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1.
Glob Health Sci Pract ; 9(4): 978-989, 2021 12 31.
Article in English | MEDLINE | ID: covidwho-1594125

ABSTRACT

INTRODUCTION: Faced with the coronavirus disease (COVID-19) pandemic, governments worldwide instituted lockdowns to curtail virus spread. Health facility closures and travel restrictions disrupted access to antiretroviral (ARV) therapy for people living with HIV. This report describes how HIV programs in Indonesia, Laos, Nepal, and Nigeria supported treatment continuation by introducing home delivery of ARVs. METHODS: Staff supporting the programs provided accounts of when and how decisions were taken to support ARV home delivery. They captured programmatic information about home delivery implementation using an intervention documentation tool. The 4 country experiences revealed lessons learned about factors favoring successful expansion of ARV home delivery. RESULTS: Three of the countries relied on existing networks of community health workers for ARV delivery; the fourth country, Indonesia, relied on a private sector courier service. Across the 4 countries, between 19% and 51% of eligible clients were served by home delivery. The experiences showed that ARV home delivery is feasible and acceptable to health service providers, clients, and other stakeholders. Essential to success was rapid mobilization of stakeholders who led the design of the home delivery mechanisms and provided leadership support of the service innovations. Timely service adaptation was made possible by pre-existing differentiated models of care supportive of community-based ARV provision by outreach workers. Home delivery models prioritized protection of client confidentiality and prevention measures for COVID-19. Sustainability of the innovation depends on reinforcement of the commodity management infrastructure and investment in financing mechanisms. CONCLUSION: Home delivery of ARVs is a feasible client-centered approach to be included among the options for decentralized drug distribution. It serves as a measure for expanding access to care both when access to health services is disrupted and under routine circumstances.


Subject(s)
COVID-19 , HIV Infections , Pharmaceutical Preparations , Communicable Disease Control , HIV Infections/drug therapy , Humans , Indonesia , Laos , Nepal , Nigeria , SARS-CoV-2
2.
PLoS One ; 16(12): e0260638, 2021.
Article in English | MEDLINE | ID: covidwho-1581778

ABSTRACT

INTRODUCTION: The study aimed at exploring the adverse events following immunization (AEFI) and their incidences among health workers in three different districts of central and western Nepal following the first dose of Covishield vaccine,. It also aimed at studying the association of AEFI with demographic and clinical characteristics of vaccinees, pre-vaccination anxiety level and prior history of COVID-19 infection (RT- PCR confirmed) status. MATERIALS AND METHODS: This was a cross-sectional study carried out via face-to-face or telephonic interview among 1006 health workers one week after receiving their first dose of the Covishield vaccine. Incidence of adverse events was calculated in percentage while Chi-square Test was used to check the association of AEFI with independent variables. Logistic regression was used to find out the adjusted odd's ratio at 95% CI. RESULTS: Incidence of AEFI was 79.8% with local and systemic AEFI being 68.0% and 59.7% respectively. Injection site tenderness was the commonest manifestation. Local and systemic symptoms resolved in less than one week among 96.8% and 98.7% vaccinees respectively. Females were more likely to develop AEFI than males (AOR = 1.7, 95% CI = 1.2-2.4). Vaccinees aged 45-59 years were 50% less likely to develop AEFI as compared to those aged less than 30 years (AOR 0.5, 95% CI = 0.3-0.8). Most of the vaccinees had not undergone RT-PCR testing for COVID-19 (59.8%). Those who were not tested for COVID-19 prior were 1.5 odds more likely to develop AEFI compared to those who were negative (AOR = 1.5, 95% CI = 1.1-2.1). CONCLUSION: More than two-third of the vaccinees developed one or more forms of adverse events, but most events were self-limiting. Females and young adults were more prone to develop AEFI.


