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Introduction: Anxiety is one of the common mental disorders frequently occurring in the community. It has been a major contributor to public ill health. Very few studies have been conducted on anxiety among academic professionals working in educational institutions. The aim of this study was to find out the prevalence of anxiety among faculty members of academic institutions of a metropolitan city. Methods: A descriptive cross-sectional study was conducted among university faculties working in academic institutions of a metropolitan city from 22 July 2021 to 30 June 2022 after taking ethical approval from the Ethical Review Board (Reference number: 94). A self-administered structured questionnaire was applied to collect the information. Beck Anxiety Inventory was used to measure anxiety; the anxiety was categorised as normal, mild, moderate, and severe and dichotomized into "present" and "absent". Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Out of 416 respondents, the prevalence of anxiety was found to be 111 (26.68%) (22.44-30.92, 95% Confidence Interval). Among them, 85 (76.58%) were mild, 13 (11.71%) of moderate and 13 (11.71%) of severe type. Among those who had anxiety, 87 (78.37%) were males, and 59 (53.15%) were in the age group of 40 year and above; 37 (33.33%) had chronic health problems. Conclusions: The prevalence of anxiety among faculty members of academic institutions was lower as compared to other studies conducted in similar settings. Keywords: anxiety; faculties; prevalence.

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BACKGROUND: High screen time, high energy dense food and low fruits and vegetables are important risk factors among children. The study aimed to find out co-occurrence of screen-time and unhealthy eating behavior among young children aged 5 to 9 years in Pokhara Metropolitan. METHODS: A cross-sectional study was conducted among children. Face to face interviews were done with 352 parents of the selected children. The study was conducted from March to October, 2020. High screen time was defined as >2 hours screen viewing each day; low fruit vegetable defined as <3 servings a day; and ≥ one serving a day of energy dense food was categorized as high consumption. RESULTS: Out of total, 33.0% did not met recommendation for single health behavior, 38.9% did not meet for two and 23.9% did not for three health behaviors; and 62.8% had two or more risk behaviors. Of total, 19.6% had low fruit vegetable and high energy dense intake, 17.0% had high screen time and low fruit vegetable, 2.3% high screen time and high energy dense and 23.9% had high screen time, high energy dense and low fruit vegetable. Proportion of co-occurrence of multiple risk behaviors was higher among those whose parents had higher screen time, offered screen devices to them; and the children who had television and television cable at home, and had personal screen device (P<0.05). CONCLUSIONS: About two-third children had multiple risk behaviors; proportion is higher among those who had access to screen devices and higher parental screen time. It may require a combination of efforts to improve healthy behaviors.

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BACKGROUND: Depression is one of the common mental disorders occurring frequently in the community. The study aimed to find out the prevalence and correlates of depression among faculties of academic institutions in Pokhara Metropolitan, Kaski, Nepal. METHODS: A cross-sectional study was conducted among 416 faculties selected from six academic institutions of Pokhara Metropolitan. A self-administered structured questionnaire method was applied to assess depression and explanatory variables among respondents. Beck Depression Inventory (BDI) was used to measure depression. The BDI score was classified into normal, mild, moderate and severe depression using the standard classification; and the depression levels were dichotomized into "absent" and "present". Descriptive statistics, bivariate analysis and multivariate logistic regression analysis were computed. Level of significance was set at 5%. RESULTS: Of the total, 21.6% of respondents had depression including 6.7% moderate and 2.9% severe type depression. The likelihood of reporting depression was significantly higher among those who had physical health problems (AOR, 2.88; 95% CI, 1.16-7.13), consumed vegetables less than 2 times a day (AOR, 2.34; 95% CI, 1.07-5.08), had limited access to teaching aids in workplace (AOR, 2.00; 95% CI 1.19-3.33), had higher job stress and higher COVID-19 fear. Depression did not differ by the socio-demographic characteristics of the respondents and type of institution. CONCLUSIONS: Improving physical health conditions, promoting vegetable consumption, ensuring access to basic facilities, and creating an enabling environment at workplace may help to address depression among faculties. Regular screening programs may help for timely identification and management of the cases.

