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1.
Int J Equity Health ; 19(1): 87, 2020 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503613

RESUMO

Due to the ongoing nationwide lockdown in Nepal, women and children face a greater risk of malnutrition and eventually leading to mortality and morbidity. To harness the progress made so far in improving the nutritional status of women and children, a focus on nutrition should be a part of the COVID-19 response plan.


Assuntos
Infecções por Coronavirus/epidemiologia , Desnutrição/prevenção & controle , Estado Nutricional , Pneumonia Viral/epidemiologia , Criança , Feminino , Humanos , Desnutrição/epidemiologia , Nepal/epidemiologia , Pandemias
2.
JNMA J Nepal Med Assoc ; 58(225): 355-359, 2020 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-32538935

RESUMO

The COVID-19 pandemic is unfolding at an unprecedented pace. The unprecedented threat provides an opportunity to emerge with robust health systems. Nepal has implemented several containment measures such as Rapid Response Team formulation; testing; isolation; quarantine; contact tracing;surveillance, establishment of COVID-19 Crisis Management Centre and designation of dedicated hospitals to gear up for the pandemic. The national public health emergency management mechanisms need further strengthening with the proactive engagement of relevant ministries; we need a strong, real-time national surveillance system and capacity building of a critical mass of health care workers; there is a need to further assess infection prevention and control capacity; expand the network of virus diagnostic laboratories in the private sector with adequate surge capacity;implement participatory community engagement interventions and plan for a phased lockdown exit strategy enabling sustainable suppression of transmission at low-level and enabling in resuming some parts of economic and social life.


Assuntos
Defesa Civil , Controle de Doenças Transmissíveis , Infecções por Coronavirus , Serviços Médicos de Emergência/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral , Betacoronavirus/isolamento & purificação , Defesa Civil/legislação & jurisprudência , Defesa Civil/métodos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Regulamentação Governamental , Humanos , Nepal/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Saúde Pública/métodos
5.
JNMA J Nepal Med Assoc ; 58(224): 248-251, 2020 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-32417862

RESUMO

INTRODUCTION: Coronavirus disease pandemic has affected large number of people globally and has continued to spread. Preparedness of individual nations and the hospitals is important to effectively deal with the surge of cases. We aimed to obtain nation wide data from Nepal, about hospital preparedness for COVID-19. METHODS: Online questionnaire was prepared in accordance with the Center for Disease Control recommendations to assess preparedness of hospitals for COVID-19. The questionnaire was circulated to the over 800 doctors across the nation, who are the life members of six medical societies. RESULTS: We obtained 131 completed responses from all seven provinces. Majority of respondents had anaesthesiology as the primary specialty. Only 52 (39.7%) participants mentioned that their hospital had policy to receive suspected or proven cases with COVID-19. Presence of isolation ward was mentioned by 83 (63.4%) respondents, with only 9 (6.9%)mentioning the presence of airborne isolation. Supply of personal protective equipment (PPE) was inadequate as per 124 (94.7%) respondents. Critical care services for COVID-19 patients were possible only in hospitals of 42 (32.1%)respondents. RT-polymerase chain reaction could be performed only in the hospital of 6 (4.6%) respondents. CONCLUSIONS: It is apparent that most of the hospitals are not well prepared for management of patients with COVID-19. Resource allocation and policy making should be aimed to enhance national preparedness for the pandemic.


Assuntos
Defesa Civil , Infecções por Coronavirus , Coronavirus , Serviço Hospitalar de Emergência/organização & administração , Pandemias , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Emergências , Humanos , Nepal/epidemiologia , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Inquéritos e Questionários
6.
JNMA J Nepal Med Assoc ; 58(224): 276-279, 2020 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-32417870

RESUMO

Pandemic outbreak of COVID-19 is the largest of its kind of this century. All countries throughout the globe are trying their best to contain the disease and eliminate at the earliest. Efforts are continuing to improve the outcome of the infection in terms of minimizing the morbidity and mortality. As a public health strategy every state has the responsibility of protecting the health of the community and such measures includes the preventive measures like social distancing or even lockdown of the state as a whole restricting the movement of the people, diagnostic measures like testing the suspects, contact tracing and isolation of the patients. Treatment of the infected requires decisions in resource constraint situation particularly ICU beds and ventilators. In the meantime, protecting doctors, nurses, other health workers as well as frontline workers need personal protective equipment which is a scarce commodity. While doing so there might be a compromise in the individual autonomy, privacy, confidentiality, and social justice for the beneficence for the larger community. This is an attempt to explore the ethical quandaries in relation to combating COVID-19 in Nepal by relating the issues with the principles of biomedical ethics.


