. The bivariate analysis and multivariate logistic regression were performed to identify the factors associated with depression at 5% level of significance. The information collected from the in-depth interviews was clustered into themes by the researchers. RESULTS: Out of 418 health professionals, 304 (72.7%) expressed that COVID-19 has impacted their family relationships, whereas 293 (70.1%) expressed that it impacted their relationships with friends and relatives, and 282 (68.1%) expressed it impacted their relationships with community people. The prevalence of depression among health professionals was noted at 39.0%. Being a female (aOR:1.425,95% CI:1.220-2.410), job dissatisfaction (aOR:1.826, 95% CI:1.105-3.016), COVID-19 impact on family relation (aOR:2.080, 95% CI:1.081-4.002), COVID-19 impact on relationship with friends and relatives (aOR:3.765, 95% CI:1.989-7.177), being badly treated (aOR:2.169, 95% CI:1.303-3.610) and experiencing moderate (aOR:1.655, 95% CI:1.036-2.645) and severe fear (aOR:2.395, 95% CI:1.116-5.137) of COVID-19 were found to the independent predictors of depression. It was noted that the pandemic has an effect on the social relations of health professionals in multiple ways. CONCLUSION: This study noted that there is a significant impact of COVID-19 on health professionals in terms of their social and mental health aspects. The social impact experienced by health professionals is an important predictor of their mental health. The mental health and well-being of these vital workforces can be enhanced by focusing on the social aspect during the pandemic.

Anxiety and depression among people with type 2 diabetes visiting diabetes clinics of Pokhara Metropolitan, Nepal: a cross-sectional study.

OBJECTIVES: To estimate the prevalence of anxiety and depression and identify the associated factors among people with type 2 diabetes mellitus (T2DM) visiting diabetes clinics of Pokhara Metropolitan, Nepal. DESIGN: Cross-sectional study. SETTING: Three diabetes clinics in Pokhara Metropolitan, Nepal, from May to July 2021. PARTICIPANTS: 283 people with T2DM visiting selected diabetes centres of Pokhara Metropolitan. OUTCOME MEASURES: Anxiety and depression were the outcome measures. Face-to-face interviews were conducted using a structured questionnaire comprising information related to participants' sociodemographic profile and several factors along with Hospital Anxiety and Depression-Anxiety subscale and Patient Health Questionnaire-9 to assess the levels of anxiety and depression, respectively. Pearson's Χ2 tests and binary logistic regression were performed to examine association between dependent and independent variables at 5% level of significance. RESULTS: The prevalence of anxiety and depression was 31.4% (95% CI 26.2% to 37.5%) and 36.4% (95% CI 30.8% to 42.0%), respectively. Anxiety was found to be associated with a lower level of perceived social support (adjusted OR (AOR) 2.442, 95% CI 1.020 to 5.845), multiple complications (AOR 2.758, 95% CI 1.015 to 7.334) and comorbidities (AOR 2.110, 95% CI 1.004 to 4.436), severe COVID-19 fear (AOR 2.343, 95% CI 1.123 to 4.887) and sleep dissatisfaction (AOR 1.912, 95% CI 1.073 to 3.047). Economical dependency (AOR 1.890, 95% CI 1.026 to 3.482), no insurance (AOR 2.973, 95% CI 1.134 to 7.093), lower perceived social support (AOR 2.883, 95% CI 1.158 to 7.181), multiple complications (AOR 2.308, 95% CI 1.585 to 6.422) and comorbidities (AOR 2.575, 95% CI 1.180 to 5.617), severe COVID-19 fear (AOR 2.117, 95% CI 1.009 to 4.573), alcohol use (AOR 2.401, 95% CI 1.199 to 4.806) and sleep dissatisfaction (AOR 1.995, 95% CI 1.093 to 3.644) were found to be associated with depression. CONCLUSION: This study showed high prevalence levels of anxiety and depression among people with T2DM. Strengthening social support and focusing on people with diabetes suffering from comorbidity and complications could help to reduce their risk of mental health problems.

Antenatal depression and its associated factors among women of Godawari Municipality, Lalitpur, Nepal: a cross-sectional study.

