Prevalence of common risk factors of major noncommunicable diseases among sexual and gender minorities in Kathmandu valley, Nepal.

Four noncommunicable diseases (NCDs): cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, account for 71% of global deaths. However, little is known about the NCDs risk profile of sexual and gender minorities (SGMs). This study aimed to determine the prevalence of NCDs risk factors among the SGMs of Kathmandu valley, Nepal. A cross-sectional study was conducted among SGMs in the Kathmandu valley, Nepal. We recruited 140 participants using the snowball sampling method. A face-to-face interview was done using a structured questionnaire adapted from World Health Organization Step Wise Approach to Surveillance (STEPS instruments V2.2 2019) along with blood pressure and anthropometric measurements. Data were analyzed using Statistical Package for Social Science (SPSS.v20). More than two-thirds of the participants, 96 (68.6%), had co-occurrence of NCDs risk factors. The prevalence of insufficient fruits and vegetables consumption, current smoking, harmful alcohol consumption, overweight/obesity, and hypertension were 95.7%, 40.0%, 32.9%, 28.5%, and 28.6%, respectively. There was a significant association between hypertension, harmful alcohol consumption, and overweight/obesity with the participants' age, employment status, and marital status, respectively. Study findings indicated a higher prevalence of NCDs risk factors among SGMs. National-level NCDs surveillance, policy planning, prevention, and targeted health interventions should prioritize the SGMs.

Factors associated with uptake of breast and cervical cancer screening among Nepalese women: Evidence from Nepal Demographic and Health Survey 2022.

Breast cancer screening (BCS) and cervical cancer screening (CCS) are integral parts of initiatives to reduce the burden associated with these diseases. In this context, we aimed to determine factors associated with BCS and CCS uptake among Nepalese women aged 30 to 49 years using data from the Nepal Demographic Health Survey (NDHS) 2022. We performed a weighted analysis to account complex survey design of the NDHS 2022. We employed univariable and multivariable logistic regression to determine factors associated with the uptake of BCS and CCS and results were presented as crude odds ratio and adjusted odds ratio (AOR) along with 95% confidence interval (CI). The uptake of BCS and CCS among Nepalese women aged 30 to 49 years were 6.5% and 11.4% respectively. Women from Terai compared to mountain region (AOR = 0.54, 95%CI: 0.31, 0.93) and those engaged in agriculture compared to non-working (AOR = 0.59, 95%CI: 0.42, 0.82) women had lower odds of BCS uptake. Conversely, Dalit women compared to Brahmin/Chhetri (AOR = 2.08, 95%CI: 1.37, 3.16), and women with basic (AOR = 1.49, 95%CI: 1.04, 2.13), secondary (AOR = 1.96, 95%CI: 1.33, 2.88), and higher education (AOR = 2.80, 95% CI: 1.51, 5.19) compared to those with no education had higher odds of BCS uptake. Women from rural areas (AOR = 0.76, 95%CI: 0.61, 0.96), and those living in Bagmati (AOR = 2.16, 95% CI: 1.44, 3.23) and Gandaki (AOR = 2.09, 95%CI: 1.40, 3.14) provinces had higher odds of CCS uptake compared to their urban counterparts and those living in Koshi province, respectively. The odds of CCS increased with age (AOR = 1.06, 95%CI: 1.04, 1.08). Women with secondary education (AOR = 1.47, 95%CI: 1.06, 2.04) had higher odds of CCS uptake compared to those without education. Similarly, married women (AOR = 8.24, 95%CI: 1.03, 66.21), and those with health insurance (AOR = 1.41, 95%CI: 1.08, 1.83) had higher odds of CCS. In conclusion, the uptake of both BCS and CCS was relatively poor among Nepalese women indicating a need for targeted and tailored intervention to increase BCS and CCS uptake.

Factors associated with self-care behaviours among people with hypertension residing in Kathmandu: a cross-sectional study.