Subject(s)
/adverse effects , Health Personnel/statistics & numerical data , Acetaminophen/pharmacology , Adult , Aged , COVID-19/epidemiology , Comorbidity , Cross-Sectional Studies , Female , Health Personnel/psychology , Humans , Male , Middle Aged , Nepal/epidemiology , Time Factors , Vaccination/adverse effects , Vaccination/psychology
3.
Acta Biomed ; 92(5): e2021421, 2021 11 03.
Article in English | MEDLINE | ID: covidwho-1504368

ABSTRACT

Nepal's second wave of COVID-19 has become the worst the world has seen so far. For a population of 29 million people, Nepal currently has only 1127 ICU beds and 453 ventilators for the entire population. The fragile healthcare system is already overwhelmed with every emergency room full of patients. Due to the unavailability of ICU beds, ventilators, oxygen, and other vital resources, sick patients are forced to stay at home with home isolation and treatment. The situation is dire, and resources are saturated. Only humanitarian aid from foreign countries can help mitigate the unprecedented disaster.


Subject(s)
COVID-19 , Humans , Nepal/epidemiology , Research , SARS-CoV-2
4.
Arch Dis Child ; 106(11): 1050-1055, 2021 11.
Article in English | MEDLINE | ID: covidwho-1501685

ABSTRACT

BACKGROUND: Globally, injuries cause >5 million deaths annually and children and young people are particularly vulnerable. Injuries are the leading cause of death in people aged 5-24 years and a leading cause of disability. In most low-income and middle-income countries where the majority of global child injury burden occurs, systems for routinely collecting injury data are limited. METHODS: A new model of injury surveillance for use in emergency departments in Nepal was designed and piloted. Data from patients presenting with injuries were collected prospectively over 12 months and used to describe the epidemiology of paediatric injury presentations. RESULTS: The total number of children <18 years of age presenting with injury was 2696, representing 27% of all patients presenting with injuries enrolled. Most injuries in children presenting to the emergency departments in this study were unintentional and over half of children were <10 years of age. Falls, animal bites/stings and road traffic injuries accounted for nearly 75% of all injuries with poisonings, burns and drownings presenting proportionately less often. Over half of injuries were cuts, bites and open wounds. In-hospital child mortality from injury was 1%. CONCLUSION: Injuries affecting children in Nepal represent a significant burden. The data on injuries observed from falls, road traffic injuries and injuries related to animals suggest potential areas for injury prevention. This is the biggest prospective injury surveillance study in Nepal in recent years and supports the case for using injury surveillance to monitor child morbidity and mortality through improved data.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Global Burden of Disease/economics , Public Health Surveillance/methods , Wounds and Injuries/epidemiology , Accidental Falls/statistics & numerical data , Accidents, Traffic/statistics & numerical data , Adolescent , Animals , Bites and Stings/epidemiology , Burns/epidemiology , Child , Child, Preschool , Drowning/epidemiology , Emergency Service, Hospital/trends , Female , Humans , Male , Nepal/epidemiology , Poisoning/epidemiology , Prospective Studies , Trauma Severity Indices , Wounds and Injuries/mortality , Wounds and Injuries/prevention & control
5.
J Nepal Health Res Counc ; 19(2): 230-238, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1456686

ABSTRACT

BACKGROUND: Hypertension, diabetes, glomerulonephritis, obesity, and family history of kidney diseases are major risk factors for chronic kidney disease. Due to the paucity of data on a national level regarding the prevalence, risk factors, and complications of chronic kidney disease, we performed this meta-analysis. METHODS: We searched online databases from January 2000 till October 2020. Two reviewers screened articles using Covidence software. Comprehensive Meta-Analysis Software version 3 was used for data analysis. RESULTS: Among chronic kidney disease patients, 35.96% were found to have high LDL, 34.22% had hypercholesterolemia, 39.18% had hypertriglyceridemia, and 42.23% had low HDL. Pigmentary changes were reported in 37.71%, pruritus in 30.96%; and xerosis in 48.55%. Among the reported nail problems, the brown nail was reported in 7.19%, half and half nail in 6.07%, and white nail in 20.65%. CONCLUSIONS: The prevalence of chronic kidney disease among high-risk cohorts in Nepal was significant among risk group with hypertension and diabetes being the most common risk factors. The most common stage of chronic kidney disease was Stage V, and the common complications were skin problems and dyslipidemia.


