Biomass Nanoarchitectonics for Supercapacitor Applications.

Nanoarchitectonics integrates nanotechnology with numerous scientific disciplines to create innovative and novel functional materials from nano-units (atoms, molecules, and nanomaterials). The objective of nanoarchitectonics concept is to develop functional materials and systems with rationally architected functional units. This paper explores the progress and potential of this field using biomass nanoarchitectonics for supercapacitor applications as examples of energetic materials and devices. Strategic design of nanoporous carbons that exhibit ultra-high surface area and hierarchically pore architectures comprising micro- and mesopore structure and controlled pore size distributions are of great significance in energy-related applications, including in high-performance supercapacitors, lithium-ion batteries, and fuel cells. Agricultural wastes or natural biomass are lignocellulosic materials and are excellent carbon sources for the preparation of hierarchically porous carbons with an ultra-high surface area that are attractive materials in high-performance supercapacitor applications due to high electrical and ion conduction, extreme porosity, and exceptional chemical and thermal stability. In this review, we will focus on the latest advancements in the fabrication of hierarchical porous carbon materials from different biomass by chemical activation method. Particularly, the importance of biomass-derived ultra-high surface area porous carbons, hierarchical architectures with interconnected pores in high-energy storage, and high-performance supercapacitors applications will be discussed. Finally, the current challenges and outlook for the further improvement of carbon materials derived from biomass or agricultural wastes in the advancements of supercapacitor devices will be discussed.

Phyllanthus emblica Seed-Derived Hierarchically Porous Carbon Materials for High-Performance Supercapacitor Applications.

The electrical double-layer supercapacitance performance of the nanoporous carbons prepared from the Phyllanthus emblica (Amala) seed by chemical activation using the potassium hydroxide (KOH) activator is reported. KOH activation was carried out at different temperatures (700-1000 °C) under nitrogen gas atmosphere, and in a three-electrode cell set-up the electrochemical measurements were performed in an aqueous 1 M sulfuric acid (H2SO4) solution. Because of the hierarchical pore structures with well-defined micro- and mesopores, Phyllanthus emblica seed-derived carbon materials exhibit high specific surface areas in the range of 1360 to 1946 m2 g-1, and the total pore volumes range from 0.664 to 1.328 cm3 g-1. The sample with the best surface area performed admirably as the supercapacitor electrode-material, achieving a high specific capacitance of 272 F g-1 at 1 A g-1. Furthermore, it sustained 60% capacitance at a high current density of 50 A g-1, followed by a remarkably long cycle-life of 98% after 10,000 subsequent charging/discharging cycles, demonstrating the electrode's excellent rate-capability. These results show that the Phyllanthus emblica seed would have significant possibilities as a sustainable carbon-source for the preparing high-surface-area activated-carbons desired in high-energy-storage supercapacitors.

An Outbreak of Dengue Virus Serotype 2 Cosmopolitan Genotype in Nepal, 2017.

Dengue virus (DENV) is one of the most prevalent neglected tropical diseases, with half of the world's population at risk of infection. In Nepal, DENV was first reported in 2004, and its prevalence is increasing every year. The present study aimed to obtain and characterize the full-length genome sequence of DENV from the 2017 outbreak. Hospital-based surveillance was conducted in two provinces of Nepal during the outbreak. Acute-phase serum samples were collected from 141 clinically suspected dengue patients after the rainy season. By serological and molecular techniques, 37 (26.9%) and 49 (34.8%), respectively, were confirmed as dengue patients. The cosmopolitan genotype of DENV-2 was isolated from 27 laboratory-confirmed dengue patients. Genomic analysis showed many amino acid substitutions distributed mainly among the E, NS3, and NS5 genes. Phylogenetic analyses of the whole genome sequence revealed two clades (Asian and Indian) among DENV-2 isolates from Nepal. The DENV isolates from hilly and Terai areas were similar to Asian and Indian strains, respectively. Further genomic study on different DENV serotypes is warranted to understand DENV epidemics in Nepal, where there are limited scientific resources and infrastructure.

Barriers to and facilitators of diabetes self-management practices in Rupandehi, Nepal- multiple stakeholders' perspective.