OBJECTIVES: To estimate the prevalence of antenatal depression and identify its associated factors among pregnant women of Godawari Municipality, Lalitpur, Nepal. DESIGN: Community-based cross-sectional study. SETTING: Godawari Municipality, Lalitpur, Nepal, between September and November 2021. PARTICIPANTS: 250 randomly selected pregnant women of Godawari Municipality, Lalitpur, Nepal. MAIN OUTCOME MEASURES: The level of antenatal depression was assessed using Edinburgh Postnatal Depression Scale. χ2 test and multivariate logistic regression analysis were applied to determine the association between antenatal depression and related variables at 95% level of confidence. RESULTS: The prevalence of antenatal depression was found to be 24.8% (95% CI: 19.2 to 30.7). Multigravida (AOR: 2.219, 95% CI: 1.113 to 4.423), unintended pregnancy (AOR: 2.547, 95% CI: 1.204 to 5.388), male sex preference of child by family (AOR: 2.531, 95% CI: 1.204 to 5.321) and intimate partner violence (AOR: 2.276, 95% CI: 1.116 to 4.640) were found to be the positive predictors of antenatal depression. CONCLUSION: This study showed a high prevalence of depression among pregnant women. The results suggest a need for mental health assessment during pregnancy. Screening for depression should be part of routine antenatal checkups for early detection and management of mental health concerns during this vulnerable period.

The Coronavirus Pandemic: What Does the Evidence Show?

Coronavirus disease 2019 (COVID-19) is a newly emerged disease that has become a global public health concern as it rapidly spread around the world. The etiologic agent responsible for this disease has been named as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses as it shows similar genomic features to that of SARS-CoV which caused a pandemic in 2002. This disease first appeared in Hubei province of China and it follows human-to-human transmission but the path this virus took to set up human infection remains a mystery. By 17 April 2020, globally there have been 2,074,529 confirmed cases with 139,378 deaths because of COVID-19. SARS-CoV-2 shows several similarities with SARS?CoV, and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) with its clinical presentations. This can vary from asymptomatic infection to severe disease and mortality. Real-time reverse-transcription polymerase chain reaction (rRT-PCR) screening is considered as the standard laboratory test for the diagnosis of COVID-19. There is no proven antiviral agent against SARS-CoV-2 so the treatment for COVID-19 is symptomatic, aiming for the management of the symptoms and prevention of the complications. The outbreak of COVID-19 has led to the implementation of extraordinary public health measures throughout the world. Numerous antiviral compounds used to treat other infections are being clinically researched to find possible treatment. Similarly, the traditional public health outbreak response strategy of isolation, quarantine, social distancing and community containment has been implemented in multiple countries and has played an important role in the prevention of new outbreaks. This review aims to enhance our understanding of COVID 19. Keywords: Coronavirus disease 2019; COVID-19; SARS-CoV-2; novel coronavirus 2019; severe acute respiratory syndrome-2.

Postpartum Depression and its Associated Factors: A Community-based Study in Nepal.

BACKGROUND: Postpartum depression is a type of mental disorder associated with childbirth during pregnancy or within the first postpartum year. It is reported as a common psychological health problem affecting 10-15% of women worldwide. The duration of postpartum depression frequently depends on its severity and the time of initiation of treatment. This study assessed depression and its associated factors among postpartum period women of Godavari municipality, Lalitpur, Nepal. METHODS: A community-based cross-sectional study was conducted using Edinburg Postpartum Depression Scale among 195 mothers who were within six months of the postpartum period. The chi-square and logistic regression were applied to establish the association between postpartum depression and associated factors. RESULTS: Out of the total 195 postpartum women, 37(19%) women suffered from depression and out of those women 2.1% had suicidal thoughts. Among the associated factors, education, occupation, the intent of pregnancy, family support and pregnancy-related problems/complications were found to be significantly associated with Postpartum depression (p<0.05). CONCLUSIONS: Nearly one-fifth postpartum women suffered from some type of depression. It is one of the public health concerns which directly or indirectly corresponds to the socio-economic condition of the women. The improved education and economic status of women, intention of pregnancy, family care and support during pregnancy and the postpartum period and early diagnosis and management of health problems could reduce the magnitude of the postpartum depression.