Assuntos
Técnicas de Laboratório Clínico/ética , Infecções por Coronavirus , Coronavirus , Assistência à Saúde/ética , Pandemias/ética , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Tomada de Decisões , Planejamento em Desastres , Humanos , Nepal/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Alocação de Recursos , Ventiladores Mecânicos/provisão & distribução
7.
JNMA J Nepal Med Assoc ; 58(224): 286-292, 2020 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-32417872

RESUMO

Lockdown is essential for containing the spread of SARS-CoV-2. It is the best measure to maintain extreme social distancing which has been effective in controlling the infection and saving lives. But they are causing huge loss economically, disrupting social life and causing distress around the world. Reopening too quickly or too boldly without a goal-oriented strategy could mean a second wave of infection as fierce or even worse as the first. The fundamentals of the virus remain the same - one infected person will, without a lockdown pass it onto three others on average. The consequences of lifting the lockdown are unforeseeable and the stakes are high. Due to the different spectrum of severity with same strain of virus and uncertainty of post lockdown era, lifting the lockdown will be a trial and error approach. Nevertheless, at some point the lockdown has to be lifted. The strategic approach would be innumerable testing, investigations, strong contact tracing, isolation and follow-up. In a low-income country like Nepal, this will mean negotiating a tricky balance between terminating the spread of SARS-CoV-2, and allowing people to recover their livelihoods before they slip into extreme poverty and anguish.


Assuntos
Infecções por Coronavirus , Pandemias , Pneumonia Viral , Perfil de Impacto da Doença , Betacoronavirus , Coronavirus , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Efeitos Psicossociais da Doença , Monitoramento Epidemiológico , Atividades Humanas , Humanos , Nepal/epidemiologia , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Saúde Pública , Quarentena
8.
J Nepal Health Res Counc ; 18(1): 126-127, 2020 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-32335607

RESUMO

The novel coronavirus COVID-19 (SARS-CoV-2) was first reported in 31 December 2019 in Wuhan City, China. The first case of COVID-19 was officially announced on 24 January, 2020, in Nepal. Nine COVID-19 cases have been reported in Nepal. We aim to describe our experiences of COVID-19 patients in Nepal. Keywords: COVID-19; experience; Nepal.


Assuntos
Infecções por Coronavirus/epidemiologia , Coronavirus , Pneumonia Viral/epidemiologia , Adulto , Idoso , Doenças Assintomáticas , Betacoronavirus , Infecções por Coronavirus/transmissão , Surtos de Doenças , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Nepal/epidemiologia , Pandemias , Pneumonia Viral/transmissão , Quarentena , Viagem , Adulto Jovem
9.
J Nepal Health Res Counc ; 18(1): 128-134, 2020 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-32335608

RESUMO

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 imposed on 24 March, 2020. Government devised comprehensive plan on 27 March, 2020 for quarantine for peoples who arrived in Nepal from COVID-19 affected countries. This article covers summary of global status, South Asian Association of Regional Cooperation (SAARC) status, and Nepal's response to contain COVID-19 infection discussed under three headings: Steps taken before and after WHO declared COVID-19 a global pandemic and lab services regarding detection of COVID-19. Nepal has documented five confirmed cases of COVID-19 till the end of March 2020, first in second week of 15 January, 2020 and 2nd case 8-weeks thereafter and 3rd case two days later, 4th on 27 March and 5th on 28 March. Four more cases detected during first week of April. Non-Pharmacological interventions like social distancing and excellent personal habits are widely practiced. Country has to enhance testing and strengthen tracing, isolation and quarantine mechanism and care of COVID-19 patients as Nepal is in risk zone because of comparably weak health system and porous borders with India. The time will tell regarding further outbreak and how it will be tackled. Keywords: COVID-19; lockdown; Nepal; pandemic; response.


