One Health Journal of Nepal

Maternal Healthcare Issues during COVID-19 pandemic in Nepal

Bibek Giri, Ashesh Malla Thakuri, Manisha Manisha Gharti Magar — Fri, 28 Jul 2023 00:00:00 +0000

The COVID-19 pandemic has affected the healthcare system worldwide, and maternal healthcare was no exception. Nepal, a low-income country with a high maternal mortality rate, faces unique challenges in providing adequate maternal healthcare during the pandemic. The pandemic has resulted in decreased access to maternal healthcare services, with pregnant women facing barriers to accessing antenatal care, delivery, and postpartum care. The pandemic has also exacerbated existing inequalities, with marginalized groups and rural communities being disproportionately affected. The COVID-19 pandemic has highlighted the need for Nepal to prioritize maternal healthcare, particularly in the context of a public health crisis. This article presents the impact of the COVID-19 pandemic on maternal healthcare in Nepal, focusing on the challenges faced by pregnant women.

Attention Deficit Hyperactivity Disorder in Children Living in Child Care Homes in Kathmandu

Gobind Prasad Pant, Lahana Maharjan, Cyril Blavo, Indira Khadka — Fri, 28 Jul 2023 00:00:00 +0000

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder of childhood, which is characterized by pervasive and impairing symptoms of inattention, hyperactivity, and impulsivity. Mental health is a major challenge in vulnerable children. The study aimed to assess ADHD among children living in childcare homes.

Methods: A cross-sectional, descriptive study was conducted among 151 children living in childcare homes in Kathmandu. Data were collected conveniently through face-to-face interview using a structured questionnaire. The ADHD was assessed using validated Devkota’s ADHD scale. Ethical approval was received, and ethical issues were addressed. Data were processed using IBM SPSS v.25.0. Descriptive statistics and chi-square test was used.

Results: ADHD was 11.92%. Hyperactivity was the most common subtype (9.93%), followed by impulsivity (5.30%) and inattention (1.32%). ADHD was higher in males (16.2%) than in females (8.4%). Similarly, the distribution of ADHD was higher in early-aged children, early-aged admitted, with long stays in childcare homes, those with family problems, and had lower educated caregivers. However, there was no significant association was observed.

Conclusions: ADHD was high among children residing in childcare homes. Hyperactivity was the most common subtype. Children in childcare homes could be vulnerable to developing behavioral disorders including ADHD. Further study is recommended to explore co-morbidity and associated factors with behavioral and emotional disorders in children in childcare homes.

Assessing Sleep Quality among COVID-19 Positive Patients of Budhanilkantha Municipality, Nepal: A Cross-Sectional Descriptive Study

Sarmila Rai, Radha Kumari Shah, Barsha Karki, Nupur Sharma — Fri, 28 Jul 2023 00:00:00 +0000

Introduction: Since the first emergence of CoronaVirus Disease in2019 in Wuhan, China on December 31, 2019, there have been many long-term impacts on health. Understanding factors associated with poor sleep quality among COVID-19 positive is important for the development of intervention. This study aimed to assess Sleep Quality among COVID-19-positive patients of Budhanilkantha Municipality, Kathmandu.

Methods: A quantitative descriptive cross-sectional study was carried out. Patients who tested COVID-19 positive during the third COVID-19 wave (omicron) residing in Budhanilkantha Municipality were selected through the convenient sampling method. Sleep quality was measured using Pittsburgh Sleep Quality Index. Data was collected through the telephone interview technique and analyzed using SPSS version 16. Descriptive analysis was described in percentages and frequency distributions. A chi-square test was done for the bivariate data analysis.

Results: This study presents a high prevalence of poor sleep quality among COVID-19-positive patients which was 58.3% (95% CI: 50.4-65.8).

Conclusions: In conclusion, this study reveals a high prevalence of poor sleep quality among COVID-19-positive patients.

Nutritional Status of Under Five Children and its Associated Factors in Urban Slums of Kathmandu Valley, Nepal

Bikram Bucha, Prabin Karki, Pranil Man Singh — Fri, 28 Jul 2023 00:00:00 +0000

Introduction: Child malnutrition is a major contributor to the global burden of disease, significantly affecting vulnerable children living in substandard environmental conditions of poverty-stricken urban slums. The study aimed to assess the prevalence of nutritional status and identify associated factors in the urban slums of Kathmandu Valley, Nepal.