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A selective, sensitive, and environmentally safe spectrophotometry method was developed and validated for the determination of zinc in pharmaceutical substances using natural reagents obtained from the leaves of plant Acacia catechu. Different factors were optimized such as volume of reagent, selection of pH, and stability of the color complex. The drug showed a stable yellowish orange color complex at 550 nm. The greenness of the methods was estimated using an eco-scale tool where the presented method was found to be excellent green with an ecoscore of 84 based on spectrophotometric determination. Also, the greenness of the method was assessed by the Green Analytical Procedure Index and found to be eco-friendly. The method was validated in conformance with ICH guidelines, with acceptable values for linearity, accuracy, precision, LOD, and LOQ. The linearity range for zinc sulphate was 5-25 µg mL-1 with an R 2 value of 0.996. The % RSD for intraday precision and interday precision was less than 2%. The suggested method can be employed for the economic analysis of zinc in its pure form and various formulations. The presented spectrophotometric method is the first analytical method for the analysis of zinc present in zinc sulphate and showed greater ecoscale as compared to the official method.

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Human immunodeficiency virus (HIV) testing is important to HIV prevention, treatment, and care. We aimed to assess the role of sociodemographic, behavioral factors and HIV knowledge on HIV testing among people aged 15-49 years in Nepal. The 2011 Nepal Demographic and Health Survey data was used for secondary data analysis. Herein, 9843 women and 3017 men who had experienced coitus were included. The respondents were asked if they underwent HIV testing and received the test results in their lifetime. Chi-square test and multivariate logistic regression analysis were applied at 5% level of significance. Adjusted odds ratios and 95% confidence intervals were computed separately for women and men. Of the total, 18.0% of men and 7.4% of women had been tested for HIV in their lifetime. As compared to the age of 15 to 24 years, males aged 25 to 29 years were more likely to report, whereas females aged 35 to 49 years were less likely to report HIV testing. Lower caste groups had more likelihood of reporting HIV testing than the other caste in both sexes. The odds of being tested for HIV were significantly higher among those who had higher education in both sexes. There was significant positive association between HIV testing and economic status in males whereas this association was reverse among females. The male respondents who spent more than one month away from home in the last 12 months were 1.68 times more likely to have been tested for HIV in their lifetime. Having multiple sexual partners was associated with higher odds of testing for HIV in both sexes. Having comprehensive HIV knowledge was independently associated with the reporting of higher odds of HIV testing in females. Promotion of HIV testing should consider sociodemographic factors, sexual behavior, and imparting comprehensive HIV knowledge.

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Cycling has proven to be an important strategy in decreasing the risk of non-communicable diseases. This study aimed to discover barriers and enabling factors influencing satisfaction and safety perceptions towards the use of bicycle roads in the Seoul metropolitan area, South Korea. A cross-sectional survey of 190 youth and adult individuals was conducted. Sex, age, purpose of bicycle use, perceived safety, availability of facilities, road gradient, road width, and traffic on the bicycle road were associated with cycling regularity. Multivariate regression analysis showed that the sufficiency of bicycle parking space, moderate slope, and enough bicycle signs were significant enabling factors for satisfaction with the use of bicycle roads. Narrow bicycle roads were found to be a barrier to satisfaction with the use of bicycle roads. Moderate slope, enough bicycle signs, and enough maintenance facilities around bike roads were found to be enabling factors in the perceived safety of the use of bicycle roads, whereas traffic on the side of the bicycle road was found to be a barrier to perceived safety. Based on these findings, we conclude that healthy cities should promote cycling behavior encouraging enabling factors and initiating attempts to improve the factors that act as barriers through urban planning.

