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Evaluating active leprosy case identifcation methods in six districts of Nepal

Infectious Diseases of Poverty 2023年第6期12卷 105-106页

作者： Ram Kumar Mahato Uttam Ghimire Madhav Lamsal Bijay Bajracharya Mukesh Poudel Prashnna Napit Krishna Lama Gokarna Dahal David T.S.Hayman Ajit Kumar Karna Basu Dev Pandey Chuman Lal Das Krishna Prasad Paudel Epidemiology and Disease Control Division Department of Health Services Ministry of Health and Population Kathmandu Nepal Epidemiology and Disease Control Division-Malaria Program Management Unit- SCI-GF Kathmandu Nepal Leprosy Control & Disability Management Section EPidemiology and Disease Control Division DoHS Kathmandu Nepal Lalgadh Leprosy Hospital & Service Center Nepal Leprosy Trust Lalgadh Nepal Molecular Epidemiology and Public Health Laboratory Infectious Disease Research Centre Hopkirk Research Institute Massey University Palmerston North New Zealand Center for Health and Disease Studies-Nepal Kathmandu Nepal DEJIMA Infectious Disease Research Alliance Nagasaki University Nagasaki Japan

Background Nepal has achieved and sustained the elimination of leprosy as a public health problem since 2009,but 17 districts and 3 provinces with 41%(10,907,128)of Nepal’s population have yet to eliminate the disease.Pediatric cases and grade-2 disabilities(G2D)indicate recent transmission and late diagnosis,respectively,which necessitate active and early case detection.This operational research was performed to identify approaches best suited for early case detection,determine community-based leprosy epidemiology,and identify hidden leprosy cases early and respond with prompt treatment.Methods Active case detection was undertaken in two Nepali provinces with the greatest burden of leprosy,Madhesh Province(40%national cases)and Lumbini Province(18%)and at-risk prison populations in Madhesh,Lumbini and Bagmati provinces.Case detection was performed by(1)house-to-house visits among vulnerable populations(n=26,469);(2)contact examination and tracing(n=7608);in Madhesh and Lumbini Provinces and,(3)screening prison populations(n=4428)in Madhesh,Lumbini and Bagmati Provinces of Nepal.Per case direct medical and nonmedical costs for each approach were calculated.Results New case detection rates were highest for contact tracing(250),followed by house-to-house visits(102)and prison screening(45)per 100,000 population screened.However,the cost per case identifed was cheapest for house-to-house visits[Nepalese rupee(NPR)76,500/case],followed by contact tracing(NPR 90,286/case)and prison screening(NPR 298,300/case).House-to-house and contact tracing case paucibacillary/multibacillary(PB:MB)ratios were 59:41 and 68:32;female/male ratios 63:37 and 57:43;pediatric cases 11%in both approaches;and grade-2 disabilities(G2D)11%and 5%,respectively.Developing leprosy was not signifcantly diferent among household and neighbor contacts[odds ratios(OR)=1.4,95%confdence interval(CI):0.24-5.85]and for contacts of MB versus PB cases(OR=0.7,95%CI 0.26-2.0).Attack rates were not signifcantly diferent among household contacts of MB cases(0.3

关键词： Leprosy Early case detection Community-based epidemiology Hidden case New case detection rate Attack rate Cost per case identifed Nepal

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A dental perspective on the successes and limitations of the disaster victim identification response to the Nepal earthquake

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Forensic Sciences Research 2022年第3期7卷 366-370页

作者： Samarika Dahal Gopal Kumar Chaudhary Mani Raj Maharjan Eugen Dolma Walung Department of Oral Pathology&Forensic Dentistry Maharajgunj Medical CampusInstitute of MedicineKathmanduNepal Department of Forensic Medicine Maharajgunj Medical CampusInstitute of MedicineKathmanduNepal

This article describes the forensic odontological analysis of the events of the 2015 Nepal earthquake.It identifies the problems encountered in the aftermath,lessons learned,and prospective future advances aimed at reducing the subjectivity in disaster victim identification(DVI).During a crisis,dental practitioners,particularly forensic odontologists,can make a substantial contribution to DVI,as highlighted in this article.It also promotes best practices in forensic dentistry that may be used by anyone in situations with few resources or people to deal with comparable scenarios.