Methods: A community-based cross-sectional study was conducted in 11 small urban slums of Kathmandu Valley among children aged 6-59 months. Standard anthropometric measurement tools were used to measure the height and weight of children. Structured questionnaires were used to collect data through direct interviews and household visits. A descriptive analysis of variables and a chi-square test was used to find the association.

Results: The prevalence of stunting, wasting, and underweight were 34.9% [95% CI: 25.8-44], 14.2% [95% CI: 7.6-20.8], and 30.2% [95% CI: 21.4-33] respectively. Both being underweight and stunting were found significantly associated with socioeconomic status of the family and ethnicity. Underweight was found significantly associated with the age of child and stunting was found significantly associated with the educational status of the mother and the age of child.

Conclusions: The study found a high prevalence of stunting and underweight in the urban slums of Kathmandu Valley. Socio-economic status, ethnicity, age of the child, and maternal education were found to be associated with malnutrition in children.

Prevalence of Social Anxiety and Its Associated Factors Among School-Going Adolescents of Butwal Sub Metropolitan City

Binay Gyawali, Rubina Shrestha, Shilpa Banjade, Rishab Shrestha, Sarita Soti — Fri, 28 Jul 2023 00:00:00 +0000

Introduction: Social Anxiety is a common and serious mental health problem among adolescents across the globe. Social anxiety symptoms if it goes beyond the threshold level it may cause social anxiety disorder which is a serious mental health issue among adolescents and youths. Despite being a serious issue among adolescents, much attention is not given in our country. The main objective of the study was to determine the prevalence of social anxiety and its associated factors among school-going adolescents of Butwal Sub Metropolitan City.

Methods: A school-based cross-sectional study among 390 school-going adolescent students aged 10 to 19 was done using a validated Nepali version of the Social Anxiety Scale for Adolescents (SAS-A) with a cutoff point ≥ 50 to measure social anxiety. Descriptive statistics like frequency, mean, median, and standard deviation were calculated. The association between social anxiety and independent variables was considered significant when p value was < 0.05, which was assessed by bivariate analysis.

Results: Among a total of 390 adolescent students, about half (49.7%, CI: 0.45-0.54) of the adolescents had social anxiety in the study area.

Conclusions: The findings highlight the considerable prevalence of social anxiety among school-going adolescents in the study area. There is a need for social support from parents, and friends for adolescents' especially early adolescents.

Factors Associated with Prevalence of Internet Gaming Disorder among School Going Adolescence of Butwal, Nepal

Rishab Shrestha, Jyoti Priyanka, Binay Gyanwali, Shilpa Banjade, Suraj Jyakhwo — Fri, 28 Jul 2023 00:00:00 +0000

Introduction: Internet gaming disorder (IGD) refers to uncontrolled gaming behavior despite the occurrence of negative consequences. The use of Internet games is popular among school children. Many studies have been conducted on IGD around the globe. This study aimed to measure the prevalence of IGD among adolescents and the factors associated with it.

Methods: A cross-sectional study was conducted among 446 students of grades 8, 9, and 10 in Butwal Sub-metropolitan city. A simple random method was used to select schools. Sections of each class of 8, 9, and 10 were selected using a lottery method (for two or more sections in a grade). All the eligible students of the selected section/ grade were included in the study. Self-administered questionnaire and Dichotomous IGD scale-9 were used for data collection. Bivariate analysis was done and 95% confidence interval was used to determine significance.

Results: The prevalence of IGD was found to be 18.9% among school-going adolescents. The associated factors found were male sex (p=0.006), daily playing behavior (p=0.001), availability of personal devices (p=0.005), habit of spending money on games (p<0.001), and presence of regular gaming partners (p=0.005).

Conclusions: IGD is an emerging issue among the young population. Appropriate measures should be taken to control the gaming behavior of students.

Nutritional Knowledge and Food Practice among Reproductive aged Women of Rainas Municipality, Lamjung

Fri, 28 Jul 2023 00:00:00 +0000

Introduction: Nutrition knowledge covers principles related to diet and health, including disease and diet correlation, nutrient sources, and dietary guidelines. Food consumption pertains to how and why people eat, and knowledge of dietary practices is vital in evaluating nutrition knowledge. Healthy eating habits improve immunity, while unhealthy behavior may result in malnutrition, obesity, and other chronic diseases. The study aimed to determine the nutritional knowledge and practice among aged women of Raina’s municipality in the Lamjung district.