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BACKGROUND: Multicomponent interventions that include both school and family or community involvements have the potential to cause significant changes in the levels of health in adolescents. To this end, KOICA and Yonsei Global Health Center implemented a school-based health promotion program from 2015 to 2016 in Northern Lima and Callao, Peru. The present study aimed to evaluate the effects of a school-based health promotion intervention on the health behaviors of school adolescents in Peru. METHODS: Health behaviors were measured using a standard self-administered questionnaire before and after the introduction of a school-based health promotion intervention in 2014 and 2016. The intervention was executed in secondary schools, specifically two schools from Lima and two from Callao, from April 2015 to November 2016. Two schools (one from each area) were selected as control schools. The interventions included health education, screening, and psychological counseling of vulnerable individuals as well as education for teachers and workshops with parents. RESULTS: Descriptive statistics, chi-square test results, and logistic regression values were computed. Sample sizes were 332 and 255 in 2014 and 933 and 599 in 2016 in the intervention and control schools, respectively. Logistic regression analysis revealed significant improvement in the consumption of vegetables and in depression in the intervention schools. Suicide attempts, television-watching, video game use, Internet use, consumption of chips and sugary drinks, and being in fights did not decrease in the intervention group but did increase in the control group. Thus, the intervention might have prevented the worsening of these behaviors in the intervention schools. CONCLUSION: The intervention had a positive effect on vegetable consumption and feeling depressed as well as on preventing the increase in sedentary behaviors, fighting, and suicide attempts.

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OBJECTIVE To assess the prevalence and correlates of insufficient physical activity in adolescents in Peru. METHODS We used a self-administered questionnaire developed from Global school-based Student Health Survey to collect information from secondary school students in North Lima and Callao in 2015. We carried out Poisson regression with robust variance using generalized linear models to estimate the crude and adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) of insufficient physical activity for its correlates. RESULTS We have found that 78% of the adolescents did not meet the global recommendation of the World Health Organization on physical activity in the last week before the survey. Female respondents (APR = 1.13, 95%CI 1.04-1.21), respondents who perceived themselves as overweight (APR = 1.10, 95%CI 1.03-1.18), and respondents who consumed insufficient vegetables and fruits [no vegetables (APR = 1.30, 95%CI 1.06-1.59), no fruits (APR = 1.15, 95%CI 1.00-1.31) as compared to those who consumed ≥ 2 servings every day in the last seven days] were more likely to report insufficient physical activity. Adolescents who worked after school (APR = 0.92, 95%CI 0.84-0.99), had physical education classes five times per week (APR = 0.94, 95%CI 0.88-0.99), and had parental supervision (APR = 0.92, 95%CI 0.87-0.98) were less likely to report insufficient physical activity. CONCLUSIONS Sex, work after school, perceived body weight, physical education class, parental support, and healthy dietary behaviors were associated with insufficient physical activity. Attempts to improve physical activity should look for ways to enhance leisure-time physical activity, parental support, physical education classes, healthy dietary behaviors, and normal body weight maintenance in adolescents with integrated efforts from the family and school.

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This study aimed to assess the prevalence and correlates of condom use at last sexual intercourse among people aged 15-49 years in Nepal. Secondary data analysis was performed using the Nepal Demographic and Health Survey 2011. The study was restricted to the respondents who reported ever having had sexual intercourse; 9843 females and 3017 males were included. Condom use was assessed by asking if respondents used condoms in their most recent sexual intercourse. Chi-square test and multivariate logistic regression analysis were performed using Complex Sample Analysis Procedure to adjust for sample weight and multistage sampling design. Overall, 7.6% of total, and 16.3% of males and 6.2% of females reported using condoms in their last sexual intercourse. Living in Far-Western region, age and wealth quintile were positively associated with condom use in both males and females. Being unmarried was the most important predictor of condom use among males. Higher education was associated with increased likelihood of condom use in females. However, mobility, having multiple sexual partners, and HIV knowledge were not significant correlates of condom use in both sexes. A big difference was observed in the variance accounted for males and females; indicating use of condoms is poorly predicted by the variables included in the study among females. Condom use was more associated with sociodemographic factors than with sexual behavior and HIV knowledge.