Subject(s)
Hypertension , Renal Insufficiency, Chronic , Humans , Hypertension/epidemiology , Nepal/epidemiology , Prevalence , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/etiology , Risk Factors
6.
J Nepal Health Res Counc ; 19(2): 408-410, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1449552

ABSTRACT

Violence against health workers has been considered a common issue throughout the world. The protection of health workers in low and middle-income countries such as Nepal has not been considered a serious issue by the government. But due to the surge of COVID-19 pandemic and increasing violence against health workers, commendable steps have been taken by the Government of Nepal to protect the safety and security of health workers and health institutions in Nepal. However, the question mark on effective implementation of the ordinance exits suggesting for the appropriate action from concerned authorities and strong collaboration among these sectors. Keywords: Health worker; Nepal; ordinance; safety.


Subject(s)
COVID-19 , Pandemics , Health Personnel , Humans , Nepal , SARS-CoV-2
7.
J Nepal Health Res Counc ; 19(2): 390-395, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1449551

ABSTRACT

BACKGROUND: In Nepal, the stress factor is exacerbated by a large number of police officers working away from home with less family contact, a hectic work schedule in a pandemic situation, companions suffering from illness and updates on additional cases with rising mortality rates, and a lack of access to Personal Protection Equipment. The main aim of this study was to identify the prevalence of COVID stress among Nepal police officers working during pandemic. METHODS: We conducted a cross-sectional study among police officers (n=1526) working during pandemic in Province X Nepal. Semi-structured questionnaire was administered using google form. COVID Stress Scale -36 (CSS-36) was used to assess the stress in officers. Data collection was done after obtaining ethical approval. Data cleaning was done using a python script and then was exported to Ms. Excel for graph analysis. RESULTS: The highest percentage was seen in the xenophobia subscale (24.63%), followed by contamination (20.10 %) and compulsive checking (19.21%). Comparing socio-demographic variables, 18-27 aged groups including male officers and unmarried groups had experienced high COVID stress. CONCLUSIONS: Most of the officers feared from the foreigners perceiving them the main source of COVID-19. Fears about getting contaminated related to COVID-19 was also seen high. There is a need to assess psychological issues and provide social support to police officers during this pandemic situation.


Subject(s)
COVID-19 , Police , Aged , Cross-Sectional Studies , Humans , Male , Nepal/epidemiology , SARS-CoV-2
8.
J Nepal Health Res Counc ; 19(2): 414-416, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1449550

ABSTRACT

One of the most common complication of Coronavirus disease 2019 (COVID-19) is acute respiratory distress syndrome requiring high flow oxygen, ventilator support, corticosteroids and other supportive therapies. Opportunistic aggressive fungal infection with Mucormycosis, although an uncommon entity otherwise, has been on rise in this pandemic especially in patients with chronic underlying illnesses. One such case of rhino-orbital Mucormycosis in a background of uncontrolled hyperglycaemia presented in the hospital and the histopathological examination of the tissues from ethmoidal sinus and frontal recess showed invasive necro-inflammatory infection by numerous Mucormycosis hyphae. Keywords: COVID-19; mucormycosis; rhino-orbital.


Subject(s)
COVID-19 , Mucormycosis , Hospitals , Humans , Mucormycosis/diagnosis , Mucormycosis/therapy , Nepal , SARS-CoV-2
9.
J Nepal Health Res Counc ; 19(2): 396-401, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1449549

