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BACKGROUND: Success in pediatric kidney transplantation is great achievement for the emerging countries. This report is the first of its kind from Nepal. It demonstrates the status of pediatric kidney transplantation in Nepal. METHODS: This is a retrospective review of transplants done in Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Living donor kidney transplant recipients ≤17 years transplanted till September 2018 were included. Demographic data, renal function, rejections, and other complications recorded in the charts were noted. Descriptive analysis was done in September 2018. RESULTS: A total of 517 living donor kidney transplants were done till September 2018 since August 2008. Twenty-three were ≤17 years. Eighteen (78.26%) were male. Mean ± SD age was 15.35 ± 1.7 years, and weight was 41.8 ± 9.8 kg. One received ABO-incompatible transplantation. Fifteen (65.22%) donors were female, 14 (60.87%) were mothers, and seven were fathers (30.43%). Mean donor age was 40.21 ± 8 years. Patient and graft survival at 1 year were 100% and 89.2%, respectively. One patient died on dialysis in second year after graft failure due to FSGS. One is on dialysis after losing graft to oxalate nephropathy. Three (13.3%) had biopsy-proven acute rejections. Two had acute cellular rejection, and 1 had antibody-mediated rejection. CONCLUSIONS: Children from poor countries are also entitled to the benefits of medical advancements.
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Trasplante de Riñón/estadística & datos numéricos , Adolescente , Femenino , Humanos , Donadores Vivos , Masculino , Nepal , Estudios RetrospectivosRESUMEN
Comparative studies are lacking on intimate partner violence (IPV) between urban poor and general populations. The objective of this study is to identify the prevalence and risk factors of physical IPV among the general and poor populations in urban Nepal. A cross-sectional study was conducted by structured questionnaire interview. Participants included 905 ever-married women in Kathmandu aged 15 to 49 years. Of the 905 participants, 680 were randomly selected from general population and 225 were recruited from urban poor population, who lived in purposively selected two communities. The prevalence and association between ever experiencing physical IPV and sociodemographic variables were examined. Results showed that the prevalence of physical IPV was 33.8% among the urban poor population (n = 225) and 19.9% among the general population (n = 680; p < .01). Several factors were significantly associated with physical IPV in both populations: the frequency of the husband's drinking, polygyny, and lower household economic status. However, two factors were associated with physical IPV only among the general population: the husband's lower educational level and early marriage. The conclusions of this study are that compared to the general population, the urban poor population showed a significantly higher prevalence of physical IPV and differences in the associated risk factors. The urban poor population requires focused data collection as well as tailored interventions to reduce IPV.
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Relaciones Interpersonales , Clase Social , Maltrato Conyugal/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/etnología , Consumo de Bebidas Alcohólicas/psicología , Estudios Transversales , Femenino , Humanos , Matrimonio , Persona de Mediana Edad , Nepal/epidemiología , Pobreza , Prevalencia , Factores de Riesgo , Maltrato Conyugal/psicología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Little is known about the mental health status of trafficked women, even though international conventions require that it be considered. This study, therefore, aims at exploring the mental health status, including anxiety, depression and post-traumatic stress disorder (PTSD), of female survivors of human trafficking who are currently supported by local non-governmental organizations (NGOs) in Katmandu, the capital of Nepal, through comparison between those who were forced to work as sex workers and those who worked in other areas such as domestic and circus work (non-sex workers group). The Hopkins Symptoms Checklist-25 (HSCL-25) was administered to assess anxiety and depression, and the PTSD Checklist Civilian Version (PCL-C) was used to evaluate PTSD. Both the sex workers' and the non-sex workers' groups had a high proportion of cases with anxiety, depression, and PTSD. The sex workers group tended to have more anxiety symptoms (97.7%) than the non-sex workers group (87.5%). Regarding depression, all the constituents of the sex workers group scored over the cut-off point (100%), and the group showed a significantly higher prevalence than the non-sex workers (80.8%). The proportion of those who are above the cut-off for PTSD was higher in the sex workers group (29.6%) than in the non-sex workers group (7.5%). There was a higher rate of HIV infection in the sex workers group (29.6%) than in the non-sex workers group (0%). The findings suggest that programs to address human trafficking should include interventions (such as psychosocial support) to improve survivors' mental health status, paying attention to the category of work performed during the trafficking period. In particular, the current efforts of the United Nations and various NGOs that help survivors of human trafficking need to more explicitly focus on mental health and psychosocial support.