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ABSTRACT OBJECTIVE To assess the prevalence and correlates of insufficient physical activity in adolescents in Peru. METHODS We used a self-administered questionnaire developed from Global school-based Student Health Survey to collect information from secondary school students in North Lima and Callao in 2015. We carried out Poisson regression with robust variance using generalized linear models to estimate the crude and adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) of insufficient physical activity for its correlates. RESULTS We have found that 78% of the adolescents did not meet the global recommendation of the World Health Organization on physical activity in the last week before the survey. Female respondents (APR = 1.13, 95%CI 1.04-1.21), respondents who perceived themselves as overweight (APR = 1.10, 95%CI 1.03-1.18), and respondents who consumed insufficient vegetables and fruits [no vegetables (APR = 1.30, 95%CI 1.06-1.59), no fruits (APR = 1.15, 95%CI 1.00-1.31) as compared to those who consumed ≥ 2 servings every day in the last seven days] were more likely to report insufficient physical activity. Adolescents who worked after school (APR = 0.92, 95%CI 0.84-0.99), had physical education classes five times per week (APR = 0.94, 95%CI 0.88-0.99), and had parental supervision (APR = 0.92, 95%CI 0.87-0.98) were less likely to report insufficient physical activity. CONCLUSIONS Sex, work after school, perceived body weight, physical education class, parental support, and healthy dietary behaviors were associated with insufficient physical activity. Attempts to improve physical activity should look for ways to enhance leisure-time physical activity, parental support, physical education classes, healthy dietary behaviors, and normal body weight maintenance in adolescents with integrated efforts from the family and school.

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This study aimed to examine whether being bullied, fighting, and injury, regarded in terms of frequency and nature, were significantly associated with psychological distress and suicidal behavior, independent of substance abuse and parental support in adolescents. Secondary analysis of data from the Global School-based Student Health Survey from Kiribati, the Solomon Islands, and Vanuatu was conducted. Binomial logistic regression analysis was used to examine the association of being bullied, fighting and injury with psychological health outcomes (loneliness, insomnia, suicidal ideation and suicide attempt) at a 5% level of significance. A total of 4122 students were included; 45.5% were male, and 52.0% were 14 years of age or younger. Of the total, 9.3% felt lonely and 9.5% had insomnia most of the time over the last 12 months; 27.6% had suicidal ideation, and 30.9% reported at least one suicide attempt in the last 12 months. Multivariable logistic regression analysis showed that being bullied, fighting and injury were significantly associated with psychological health outcomes; adjusted odds ratios (AORs) of loneliness, insomnia, suicidal ideation and suicide attempt increased with increased exposure to bullying, fighting, and injury compared to non-exposed group. Among the types of bullying victimization, the highest AORs of insomnia and suicide attempt were among students who were left out of activities, compared to the non-bullied. Among the causes of injury, adolescents injured due to a physical attack were the most likely to report the highest AORs of loneliness, insomnia and suicidal ideation compared to those not injured. Preventing violence and injury among adolescents might contribute to better mental health and reduction of suicidal behavior.