Methods: A descriptive cross-sectional study involving 233 participants was conducted with prior ethical approval obtained for data collection. Information was collected through face-to-face interviews using semi-structured questionnaires. Convenient sampling was utilized for both area and respondent selection. The gathered data were coded and entered on Epidata then exported to SPSS version 26 for descriptive and inferential statistical analysis.

Results: The study revealed that a notable proportion of participants, specifically 55.5%, possessed a good level of knowledge concerning nutrition, whereas 44.5% demonstrated a deficiency in their understanding. In parallel, a majority of the respondents, comprising 56.7%, exhibited poor food practices, while 43.3% showcased good practices.

Conclusions: The study concludes that while respondents demonstrated good knowledge regarding nutrition, their practical implementation of this knowledge in their dietary practices was relatively poor. This highlights the need for interventions and strategies aimed at bridging the gap between knowledge and practice to promote healthier behaviors and improve overall nutrition among the studied population.

Menstrual Disorder and Associated Factors among Female of Reproductive Age Group in Sunkoshi Rural Municipality, Sindhuli: A Community-based Cross-sectional Study

Fri, 28 Jul 2023 00:00:00 +0000

Introduction: A menstrual disorder is an abnormal condition in women’s menstrual cycle. Menstrual disorders may present as abnormal uterine bleeding, dysmenorrhea, premenstrual syndrome, and premenstrual syndromes. Within the Himalayan country of Nepal, menstruation is taken into account as taboo, an incident of stigma and sin. The main objective of the study was to assess the menstrual disorders of women of reproductive age group and find out the association between different factors.

Methods: A community-based cross-sectional study was conducted among 272 women. Convenience sampling was adopted for area selection and respondent selection. The study was done in Sindhuli. A semi-structured questionnaire was prepared whereas a face-to-face interview was done for information collection. SPSS software was used for data analysis.

Results: The prevalence of menstrual disorders was found to be 84.2%. The most contributing factors that remained to be statistically significant and independently associated with menstrual disorder were ethnicity (p=0.029), pregnancy history (p=0.032), family type (p=0.028), and junk food (p=0.014).

Conclusions: High prevalence of menstrual disorders among women of reproductive age group was seen. Several other research showed similar results even though there's limited research on menstrual disorders in Nepal, despite having a soaring number of menstrual disorders among women.

Prevalence of Overweight and Its Associated Factors Among School Going Adolescents of Butwal, Nepal: A School-based Cross-sectional Study

Sun, 23 Jul 2023 00:00:00 +0000

Introduction: Adolescent overweight can cause various health problems and increase adulthood obesity and non-communicable diseases(NCDs). Incidences of non-communicable diseases are preventable, and if prevented at an early stage, it can reduce the risk of health issues later in life. This study aimed to explore the prevalence of overweight and its associated factors among school-going adolescents.

Methods: A descriptive cross-sectional study was conducted in four randomly selected schools of Butwal, Rupandehi district from December 2021 to March 2022. Descriptive analysis data was calculated in terms of frequency, percentage, mean, and standard deviation using the Statistical Package for social sciences (SPSS v26).

Results: In this study, the prevalence of overweight was 21.5% (95% CI: 17.9 to 25.1) among adolescent students. Students studying in Government schools, upper socioeconomic class, consuming junk food on a daily basis, and aerated drinks were found to be associated with being overweight.

Conclusions: Understanding the current situation of consistently prevalent rising overweight, should be emphasized and considered a public health concern. Governmental and non-governmental collaboration, public awareness, school-based educational programs, physical activity, and the importance of dietary management can be done before childhood and adolescent overweight turns into an epidemic.

Knowledge of Epidural Analgesia for Labour Pain among Healthcare Workers: A Hospital-based Cross-sectional Study

Adim Prasai, Abha Prasai, Ashwini Bhattarai — Fri, 28 Jul 2023 00:00:00 +0000

Introduction: Childbirth is one of the most painful experiences of a woman’s life. Epidural analgesia is a gold-standard technique to alleviate labor pain. However, its use is 1.3% in developing countries. The main aim of this study was to assess the knowledge of epidural analgesia for labor pain among healthcare workers of Nepal Medical College Teaching Hospital.