ABSTRACT

BACKGROUND: Corona virus disease 2019 has become a global health issue. The goal of this study was to investigate the characteristics and outcomes of patients with corona virus disease 2019 undergoing invasive mechanical ventilation and identify factors associated with mortality. METHODS: Ninety four consecutive critically ill patients with confirmed corona virus disease 2019 undergoing invasive mechanical ventilation were included in this retrospective, single-center, observational study. The outcome variable was mortality of patients undergoing invasive mechanical ventilation and factors associated with it during intensive care unit stay. RESULTS: Seventy nine (84%) out of 94 patients with confirmed corona virus disease 2019 who underwent invasive mechanical ventilation didn't survive. Ninety four percent of patients who had Type 2 Diabetes Mellitus did not survive in comparison to 72 percent of patients who didn't have Type 2 Diabetes Mellitus. Similarly, 48 (94.1%) out of 51 patients with a positive C-reactive protein value didn't survive in comparison to 31 (72%) out of 43 patients with a negative C-reactive protein. CONCLUSIONS: The presence of Type 2 Diabetes Mellitus and a positive C-reactive protein value were strongly associated with mortality. Patients with a Sequential organ failure assessment score of more than eight at intensive care unit admission and peak D-dimer level of more than or equal to two during intensive care unit stay didn't show significant association with mortality. These findings need further exploration through larger prospective studies.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Respiratory Insufficiency , Diabetes Mellitus, Type 2/therapy , Humans , Nepal , Respiration, Artificial , Retrospective Studies , SARS-CoV-2 , Tertiary Care Centers
10.
J Nepal Health Res Counc ; 19(2): 349-354, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1449548

ABSTRACT

BACKGROUND: COVID-19 pandemic hit all age group with different presentations and outcome. This study aimed at exploring the clinical characteristics, investigational findings, hospital outcome along with 90 days follow up of COVID-19 infection in children. METHODS: This was longitudinal descriptive study among hospital admitted children with COVID-19 RT-PCR positive during first wave of Pandemic with 90 days telephonic follow up. Demographic and clinical characteristics, comorbidities, SPO2, investigations, need of oxygen , PICU admission, need of ventilator, outcome (improved and discharged, death) and duration of hospital stay were recorded and 90 days telephonic follow up was performed for any illness and hospital admission. RESULTS: Out of 65 children admitted, male 44 (67.7%) and female 21 (32.3%), median age was 23 months ( IQR 6 days -14 years) with 52( 80.0%) without any comorbid conditions. The common signs were Fever 40(61.5%) vomiting 15 (23.1%) and Cough 11(16.9%).Thirteen (20.0%) children has platelets count less than 150000 and 16(24.6%) had C - reactive protein Positive .Mean duration of hospital stay 8 days (Range 1 -44 days), 20( 30.8% ) needed oxygen , 20(30.8%) needed Pediatric intensive care unit (PICU)admission and 6 (9.2%), needed ventilator. Forty seven (72.3%) recovered and discharged with death of 6.2% (n=4). Fifty six children (75.4%) has not experienced any problem after COVID -19 and only 2 children needed hospital admission in 90 days telephone follow up. CONCLUSIONS: In the first wave of the pandemic, Respiratory and Gastrointestinal symptoms were common presentation with few Severe and critical cases. Majority had good outcome. Majority has no other related illness till 90 days after discharge.


Subject(s)
COVID-19 , Pandemics , Child , Child, Preschool , Female , Hospitals, Pediatric , Humans , Infant , Laboratories , Male , Nepal/epidemiology , SARS-CoV-2
11.
J Nepal Health Res Counc ; 19(2): 372-377, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1449547

ABSTRACT

BACKGROUND: The laboratory abnormalities for hospitalized patients with the SARS-CoV-2 have been described in various studies. Limited data are available for the recovered patients. This study aimed to evaluate various laboratory findings in the recovered SARS-CoV-2 patients. METHODS: In this cross sectional study, the laboratory findings of various hematological and biochemical parameters along with antibody against SARS-CoV-2 of 150 patients who visited Samyak Diagnostic Pvt. Ltd for recovery check up after SARS-CoV-2 were studied from October 2020 to March 2021. RESULTS: Out of total 150 participants, 84% of SARS-CoV-2 recovered patients, who had mild or moderate illness, reported persistence of milder symptoms. Persistence of high serum inflammatory markers such as CRP, Ferritin and LDH along with abnormal cell count and morphology of leukocyte lineage was present in 45.4% of these patients. Similarly, 98.7 % had SARS-CoV-2 IgG antibody after 37 median days of recovery. CONCLUSIONS: Various laboratory abnormalities may persist after SARS-CoV-2 recovery in addition to the presence of SARS-CoV-2 IgG antibody. Follow up study is needed to determine the period up to which these abnormalities are present and the protection from antibody is conferred.