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The study assessed television viewing >2 h a day and its association with sedentary behaviors, self-rated health, and academic performance among secondary school adolescents. A cross-sectional survey was conducted among randomly selected students in Lima in 2015. We measured self-reported responses of students using a standard questionnaire, and conducted in-depth interviews with 10 parents and 10 teachers. Chi-square test, correlation and multivariate logistic regression analysis were performed among 1234 students, and thematic analysis technique was used for qualitative information. A total of 23.1% adolescents reported watching television >2 h a day. Qualitative findings also show that adolescents spend most of their leisure time watching television, playing video games or using the Internet. Television viewing had a significant positive correlation with video game use in males and older adolescents, with Internet use in both sexes, and a negative correlation with self-rated health and academic performance in females. Multivariate logistic regression analysis shows that television viewing >2 h a day, independent of physical activity was associated with video games use >2 h a day, Internet use >2 h a day, poor/fair self-rated health and poor self-reported academic performance. Television viewing time and sex had a significant interaction effect on both video game use >2 h a day and Internet use >2 h a day. Reducing television viewing time may be an effective strategy for improving health and academic performance in adolescents.

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BACKGROUND: Witnessing inter-parental violence and bullying victimization is common for many children and adolescents. This study examines the role of witnessing inter-parental violence and bullying victimization in involvement in physical fighting among Peruvian adolescents. METHODS: A cross-sectional study was conducted among 1,368 randomly selected adolescents in 2015. We conducted logistic regression analyses to obtain crude and adjusted odds ratios with 95% confidence intervals for involvement in fighting among male and female adolescents. RESULTS: Among all adolescents, 35.8% had been involved in fighting in the last 12 months, 32.9% had been victim of verbal bullying and 37.9% had been the victim of physical bullying. Additionally, 39.2% and 27.8% of adolescents witnessed violence against their mother and father, respectively, at least once in their lives. Multivariate logistic regression analyses found that late adolescence, participation in economic activities, being the victim of verbal bullying, stress, and witnessing violence against the father among male adolescents, and self-rated academic performance and being the victim of physical or verbal bullying among female adolescents were associated with higher odds of being involved in fighting. CONCLUSION: Verbal bullying victimization and witnessing violence against the father in males and bullying victimization in females were associated with greater odds of adolescents being involved in fighting. Creating a non-violent environment at both home and school would be an effective strategy for reducing fighting among the adolescent population.

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OBJECTIVE: We examined the role of gender, family, lifestyle and psychological factors in self-rated health. DESIGN: Cross-sectional study. SETTING: A total of 970 randomly selected students from 11 secondary schools in Lima and Callao, Peru, participated in 2014. MAIN OUTCOME MEASURE: Self-rated health was measured with a single item: 'In general, how would you rate your health?' Responses were arranged along a five-point Likert-type scale: 'excellent', 'very good', 'good', 'fair' and 'poor'. The outcome variable was dichotomised as 'good' (excellent, very good or good) or 'poor/fair' (poor or fair). METHODS: We calculated adjusted ORs (AORs) and 95% CIs for poor/fair self-rated health using multivariate logistic regression analyses at 3-graded levels. RESULTS: 32.5% of the respondents had fair/poor self-rated health, 23.7% of the total males and 40.0% of the total female samples. Males were less likely to have poor/fair self-rated health (AOR 0.61; CI 0.41 to 0.91). Poor family support strongly increased the likelihood of having poor/fair self-rated health (no support, (AOR 3.15; CI 1.63 to 6.09); low support, (AOR 2.50; CI 1.29 to 4.85)). The other associated variables were missed meals due to a shortage of food (AOR 1.97; CI 1.15 to 3.36), television watching during leisure time (AOR 1.70; CI 1.09 to 2.67), low physical activity (AOR 1.49; CI 1.03 to 2.15), school absenteeism (AOR 1.54; CI 1.03 to 2.31) and perceived life satisfaction (AOR 0.28; CI 0.15 to 0.25). CONCLUSIONS: Gender, missing meals due to a shortage of food, family support, physical activity and life satisfaction influenced self-rated health among adolescents in Peru. Interventions that focus on promoting physical activity for at least 1 h each day for 3 or more days per week, food security and strengthening supportive family roles may improve self-rated health during adolescence.