OBJECTIVE: To determine the prevalence and associated factors of self-care behaviours among people with hypertension in the Kathmandu district of Nepal. DESIGN: Cross-sectional study. SETTING: Municipalities of Kathmandu district, Nepal. PARTICIPANTS: We enrolled 375 adults aged ≥18 years with a minimum 1-year duration of hypertension using multistage sampling. OUTCOME MEASURES: We used the Hypertension Self-care Activity Level Effects to assess self-care behaviours and collected data through face-to-face interviews. We conducted univariate and multivariable logistic regression analyses to determine the factors associated with self-care behaviours. The results were summarised as crude and adjusted ORs (AORs) with 95% CIs. RESULTS: The adherence to antihypertensive medication, Dietary Approach to Stop Hypertension (DASH) diet, physical activity, weight management, alcohol moderation, and non-smoking were 61.3%, 9.3%, 59.2%, 14.1%, 90.9%, and 72.8%, respectively. Secondary or higher education (AOR: 4.42, 95% CI: 1.11 to 17.62), Brahmin and Chhetri ethnic groups (AOR: 3.30, 95% CI: 1.26 to 8.59) and good to very good perceived health (AOR: 3.96, 95% CI: 1.60 to 9.79) were positively associated with DASH diet adherence. Males (AOR: 2.05, 95% CI: 1.19 to 3.55) had higher odds of physical activity. Brahmin and Chhetri ethnic groups (AOR: 3.44, 95% CI: 1.63 to 7.26) and secondary or higher education (AOR: 4.70, 95% CI: 1.62 to 13.63) were correlates of weight management. Secondary or higher education (AOR: 2.47, 95% CI: 1.16 to 5.29), body mass index ≥25 kg/m2 (AOR: 1.83, 95% CI: 1.04 to 3.22) and income above the poverty line (AOR: 2.24, 95% CI: 1.08 to 4.63) were positively associated with non-smoking. Furthermore, Brahmin and Chhetri ethnic groups (AOR: 4.51, 95% CI: 1.64 to 12.40), males (AOR: 0.17, 95% CI: 0.06 to 0.50) and primary education (AOR: 0.26, 95% CI: 0.08 to 0.85) were associated with alcohol moderation. CONCLUSION: The adherence to the DASH diet and weight management was particularly low. Healthcare providers and policymakers should focus on improving self-care by designing simple and affordable interventions for all patients with hypertension.

Prevalence and factors associated with depression, anxiety and stress symptoms among construction workers in Nepal.

INTRODUCTION: The construction industry in Nepal, which employs a significant proportion of the population, ranks as one of the largest industries in the country. Construction work is physically demanding and can be risky due to the use of heavy machinery and the presence of intense physical labor. However, the physical and mental health of construction workers in Nepal is often neglected. This study aimed to assess psychological distress (depression, anxiety, and stress symptoms) and its association with socio-demographic, lifestyle, and occupational factors among construction workers in Kavre district, Nepal. METHODS: We conducted a cross-sectional study from 1st October 2019 to 15th January 2020 among 402 construction workers in Banepa, and Panauti municipalities of Kavre district, Nepal. We collected data with face-to-face interviews using a structured questionnaire consisting of a) socio-demographic characteristics; b) lifestyle and occupational characteristics; and c) depression, anxiety and stress symptoms. We collected data using electronic forms in KoboToolbox and imported them into R version 3.6.2 for statistical analysis. We present parametric numerical variables as mean and standard deviation, and categorical variables as percentage and frequency. The confidence interval around proportion was estimated with the Clopper-Pearson method. We applied univariate and multivariable logistic regression to determine factors associated with depression symptoms, anxiety, and stress. The result of logistic regression was presented as crude odds ratio, adjusted odds ratio (AOR), and their 95% confidence interval (CI). RESULTS: The prevalence of depression, anxiety and stress symptoms were 17.1% (95%CI: 13.6-21.2), 19.2% (95%CI: 15.5-23.4) and 16.4% (95%CI: 12.9-20.4), respectively. In multivariable logistic regression analysis, depression symptom was positively associated with poor sleep quality (AOR = 3.51; 95%CI: 1.5-8.19; p-value: 0.004); stress symptom was positively associated with Brahmin ethnicity (AOR = 3.76; 95%CI:1.34-10.58; p-value: 0.012) and current smoking (AOR = 2.0; 95%CI: 1.11-3.82 p-value: 0.022). But anxiety symptoms were not associated with any of the variables. CONCLUSIONS: The prevalence of depression, anxiety, and stress symptoms were high among construction workers. Developing evidence-based and appropriate community-based mental health prevention programs among laborers and construction workers is recommended.