Assuntos
Infecções por Coronavirus/epidemiologia , Coronavirus , Surtos de Doenças/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Quarentena , Adulto , Idoso , Betacoronavirus , Infecções por Coronavirus/transmissão , Humanos , Pessoa de Meia-Idade , Nepal/epidemiologia , Pneumonia Viral/transmissão , Adulto Jovem
10.
J Nepal Health Res Counc ; 18(1): 135-137, 2020 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-32335609

RESUMO

The novel coronavirus (COVID-19) cause various symptoms such as pneumonia, fever, breathing difficult and lung infection. Till now, total 9 cases are reported in Nepal and 4 cases from this province. This case series is to describe the initial clinical features of COVID-19 among the patients admitted in isolation ward of Seti Provincial Hospital. Oropharyngeal swab was taken from all four patients and sample was transfer to national reference laboratory. Three patients were coming from infected country and one is local transmission. Age of patients was range from 20 to 40 years of age with male preponderance. The patient coming from United Arab Emirate was presented with mild symptoms and others were asymptomatic. More tests, contact tracing and keeping them in quarantine are the necessitated action need to be taken by government of Nepal. Keywords: COVID-19; local transmission; oropharyngeal swab.


Assuntos
Infecções por Coronavirus/epidemiologia , Coronavirus , Surtos de Doenças/prevenção & controle , Pneumonia Viral/epidemiologia , Quarentena , Viagem , Adulto , Betacoronavirus , Infecções por Coronavirus/transmissão , Tosse/etiologia , Febre/etiologia , Humanos , Índia , Nepal/epidemiologia , Pandemias , Pneumonia Viral/transmissão , Emirados Árabes Unidos , Adulto Jovem
12.
BMC Public Health ; 20(1): 300, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32143673

RESUMO

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a progressive and debilitating condition that affects individuals' quality of life. COPD self-management and supports provided by carers is key to the quality of life people living with COPD. Health literacy (HL) and Patient Activation (PA) are main drivers of self-management practices (SMPs). However, their contribution remains to be fully explored. This study aimed to examine the level of self-management practices, and the relationship with socio-demographic factors, HL and PA among multi-morbid COPD patients from rural Nepal. METHODS: This is a cross-sectional study conducted between July 2018 and January 2019. Patients completed a survey, including Self-management Practices questionnaire (SMPQ), five domains of the Health Literacy Questionnaire (HLQ), and Patient Activation Measure (PAM). The relationship between HL, PAM, and SMPs was examined using univariate statistics. Multivariable analysis was conducted to identify the factors associated with SMPs. RESULTS: A total of 238 patients responded to the study. The mean score of SMPQ was 45.31(SD = 9.00). The HLQ and PAM scores were positively correlated with the total score of SMPQ. Low level of SMPs were found to be positively associated with being uneducated (ß = - 0.43, p = .001), having a low family income (ß = - 5.22, p = .002), and, negatively associated with the presence of more than one co-morbidity (ß = 3.58, p = 0.007) after controlling for other socio-demographic variables in the multivariable analysis. CONCLUSION: The overall SMPs among this sample of Nepalese with COPD were low. Our findings highlight the need to implement a self-management intervention program involving patient activation and health literacy-focused activities for COPD, creating a support system for patients from low-income families and low education.


Assuntos
Letramento em Saúde/estatística & dados numéricos , Multimorbidade , Participação do Paciente/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/terapia , População Rural/estatística & dados numéricos , Autogestão , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Qualidade de Vida , Fatores Socioeconômicos , Inquéritos e Questionários
13.
PLoS One ; 15(3): e0218840, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32176883

RESUMO

INTRODUCTION: Non-Communicable Diseases (NCDs) are the major killer diseases globally. They share the common risk factors such as smoking, harmful use of alcohol, physical inactivity, and low fruits/vegetable consumption. The clustering of these risk factors multiplies the risk of developing NCDs. NCDs affect women inequitably causing significant threats to the health of women and future generations. But, the distribution and clustering of NCDs risk factors among Nepalese women are not adequately explored yet. This study aimed to assess the clustering and socio-demographic distribution of major NCD risk factors in Nepalese women. METHODS: We used the data of 6,396 women age 15 to 49 years from the recent Nepal Demographic and Health Survey (NDHS). The survey applied a stratified multi-stage cluster sampling method to select the eligible women participants from across Nepal. We analyzed data using the multiple Poisson regression and reported the adjusted prevalence ratio (APR). RESULTS: A total of 8.9% of participants were current smokers, 22.2% were overweight and obesity and 11.5% of the participants were hypertensive. Around 6% of participants had co-occurrence of two NCDs risk factors. Smoking, overweight and obesity and hypertension were significantly associated with age, education, province, wealth index, and ethnicity. Risk factors were more likely to cluster in women of age40-49 years (ARR = 2.95, 95%CI: 2.58-3.38), widow/separated (ARR = 3.09; 95% CI:2.24-4.28) and among Dalit women (ARR = 1.34; 95% CI:1.17-1.55). CONCLUSION: This study found that NCDs risk factors were disproportionately distributed by age, education, socio-economic status and ethnicity and clustered in more vulnerable groups such as widow/separated women and the Dalit women.