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BACKGROUND: Neonatal mortality has remained unchanged since 2006 in Nepal. Reducing neonatal mortality is indispensable to reduce child mortality. The objective of this study was to investigate the factors associated with neonatal mortality. This study assesses socio-demographic factors, maternal health care and newborn care practices contributing to neonatal deaths in Chitwan district of Central Nepal. METHODS: A case-control study was conducted during April-July 2012. The study used a mixed-method approach, in which records of neonatal deaths were obtained from the District Public Health Office and a comparison group, survivors, was obtained from the same community. A total of 198 mothers (of 99 neonatal deaths and 99 survivor neonates) were included in the survey. Focus group discussions, in-depth interviews and case studies were also conducted. Maternal characteristics were analyzed using descriptive statistics, Mc Nemar's Chi square test and multivariable backward conditional logistic regression analysis. Qualitative data were analyzed by narrative analysis method. RESULTS: More than four-fifth of mothers (86%) had antenatal check-up (ANC) and the proportion of four or more ANC was 64%. Similarly, the percentage of mothers having institutional delivery was 62%, and postnatal check-up was received by 65% of mothers. In multivariable analysis, low birth weight [adjusted odds ratio: 8.49, 95% CI (3.21-22.47)], applying nothing on cord [adjusted odds ratio: 5.72, 95% CI (1.01-32.30)], not wrapping of newborn [adjusted odds ratio: 9.54, 95% CI (2.03-44.73)], and no schooling of mother [adjusted odds ratio: 2.09, 95% CI (1.07-4.11)] were significantly associated with an increased likelihood of neonatal mortality after adjusting for other confounding variables. Qualitative findings suggested that bathing newborns after 24 h and wrapping in clean clothes were common newborn care practices. The mothers only attended postnatal care services if health problems appeared either in the mother or in the child. CONCLUSION: Results of this study suggest that the current community based newborn survival intervention should provide an even greater focus to essential newborn care practices, low birth weight newborns, and female education.

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The study examines the prevalence of suicidal ideation and suicide attempt, and associated factors among school-going urban adolescents in Peru. A cross-sectional survey was conducted in a sample of 916 secondary school adolescents in 2014. A structured questionnaire adapted from Global School-based Student Health Survey was used to obtain information. Data were analyzed using logistic regression models at 5% level of significance. Overall, 26.3% reported having suicidal ideation, and 17.5% reported having attempted suicide during the past 12 months. Multivariate logistic regression analysis showed that female sex, being in a fight, being insulted, being attacked, perceived unhappiness, smoking and sexual intercourse initiation were significantly associated with increased risk of suicidal ideation, while female sex, being in a fight, being insulted, being attacked, perceived unhappiness, alcohol and illicit drug use were related to suicide attempt. The prevalence of suicidal ideation and suicide attempts observed in the survey area is relatively high. Female adolescents are particularly vulnerable to report suicidal ideation and suicide attempt. Interventions that address the issue of violence against adolescents, fighting with peers, health risk behaviors particularly initiation of smoking, alcohol and illicit drug use and encourage supportive role of parents may reduce the risk of suicidal behaviors.

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BACKGROUND: Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. METHODS: A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95(th) percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95(th) percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. RESULTS: The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p < 0.01). CONCLUSION: The prevalence of obesity and hypertension observed in the study area is relatively high. Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.

