Predictors to Intensive Care Unit admission among patient with coronavirus disease in Sukraraj Tropical and Infectious Disease Hospital, Nepal: A case-control study.

The clinical features of COVID-19 are vary widely, ranging from asymptomatic states or mild upper respiratory tract infections to severe pneumonia. Previous studies have shown that 20.0% of COVID-19 patients are hospitalized, out of which 10.0-20.0% are admitted to the Intensive Care Unit. The present study aims to assess predictors associated with COVID-19 leading to Intensive Care Unit admission among reverse transcriptase- polymerase chain reaction (RT-PCR) positive patients in Sukraraj Tropical and infectious disease hospital, Nepal. A case-control study was conducted from June 2022 to July 2022 among patients admitted to Sukraraj Tropical and Infectious Disease Hospital. A hospital-based age (± 2 years) and sex-matched case-control study design were adopted in which ICU admitted (case group, n = 33) and general ward admitted (control group, n = 66) were included. Data were collected using a structured questionnaire comprising of socio-demographic, clinical, and preventive predictors. Data were analyzed using the Statistical Package for Social Science version 11.5. The Chi-square test and conditional logistic regression to determine the predictors associated with ICU admission. High blood pressure, high C-reactive protein and poor application of preventive practices were found to be the predictors of ICU admission. Conditional logistics regression analyses revealed that independent risk factors associated with ICU admission were elevated blood pressure (AOR = 2.22; 95% CI 1.05-4.71, p = 0.015) and abnormal C-Reactive Protein (AOR = 2.92; 95% CI 1.24-6.84, p = 0.012) at the time of hospital admission were more likely to get admitted to ICU. Likewise, patients with poor preventive practice (AOR = 3.34; 95% CI 1.19-9.31, p = 0.02) more likely to get admitted to ICU than patient with good preventive practices.These research findings hold potential significance for facilitating early triage and risk assessment in COVID-19 patients.

Medical students' attitude towards cultural diversity: a cross-sectional study at a health sciences university in eastern Nepal.

OBJECTIVES: To assess the attitude of medical students towards cultural diversity aiming to elucidate our current status in understanding cultural awareness and sensitivity. DESIGN, SETTING AND PARTICIPANTS: A web-based cross-sectional study was carried out among 601 undergraduate health science students (medical and dental courses) at a health sciences university in eastern Nepal via various modes of social-media platforms like WhatsApp, Messenger, Gmail, etc. OUTCOME MEASURES: Medical students' attitude towards cultural diversity and its association with the sociodemographic profile of the students. RESULTS: A total of 601 students participated in the study, out of which, 64.2% were men with a sex ratio of 1.8:1 and a mean age of 22.3±1.9 years. More than two-thirds (77.2%) of the students had an excellent to good attitude towards cultural diversity. The proportion of students reporting 'excellent' attitude towards cultural diversity was higher among male students compared with female students (37.8% vs 20.5%) and students aged >22 years compared with younger students (37.1% vs 26.7%). Gender (p<0.001) and age (p=0.009) were significantly associated with the attitude towards cultural diversity. CONCLUSIONS: Medical students, in general, are aware of the impacts of a cross-cultural society on the delivery of quality healthcare and also about the need to be aware of prejudices doctors may have towards certain cultures. Majority suggest the inclusion of concepts of multicultural awareness and sensitivity in the medical curriculum itself.

Compliance with the smoke-free public places legislation in Nepal: A cross-sectional study from Biratnagar Metropolitan City.