Assuntos
Demografia , Inquéritos Epidemiológicos , Doenças não Transmissíveis/epidemiologia , Reprodução , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Nepal/epidemiologia , Prevalência , Fatores de Risco , Adulto Jovem
14.
PLoS Negl Trop Dis ; 14(3): e0008132, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32150578

RESUMO

Visceral leishmaniasis (VL) in Nepal is found in 61 out of 75 districts including areas previously listed as non- endemic. This study focused on the role of housing conditions and its immediate environment in VL transmission, to limit future transmissions, ensure sustainable vector control and support the VL elimination program. The objective was to explore the risk factors in rural housing-and land lot typologies contributing to clinical VL occurrence and transmission. Housing structures and land lots were examined based on characteristics as risk factors of VL transmission in a case-control analysis. VL cases from 2013-2017 were identified based on the existing database from the Epidemiology and Disease Control Division and District Public Health Office from the plain Terai area (Morang, and Saptari districts) and hilly area (Palpa district) of Nepal. Two hundred and three built environments were analyzed (66 cases and 137 controls). Inferential statistics and logistic regression analysis were performed to determine the association of risk factors with VL. The risk factors with the highest odds of VL were: bamboo walls (adjusted odds ratio (AOR)- 8.1, 95% CI 2.40-27.63, p = 0.001), walls made of leaves/branches (AOR- 3.0, 95% CI 0.84-10.93, p = 0.090), cracks in bedroom walls (AOR- 2.9, 95% CI 0.93-9.19, p = 0.065), and placing sacks near sleeping areas (AOR- 19.2, 95% CI 4.06-90.46, p <0.001). Significant outdoor factors were: lots with Kadam trees (AOR- 12.7, 95% CI 3.28-49.09, p <0.001), open ground-outdoor toilets (AOR- 9.3, 95% CI 2.14-369.85, p = 0.003), moisture in outdoor toilet sheds (AOR- 18.09, 95% CI 7.25-451.01, p = 0.002), nearby- open land (AOR- 36.8, 95% CI 3.14-430.98, p = 0.004), moisture inside animal sheds (AOR- 6.9, 95% CI 1.82-26.66, p = 0.005), and surrounding animals/animals wastes particularly goats (AOR- 3.5, 95% CI 1.09-10.94, p = 0.036). Certain housing and surrounding environmental conditions and characteristics are risk factors for VL. Hence, elimination and educational programs should include the focus on housing improvement and avoidance of risk factors. Longitudinal interventional studies are required to document temporal relationships and whether interventions on these factors will have an impact on Leishmania transmission or burden.


Assuntos
Transmissão de Doença Infecciosa , Meio Ambiente , Habitação , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/transmissão , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Nepal/epidemiologia , Fatores de Risco
16.
BMC Infect Dis ; 20(1): 89, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000695