Methods: A hospital-based cross-sectional study was conducted among 422 healthcare workers. All healthcare workers fulfilling the inclusion criteria were included. Data collection was done via a self-administered questionnaire. Descriptive analysis was done using IBM SPSS version 20.

Results: Among the participants, 94.3% perceived labor pain to be severe. 97.9% had an idea on labor analgesia. 81.3% percent of the participants believed epidural analgesia to be the best modality of pain relief. 58.3% of the participants believed that epidural analgesia leads to an increased risk of caesarean section and 15.2% believed there would be an increased risk to the baby.

Conclusions: Most healthcare workers have knowledge about labor analgesia and think that it should be available to all patients in labor. However, this study shows that there is still some misconception about the risks and complications of epidural analgesia. Adequate knowledge should be provided to all healthcare workers for efficient services.

Knowledge Regarding Prevention of Cervical Cancer among Reproductive Age Women in Bote Community, Nawalparasi: A Community-based Cross-sectional Study

Barsha Karki, Neelu Sharma, Radha Kumari Shah, Prakriti Pokhrel, Sarmila Rai — Fri, 28 Jul 2023 00:00:00 +0000

Introduction: Preventable cervical cancer poses a significant threat to the lives of women in their reproductive years in Nepal. Educating women about cervical cancer is crucial in early detection and implementing suitable preventive measures. This study centered on the Bote community and aimed to assess the knowledge of women in terms of preventing cervical cancer.

Methods: A community, cross-sectional study was conducted among the reproductive age group of the Bote community. All women in the reproductive age group (15–49 years) were included from selected wards with 170 respondents. Face-to-face interviews were conducted using semi-structured questionnaires. The data were analyzed in SPSS version 16 for Windows using descriptive statistics.

Results: Out of the 170 respondents, only 48.12% heard about cervical cancer, while 90.6% had a limited understanding of preventive measures. A small proportion of respondents, specifically 7.2%, were familiar with the concept of a pap smear examination, and only 12% were aware of the availability of the HPV vaccine, which effectively prevents cervical cancer.

Conclusions: Women of reproductive age in the Bote community demonstrated a lack of adequate knowledge concerning cervical cancer prevention. Most of the respondents were unaware of the HPV vaccine's accessibility and cervical cancer prevention strategies. Therefore, local and federal governments must prioritize implementing targeted advocacy programs tailored to reach and educate marginalized women in minority communities.

Teenage Pregnancy and Fetomaternal Outcomes in Tertiary Maternity Hospital of Nepal

Rupa Paneru, Kalpana Chaudhary, Usha Ghimire, Natasha Bhattarai, Bandana Paneru — Fri, 28 Jul 2023 00:00:00 +0000

Introduction: Teenage pregnancy is a global public health concern that causes adverse effects on the mother and fetus. In Nepal, the teenage pregnancy burden is high. Several studies have reported that teenage pregnancy and delivery are associated with adverse neonatal outcomes whereas some studies have reported contradictory findings. Thus this study aimed to assess maternal and fetal outcomes of teenage pregnancy in Nepal.

Methods: In a comparative cross-sectional study, we assessed 577 pregnant women aged 13-19 years and 577 adult pregnant women at Paropakar Maternity and Women's Hospital in Kathmandu, Nepal. Singleton pregnant women between the ages of 14 and 19 were assigned to Group A and Singleton pregnant women over the age of 19 were assigned to Group B. Maternal outcomes examined hypertensive disorders, gestational diabetes, anemia, genital tract injuries during vaginal delivery, and postpartum hemorrhage (excessive bleeding after childbirth). Fetal outcomes included low birth weight (LBW), preterm birth, low Apgar score at 5 minutes, neonatal death, and stillbirth. The chi-square test was employed to ascertain the association between teenage pregnancy and maternal and fetal complications.

Results: A total of 9360 deliveries were performed during the study period out of this 577(6.2%) were teenage pregnancies. For the study group, the mean age was 18.3 ± 0.9 years compared with 20.1 ± 2.3 years for the older group. Thirteen percent of participants from Group A and 1% from Group B had maternal complications. Around 16% of women have fetal complications, and 20% of these complications were among Group A.

Conclusions: Teenage pregnancies showed higher rates of maternal and fetal complications compared to adult pregnancies. These complications include genital tract injuries, postpartum hemorrhage, and giving birth to low birth weight babies.