BACKGROUND: Smoke-free legislation banning tobacco smoking in public places was implemented across Nepal in 2014 with the ambition to reduce the impact of second-hand smoking. As part of a comprehensive policy package on tobacco control, the implementation of the legislation has seen a marked reduction in tobacco consumption. Yet there remains uncertainty about the level of compliance with smoke-free public places. OBJECTIVES: This study assesses the compliance with smoke-free laws in public places and the factors associated with active smoking in public places in Biratnagar Metropolitan City, Nepal. METHODS: A cross-sectional study was conducted in the Biratnagar metropolitan city in Province 1 of Nepal from July to December 2019. A total of 725 public places within the metropolitan city were surveyed using a structured survey tool. Active smoking was the primary outcome of the study which was defined as smoking by any person during the data collection time at the designated public place. RESULTS: The overall compliance with smoke-free legislation was 56.4%. The highest compliance (75.0%) was observed in Government office buildings. The lowest compliance was observed in eateries, entertainment, and shopping venues (26.3%). There was a statistically significant association between active smoking and the presence of 'no smoking' notices appended at the entrance and the odds of active smoking in eateries, entertainment, hospitality, shopping venues, transportations and transits was higher compared to education and health care institutions. None of the 'no smoking' notices displayed fully adhered to the contents as prescribed by the law. CONCLUSION: As more than half of the public places complied with the requirements of the legislation, there was satisfactory overall compliance with the smoke-free public places law in this study. The public venues (eateries, shopping venues and transportations) that are more frequently visited and have a high turnover of the public have lower compliance with the legislation. The content of the message in the 'no smoking' notices needs close attention to adhere to the legal requirements.

Use of the English Health Literacy Questionnaire (HLQ) with Health Science University Students in Nepal: A Validity Testing Study.

Research evidence shows that health literacy development is a key factor influencing non-communicable diseases care and patient outcomes. Healthcare professionals with strong health literacy skills are essential for providing quality care. We aimed to report the validation testing of the Health Literacy Questionnaire (HLQ) among health professional students in Nepal. A cross-sectional study was conducted with 419 health sciences students using the HLQ in Nepal. Validation testing and reporting were conducted using five sources outlined by 'the 2014 Standards for Educational and Psychological Testing'. The average difficulty was lowest (17.4%) for Scale 4. Social support for health, and highest (51.9%) for Scale 6. Ability to actively engage with healthcare providers. One factor Confirmatory Factor Analysis (CFA) model showed a good fit for Scale 2, Scale 7 and Scale 9 and a reasonable fit for Scale 3 and Scale 4. The restricted nine-factor CFA model showed a satisfactory level of fit. The use of HLQ is seen to be meaningful in Nepal and warrants translation into native Nepali and other dominant local languages with careful consideration of cultural appropriateness using cognitive interviews.

Prehypertension and its predictors among older adolescents: A cross-sectional study from eastern Nepal.

Prehypertension is a state of transition between normal blood pressure and hypertension. Adolescent prehypertension is a strong predictor of hypertension in adults and is now considered for cardiovascular intervention or risk reduction. This study was conducted among adolescents to assess the burden of pre-hypertension and its predictors. A cross-sectional study was conducted among grade 11 and 12 students in three districts in eastern Nepal namely Jhapa, Morang and Sunsari. Sampling was done using a multistage stratified proportionate random method. A semi-structured questionnaire adapted from the WHO STEPwise approach to the non-communicable disease risk factor surveillance (STEPS) instrument was used as a study tool after modification and pre-testing in addition to the anthropometric and blood pressure measurements by the investigators. The prevalence of prehypertension was assessed along with the identification of its predictors through multivariable binary logistic regression modelling. A total of 806 participants aged 15 to 19 years, with 57.1% female, participated in the study. Prehypertension was found in 20.8% (24.6% in males and 18.0% in females) of the participants, while 7.1% of them were hypertensive (9.2% males and 5.4% females). Obesity and central obesity were seen among 6.3% and 17.7% of the respondents respectively. Age, sex, ethnicity and obesity were found to be significantly associated with prehypertension. A significant proportion of prehypertension was seen among the adolescent population along with a notable presence of risk factors such as smoking, alcohol consumption, obesity, and eating out. This warrants careful consideration and identification of relevant strategies to reduce the burden of prehypertension via school-based interventions to reduce the modifiable risk factors.

Pulmonary Tuberculosis among Male Inmates in the Largest Prison of Eastern Nepal.