Association between cancer stigma and cervical cancer screening uptake among women of Dhulikhel and Banepa, Nepal.

BACKGROUND: Cervical cancer ranks as the most common cancer among Nepalese women with a high incidence and mortality. Despite evidence that effective screening programs reduce disease burden, screening services are under-utilized. Cancer stigma can be a major barrier to cervical cancer screening uptake among Nepalese women. OBJECTIVES: This study assessed the association between cancer stigma and cervical cancer screening uptake among women residing in semi-urban areas of Kavrepalanchok district (Dhulikhel and Banepa), Nepal. METHODS: We conducted a cross-sectional study among 426 women aged 30-60 years using telephone interview method from 15th June to 15th October 2021. A validated Cancer Stigma Scale (CASS) was used to measure cancer stigma and categorized women as presence of cancer stigma if the mean total score was greater than three. We obtained information on cervical cancer screening uptake through self-reported responses. Univariable and multivariable logistic regression were performed to assess the association between cancer stigma and cervical cancer screening uptake. We adjusted socio-demographic: age, ethnicity, occupation, religion and education, and reproductive health variables: parity, family planning user, age of menarche and age at first sexual intercourse during multivariable logistic regression. RESULTS: Twenty-three percent of women had cancer stigma and 27 percent reported that they had ever been screened for cervical cancer. The odds of being screened was 0.23 times lower among women who had stigma compared to those who had no stigma (95% CI: 0.11-0.49) after adjusting for confounders: age, ethnicity, occupation, religion, education, parity, contraceptive use, age of menarche and age at first sexual intercourse. CONCLUSION: Women residing in semi-urban areas of Nepal and had cancer stigma were less likely to have been screened for cervical cancer. De-stigmatizing interventions may alleviate cancer stigma and contribute to higher uptake of cervical cancer screening.

Prevalence and factors associated with depression, anxiety, and stress symptoms among home isolated COVID-19 patients in Western Nepal.