RESUMO

BACKGROUND: Outbreaks of acute undifferentiated febrile illness (AUFI) are common in Nepal, but the exact etiology or risk factors for them often go unrecognized. Diseases like influenza, enteric fever and rickettsial fevers account for majority of such outbreaks. Optimal diagnostic tests to inform treatment decisions are not available at the point-of-care. A proper epidemiological and clinical characterization of such outbreaks is important for appropriate treatment and control efforts. METHODS: An investigation was initiated as a response to increased presentation of patients at Patan Hospital from Chalnakhel locality in Dakchinkali municipality, Kathmandu with AUFI from June 10 to July 1, 2016. Focused group discussion with local inhabitants and the epidemiological curve of febrile patients at local primary health care centre confirmed the outbreak. The household-survey was conducted in the area with questionnaire administered on patients to characterize their illnesses and their medical records were reviewed. A different set of questionnaire was administered on the patients and controls to investigate the association with common risk factors. Water samples were collected and analyzed microbiologically. RESULTS: Eighty one patients from 137 households suffered from febrile illness within 6 weeks window before the investigation. All the 67 sampled patients with acute fever had a generalized illness without a discernible focus of infection. Only 38% of the patients had received a clinical diagnosis while the rest were treated empirically without a diagnosis. Three patients had blood culture confirmed enteric fever. Forty-two (63%) patients had been administered antibiotics, most commonly, ofloxacin, cefixime or azithromycin with a mean fever clearance time of 4 days. There was no definite association between several risk factors and fever. Fecal contamination was noted in tap water samples. CONCLUSION: Based on the pattern of illness, this outbreak was most likely a mixture of self-limiting viral infections and enteric fever. This study shows that even in the absence of a confirmed diagnosis, a detailed characterization of the illness at presentation and the recovery course can suggest the diagnosis and help in formulating appropriate recommendation for treatment and control.


Assuntos
Antibacterianos/uso terapêutico , Febre/epidemiologia , Febre/etiologia , Febre Tifoide/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Azitromicina/uso terapêutico , Cefixima/uso terapêutico , Criança , Surtos de Doenças , Feminino , Febre/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Ofloxacino/uso terapêutico , Fatores de Risco , Febre Tifoide/tratamento farmacológico , Febre Tifoide/etiologia , Viroses/tratamento farmacológico , Viroses/epidemiologia , Viroses/etiologia , Adulto Jovem
17.
BMC Infect Dis ; 20(1): 138, 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32054525

RESUMO

BACKGROUND: Scrub typhus is an acute febrile illness caused by the obligate intracellular bacterium, Orientia tsutsugamushi. Immunochromatography (ICT) and IgM ELISA are two of the routinely employed antibody based assays for diagnosis of Scrub typhus fever in Nepal, although the recommended gold standard diagnostic test is IgM Immunofluorescence assay (IFA). This study evaluated InBios Scrub Typhus Detect™ Immunoglobulin M (IgM) ELISA and IgM Immunofluorescence assays in single serum sample at the time of admission. METHOD: Study participants (1585 suspected cases), were enrolled based on acute febrile illness with suspected scrub typhus cases in central Nepal. Blood sample was collected from the suspected patients of scrub typhus, presenting with acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit and an in-house IgM IFA. The IFA assay was performed with the Gilliam, Karp, Kato strains and O. chuto antigens following the ARRL protocol. RESULT: Statistical analysis of IgM ELISA results when compared to reference test, IgM IFA results demonstrated the following characteristics, sensitivity 84.0% (95%CI: 79.73-87.68%), specificity 94.82% (95% CI: 93.43-95.99%), positive likelihood ratio 16.21% (95% CI: 12.71-20.67%), negative likelihood ratio 0.17% (95% CI: 0.13-0.21%), disease prevalence 22.08% (95% CI: 20.06 -24.21%), positive predictive value 82.12% (95% CI: 78.28-85.42%) and negative predictive value 95.44% (95% CI: 94.27-96.38%) respectively. CONCLUSION: Although IgM IFA is considered the gold standard test for the diagnosis of scrub typhus cases, it is relatively expensive, requires trained personal and a microscope with fluorescence filters. Scrub typhus IgM ELISA may be the best alternative test and possible viable option for resource limited endemic countries like Nepal.


Assuntos
Testes Diagnósticos de Rotina/métodos , Ensaio de Imunoadsorção Enzimática/métodos , Imunofluorescência/métodos , Imunoglobulina M/sangue , Orientia tsutsugamushi/imunologia , Tifo por Ácaros/diagnóstico , Tifo por Ácaros/epidemiologia , Adulto , Anticorpos Antibacterianos/sangue , Doenças Endêmicas , Feminino , Imunofluorescência/economia , Humanos , Masculino , Nepal/epidemiologia , Estudos Prospectivos , Sensibilidade e Especificidade
18.
PLoS One ; 15(2): e0228862, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32040537