INTRODUCTION: The prevalence of Pulmonary Tuberculosis (PTB) is much higher in the prison population than in the general population. This study aims to find out the prevalence of PTB and its associated factors among inmates in eastern Nepal. METHODS: This cross-sectional study was conducted in Jhumka Regional Prison, the largest male prison of Eastern Nepal from September 2014 to August 2015. Semi-structured questionnaires were used to identify individuals with a cough more than one-week duration among 434 randomly selected inmates. Screening of PTB was done by sputum smear test and/or GeneXpert test. Prevalence of TB was defined as the number of cases detected during the study period divided by the total number of inmates screened during that period. Fisher's exact test was used to find out the association of PTB with related variables. RESULTS: A total of 434 inmates were screened for PTB with mean age 35.7 years and body mass index 22.7 kg/m2. A total of 68 inmates had a productive cough of more than a week and two patients were already on anti-tuberculosis therapy at the time of screening. Sixty sputum samples were considered for sputum smear/GeneXpert test and 6 of them (10%) had positive results. The prevalence of TB in the Prison was 1843/100,000 population. Chest pain and abnormal chest auscultation findings were found to be significantly associated with PTB. CONCLUSIONS: This study showed that there was a high rate of PTB among inmates in Nepal. The results suggest a need for effective screening of PTB and strategies to improve management including reduction of PTB transmission in the prison.

What motivates open defecation? A qualitative study from a rural setting in Nepal.

INTRODUCTION: Open defecation is ongoing in Nepal despite the rise in efforts for increasing latrine coverage and its use. Understanding the reasons for open defecation would complement the ongoing efforts to achieve the 'open defecation free' status in Nepal. This study aimed at exploring different motivations of people who practice open defecation in a village in Nepal. METHODS: This study was conducted among the people from the Hattimudha village in Morang district of eastern Nepal, who practiced open defecation. Maximum variation sampling method was used to recruit participants for 20 in-depth interviews and 2 focus group discussions. We adopted a content analysis approach to analyze the data. RESULTS: We categorized different reasons for open defecation as motivation by choice and motivation by compulsion. Open defecation by choice as is expressed as a medium for socializing, a habit and an enjoyable outdoor activity that complies with spiritual and religious norms. Open defecation by compulsion include reasons such as not having a latrine at home or having an alternative use for the latrine structures. Despite having a private latrine at home or access to a public latrine, people were compelled to practice open defecation due to constraints of norms restricting latrine use and hygiene issues in general. For women the issues with privacy and issues refraining women to use the same latrine as men compelled women to look for open defecation places. CONCLUSION: Open defecation is either a voluntary choice or a compulsion. This choice is closely linked with personal preferences, cultural and traditional norms with special concerns for privacy for women and girls in different communities. The ongoing campaigns to promote latrine construction and its use needs to carefully consider these factors in order to reduce the open defecation practices and increase the use of sanitary latrines.

Health literacy of future healthcare professionals: a cross-sectional study among health sciences students in Nepal.

Background: There is an assumption that health literacy is higher among health professionals, allowing them to improve the health literacy of their patients. This study explored health literacy profiles of health science students in Nepal, the future health professionals and educators of health literacy. Methods: The multidimensional Health Literacy Questionnaire and demographic questions were administered online to medical and other health science students at the B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Results: More than half (55.8%) of the participants were male, 68.3% were ≤19 y of age, 62.2% had parents with a university degree, 73.5% were studying undergraduate courses and 61.6% were pursuing medicine. Students reported having moderate support and skills to manage their health. Health was regarded as important to them. They reported a moderate ability to engage with health professionals and the healthcare system. Medical students reported higher scores for all scales except social support for health, which was similar across the groups. Conclusions: Universities should target interventions to improve students' access to health information and to develop students' ability to engage actively with healthcare providers. This will likely produce health professionals with improved health literacy levels who are sensitive to the health literacy needs of their patients from different population groups.

Health needs and risky behaviours among inmates in the largest prison of eastern Nepal.