BACKGROUND: Self-management of diabetes is associated with glycaemic control and adherence to medication and healthy lifestyle practices. There is lack of information on the barriers to and facilitators of diabetes self-management practices in low income country, Nepal. This study aimed to explore the barriers to and facilitators of Type 2 diabetes self-management practices taking multiple stakeholders' perspectives in Nepal. METHODS: Four focus group discussions and 16 semi-structured interviews with people with Type 2 diabetes, caregivers, health care providers and health managers were conducted from April to May 2018 in Rupandehi district of Western Nepal. They were audio-recorded, transcribed, and analysed using a thematic approach. RESULTS: Five main themes emerged that influenced diabetes self-management practices: individual factors, socio-cultural and economic factors, health system and policy factors, availability and accessibility of resources, and environmental factors. The important barriers were: lack of knowledge about diabetes self-management practices, cultural practices, insufficient counselling, lack of guidelines and protocols for counselling, and financial problems. The major facilitators were: motivation; support from family, peers, and doctors; and availability of resources in the community. CONCLUSION: Based on our findings, a multilevel approach is needed to address these barriers and facilitators. These findings will help guide strategies to develop programs that impart knowledge and skills to improve the diabetes self-management practices of people with Type 2 diabetes.

Effects of Female Community Health Volunteer Capacity Building and Text Messaging Intervention on Gestational Weight Gain and Hemoglobin Change Among Pregnant Women in Southern Nepal: A Cluster Randomized Controlled Trial.

Introduction: Public health interventions such as text messaging are commonly evaluated in high-income countries and that the evaluation reports of the effectiveness of community health volunteers in low-income countries like Nepal is scarce. This study aimed to determine whether female community health volunteer (FCHV) capacity building and text messaging to expectant mother increases gestational weights and hemoglobin levels of pregnant women living in southern Nepal. Methods: A cluster randomized control trial was carried out in 52 clusters of 6 Village Development Committees in southern Nepal between July 2015 and March 2016. A total of 413 pregnant mothers of gestation age between 13 and 28 weeks (214 in the intervention group and 199 in the control group) were included in the analysis. Intervention consisted of FCHV capacity building followed by regular supervision and monitoring and mobile phone text messaging to expectant mothers. Regression analysis, controlled for confounders, was conducted to assess gestational weight gains and changes in hemoglobin levels. Results: At the end of the pregnancy, the mean weight gain difference between the intervention and control groups was 1.1 kg (95% CI: 1.0, 1.9). Rates of weight increases in the intervention and control groups were 0.504 kg/week (95% CI: 0.371, 0.528), and 0.399 kg/week (95% CI: 0.362, 0.465), respectively. Similarly, the mean inter group difference in hemoglobin levels was 0.11 gm/dl (95% CI: 0.09, 0.15), and rates of hemoglobin increases (gm/dl/week) in the intervention and control groups were 0.02 gm/dl (95% CI: 0.01, 0.09) and 0.004 gm/dl (95% CI: 0.02, 0.12), respectively. Conclusions: The study shows that FCHV capacity building and mobile text messaging have a positive effect on the gestational weights and hemoglobin levels of expectant mothers. Our findings suggest that mobile text messaging coupled with FCHV capacity building services should be supported and would usefully expand in resource poor settings. Trial registration: ISRCTN60684155.

Socio-Demographic and Diet-Related Factors Associated with Insufficient Fruit and Vegetable Consumption among Adolescent Girls in Rural Communities of Southern Nepal.

Sufficient fruit and vegetable (FV) consumption has been associated with reduced risks of chronic diseases and adverse health conditions. However, the determinants of insufficient of FV intake among adolescent girls in Nepal have not been determined. This study was undertaken to identify associations between socio-demographic and diet-related factors with insufficient fruit and vegetable consumption among adolescent girls living in rural communities. This community-based, cross-sectional study was conducted on 407 adolescent girls from rural communities in the Bateshwar rural municipality of Dhanusha district, Southern Nepal between 12 October, 2018 and 14 December, 2018. The study subjects responded to FV consumption and dietary factor-related questionnaires, and anthropometric measurements were taken. Data were analyzed using the univariate logistic regression followed by multivariable logistic regression analyses. Unadjusted and adjusted odds ratios with 95% confidence intervals (CI) are reported. From the 407 study subjects, 359 (88.2%) reported insufficient FV consumption. The factors significantly associated with insufficient FV consumption were education to under the 10th grade, household income in the first tercile, lack of awareness of the importance of FV consumption, the non-availability of FVs at the household level, the low level of dietary diversity, and undernutrition (BMI (body mass index) (<18.5)). The study shows almost 90% of adolescent girls consumed inadequate amounts of FV and that socio-demographic and dietary factors should be taken into account while designing preventive strategies to increase fruit and vegetable consumption to recommended levels.