Introduction: Globally, COVID-19 pandemic has a significant impact on mental health. In Nepal, COVID-19 positive cases have to self-isolate at home in multi-generational and multi-family households. This could be strongly associated with depression, anxiety, and stress-related health outcomes. Additionally, COVID-19 related stigma and fear of transmission may intensify depression, anxiety, and stress symptoms. This study determined the prevalence of depression, anxiety, and stress symptoms and their association with presence of COVID-19 symptoms and comorbid conditions among home isolated COVID-19 positives in the Karnali province, Nepal. Methods: We conducted a cross-sectional study to assess depression, anxiety, and stress symptoms among 402 home isolated COVID-19 patients of Karnali province from January to May 2021 using "Depression, Anxiety and Stress Scale-21 (DASS-21)". We interviewed patients to collect socio-demographic, DASS-21, COVID-19 symptoms, comorbid conditions, and self-treatment. We conducted a telephonic interview using a standardized questionnaire using Kobotoolbox. We calculated the prevalence of depression, anxiety, and stress symptoms. We utilized univariate and multivariate logistic regression to determine their association with the presence of COVID-19 symptoms and comorbid conditions. In multivariate logistic regression, we adjusted sociodemographic factors (age, gender, ethnicity, marital status, monthly family income, education level), smoking status and history of self-treatment. We reported adjusted odds ratios (aOR) with 95% confidence intervals. All analyses were conducted in R (version: 4.0.3). Results: The prevalence of depression, anxiety and stress symptoms among home isolated COVID-19 patients were 8.0% (95% CI: 5.5 to 11.1), 11.2% (95% CI: 8.3 to 14.7), and 4.0% (95% CI: 2.3 to 6.4) respectively. Higher odds of depression symptoms (aOR: 2.86; 95% CI: 1.10-7.44, p = 0.03), anxiety symptoms (aOR: 3.81; 95% CI: 1.62 to 8.93; p = <0.01) and stress symptoms (aOR: 7.78; 95% CI: 1.43 to 42.28; p = 0.02) were associated significantly with presence of COVID-19 symptoms in past week. Higher odds of anxiety symptoms were associated with the presence of comorbid conditions (aOR = 2.92; 95% CI: 1.09 to 7.80; p = 0.03). Conclusion: Depression, anxiety, and stress symptoms were present in a significant proportion of home isolated COVID-19 patients in western Nepal and positively associated with the presence of COVID-19 symptoms. In this global COVID-19 pandemic, it is important to provide timely counseling to high-risk groups like those with comorbidities and COVID-19 symptoms to maintain a high level of mental health among home isolated COVID-19 patients.

Co-occurrence of non-communicable disease risk factors and its determinants among school-going adolescents of Kathmandu Metropolitan City.

BACKGROUND: Adolescence is a critical transition in human growth and adolescents tend to engage in various risky behaviors which are likely to continue into adulthood. Co-occurrence of non-communicable disease risk factors has the potential to increase risks of chronic disease comorbidity and increased mortality in later life. Behavioral risk factors are adopted due to changes in lifestyle and adolescents are more prone to acquire them. This study aimed to determine the prevalence and associated factors of co-occurrence of non-communicable disease risk factors among school-going adolescents of Kathmandu Metropolitan City. METHODS: We conducted a cross-sectional study among school-going adolescents of Kathmandu Metropolitan City in January/February 2020. We used stratified random sampling to select 1108 adolescents studying in 9, 10, 11, and 12 grades. We used Global Schools Health Survey tools to collect data. We entered data in EpiData 3.1 and exported it into Statistical Package for Social Science (SPSS) version 20 for statistical analysis. We estimated prevalence of NCDs risk factors and co-occurrence of risk factors. We applied multivariate multinomial logistic regression analysis adjusting for age, gender, ethnicity, religion, education, type of school, and parental education to determine factors associated with co-occurrence of NCDs risk factors. RESULTS: The prevalence of physical inactivity, unhealthy diet, harmful use of alcohol and tobacco among school-going adolescents were 72.3% (95%CI: 69.6-74.9), 41.1% (95%CI: 38.2-44.0), 14.8% (95%CI: 12.8-17.0) and 7.8% (95%CI:6.3-9.5) respectively. The adolescent with co-occurrence of two or more risk factors was 40.7% (95%CI: 37.8-43.7). The school-going adolescents who were in higher age group (AOR = 1.72, 95% CI- 1.06, 2.77), Hindus (AOR = 1.78, 95% CI-1.09, 2.89), other than Brahmin/Chhetri by ethnicity (AOR = 2.11, 95% CI-1.39, 2.22) and with lower education level of mothers (AOR = 2.40, 95% CI- 1.46,3.98) were more likely to have co-occurrence of NCDs risk factors after adjusting for all socio-demographic variables. CONCLUSION: The co-occurrence of non-communicable disease risk factors was high among school going adolescents and was associated with age, religion, ethnicity and mother's education. Integrated and comprehensive interventional programs should be developed by concerned authorities.