PURPOSE: The purpose of this paper is to assess the health status and risky behaviours of inmates in Nepal. DESIGN/METHODOLOGY/APPROACH: This cross-sectional study was conducted in Jhumka Regional Prison, the largest male prison in eastern Nepal from September 2014 to August 2015. Data were collected through face-to-face interviews from 434 randomly selected incarcerated participants using semi-structured questionnaires. FINDINGS: The mean age of 434 participants was 35.7 years (SD 13.3). The majority (84 per cent) had at least one current health problem, of which the commonest were respiratory (50 per cent), skin (38 per cent) and digestive (26 per cent). Alcohol (73 per cent) and cigarettes (71 per cent) were the most commonly used substances prior to imprisonment. Approximately, 27 and 11 per cent reported illicit drug use and injectable drug use prior to incarceration, respectively. A total of 204 inmates reported having intercourse with sex workers. Of these, 49 per cent did not use a condom in their last intercourse with a sex worker. RESEARCH LIMITATIONS/IMPLICATIONS: This paper illustrates that a wide range of physical and mental health problems exist among incarcerated people in Nepal. The study may lack generalisability, however, as it was conducted in a single male prison. PRACTICAL IMPLICATIONS: The paper suggests a need for medical, psychiatric and substance abuse care in correctional settings to improve the health status of the prison population. It is also important to develop screening policies for blood-borne viral and other infectious diseases in the prison. ORIGINALITY/VALUE: This is the first study of its kind drawn from prisons in Nepal.

Work Related Injury among Welders Working in Metal Workshops of Dharan Municipality, Nepal.

BACKGROUND: Injuries are a problem worldwide in all occupations. Welders are exposed to many hazards at work resulting in a variety of health problems including injuries at work. This study was conducted to find out the prevalence and factors associated with injuries among welders in Dharan city of eastern Nepal. METHODS: A cross sectional study was conducted among 86 welders in Dharan city. Occurrence of injury in past 2 weeks and past 12 months were recorded. Data regarding sociodemographic along with occupational characteristics was collected using semi structured questionnaire. Data analysis was done using SPSS version 17. RESULTS: All the welders in this study were male with almost half of the welders under the age of 25 years and about a fifth (21.1%) of the welders having received some form of welding training. In the past 12 months, 21.1% of the welders suffered from work related injuries. More than 95% welders used at least one personal protective equipment in this study. More injuries were seen among welders with age ?35 years, working experience ? 5 years, not received training and not using of PPE at work. However, these factors were not found to be statistically significant. CONCLUSIONS: Work related injuries are high among welders of Dharan. Further research is required to explore the relationship between age, literacy, training and use of personal protective equipment with the occurrence of injuries among the welders.

Health Literacy and Knowledge of Chronic Diseases in Nepal.

BACKGROUND: Understanding of risk factors and developing healthy lifestyles is a way of tackling the surging burden of chronic diseases in low-to-middle income countries such as Nepal. Health literacy (HL) has a pivotal role in prevention, adherence to treatment, self-care, and better use of health care; therefore, factors associated with HL need to be studied in the context of Nepal. OBJECTIVE: This study was conducted to assess the level of HL and explore disease-specific knowledge among patients with chronic diseases. METHODS: A cross-sectional study was conducted among 426 respondents with hypertension, diabetes mellitus, or chronic obstructive pulmonary disease from a tertiary care hospital and primary care clinics using face-to-face interviews. HL was measured using a translated and pretested HL questionnaire (the Europe-Asia Health Literacy Survey Questionnaire). Disease-related knowledge was assessed using a validated questionnaire. KEY RESULTS: The study found that 27% of the respondents had sufficient HL, 19% had marginal HL, and 54% had inadequate HL. Factors associated with inadequate HL included being older and female, and having lower or no education, unemployment or retired status, poverty, and having a history of smoking or a history of consuming alcohol. HL was a strong predictor of knowledge regarding hypertension (ß = 0.32; p < .05), diabetes mellitus (ß = 0.41; p < .05), and chronic obstructive pulmonary disease (ß = 0.37; p < .05) in multiple regression analyses after adjusting for age, gender, education, marriage, family history of disease, attendance at follow-up clinics at recommended intervals, information received regarding disease at clinics, smoking, and alcohol intake. CONCLUSIONS: A sufficient level of HL was uncommon among participants in our study. People with sufficient HL knew significantly more about their diseases or conditions than those with inadequate HL. [HLRP: Health Literacy Research and Practice. 2018;2(4):e221-e230.]. PLAIN LANGUAGE SUMMARY: Very little is known about health literacy in Nepal. We conducted a study to learn how much people in Nepal with hypertension, diabetes, or chronic obstructive pulmonary disease knew about their condition and sought to check its association with health literacy. We found that more than one-half of the participants did not have adequate health literacy levels. Participants who were older, female, uneducated, retired from work, or poor had lower levels of health literacy. We also found that those with high levels of health literacy had better knowledge of their disease. Therefore, we recommend that in Nepal health literacy should be measured for each patient and support regarding management of his or her condition should be provided if necessary.