关键词： Forensic sciences earthquake forensic dentistry identification Nepal

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The P-T-t-D evolution of the Mahabharat,east-central Nepal:The out-of-sequence development of the Himalaya

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Geoscience Frontiers 2022年第2期13卷 372-382页

作者： Kyle P.Larson Sudip Shrestha Mathieu Soret Matthijs Smit Department of Earth Environmental and Geographic SciencesUniversity of British Columbia Okanagan3247 University WayKelownaBC V1V 1V7Canada Department of Earth Ocean and Atmospheric SciencesUniversity of British Columbia Vancouver2020-2207 Main MallVancouverBC V6T 1Z4Canada

A garnet-bearing schist from the southernmost such exposure along the Himalaya in east central Nepal records prograde metamorphism at 32.4±0.3 Ma.Phase equilibria modelling,combined with Ti-in-biotite and quartz caxis thermometry,outline a tight-to-hairpin pressure-temperature(P-T)path extending from~515℃ and 5.5 kbar to peak conditions at~575℃ and 7 kbar followed by deformation during the retrograde phase at 480-515℃ and 6-7 kbar.The new geochronology data place an upper bound on the evolution of metamorphism and deformation in the frontal-most part of the Himalaya,which lasted until 17.5 Ma,as indicated by previously published ^(40)Ar/^(39)Ar data.The P-T-time data from this part of the Himalaya,as well as that from more hinterlandward portions of the orogen,outline a progressive,stepwise,commonly out-of-sequence evolution.Further data from along the orogen indicates that this evolution is not a local phenomenon,but instead characterizes the tectonics of this system as a whole.

关键词： Himalaya Metamorphism Kinematics Lu-Hf Geochronology Nepal

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An Integrative Taxonomy of Amphibians of Nepal:An Updated Status and Distribution

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Asian Herpetological Research 2021年第1期12卷 1-35页

作者： Janak Raj KHATIWADA Bin WANG Tian ZHAO Feng XIE Jianping JIANG CAS Key Laboratory of Mountain Ecological Restoration and Bioresource Utilization&Ecological Restoration and Biodiversity Conservation Key Laboratory of Sichuan Province Chengdu Institute of BiologyChinese Academy of Sciences.Chengdu 610041SichuanChina

Amphibians are declining worldwide.At the same time,each year many species of amphibians are described,indicating that biological diversity on Earth remains poorly understood.This is especially true for mountainous regions,such as the Himalayas,which are also regarded as a biodiversity hotspot.However,it is most likely that the current diversity of amphibians in Nepal is highly underestimated.Amphibian inventories by the past researchers primarily used phenotypic characters as the basis for species identification.However,the application of molecular systematics methods to taxonomic studies has successfully uncovered the taxonomic status of several cryptic taxa.This study used both molecular(16 S rDNA sequences)and morphological comparisons and estimated the diversity of amphibians from Nepal.This study reports the occurrence of 38 species of amphibians based on both molecular and morphological comparisons.Among them,three species were recorded for the first time in Nepal.This study also invalids the taxonomic status of Sphaerotheca paschima.This study highlights the importa nce of integrative taxonomic approaches that help to resolve the current taxonomic ambiguities of Nepalese amphibians.

关键词： amphibian distribution molecular phylogenetics Nepal species diversity taxonomy

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Epidemiology of burn injuries in Nepal:a systemic review

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Burns & Trauma 2017年第2期5卷 107-112页

作者： Sanjib Tripathee Surendra Jung Basnet Plastic Surgery Department Kirtipur Hospital Kirtipur Nepal

