Health-related quality of life among people living with type 2 diabetes: a community based cross-sectional study in rural Nepal.

BACKGROUND: Diabetes as being a chronic disease with a number of complications deteriorates the quality of life among the people with type 2 diabetes. Health related quality of life is widely used as an important health outcome measure worldwide. This study assessed the quality of life among the people living with type 2 diabetes in rural area of eastern Nepal. METHODS: A cross sectional study was conducted among type 2 diabetic patient of rural area of eastern Nepal. Pre-tested Nepali version of D-39 questionnaire was administered through face to face interview to assess the quality of life. Door to door visit was done to identify all the type 2 diabetic patients residing in Baniyani village. Data was entered in Micro-soft excel 2007 and further processed in SPSS v.11.5 for analysis. RESULTS: Highest quality of life mean (SD) score was in social burden domain (56.26 ± 12.07), followed by sexual functioning domain (54.35 ± 9.47), Anxiety and worry domain (54.33 ± 7.76), energy and mobility domain (51.46 ± 8.73) and diabetes control domain (50.08 ± 10.84). There was negative correlation between age and domains sexual functioning (p = 0.001) and energy and mobility (p = 0.002). In bivariate analysis, there was significance difference by sex in sexual functioning (p = 0.002), educational status in diabetes control (p = 0.021), smoking habit in energy and mobility (p = 0.038), duration of disease in diabetes control (p = 0.002) and sexual functioning (p = 0.001), presence of co-morbidity in social burden (p = 0.034) and family history of diabetes in anxiety and worry (p = 0.042). CONCLUSION: Increasing age affects sexual life and mobility of the type 2 diabetic patient. The domain sexual functioning is difference by sex and presence of co-morbidity. Similarly, domain diabetic control is affected by duration of disease and educational status of the patient. And having family history of diabetes affects the mental state of the type 2 diabetic patient.

Tobacco Use during Pregnancy and Its Associated Factors in a Mountain District of Eastern Nepal: A Cross-Sectional Questionnaire Survey.

BACKGROUND: Tobacco using among women is more prevalent in Nepal as compared to other South-East Asian countries. The effect of its use is seen not only on the pregnant women, but also health of the growing fetus is compromised. Currently, little is known about the tobacco use among women especially during pregnancy in Nepal. This study explored the tobacco use prevalence and its associated factors during pregnancy. MATERIALS AND METHODS: A cross-sectional study was conducted in Sankhuwasabha, a mountain district of eastern Nepal. Representative sample of 436 women of reproductive age group with infant were selected by stratified simple random sampling. Data were collected by face-to-face interviews of selected participants. Data were analyzed with SPSS version 16.0. Binary logistic regression was used to analyze the relationship among variables. RESULTS: The study revealed that the prevalence of tobacco use during pregnancy was 17.2%. Only one fifth of the research participants were asked to quit tobacco by health workers during last pregnancy. Multivariable analyses revealed that illiteracy (AOR: 2.31, CI: 1.18-4.52), more than two parity (AOR: 2.45, CI: 1.19-5.07), alcohol use during last pregnancy (AOR: 3.99, CI: 1.65-9.68), and having tobacco user within family (AOR: 2.05, CI: 1.11-3.78) are more likely to use tobacco during pregnancy. CONCLUSION: Tobacco use during pregnancy was widely prevalent. Tobacco-focused interventions are required for antenatal women to promote cessation among user and prevent initiation with focus on overcoming problems like illiteracy, high parity, alcohol use, and having other tobacco user family members in family.

Chronic pain and cost: an epidemiological study in the communities of Sunsari district of Nepal.

The purpose of the study was to find out the prevalence of chronic pain in economically active population and associated economic loss. This cross-sectional observational study was carried out in 3 VDCs of Sunsari District involving 1730 individuals of 15-64 years age group selected by multistage random sampling. Demographic data, absence or presence of pain, site, severity, duration and relieving measures, approximate expenditure in treating pain and number of days lost due to pain were noted using a preformed questionnaire. Out of 1730 individuals interviewed, 882 (50.1%) had pain of which 93.7% had chronic pain (pain lasting for > 3 months). Backache (25.8%), headache (20.1%) and abdominal pain due to acid peptic disease (12.5%) were the most prevalent painful conditions. About 14.0% of individuals had severe grade pain. Female sex, age e"30 years, lack of formal schooling, smoking habit and dependent status were associated with higher prevalence of pain. Almost 19.0% of individuals with pain were unable to go to work the previous day. Man-days loss due to pain was 1.37 days/month/person in the study population. In terms of cost, pain related losses were Nepalese Rupees (NRs) 1671.89/person/year as against the per capita GDP of NRs 98,640.00 (US$ 1370.0). The money incurred by individuals for therapy on pain was NRs 760.15/person/year. In conclusion, probably first time, we are reporting the prevalence of chronic pain in our communities with people having to spend significant portion of their scarce income (and country's GDP) to treat pain, thus, highlighting it as a public health problem.