Association of water handling and child feeding practice with childhood diarrhoea in rural community of Southern Nepal.

Diarrhoea is a major cause of childhood morbidity and mortality globally. While the childhood diarrhoea and its association with child feeding, and hygiene, hand washing and water treatment are studied elsewhere, the association of water handling and child feeding with childhood diarrhoea is an understudied area in Nepal. This study aimed to investigate the association of water handling and child feeding practice with childhood diarrhoea among children of one to five years of age in Southern, Nepal. A cross-sectional study was conducted in the Dhanusha district of Southern Nepal in 2013. A total of 284 mother-child pairs were selected using systemic random sampling. A four-week prevalence of childhood diarrhoea was reported using frequency distribution. The association of childhood diarrhoea with water handling and child feeding practices was ascertained using multiple logistic regressions after adjusting for potential confounders. The result of the study demonstrated that the four-week prevalence of childhood diarrhoea was 36.6%. Our finding showed that unsafe water handling practices were associated independently with childhood diarrhoea: untreated water (aOR 3.55; 95% CI: 1.13-11.10), uncovered water (aOR 2.14; 95% CI: 1.09-4.19). Similarly, partial breast feeding (aOR 4.35; 95% CI: 1.87-10.12) was also associated with higher odds of childhood diarrhoea. One third of children in Southern Nepal still had diarrhoea within the four weeks preceding the survey. As poor water handling and sub optimal infant feeding practice were major risk factors contributing to such a high burden of the disease, health promotion strategies such as promotion of safe water handling, improved hygiene and child feeding practices are recommended for the prevention of childhood diarrhoea in Southern Terai of Nepal.

Nanoporous carbon materials with enhanced supercapacitance performance and non-aromatic chemical sensing with C1/C2 alcohol discrimination.

We have investigated the textural properties, electrochemical supercapacitances and vapor sensing performances of bamboo-derived nanoporous carbon materials (NCM). Bamboo, an abundant natural biomaterial, was chemically activated with phosphoric acid at 400 °C and the effect of impregnation ratio of phosphoric acid on the textural properties and electrochemical performances was systematically investigated. Fourier transform-infrared (FTIR) spectroscopy confirmed the presence of various oxygen-containing surface functional groups (i.e. carboxyl, carboxylate, carbonyl and phenolic groups) in NCM. The prepared NCM are amorphous in nature and contain hierarchical micropores and mesopores. Surface areas and pore volumes were found in the range 218-1431 m2 g-1 and 0.26-1.26 cm3 g-1, respectively, and could be controlled by adjusting the impregnation ratio of phosphoric acid and bamboo cane powder. NCM exhibited electrical double-layer supercapacitor behavior giving a high specific capacitance of c.256 F g-1 at a scan rate of 5 mV s-1 together with high cyclic stability with capacitance retention of about 92.6% after 1000 cycles. Furthermore, NCM exhibited excellent vapor sensing performance with high sensitivity for non-aromatic chemicals such as acetic acid. The system would be useful to discriminate C1 and C2 alcohol (methanol and ethanol).

Determinants of infant and young child feeding practices in Rupandehi, Nepal.

BACKGROUND: Undernutrition is a major problem in Nepal and meeting the minimum dietary standard is essential for growth and development of young children. Continuous monitoring of such practices is important to inform policy and program formulation. This study aimed to assess complementary feeding practices, and associated factors in Western Nepal. METHODS: This was a cross-sectional study conducted in Rupandehi district of Western Nepal. Face-to-face interviews were conducted among 178 mothers of young children aged 6-23 months using a structured questionnaire and data on complementary feeding practices. These practices were reported as frequency distribution and the factors associated were ascertained using multiple logistic regression. RESULTS: Only 57% of mothers initiated complementary feeding at the age of 6 months. While the proportion of young children receiving minimum meal frequency was reasonably high (84 %), meal diversity (35%) and minimum acceptable diet (33%) remained low. Maternal education and having had their children's growth monitored were independently associated with receiving minimum acceptable diet. CONCLUSION: Few infants and young children received the recommended infant and young children feeding practices. Implementing health promotion programs that educate and enhance the skills of mothers should be a priority for future nutrition interventions.