Burn is a global public health problem associated with significant morbidity and mortality, mostly in low- and middle-income countries. Southeast-Asian countries share a big burden of burn injuries, and Nepal is not an exception. We performed a systemic review to examine the epidemiological characteristics of burn injures in Nepal.Relevant epidemiological studies were identified through systemic search in PubMed, EMBASE, and Google Scholar.Reference lists from relevant review articles were also searched. Studies were included if they meet our selection criteria. Eight studies were included in our systemic review. Most of the burn victims belong to the working age group between 15-60 years old. Flame burns were found to be the most common cause of burn injury followed by scald burns, whereas scald burns were the most common cause of burn injury among the pediatric population.Most patients sustained less severe burn injuries, with home being the most common place of burn injury. The average hospital stay among the burn victims ranged from 13 to 60 days. Mortality among the burn victims ranged from 4.5 to 23.5%, with highest mortality among the flame burn patients. Developed nations have significantly reduced the burn incidence through effective intervention program. Although, burn injuries are the leading cause of morbidity and mortality in Nepal, effective intervention programs are lacking due to the limited epidemiological data related to burn injuries. Further large scale research is imperative to investigate the problem and assess the effectiveness of an intervention program.

关键词： Burns Nepal Epidemiology Injury Systemic review

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Undergraduate nursing students' knowledge of aging, attitudes toward and perceptions of working with older adults in Kathmandu Nepal

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International Journal of Nursing Sciences 2019年第2期6卷 204-210页

作者： Saruna Ghimire Nitisha Shrestha Karen E.Callahan Dhirendra Nath Binaya Kumar Baral Nirmala Lekhak Devendra Raj Singh Agrata Health and Education(AHEAD)-Nepal KathmanduNepal School of Public Health University of NevadaLas VegasUSA Asian College for Advanced Studies Purbanchal UniversityLalitpurNepal Southeast Asia Development Actions Network(SADAN) LalitpurNepal Department of Biochemistry Nepal Medical College and Teaching HospitalKathmanduNepal School of Nursing University of NevadaLas VegasUSA

Objectives: This study aims to examine Nepalese undergraduate nursing students' knowledge of aging,attitudes towards older adults and perceptions of working with older adults,and to assess differences in these outcomes by socio-demographic characteristics as well as type of nursing program.Methods: A cross-sectional study was conducted among 385 undergraduate nursing students in six nursing colleges located in the Kathmandu Valley,Knowledge of aging,attitudes toward older adults and perceptions of working with older adults were assessed using standardized tools,the Palmore Facts on Aging Quiz,Kogan's Attitudes towards Older People Scale,and Nolan's Intent to Work with Older People Questionnaire,respectively.Results: The mean knowledge scores on older adults and aging were relatively low;participants scored an average of 26.9 out of 50.Scores assessing attitudes towards and perceptions of working with older adults were more favorable.Compared to students pursuing a Bachelor of Science in Nursing (BSN),students pursuing a Bachelor of Nursing (BN) had a significantly higher score on the knowledge,attitudes and perception of aging scales.Linear regression analyses showed that the students' knowledge of aging (β =0.55;95% CI =0.25-0.86) and perceptions of working with older adults (β =0.22;95% Cl =0.05 -0.38) had a significant positive association with their attitudes toward older adults.Conclusions: Undergraduate nursing students in the Kathmandu Valley of Nepal displayed a relatively low level of knowledge,but a positive attitude towards older adults,and a positive perception of working with older adults.Observed differences in knowledge,attitude,and perception scores between students in BSN and BN programs needs further investigation;closing this gap may be important for bolstering undergraduate gerontological preparation in Nepal.

关键词： Aged Attitudes Knowledge Perceptions Students Nursing Nepal

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The role of active case finding in reducing patient incurred catastrophic costs for tuberculosis in Nepal

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Infectious Diseases of Poverty 2019年第6期8卷 61-75页