Depression among inmates in a regional prison of eastern Nepal: a cross-sectional study.

BACKGROUND: Depression is the most common form of mental disorder among inmates, with a prevalence much higher than in the general population. This study aims to estimate the prevalence of depression among inmates and identify factors associated with it. METHODS: This cross-sectional study was conducted in Jhumka Regional Prison, the largest prison in eastern Nepal, from September 2014 to August 2015. A total of 434 randomly selected inmates were interviewed using a semi-structured questionnaire examining socio-demographic characteristics, detention status, self-reported health problems, substance use status, and suicidal ideation. Depression was screened using the Center for Epidemiologic Studies Depression scale. Chi-square tests and multiple logistic regression analysis were applied to determine the association between depression and related variables. RESULTS: The mean age of the participants was 35.7 years (SD 13.3). The prevalence of depression among the inmates was 35.3%. Approximately 2.3% reported suicidal ideation during imprisonment and 0.9% had attempted suicide inside the prison. In bivariate analysis, depression was significantly associated with previous incarceration (OR = 1.91, 95% CI = 1.05-3.47, p = 0.033), poor self-rated health (OR = 1.75, 95% CI = 1.16-2.64, p = 0.007), frequent appointments when encountering health problems (OR = 1.66, 95% CI = 1.06-2.61, p = 0.028), suicidal ideation (OR = 4.44, 95%CI = 1.13-17.44, p = 0.038) and loss of weight (OR = 1.49, 95% CI = 1.00-2.23, p = 0.049). However, only previous incarceration (AOR = 1.97, 95% CI = 1.04-3.74, p = 0.037) and frequent appointments when encountering health problems (AOR = 1.61, 95% CI = 1.01-2.57, p = 0.046) remained significant in a multivariate model. CONCLUSIONS: This study showed a high rate of depression among inmates in Nepal. The results suggest a need for psychiatric and rehabilitative care in correctional settings to improve the health status of the inmates.

Latrine coverage and its utilisation in a rural village of Eastern Nepal: a community-based cross-sectional study.

BACKGROUND: A little more than 1/3rd of the rural households in Nepal have improved latrine facility. The government of Nepal is working towards making an open defecation free area all over Nepal. There is no data found in literature searches regarding the status of latrines and its utilisation in Nepal. This study aims to estimate the coverage and utilisation of latrine and its associated factors in a rural community of Nepal. METHODS: We conducted a cross sectional study in March 2015-September 2015 among 625 households in Hattimuda Village, Morang district in Eastern Nepal using semi-structured pre-tested questionnaire with observational checklists. RESULTS: Out of 623 households, 473 (76.9%) have latrine facilities. There is an increase in latrine coverage in Hattimuda by 37% (38.9% in 2011 to 75.9% in 2016). Majority of the latrines (89.9%) were functional, however 32.3% needs maintenance. The extent of latrine utilisation among those households with a toilet at home was satisfactory (94.3%). Presence of child below 5 years of age at home (OR 2.37, 95% CI 0.05-0.46), functional latrine (OR 27.37, 95% CI 6.84-109.45), frequency of cleaning (OR 3.66, 95% CI 1.09-12.29) and latrine constructed with self-initiation (OR 4.21, 95% CI 1.06-16.66) are factors significantly associated with the utilisation of the latrine. CONCLUSIONS: While the coverage needs to be increased, appropriate interventions to increase the utilisation of latrine needs to be in place so that the village moves closer to open defecation free (ODF) status. As other studies are not found from Nepal, the findings from this study can be used a reference for other rural areas of Nepal.

Tobacco Use during Pregnancy and Its Associated Factors in a Mountain District of Eastern Nepal: A Cross-Sectional Questionnaire Survey.