Impact of mass media on the utilization of antenatal care services among women of rural community in Nepal.

BACKGROUND: Antenatal care has several benefits for expecting mothers and birth outcomes; yet many mothers do not utilise this service in Nepal. Mass media may play an important role in increasing the use of antenatal care and other maternal health services. However, the effect of mass media on increasing health service utilisation has remained an under studied area in Nepal. The aim of this study was to investigate the impact of mass media on the utilisation of antenatal care services in rural Nepal. METHODS: A community-based cross-sectional study was conducted in Sinurjoda Village Development Committee of Dhanusha District, Nepal. A total of 205 mothers of children aged under 1 year were selected using systematic random sampling. Logistic regression was employed to examine the association between selected antenatal care services and mass media exposure after adjusting for other independent variables. RESULTS: A majority of mothers were exposed to mass media. Radio was accessible to most (60.0%) of the participants followed by television (43.41%). Mothers exposed to mass media were more likely to attending antenatal visits [Odds ratio (OR) 6.28; 95% CI (1.01-38.99)], taking rest and sleep during pregnancy [OR 2.65; 95% CI (1.13-6.26)], and receiving TT immunization [OR 5.12; 95% CI (1.23-21.24)] than their non-exposed counterparts. CONCLUSIONS: The study reported a positive influence of mass media on the utilisation of antenatal care services in Nepal. Therefore, further emphasis should be given to increase awareness of women of rural Nepal through mass media to improve utilisation of antenatal care services in Nepal.

Factors associated with early initiation of breastfeeding among Nepalese mothers: further analysis of Nepal Demographic and Health Survey, 2011.

BACKGROUND: Timely initiation of breastfeeding has been reported to reduce neonatal mortality by 19.1%. The World Health Organisation recommends early initiation of breastfeeding i.e. breastfeeding a newborn within the first hour of life. Knowledge on the rate and the determinants of early initiation of breastfeeding may help health program managers to design and implement effective breastfeeding promotion programs. The aim of this study was to determine the rate and the determinants of early initiation of breastfeeding in Nepal. METHODS: This study used the data from Nepal Demographic and Health Survey (NDHS) 2011 which is a nationally representative sample study. Chi square test and multiple logistic regression analysis were used to examine the factors associated with early initiation of breastfeeding (within one hour of birth). RESULTS: Of 4079 mothers, 66.4% initiated breastfeeding within one hour of delivery. Mothers with higher education (Odds Ratio (OR) 2.56; 95% CI : 1.26, 5.21), mothers of disadvantaged Janjati ethnicity (OR 1.43; 95% CI : 1.04, 1.94), mothers who were involved in agriculture occupation (OR 1.51; 95% CI : 1.16, 1.97), mothers who delivered in a health facility (OR 1.67; 95% CI : 1.25, 2.23), whose children were large at birth (OR 1.46; 95% CI : 1.07, 1.99) were more likely to initiate breastfeeding within the first hour of child birth. CONCLUSIONS: Results suggest that two thirds of children in Nepal were breastfed within the first hour after birth. Although there was a higher prevalence of early initiation of breastfeeding among mothers who delivered in health facilities compared to mothers who delivered at home, universal practice of early initiation of breastfeeding should be a routine practice. The findings suggest the need of breastfeeding promotion programs among the mothers who are less educated, and not working. Such breastfeeding promotion programmes could be implemented via Nepal's extensive network of community-based workers.

Utilization of maternal and child health services in western rural Nepal: a cross-sectional community-based study.

BACKGROUND: Considering the commitment and investment of Nepal to reduce maternal and child mortality, understanding service utilization and factors associated with a child and maternal health services is important. OBJECTIVES: This study was examined the factors associated with utilization of maternal and child health services in Kapilvastu District of Nepal. MATERIALS AND METHODS: A cross-sectional study was conducted in 2010 by interviewing 190 mothers having children of aged 12-23 months using the standardized questionnaire. RESULTS: Immunization status (97.4%) and vitamin A supplementation (98.4%) was high. However, initiation of breastfeeding within an hour of birth was low (45.3%) and 63.2% had practiced exclusive breastfeeding. Majority (69.5%) of respondents delivered their child at home and 39.5% sought assistance from health workers. The mothers who did not have any education, mothers from Dalit/Janjati and the Terai origin were less likely to deliver at the health facility and to seek the assistance of health workers during childbirth. CONCLUSION: The immunization program coverage was high, whereas maternal health service utilization remained poor. Interventions that focus on mothers from Dalit/Janjati group and with lower education are likely to increase utilization of maternal health services.