作者： Suman Chandra Gurung Kritika Dixit Bhola Rai Maxine Caws Puskar Raj Paudel Raghu Dhital Shraddha Acharya Gangaram Budhathoki Deepak Malla Jens W.Levy Job van Rest Knut Lonnroth Kerri Viney Andrew Ramsay Tom Wingfield Buddha Basnyat Anil Thapa Bertie Squire Duolao Wang Gokul Mishra Kashim Shah Anil Shrestha Noemia Teixeira de Siqueira-Filha Birat Nepal Medical Trust KathmanduNepal Department of Clinical Sciences Liverpool School of Tropical MedicineLiverpoolUK KNCV Tuberculosis Foundation The HagueNetherlands Department of Public Health Sciences Karolinska InstitutetStockholmSweden Research School of Population Health Australian National UniversityCanberraAustralia University of St Andrews St AndrewsUK University of Liverpool LiverpoolUK Oxford University Clinical Research Unit KathmanduNepal National Tuberculosis Centre BhaktapurNepal Nick Simons Institute LalitpurNepal Institute for Health Technology Assessment Porto AlegreBrazil

Background:The World Health Organization(WHO)End TB Strategy has established a milestone to reduce the number of tuberculosis(TB)-affected households facing catastrophic costs to zero by 2020.The role of active case finding(ACF)in reducing patient costs has not been determined globally.This study therefore aimed to compare costs incurred by TB patients diagnosed through ACF and passive case finding(PCF),and to determine the prevalence and intensity of patient-incurred catastrophic costs in Nepal.Methods:The study was conducted in two districts of Nepal:Bardiya and Pyuthan(Province No.5)between June and August 2018.One hundred patients were included in this study in a 1:1 ratio(PCF:ACF,25 consecutive ACF and 25 consecutive PCF patients in each district).The WHO TB patient costing tool was applied to collect information from patients or a member of their family regarding indirect and direct medical and non-medical costs.Catastrophic costs were calculated based on the proportion of patients with total costs exceeding 20%of their annual household income.The intensity of catastrophic costs was calculated using the positive overshoot method.The chi-square and Wilcoxon-Mann-Whitney tests were used to compare proportions and costs.Meanwhile,the Mantel Haenszel test was performed to assess the association between catastrophic costs and type of diagnosis.Results:Ninety-nine patients were interviewed(50 ACF and 49 PCF).Patients diagnosed through ACF incurred lower costs during the pre-treatment period(direct medical:USD 14 vs USD 32,P=0.001;direct non-medical:USD 3 vs USD 10,P=0.004;indirect,time loss:USD 4 vs USD 13,P<0.001).The cost of the pre-treatment and intensive phases combined was also lower for direct medical(USD 15 vs USD 34,P=0.002)and non-medical(USD 30 vs USD 54,P=0.022)costs among ACF patients.The prevalence of catastrophic direct costs was lower for ACF patients for all thresholds.A lower intensity of catastrophic costs was also documented for ACF patients,although the difference was not statistically signifi

关键词： Tuberculosis Case finding Cost Catastrophic cost Patient-incurred cost Nepal

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Modeling transmission dynamics of rabies in Nepal

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Infectious Disease Modelling 2021年第1期6卷 284-301页

作者： Buddhi Pantha Sunil Giri Hem Raj Joshi Naveen K.Vaidya Department of Science and Mathematics Abraham Baldwin Agricultural CollegeTiftonGAUSA Department of Mathematics Florida Atlantic UniversityBoca RatonFLUSA Department of Mathematics Xavier UniversityCincinnatiOHUSA Department of Mathematics and Statistics San Diego State UniversitySan DiegoCAUSA Computational Science Research Center San Diego State UniversitySan DiegoCAUSA Viral Information Institute San Diego State UniversitySan DiegoCAUSA

Even though vaccines against rabies are available,rabies still remains a burden killing a significant number of humans as well as domestic and wild animals in many parts of the world,including Nepal.In this study,we develop a mathematical model to describe transmission dynamics of rabies in Nepal.In particular,an indirect interspecies transmission from jackals to humans through dogs,which is relevant to the context of Nepal,is one of the novel features of our model.Our model utilizes annual dog-bite data collected from Nepal for a decade long period,allowing us to reasonably estimate parameters related to rabies transmission in Nepal.Using our model,we calculated the basic reproduction number(R_(0)=1:16)as well as intraspecies basic reproduction numbers of dogs(R_(0)^(D)=1:14)and jackals(R_(0)^(J)=0:07)for Nepal,and identified that the dog-related parameters are primary contributors to R0.Our results show that,along with dogs,jackals may also play an important role,albeit lesser extent,in the persistence of rabies in Nepal.Our model also suggests that control strategies may help reduce the prevalence significantly but the jackal vaccination may not be as effective as dog-related preventive strategies.To get deeper insight into the role of intraspecies and interspecies transmission between dog and jackal populations in the persistence of rabies,we also extended our model analysis into a wider parameter range.Interestingly,for some feasible parameters,even though rabies is theoretically controlled in each dog and jackal populations(R_(0)^(D)1)due to interspecies transmission.These results may be useful to design effective prevention and control strategies for mitigating rabies burden in Nepal and other parts of the world.

