Seroprevalence of SARS-CoV-2 infection in the general population of Nepal during the first and second generalized waves of the COVID-19 pandemic-2020-2021.

Few seroprevalence studies have been conducted on coronavirus disease (COVID-19) in Nepal. Here, we aimed to estimate seroprevalence and assess risk factors for infection in the general population of Nepal by conducting two rounds of sampling. The first round was in October 2020, at the peak of the first generalized wave of COVID-19, and the second round in July-August 2021, following the peak of the wave caused by the delta variant of SARS-CoV-2. We used cross-sectional probability-to-size (PPS)-based multistage cluster sampling to estimate the seroprevalence in the general population of Nepal at the national and provincial levels. We tested for anti-SARS-CoV-2 total antibody using the WANTAI SARS-CoV-2 Ab ELISA kit. In Round 1, the overall national seroprevalence was 14.4%, with provincial estimates ranging from 5.3% in Sudurpaschim to 27.3% in Madhesh Province. In Round 2, the estimated national seroprevalence was 70.7%, with the highest in the Madhesh Province (84.8%) and the lowest in the Gandaki Province (62.9%). Seroprevalence was comparable between males and females (Round 1, 15.8% vs. 12.2% and Round 2, 72.3% vs. 68.7%). The seroprevalence in the ecozones-Terai, hills, and mountains-was 76.3%, 65.3%, and 60.5% in Round 2 and 17.7%, 11.7%, and 4.6% in Round 1, respectively. In Nepal, COVID-19 vaccination was introduced in January 2021. At the peak of the first generalized wave of COVID-19, most of the population of Nepal remained unexposed to SARS-CoV-2. Towards the end of the second generalized wave in April 2021, two thirds of the population was exposed.

Frontline Healthcare Workers' Knowledge and Perception of COVID-19, and Willingness to Work during the Pandemic in Nepal.

This study investigated the contextual factors associated with the knowledge, perceptions, and the willingness of frontline healthcare workers (FHWs) to work during the COVID-19 pandemic in Nepal among a total of 1051 FHWs. Multivariable logistic regression analysis was applied to identify independent associations between predictors and outcome variables. Of the total study subjects, 17.2% reported inadequate knowledge on COVID-19, 63.6% reported that they perceived the government response as unsatisfactory, and 35.9% showed an unwillingness to work during the pandemic. Our analyses demonstrated that FHWs at local public health facilities, pharmacists, Ayurvedic health workers (HWs), and those with chronic diseases were less likely, and male FHWs were more likely, to have adequate knowledge of COVID-19. Likewise, nurses/midwives, public health workers, FHWs from Karnali and Far-West provinces, and those who had adequate knowledge of COVID-19 were more likely to have satisfactory perceptions towards the government response. Further, FHWs-paramedics, nurse/midwives, public health workers, laboratory workers-FHWs from Karnali Province and Far-West Province, and those with satisfactory perceptions of government responses to COVID-19 were predictors of willingness to work during the COVID-19 pandemic. These results suggest that prompt actions are required to improve FHWs' knowledge of COVID-19, address negative perceptions of government responses, and motivate them through specific measures to provide healthcare services during the pandemic.

Socio-demographic and Healthcare-seeking Predictors of Undernutrition among Children Under-five Years of Age in a Western District of Nepal.

BACKGROUND: Undernutrition is highly prevalent in Nepal, which interferes with physical and mental development among children. It is one of the severe health problems contributing to the significant portion of the disease burden. This study aimed to explore socio-demographic and healthcare-seeking related predictors of undernutrition among children under five years old in Dang, Nepal. METHODS: This was a descriptive cross-sectional study. A sample of 426 children was participated through stratified proportionate random sampling to identify socio-demographics and healthcare-seeking predictors of undernutrition. Multivariable regression was applied to identify the independent predictors of undernutrition. RESULTS: This study found that children below 24 months of age were more likely to be undernourished than children aged 24-36 months. Female children (OR=2.32, 95% CI: 1.19-4.54), illiterate or non-formally educated women (OR=4.09, 95% CI: 1.84-9.08), mother's occupation other than a housewife (OR=13.05, 95% CI: 4.19-40.68), labor work of father (OR=2.40, 95% CI: 1.04-5.57) had increased risk of undernutrition among children. Similarly, food insufficiency from their land, antenatal care visit, postnatal care visit, and delivery place were significantly associated with childhood undernutrition among children.  Conclusions: The study showed that undernutrition among children is associated with age and gender of children, educational attainment of the mother, food sufficiency, health-seeking practices of the mother during pregnancy, delivery, and postnatal. Socio-demographics and health-seeking practices related predictors must be explicitly considered to address undernutrition among children under the age of five years.