Poor thermal care practices among home births in Nepal: further analysis of Nepal Demographic and Health Survey 2011.

INTRODUCTION: Hypothermia is a major factor associated with neonatal mortality in low and middle income countries. Thermal care protection of newborn through a series of measures taken at birth and during the initial days of life is recommended to reduce the hypothermia and associated neonatal mortality. This study aimed to identify the prevalence of and the factors associated with receiving 'optimum thermal care' among home born newborns of Nepal. METHODS: Data from the Nepal Demographic and Health Surveys (NDHS) 2011 were used for this study. Women who reported a home birth for their most recent childbirth was included in the study. Factors associated with optimum thermal care were examined using Chi-square test followed by logistic regression. RESULTS: A total of 2464 newborns were included in the study. A total of 57.6 % were dried before the placenta was delivered; 60.3% were wrapped; 24.5% had not bathing during the first 24 hours, and 63.9% were breastfed within one hour of birth. Overall, only 248 (10.7%; 95% CI (8.8 %, 12.9%)) newborns received optimum thermal care. Newborns whose mothers had achieved higher education (OR 2.810; 95% CI (1.132, 6.976)), attended four or more antenatal care visits (OR 2.563; 95% CI (1.309, 5.017)), and those whose birth were attended by skilled attendants (OR 2.178; 95% CI (1.428, 3.323)) were likely to receive optimum thermal care. CONCLUSION: The current study showed that only one in ten newborns in Nepal received optimum thermal care. Future newborn survival programs should focus on those mothers who are uneducated; who do not attend the recommended four or more attend antenatal care visits; and those who deliver without the assistance of skilled birth attendants to reduce the risk of neonatal hypothermia in Nepal.

Factors associated with the utilisation of postnatal care services among the mothers of Nepal: analysis of Nepal demographic and health survey 2011.

BACKGROUND: Postnatal care is essential to save the life of the mother and newborn. Knowledge on the determinants of postnatal care assists the policy makers to design, justify and implement appropriate interventions. The current study aimed to analyse the factors associated with utilisation of postnatal care services by mothers in Nepal based on the data from Nepal Demographic and Health Survey (NDHS) 2011. METHODS: This study utilised the data from NDHS 2011. The association between utilisation of at least one postnatal care visit (within 6 weeks of delivery) and immediate postnatal care (within 24 hours of delivery) with selected factors was examined by using Chi-square test (χ(2)), followed by multiple logistic regression. RESULT: Of the 4079 mothers, 43.2% reported attending postnatal care within the first six weeks of birth, while 40.9% reported attending immediate postnatal care. Mothers who were from urban areas, from rich families, who were educated, whose partners were educated, who delivered in a health facility, who had attended a four or more antenatal visits, and whose delivery was attended by a skilled attendant were more likely to report attending at least one postnatal care visit. On the other hand, mothers who reported agricultural occupation, and whose partners performed agricultural occupation were less likely to have attended at least one postnatal care visit. Similarly, mothers who were from the urban areas, from rich families, who were educated, whose partners were educated, who had attended four or more antenatal visits, who delivered in a health facility and had delivered in the presence of a skilled birth attendant were more likely to report attending immediate postnatal care. Mothers who reported agricultural occupation, and whose partners performed agricultural occupation were less likely to attend immediate postnatal care. CONCLUSION: The majority of postnatal mothers in Nepal did not seek postnatal care. Increasing utilisation of the recommended four or more antenatal visits, delivery at health facility and increasing awareness and access to services through community-based programs especially for the rural, poor, and less educated mothers may increase postnatal care attendance in Nepal.

Low compliance with iron-folate supplementation among postpartum mothers of Nepal: an analysis of Nepal Demographic and Health Survey 2011.