关键词： Interspecies transmission Intraspecies transmission Mathematical models Nepal Rabies R_(0)

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An Analysis of Social Vulnerability to Natural Hazards in Nepal Using a Modified Social Vulnerability Index

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International Journal of Disaster Risk Science 2019年第1期10卷 103-116页

作者： Sanam K.Aksha Luke Juran Lynn M.Resler Yang Zhang Department of Geography Virginia Tech Virginia Water Resources Research Center Virginia Tech Urban Affairs and Planning Virginia Tech

Social vulnerability influences the ability to prepare for, respond to, and recover from disasters. The identification of vulnerable populations and factors that contribute to their vulnerability are crucial for effective disaster risk reduction. Nepal exhibits multihazard risk and has experienced socioeconomic and political upheaval in recent decades, further increasing susceptibility to hazards.However, we still know little regarding social vulnerability in Nepal. Here, we investigate social vulnerability in Nepal by adapting Social Vulnerability Index(SoVI) methods to the Nepali context. Variables such as caste, and populations who cannot speak/understand Nepali were added to reflect the essence of the Nepali context. Using principal component analysis, 39 variables were reduced to seven factors that explained 63.02% of variance in the data.Factor scores were summarized to calculate final SoVI scores. The highest levels of social vulnerability are concentrated in the central and western Mountain, western Hill, and central and eastern Tarai regions of Nepal, while the least vulnerable areas are in the central and eastern Hill regions. These findings, supplemented with smaller-scale analyses, have the potential to assist village officers, policymakers,and emergency managers in the development of more effective and geographically targeted disaster management programs.

关键词： Disaster risk reduction Natural hazards Nepal Principal component analysis Social Vulnerability Index

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Composition of forests and vegetation in the Kailash Sacred Landscape,Nepal

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Journal of Forestry Research 2020年第5期31卷 1625-1635页

作者： Ripu Mardhan Kunwar Maria Fadiman Tobin Hindle Madan Krishna Suwal Yagya Prasad Adhikari Kedar Baral Rainer Bussmann Department of Geosciences Florida Atlantic University777 Glades RoadBoca RatonFL 33431USA Department of Geography University of BergenFosswinckelsgate 6P.O.Box 78025020 BergenNorway Department of Biogeography University of BayreuthUniversitatsstr.3095447 BayreuthGermany Department of Forests Kathmandu 44600Nepal Ilia State University Kakutsa Cholokashvili Ave 3/50162 TbilisiRepublic of Georgia

A total of 141 quadrats were sampled using stratified random sampling to study forest,environment and human interactions along an elevation gradient 1800 to 3665 m at the remote Kailash Sacred Landscape,Nepal.Eight forest types were identified,including Laurel-Oak to Rhododendron to Blue pine,comprising 191 species including 60 useful from 166 genera and 87 families.The environmental variables elevation,slope,and temperature were significant(p<0.001)in determining the composition and distribution of forest types.Records of large numbers of useful plants along with diverse forest and vegetation types suggest a strong association between the culture of local villages and nature conservation.Due to changes in climate,socio-culture and land-use,forest degradation is expected to accelerate,thus forcing government and indigenous community forest management measures to acknowledge human,cultural and environmental variables for sustainable forest management.

关键词： Phyto-sociological assessment Environmental factors Forest types Culture Kailash Sacred Landscape Nepal

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