Subject(s)
COVID-19 , SARS-CoV-2 , Cross-Sectional Studies , Humans , Immunoglobulin G , Laboratories , Nepal , Referral and Consultation
12.
J Nepal Health Res Counc ; 19(2): 277-283, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1449546

ABSTRACT

BACKGROUND: COVID-19 is a highly contagious viral disease. The anxiety, misinformation about COVID-19, and the fear of being infected by the virus have led to widespread stigma in local communities. Thus, we conducted a study to evaluate the status of patients and disease-associated stigma of patients who recovered from COVID-19. METHODS: Status of discharged/ improved COVID-19 individuals were followed after their discharge within 2 months after COVID-19 status through telephonic interview. Data of interview was recorded in excel sheets, which was imported in Stata v. 15. Simple descriptive analysis performed and finding presented in appropriate tabulation. Further binomial logistic regression analysis was performed for post-treatment stigmatization. RESULTS: Among 365 case details retrieved, 262 cases contained contact details. Among them, 221 total phone calls were made, of which only 94 could reach for phone interview. 50 (53.19%) were male; 59 (62.77%) were married; and 85 (90.43%) were Hinduism by religion. Majority (n=74, 78.72%) were asymptomatic. The average hospital/isolation stay of patients was 11.23±4.75 days. Among interviewed individuals, 24 (25.81%) reported some type of stigmatization. Individuals with comorbidities and tested for travel purpose has less chance of stigmatization comparing than others. Higher the age in years and longer the duration of hospital/isolation stay; higher the odds of having stigmatization. CONCLUSIONS: High level of stigma was seen among COVID-19 survivors. The stigma associated with COVID-19 was shown to increase with age and length of hospital stay while the stigma decreased with the presence of co-morbidities and was tested for travel purposes.


Subject(s)
COVID-19 , Patient Discharge , Health Facilities , Humans , Male , Nepal , SARS-CoV-2
13.
Glob Health Res Policy ; 6(1): 36, 2021 09 30.
Article in English | MEDLINE | ID: covidwho-1440961

ABSTRACT

BACKGROUND: The highly contagious nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) places physicians in South Asia at high risk of contracting the infection. Accordingly, we conducted this study to provide an updated account of physician deaths in South Asia during the COVID-19 pandemic and to analyze and compare the different characteristics associated with physician mortality amongst the countries of the region. METHODS: We performed a cross-sectional study by using published news reports on the websites of news agencies from 9 selected countries in South Asia. Our study included only those physicians and doctors who died after contracting COVID-19 from their respective workplaces. All available data about the country of origin, type of, sex, age, medical or surgical specialty, and date of death were included. RESULTS: The total number of physician deaths reported due to COVID-19 in our study was 170, with half (87/170, 51%) of the deaths reported from Iran. Male physician deaths were reported to be 145 (145/170 = 85%). Internal Medicine (58.43%) was the most severely affected sub-specialty. The highest physician mortality rate in the general population recorded in Afghanistan (27/1000 deaths). General physicians from India [OR = 11.00(95% CI = 1.06-114.08), p = 0.045] and public sector medical practitioners from Pakistan [aOR = 4.52 (95% CI = 1.18-17.33), p = 0.028] were showing significant mortality when compared with other regions in multivariate logistic regression. CONCLUSION: An increased number of physician deaths, owing to COVID-19, has been shown in South Asia. This could be due to decreased personal protective equipment and the poor health care management systems of the countries in the region to combat the pandemic. Future studies should provide detailed information of characteristics associated with physician mortalities along with the main complications arising due to the virus.