One in five maternal deaths are directly attributable to anaemia in the world. The World Health Organization recommends iron supplementation from the second trimester of pregnancy to 45 days after delivery. The aim of this study was to determine the compliance rate of iron-folate consumption and the factors associated with iron-folate consumption among post-natal mothers in Nepal. This study utilised the data of Nepal Demographic and Health Survey (NDHS) 2011. The NDHS 2011 is a cross sectional and nationally representative survey. Of the 4,148 respondents, only 20.7% consumed iron throughout the post-natal period for 45 days. Mothers who had higher and secondary education [adjusted Odd ratio (aOR) 3.101; 95% CI (2.268-4.240)]; had attended four or more antenatal care visits [aOR 9.406; 95% CI (5.552-15.938)]; lived in Far-western development region [aOR 1.822; 95% CI (1.387-2.395)]; delivered in health facility [aOR 1.335; 95% CI (1.057-1.687)]; and attended postnatal care [aOR 2.348; 95% CI (1.859-2.965)] were more likely to take iron for 45 days of postpartum. Intervention to increase the compliance with the postpartum iron-folate supplementation are required to avoid adverse pregnancy outcomes associated with poor iron status with especial focus on the mothers who delivered at homes and did not attend post-natal check up.

Social determinants of tobacco consumption among Nepalese men: findings from Nepal Demographic and Health Survey 2011.

BACKGROUND: In the 20th century, 100 million people across the globe lost their lives due to consumption of tobacco. Every year 15,000 deaths in Nepal are attributable to tobacco smoking and using other products of tobacco. This study aimed to establish the proportion and the social determinants of tobacco use among Nepalese men based on the Nepal Demographic and Health Survey (NDHS), 2011. METHODS: This study used the NDHS 2011 data. The prevalence of cigarette smoking, other forms of tobacco 16 smoking and use of tobacco in any form is reported as a percentage (%). The significance of association of the statistically significant variables established using Chi-square test was further tested by using multiple logistic regression. RESULTS: Of the 4121 participants, the prevalence of consuming any form of tobacco was 51.9% [95% confidence interval (CI) (49.6%- 54.3%)]; chewing/sniffing tobacco was 34.8% (95% CI: 32.4%- 37.3%) and tobacco smoking was 33.6% (95% CI 31.3%-36.0%).Men with no education [Odds Ratio (OR) 3.477; 95% CI (2.380-5.080)], from an older age group (36-49) [OR 2.399; 95% CI (1.858-3.096)] who were from a manual occupation [OR 1.538; 95% CI (1.188-1.985)], who were married[OR 1.938; 95% CI ( 1.552-2.420)], and who were from the Terai region [OR 1.351; 95% CI (1.083-1.684)] were more likely to consume tobacco. Men who watched television at least once a week [OR 0.642; 95% CI (0.504-0.819)] were less likely to consume tobacco. CONCLUSIONS: The current study showed that over half of Nepalese men consume tobacco. There is an urgent need to fully implement Nepal's Tobacco Control and Regulation Act which will ban smoking in public places; enforced plain packaging and display of health warnings over 75% of the packaging, and has banned selling of tobacco products to those under 18 years of age. There is a need to increase the social unacceptability of tobacco in Nepal by raising awareness through different electronic and cultural media. Anti-tobacco campaigns should focus on those who are less educated, have manual occupations, are in poorer economic groups, and are from the Terai region of Nepal.

Factors associated with the introduction of prelacteal feeds in Nepal: findings from the Nepal Demographic and Health Survey 2011.

BACKGROUND: A prelacteal feed is any food except mother's milk provided to a newborn before initiating breastfeeding. Prelacteal feeding is a major barrier to exclusive breastfeeding. It is a prevalent practice in Nepal. Little is known about the factors associated with providing prelacteal feeds to the Nepalese newborn. This study explored the factors associated with providing prelacteal feeds to children under three years in Nepal using the Nepal Demographic and Health Survey (NDHS) 2011. METHODS: This study utilised the NDHS 2011 child dataset which is a nationally representative study. The rates of providing prelacteal feeds were reported as a proportion. Complex Sample Analysis method was used to account for the cluster design and sample weight of the study. Chi-square tests and multiple logistic regression were used to analyse the factors associated with providing prelacteal feeds. RESULTS: A sample of 3948 mothers were included in the study. A total of 841 [26.5% (95% CI: 23.1%-30.3%)] weighted proportion) of mothers reported of providing prelacteal feeds to their newborn infants. Plain water (n = 75), sugar/glucose (n = 35), gripe water (n = 3), sugar/salt solution (n = 3), fruit juice (n = 3), infant formula (n = 96), tea (n = 3) and other milk other than breast milk (n = 556) were some of the types of prelacteal feeds reported. The multiple regression analysis showed that the mothers who had no education, were not working, were from the middle wealth quintile, who had not attended four antenatal care visits, were first time mothers and who were from the Terai/Plain region were more likely to provide prelacteal feeds. CONCLUSIONS: Given that one in four infants were provided with prelacteal feeds, there is a need to implement breastfeeding promotion programs to increase the practice of exclusive breastfeeding and reduce prelacteal feeding practices. Breastfeeding counseling at antenatal clinics and peer support for exclusive breastfeeding should be included as part of breastfeeding promotion programs. Mobilisation of female community health volunteers for peer counseling is also a feasible option for Nepal.