BACKGROUND: Tobacco using among women is more prevalent in Nepal as compared to other South-East Asian countries. The effect of its use is seen not only on the pregnant women, but also health of the growing fetus is compromised. Currently, little is known about the tobacco use among women especially during pregnancy in Nepal. This study explored the tobacco use prevalence and its associated factors during pregnancy. MATERIALS AND METHODS: A cross-sectional study was conducted in Sankhuwasabha, a mountain district of eastern Nepal. Representative sample of 436 women of reproductive age group with infant were selected by stratified simple random sampling. Data were collected by face-to-face interviews of selected participants. Data were analyzed with SPSS version 16.0. Binary logistic regression was used to analyze the relationship among variables. RESULTS: The study revealed that the prevalence of tobacco use during pregnancy was 17.2%. Only one fifth of the research participants were asked to quit tobacco by health workers during last pregnancy. Multivariable analyses revealed that illiteracy (AOR: 2.31, CI: 1.18-4.52), more than two parity (AOR: 2.45, CI: 1.19-5.07), alcohol use during last pregnancy (AOR: 3.99, CI: 1.65-9.68), and having tobacco user within family (AOR: 2.05, CI: 1.11-3.78) are more likely to use tobacco during pregnancy. CONCLUSION: Tobacco use during pregnancy was widely prevalent. Tobacco-focused interventions are required for antenatal women to promote cessation among user and prevent initiation with focus on overcoming problems like illiteracy, high parity, alcohol use, and having other tobacco user family members in family.

The potential of health literacy to address the health related UN sustainable development goal 3 (SDG3) in Nepal: a rapid review.

BACKGROUND: Health literacy has been linked to health outcomes across population groups around the world. Nepal, a low income country, experiences the double burden of highly prevalent communicable as well as non-communicable diseases. The World Health Organization (WHO) has positioned health literacy as a key mechanism to meet the health-related Sustainable Development Goal (SDG3). However, there is little known about the status of health literacy in developing countries such as Nepal. This paper aims to review the potential of health literacy to address SDG3 in Nepal. METHODS: A rapid review was conducted using the knowledge to action evidence summary approach. Articles included in the review were those reporting on barriers to health care engagements in Nepal published in English language between January 2000 and December 2015. RESULTS: Barriers for healthcare engagement included knowledge and education as strong factors, followed by culture, gender roles, quality of service and cost of services. These barriers influence the Nepalese community to access and engage with services, and make and enact healthcare decisions, not only at the individual level but at the family level. These factors are directly linked to health literacy. Health literacy is a pivotal determinant of understanding, accessing and using health information and health services, it is important that the health literacy needs of the people be addressed. CONCLUSION: Locally identified and developed health literacy interventions may provide opportunities for systematic improvements in health to address impediments to healthcare in Nepal. Further research on health literacy and implementation of health literacy interventions may help reduce inequalities and increase the responsiveness of health systems which could potentially facilitate Nepal to meet the sustainable development goals. While there is currently little in place for health literacy to impact on the SDG3, this paper generates insights into health literacy's potential role.

Factors influencing medical students' motivation to practise in rural areas in low-income and middle-income countries: a systematic review.

OBJECTIVES: There is a shortage of doctors working in rural areas all over the world, especially in low-income and middle-income countries. The choice to practise medicine in a rural area is influenced by many factors. Motivation developed as a medical student is one key determinant of this choice. This study explores influences on medical students' motivation to practise in rural areas of low-income and middle-income countries following graduation. DESIGN: A systematic review was conducted to identify influences on medical students' motivation to work in rural areas in low-income and middle-income countries. Papers reporting influences on motivation were included, and content analysis was conducted to select the articles. Articles not published in English were excluded from this review. RESULTS: A rural background (ie, being brought up in a rural area), training in rural areas with a community-based curriculum, early exposure to the community during medical training and rural location of medical school motivate medical students to work in rural areas. Perceived lack of infrastructure, high workload, poor hospital management and isolation are among the health facility factors that demotivate medical students for medical practice in rural areas. CONCLUSIONS: Medical school selection criteria focusing on a rural background factor and medical education curriculum focusing on rural area are more relevant factors in low-income and middle-income countries. The factors identified in this review may assist the planners, medical educators and policymakers in low-income and middle-income countries in designing relevant interventions to positively influence rural choices where the shortage of rural physicians is an ongoing and increasing concern.

The 17th International Congress on Infectious Diseases workshop on developing infection prevention and control resources for low- and middle-income countries.