Subject(s)
COVID-19/mortality , Mortality , Occupational Diseases/mortality , Occupational Exposure/statistics & numerical data , Occupational Health/statistics & numerical data , Physicians/statistics & numerical data , Adult , Afghanistan/epidemiology , Aged , Bangladesh/epidemiology , Bhutan/epidemiology , COVID-19/virology , Cross-Sectional Studies , Female , Global Health/statistics & numerical data , Humans , India/epidemiology , Indian Ocean Islands/epidemiology , Iran/epidemiology , Male , Middle Aged , Nepal/epidemiology , Occupational Diseases/virology , Pakistan/epidemiology , Sri Lanka/epidemiology
15.
JNMA J Nepal Med Assoc ; 59(236): 429-431, 2021 Apr 30.
Article in English | MEDLINE | ID: covidwho-1404349

ABSTRACT

During the episodes of large case surge of COVID-19, the health care system of many nations have struggled, more so in nations with resource limitations. Recently, Nepal and the neighboring nation India are being hit hard by the pandemic. Management of patients with moderate and severe COVID-19 remains largely supportive, with oxygen therapy being the cornerstone of the management. Procurement, maintenance of oxygen supply system, coupled with avoiding misuse and wastage of oxygen is of paramount importance to better utilize the scarce resources amidst the peaks of a pandemic. Nepal needs to adopt policies to make best use of its stores and supplies with a collective effort from all stakeholders to save additional lives.


Subject(s)
COVID-19 , Pandemics , Humans , Nepal/epidemiology , Oxygen , Pandemics/prevention & control , SARS-CoV-2
16.
Int J Tuberc Lung Dis ; 25(9): 777-778, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1395201
17.
JNMA J Nepal Med Assoc ; 59(240): 821-822, 2021 Aug 12.
Article in English | MEDLINE | ID: covidwho-1389986

ABSTRACT

The efforts shown by healthcare professionals, security personnel and the general public in fighting Coronavirus Disease 2019 pandemic is highly appreciable. Medical students are future healthcare professionals and have the opportunity to volunteer and help their seniors fight Coronavirus Disease 2019 pandemic. In Nepal, we as medical students are contributing by raising awareness about Coronavirus Disease 2019 along with some innovative initiatives which are Project Personal Protective Equipment, Project Telemedicine and the ″Donate Plasma, Help Defeat COVID-19″ Campaign. Since we were able to support thousands of frontline healthcare workers with personal protective equipment and reduce burden in hospitals by providing telemedicine service, we believe such volunteering and initiations from medical students can be an inspiration for all students for future crises.


Subject(s)
COVID-19 , Students, Medical , Humans , Nepal/epidemiology , Pandemics/prevention & control , SARS-CoV-2 , Volunteers
18.
JNMA J Nepal Med Assoc ; 59(240): 805-807, 2021 Aug 12.
Article in English | MEDLINE | ID: covidwho-1389984

ABSTRACT

Nepal started the COVID-19 vaccination on 27 January 2021 with AstraZeneca/Oxford Coronavirus Disease-19 AZD1222 (Covishield) vaccine to control the Coronavirus disease pandemic. The vaccine has a good safety profile, with cardiovascular complications being rare. Herein we report a rare case of cardiovascular complication following Covishield vaccination in a 33 years old female who had dizziness and elevated blood pressure immediately following vaccination and abnormal electrocardiogram showing T wave inversions followed by left bundle branch block. The patient was kept on observation, following which the blood pressure and electrocardiogram changes were normal by seven days. This cardiovascular complication following the vaccination demands further investigation into the adverse event of the vaccine. However, since the benefit of the vaccine outweighs the risk, World Health Organization has recommended the continuity of the vaccine as of now.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Female , Humans , Nepal , SARS-CoV-2 , Vaccination
19.
Indian J Tuberc ; 68S: S93-S100, 2021.
Article in English | MEDLINE | ID: covidwho-1373077