Social determinants of poor knowledge on HIV among Nepalese males: findings from national survey 2011.

Since the first case detection in Nepal in 1988, the number of cases of Human Immunodeficiency Virus (HIV) are increasing. Limited studies exist concerning the knowledge on HIV among the Nepalese men. This study aimed to examine the social determinants of poor knowledge on HIV among Nepalese men aged 15-49 years based on Nepal Demographic and Health Survey (NDHS), 2011. This study is based on the secondary data of NDHS 2011. HIV knowledge was assessed by using structured qustionnaire. A Chi square test followed by logistic regression was performed to find the association of social determinants with outcome variables. Of the 3,991 participants, 1,217 (30.5%) had comprehensive knowledge and the majority (69.5%) had poor knowledge on HIV. More than half (54.6%) reported that mosquito bite can transmit HIV and 26.5% reported that sharing food can transmit HIV. Respondents who were uneducated [aOR 10.782; 95% CI (6.673-17.421)], were manual workers [aOR 1.442; 95% CI (1.152-1.804)], were poor [aOR 1.847; 95% CI (1.350-2.570)]; lived in the the Eastern region [aOR 2.203(1.738-2.793)], or in the Mountain [aOR 1.542; 95% CI (1.132-1.864)]; did not read newspaper/magazine at all [aOR 1.454; 95% CI (1.142-1.851)] and did not listen to the radio at all [aOR 1.354; 95% CI (1.046-1.752)] were likely to have poor knowledge of HIV. HIV prevention programs should include men incorporating appropriate educatoinal intervention to increase their knowledge.

Social determinants that lead to poor knowledge about, and inappropriate precautionary practices towards, avian influenza among butchers in Kathmandu, Nepal.

BACKGROUND: Avian influenza (AI) is a global public health threat. Understanding the knowledge that butchers have about it and the precautionary practices they take against it is crucial for designing future preparedness programs. This study aimed to identify the social determinants of knowledge and precautionary measures of AI among butchers in the Kathmandu district in Nepal. METHODS: The study was based on a cross-sectional study design using structured interview questionnaires and checklists to observe social determinants and the precautionary measures of 120 butchers aged 15 years and above from the Kathmandu district. RESULTS: The majority of the respondents were male (69.2%) and more than half (53.3%) were from the age group of 25-39 years (mean: 31.08, SD: ±9.82). Nearly two-thirds (61.3%) of the respondents had a 'poor knowledge', and the remaining had 'some knowledge', about AI. More than half (55.4%) of the respondents were in the category of displaying 'poor practice' towards AI and the remaining half were in the 'satisfactory practice' category. None of the respondents had 'adequate knowledge' or displayed 'good practice'. The respondents in the >25 years of age group were less likely [OR 0.169; 95% CI (0.056-0.512)] compared to those in the <25 years age group to have a poor knowledge about AI; and the respondents with 'primary education' were more likely [OR 3.265; 95% CI (1.326-8.189)] to have a poor knowledge about AI as compared to those who had a secondary or above level of education. Respondents who did not know the correct definition of AI were more likely to follow poor practices [OR 4.265; 95% CI (1.193-15.242)]; and the respondents who did not know the risk groups associated with AI were also more likely to follow poor practices [OR 3.103; 95% CI (1.191-8.083)]. CONCLUSION: This study points out the need to address butchers to improve their knowledge of, and more importantly their compliance with, the precautionary measures to prevent avian influenza.