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Víctimas de Crimen/psicología , Salud Mental , Trabajo Sexual/psicología , Adulto , Ansiedad/epidemiología , Ansiedad/psicología , Estudios Transversales , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Nepal/epidemiología , Escalas de Valoración Psiquiátrica , Delitos Sexuales/psicología , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , SobrevivientesRESUMEN
Developing a strategy for monitoring iodine deficiency disorders (IDD) remains a big challenge in rural Nepal where great variations could exist in IDD status. To explore the possibility of variation in urinary iodine excretion (UIE) level in rural settings, we carried out a detailed study of UIE among 586 school children of 20 schools in five villages. Our data revealed statisitically significant differences in UIE values among rural villages and schools in the same villages. The policy-makers should keep such variations in mind for a successful monitoring of IDD in Nepal and other countries where such variations may exist.
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Enfermedades Carenciales/epidemiología , Enfermedades Carenciales/prevención & control , Yodo/deficiencia , Servicios Preventivos de Salud/organización & administración , Niño , Enfermedades Carenciales/etiología , Enfermedades Carenciales/orina , Femenino , Humanos , Yodo/orina , Masculino , Nepal/epidemiología , Evaluación de Resultado en la Atención de Salud , Servicios de Salud Rural/organización & administración , Servicios de Salud Escolar/organización & administración , Urinálisis/estadística & datos numéricosAsunto(s)
Eficiencia Organizacional , Accesibilidad a los Servicios de Salud , Programas de Inmunización/organización & administración , Vacunas/provisión & distribución , Guerra , Niño , Almacenaje de Medicamentos , Grupos Focales , Humanos , Programas de Inmunización/estadística & datos numéricos , Nepal , Salud Laboral , Refrigeración , Sistema de Registros , Medidas de SeguridadRESUMEN
This study aims to identify an effective intervention group for the control of the intestinal helminth infection among school-age children in rural Nepal. We examined 1677 stool samples of school-age children from 25 schools and 1014 samples from 25 communities in rural Nepal. We used formalin-ether sedimentation technique for the microscopic examination of the stool samples and identified three major intestinal helminths: Ascariasis lumbricoides, hookworm and Trichuris trichiura. Our results revealed that the newly enrolled under-6-year-old children at the schools were more widely infected with at least one of the three major helminths than those in the communities (odds ratio [OR] 2.29). We detected a significant difference in the prevalence of A. lumbricoides (OR 1.70), hookworm (OR 2.57) and T.trichiura (OR 3.23) between under-6-year-old children at the schools and those at the communities. The study results suggest that an appropriate deworming programme is needed for the newly enrolled under-6-year-old children in the primary schools in Nepal.
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Ascariasis/prevención & control , Infecciones por Uncinaria/prevención & control , Parasitosis Intestinales/prevención & control , Población Rural , Tricuriasis/prevención & control , Adolescente , Adulto , Distribución por Edad , Ancylostomatoidea/aislamiento & purificación , Animales , Ascariasis/epidemiología , Ascariasis/parasitología , Ascaris lumbricoides/aislamiento & purificación , Niño , Preescolar , Heces/parasitología , Femenino , Infecciones por Uncinaria/epidemiología , Infecciones por Uncinaria/parasitología , Humanos , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/parasitología , Masculino , Nepal/epidemiología , Prevalencia , Tricuriasis/epidemiología , Tricuriasis/parasitología , Trichuris/aislamiento & purificaciónAsunto(s)
Personal de Salud , Rol Profesional , Guerra , Atención a la Salud , Humanos , Nepal , Política , Sistemas de SocorroRESUMEN
In this paper, we evaluated a western medical training model for traditional healers (THs) in rural Nepal. We used semi-structured interviews to compare 48 trainees with 30 randomly selected untrained THs, 1 year after the training was completed. We asked them about their knowledge of the causes, prevention and treatment of common illnesses and HIV/AIDS, and their relationship with government health workers (GHWs) in the area. Nine GHWs were also interviewed about their perceptions of THs. We found that trained THs had a better knowledge of allopathic medicine, practised modern treatment using first aid kits, and were more likely to refer patients to GHWs. They also improved their relationships with the GHWs. Up-scaling this model is a challenge for improving community health care in Nepal in the future.
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Servicios de Salud Comunitaria/organización & administración , Educación Médica/métodos , Medicina Tradicional , Conocimientos, Actitudes y Práctica en Salud , Humanos , Relaciones Interprofesionales , Persona de Mediana Edad , Nepal , Derivación y Consulta , Rol , Salud RuralRESUMEN
In Nepal, little emphasis has been placed on the need to link healthcare-seeking behavior (HCSB) with health policy. The purpose of this study is to identify the HCSB of 405 households that were randomly selected from 28 communities in a hilly region of central Nepal. In assessing HCSB, we found that some form of illness strikes about 50% of households each year. When rural Nepalese are moderately or severely ill, they seek healthcare from traditional healers first, before visiting other health workers. Mild illnesses are treated at home. To improve the health of the rural population, health planners should recognize these realities and incorporate them into the development of health policies.