ABSTRACT

INTRODUCTION: Tobacco smoking is a significant risk factor for developing tuberculosis (TB), contributing to diagnostic delays, poor treatment outcomes and an increased risk of death and relapse. The World Health Organization (WHO) has reported that TB rates could decline by as much as 20% if smoking were eliminated. Tobacco smoking was a risk factor in at least 860,000 TB cases in 2018, and has been documented as one of the leading contributors to TB in India, Indonesia, Myanmar, Nepal and Philippines. METHODS: Joint External Monitoring Missions (JEMM) are arranged by WHO to review the progress, challenges and plans for national TB control programs and provide guidance for improvement of policies, planning and implementation. During May and June 2021, JEMM reports from five South-East Asian countries that had a JEMM in 2019 and early 2020 were reviewed. Reports reviewed from India, Indonesia, Myanmar, Nepal and the Philippines. Any mention of the association of TB and smoking, TB and tobacco use, impact of tobacco use/smoking on TB outcomes, current practices and challenges of TB and tobacco in the TB control program and proposed actions were documented. RESULTS: Of the five country JEMM, Myanmar's did not recognise the impact of smoking tobacco on TB at all, and only one of the five countries, India, identified a very limited number of current TB-Tobacco practises including that a collaborative framework for TB/tobacco was in place. Nepal's 2019 JEMM acknowledged that there was no smoking cessation within the TB Control program and health providers were not aware about the brief advice and smoking cessation program. The Philippines and Myanmar reported neither current practices nor challenges in implementing tobacco intervention in TB control programs. CONCLUSION: Given the importance of tobacco smoking as a key risk factor for TB, assessing its burden on the national TB epidemic should be included as one of the key indicators in the JEMM framework. Key interventions include brief cessation support through regular TB services and the use of Nicotine Replacement Therapy (NRT) and other medications as part of a comprehensive package of care for people with TB to improve the quality of the services they receive. Multisectoral efforts to stop smoking also contribute the non-communicable disease agenda as well as protecting against poor outcomes for COVID-19. The support of TB programs to integrate tobacco control is critical and will contribute to national TB control program targets that support WHO's End TB Strategy.


Subject(s)
Smoking Cessation , Smoking/adverse effects , Tuberculosis/epidemiology , Tuberculosis/prevention & control , Communicable Disease Control , Humans , India/epidemiology , Indonesia/epidemiology , Myanmar/epidemiology , Nepal/epidemiology , Philippines/epidemiology , Risk Factors , World Health Organization
20.
JNMA J Nepal Med Assoc ; 59(239): 645-648, 2021 Jul 30.
Article in English | MEDLINE | ID: covidwho-1362825

ABSTRACT

INTRODUCTION: Depression is a common mental disorder. Medical school is a stressful environment. The outbreak of COVID-19 has added to the plight of medical students. This study was conducted to determine the prevalence of depression among medical students of a medical college in Nepal during the COVID-19 pandemic. METHODS: A descriptive cross-sectional study was conducted among medical students of a medical college in Nepal from August 2020 to September 2020. The sample size of our study was 223. A convenient sampling method was adopted for the selection of respondents. The study was approved by the Institutional Review Committee (Reference no:321). The data were analyzed using Statistical Package for Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. The study instrument consisted of the Patient Health Questionnaire and socio-demographic information. RESULTS: Out of 223 participants, the prevalence of depression was seen among 52 (23.3%) (17.7%-28.9% at 95% Confidence Interval) students in our study. Among them, 25 (48.1%) females and 27 (51.9%) males were depressed. The prevalence of depression was higher in preclinical years (first and second year) than in clinical years (third, fourth and final year). CONCLUSIONS: The prevalence of depression among medical students in Nepal during the pandemic was less than the findings of similar studies conducted in Nepal before the pandemic. Further studies are required to get more knowledge about the factors associated with mental health of medical students.


Subject(s)
COVID-19 , Students, Medical , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Male , Nepal/epidemiology , Pandemics , SARS-CoV-2
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