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INTRODUCTION: Intestinal parasitic infection has been a significant problem in HIV patients, worldwide. In this study, we aimed to measure the prevalence and identify the factors associated with intestinal parasitic infection in people infected with HIV and attending National Public Health Laboratory in Kathmandu, Nepal, for CD4 T-cell count. METHODOLOGY: An analytical cross-sectional study in 745 HIV-infected people attending for CD4 T-cell count was conducted. RESULTS: The prevalence of intestinal parasitic infection was 22.4% (95% CI 19.5 to 25.5). In univariate analysis, age, sex, longer time since diagnosis of HIV, CD4 T-cell count of <200/µL, diarrhoea, marital status, and being under tuberculosis (TB) treatment were significantly associated with increased odds of intestinal parasite infection. However, in the logistic regression model, only the CD4 T-cell count of <200/µL (adjusted OR=4.2, 95% CI 2.5 to 7.0), diarrhoea (adjusted OR=2.8, 95% CI 1.8 to 4.3) and being under TB treatment (adjusted OR=2.9, 95% CI 1.8 to 4.6) remained as significant predictors. On stratification, CD4 T-cell count of <200/ µL was independently associated with higher odds of protozoal as well as helminthes infection. The parasites Cryptosporidium and Cyclospora were observed only in participants with CD4 T-cell counts <200/µL. CONCLUSIONS: Both protozoal and helminthic intestinal parasitic infections are common in HIV-infected people seeking care in healthcare facilities. The poor immune status as indicated by low CD4 T-cell count and TB may account for such a high risk of parasitic infection.

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Highly active anti-retroviral therapy (HAART) has been freely available in Nepal since 2004. In the present longitudinal study, we followed two distinct cohorts of human immunodeficiency virus-infected participants, those receiving HAART and those under assessment of eligibility for HAART, during the period 2005-2007 in Kathmandu, Nepal. The median change in CD4+ T-cell count among participants receiving HAART after 12 months of the initiation of therapy was +118 T cells/µl (95% confidence interval [CI], +91 to +145 T cells/µl) and that among participants under assessment of eligibility for HAART was -74 T cells/µl (95% CI, -103 to -44 cells/µl). However, the median CD8+ T-cell count after 12 months remained stable in both the cohorts (P > 0.05). The CD4+/CD8+ T-cell ratio increased from 0.16 to 0.26 after 12 months of therapy (P < 0.001). The multivariate regression model revealed that participants >30 years of age, and injection drug users had significantly lower increases in the CD4+ T-cell count in response to therapy. We observed a high proportion of loss to follow-up after 12 months of therapy; however, the associated factors were unknown. In conclusion, we observed a significant improvement in the CD4+ T-cell count in participants receiving HAART; however, the CD4+/CD8+ T-cell ratio remained <0.5 after 12 months of treatment.

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BACKGROUND: Tuberculosis is the leading cause of deaths among HIV patients. In this study, we estimated the prevalence of pulmonary tuberculosis (PTB) and identified the factors/co-morbidities associated with active PTB in HIV-infected people visiting the national public health laboratory to assess their eligibility to receive highly active antiretroviral therapy. METHODS: A cross-sectional study was conducted to measure the prevalence of pulmonary tuberculosis. Data on probable risk factors in patients with and without PTB were compared, calculating the odds ratio as a measure of association. Factors showing significant association in univariate analyses were included in a stepwise backward logistic regression model to adjust for confounding. RESULTS: The prevalence of pulmonary tuberculosis was 32.4 % (95% confidence interval (CI) 30.25-34.56). In the univariate analysis, patients with PTB were more likely to be older, married, and have a longer duration since the diagnosis of HIV, diarrhoea, parasitic infection, lower CD4 T-cell counts, and lower CD4/CD8 ratio. However, the backward stepwise logistic regression revealed that only the CD4 T-cell count < 200/µL (AOR 11.69, 95% CI 6.23-21.94), CD4 T-cell count 200-350/µL (AOR 2.52, 95% CI 1.30-4.89), diarrhoea (AOR 2.77, 95% CI 1.78-4.31), parasitic infection (AOR 3.34, 95% CI 2.02-5.50) and 'sex with partner' as probable modes of transmission (AOR 0.44, 95% CI 0.20-0.93) were independently associated with pulmonary tuberculosis. CONCLUSION: A high prevalence of pulmonary tuberculosis was observed. Participants with tuberculosis were significantly more likely to have lower CD4 counts, diarrhoea, and parasitic infections. HIV treatment programmes should consider these factors for better outcomes.