RESUMO

BACKGROUND: The prevalence of overweight and obesity, particularly among women, is increasing in Nepal. Previous studies in the South Asia have found television watching to be a risk factor for overweight and obesity among women of reproductive age. However, this association had not been studied in the context of Nepal. This study aims to identify the association between frequency of television watching and overweight and obesity among Nepalese women of reproductive age. METHODS: This cross-sectional study utilized the Nepal Demographic and Health Survey 2016 (NDHS 2016) data. A total weighted sample of 6,031 women were included in the final analyses. The women were 15-49 years of age and were either not pregnant or had not delivered a child within the two months prior to the survey. Body mass index (BMI) was the primary outcome of this study, which was categorized using an Asia-specific cutoff value. Normal and/or underweight was defined as a BMI <23.0 kg/m2, overweight was defined as a BMI between 23.0 kg/m2 and <27.5 kg/m2, and obesity was defined as a BMI ≥27.5 kg/m2. Frequency of watching television was the main independent variable of this study, which was divided into the following three categories: not watching television at all, watching television less than once a week, and watching television at least once a week. Multilevel ordered logistic regression was conducted to find the factors associated with overweight and obesity. A p-value <0.05 was considered significant in the final model. RESULTS: Around 35% of the participants were overweight or obese (overweight: 23.7% and obese: 11.6%). A majority of the study participants was aged between 15 and 24 years (36.5%), and resided in an urban area (63.2%), Province No. 3 (22.3%), and the Terai ecological region (49.5%). Around one-third (34.0%) of the participants received no formal education while an almost similar proportion (35.5%) completed secondary education. Approximately half of the study participants (50.6%) reported watching television at least once a week, whereas more than a quarter (28.7%) of them did not watch television at all. Women who watched television at least once a day had a higher prevalence of overweight and obesity than the other groups (p-value <0.0001). Women who watched television at least once a week were 1.3 times more likely to be overweight or obese in comparison to women who never watched television (Adjusted Odds Ratio (AOR): 1.3, 95% CI: 1.0-1.7; p-value <0.05). In the urban areas, women who watched television at least once a week were 40% more likely to be overweight or obese than those who did not watch television at all (AOR: 1.4, 95% CI: 1.1-1.7; p-value <0.01). No significant association between overweight and obesity and the frequency of viewing television was observed in the rural area. CONCLUSIONS: Watching television at least once a week is associated with overweight and obesity in women of reproductive age living in the urban areas of Nepal. Public health promotion programs should raise awareness among women regarding harmful health consequences of sedentary lifestyle due to television watching.


Assuntos
Obesidade/epidemiologia , Sobrepeso/epidemiologia , Televisão , Adolescente , Adulto , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Nepal/epidemiologia , Prevalência , Fatores de Risco , Comportamento Sedentário , Televisão/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto Jovem
20.
BMC Public Health ; 20(1): 175, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019537

RESUMO

BACKGROUND: Food insecurity is widely prevalent in certain sections of society in low and middle-income countries. The United Nations has challenged all member countries to eliminate hunger for all people by 2030. This study examines the prevalence and correlates of household food insecurity among women, especially Dalit women of reproductive age in Nepal. METHODS: Data came from 2016 Nepal Demographic Health Survey, a cross-sectional, nationally representative survey that included 12,862 women between 15 and 49 years of age of which 12% were Dalit. Descriptive analysis was used to assess the prevalence of household food insecurity while logistic regression examined the relationship between women's ethnicity and the risk of food insecurity after accounting for demographic, economic, cultural, and geo-ecological characteristics. RESULTS: About 56% of all women and 76% of Dalit women had experienced food insecurity. Ethnicity is strongly related to food insecurity. Dalit women were most likely to be food insecure, even after accounting for factors such as education and wealth. They were 82, 85, 89 and 92% more vulnerable to food insecurity than Muslims, Brahmin/Chhetri, Terai Indigenous, and Hill Indigenous populations, respectively. Education was a protective factor-women with secondary education (6th to 10th grade) were 39% less likely to be food insecure compared to their counterparts without education. With a more than 10th grade education, women were 2.27 times more likely to be food secure compared to their counterparts without education. Marriage was also protective. Economically, household wealth is inversely correlated with food insecurity. Finally, residence in the Mid-Western, Far-Western and Central Development regions was correlated with food insecurity. CONCLUSION: To reduce food insecurity in Nepal, interventions should focus on improving women's education and wealth, especially among Dalit and those residing in the Far- and Mid-Western regions.


Assuntos
Abastecimento de Alimentos/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Nepal/epidemiologia , Prevalência , Fatores de Risco , Adulto Jovem
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