Hospital-acquired infections (HAIs) are a major concern to healthcare systems around the world. They are associated with significant morbidity and mortality, in addition to increased hospitalization costs. Recent outbreaks, including those caused by the Middle East respiratory syndrome coronavirus and Ebola virus, have highlighted the importance of infection control. Moreover, HAIs, especially those caused by multidrug-resistant Gram-negative rods, have become a top global priority. Although adequate approaches and guidelines have been in existence for many years and have often proven effective in some countries, the implementation of such approaches in low- and middle-income countries (LMICs) is often restricted due to limited resources and underdeveloped infrastructure. While evidence-based infection prevention and control (IPC) principles and practices are universal, studies are needed to evaluate simplified approaches that can be better adapted to LMIC needs, in order to guide IPC in practice. A group of experts from around the world attended a workshop held at the 17th International Congress on Infectious Diseases in Hyderabad, India in March 2016, to discuss the existing IPC practices in LMICs, and how best these can be improved within the local context.

Reusable sanitary towels: promoting menstrual hygiene in post-earthquake Nepal.

It is a normal human tendency to 'run for your life' when an earthquake occurs. Adolescent girls and women of reproductive age leave their homes with only the clothes they are wearing to save their own and their families' lives. Immediate disaster relief aid with its (unintentional) lack of gender sensitivity has little or no materials for the appropriate management of menstrual hygiene. The biological needs of disaster-affected women will not change despite the dire need for basic food, shelter and security. Timely identification and preparation beforehand with appropriate and culturally sensitive techniques and locally available materials that are reusable can help introduce sustainable and acceptable means of managing menstrual hygiene in a crisis. The use of reusable sanitary towels is well accepted for menstrual hygiene management in non-disaster situations and is appropriate in post-earthquake relief in Nepal.

Morbidity patterns among the welders of eastern Nepal: a cross-sectional study.

BACKGROUND: Welding process has many hazards that the welders are exposed to resulting in numbers of health effects and diseases. Safety measures and practices among welders are important ways of preventing or reducing the health hazards associated with this occupation. We conducted this study to find out the morbidity patterns among the welders working in eastern Nepal. METHODS: A cross sectional study was conducted among 300 welders using semi structured questionnaire. Morbidity categories were classified based on symptoms experienced in past 6 months. RESULTS: All the welders learned welding by apprenticeship, without any formal health and safety training. Injury was the most common problem at work followed by skin problems and eye symptoms. Age of the welders, duration of employment & welding hours per day were associated with the morbidities among the welders. CONCLUSIONS: There is a need for occupational health services for welders in Nepal. While further research may be required to make policy recommendations, the current study provides a baseline morbidity burden among these welders to look for interventions to promote health and safety at work for this neglected group of workers in Nepal.

Work-related injuries among farmers: a cross-sectional study from rural Nepal.

BACKGROUND: Agriculture work is one of the most hazardous occupations across countries of all income groups. In Nepal, 74 % of people are working in the agricultural sector. This study aims to identify patterns and factors associated with injuries among farmers of rural Nepal. METHODS: A community-based cross-sectional study was conducted in a rural village in eastern Nepal. House to house visit was done to collect data from the farmers. The study included 500 farmers from Shanishchare village in Morang district of Nepal. A pre-tested semi-structured questionnaire was used to collect data on socioeconomic profile, agriculture work and injury. Prevalence of injuries among farmers in the last 12 months was calculated along with factors associated with the injuries. RESULTS: The overall prevalence of work- related injuries among farmers was 69 % in the last 12 months. Common injuries among the farmers were cuts (79.7 %), puncture wound (11.3 %) and laceration (7.5 %). Hand tools were responsible for most of the injuries followed by slipping at work, sharp instruments, animals and fall from height. Upper limb injury comprised of 67 % of all injuries and the most involved part was fingers (43 %). The average number of years worked in farming by the respondents was 23.6 ± 13.6 years. Age and working experience of the farmers was found to be significantly associated with the occurrence of injuries among the farmers. CONCLUSIONS: The prevalence of injury among farmers in this study was high. Further research is needed to identify interventions to reduce the agricultural injuries in Nepal.