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Bharatpur, Nepal

Khanal V.,Nepal Development Society | Khanal V.,Curtin University Australia | Scott J.A.,Curtin University Australia | Lee A.H.,Curtin University Australia | And 2 more authors.
International Journal of Environmental Research and Public Health | Year: 2015

The initiation of breastfeeding within one hour of birth has numerous nutritional and immunological benefits and has been found to reduce neonatal mortality. This communitybased prospective cohort study aimed to report the rate of, and factors associated with, early initiation of breastfeeding in Western Nepal. The rate of early initiation of breastfeeding was reported, and associations between early initiation and independent variables were tested by Chi-square test, followed by multiple logistic regression. Of the 735 mother-infant pairs, a total of 310 (42.2%) reported early initiation. Mothers who were assisted by traditional attendants during childbirth, delivered by caesarean section, from ethnically disadvantaged families and had delivered low birth weight infants, were less likely to initiate breastfeeding early whereas the mothers who were from the poorest families and did not introduce prelacteal feeds to their infants were more likely to initiate breastfeeding within the first hour. Skills-training to support breastfeeding as part of the training of skilled birth attendants and other health workers is likely to promote recommended infant feeding practices. © 2015 by the authors; licensee MDPI, Basel, Switzerland.


Gautam K.P.,Save the Children | Adhikari M.,Nepal Development Society | Khatri R.B.,Save the Children | Devkota M.D.,Tribhuvan University
BMC Research Notes | Year: 2016

Background: Undernutrition is a major problem in Nepal and meeting the minimum dietary standard is essential for growth and development of young children. Continuous monitoring of such practices is important to inform policy and program formulation. This study aimed to assess complementary feeding practices, and associated factors in Western Nepal. Methods: This was a cross-sectional study conducted in Rupandehi district of Western Nepal. Face-to-face interviews were conducted among 178 mothers of young children aged 6-23 months using a structured questionnaire and data on complementary feeding practices. These practices were reported as frequency distribution and the factors associated were ascertained using multiple logistic regression. Results: Only 57 % of mothers initiated complementary feeding at the age of 6 months. While the proportion of young children receiving minimum meal frequency was reasonably high (84 %), meal diversity (35 %) and minimum acceptable diet (33 %) remained low. Maternal education and having had their children's growth monitored were independently associated with receiving minimum acceptable diet. Conclusion: Few infants and young children received the recommended infant and young children feeding practices. Implementing health promotion programs that educate and enhance the skills of mothers should be a priority for future nutrition interventions. © 2016 Gautam et al.


Neupane D.,University of Aarhus | McLachlan C.S.,University of New South Wales | Sharma R.,University of Southern Denmark | Gyawali B.,University of Southern Denmark | And 4 more authors.
Medicine (United States) | Year: 2014

Hypertension is a leading attributable risk factor for mortality in South Asia. However, a systematic review on prevalence and risk factors for hypertension in the region of the South Asian Association for Regional Cooperation (SAARC) has not carried out before. The study was conducted according to the Meta-Analysis of Observational Studies in Epidemiology Guideline. A literature search was performed with a combination of medical subject headings terms, "hypertension" and "Epidemiology/EP". The search was supplemented by cross-references. Thirty-three publications that met the inclusion criteria were included in the synthesis and meta-analyses. Hypertension is defined when an individual had a systolic blood pressure (SBP) ≥140mm Hg and/or diastolic blood pressure (DBP) ≥90mm Hg, was taking antihypertensive drugs, or had previously been diagnosed as hypertensive by health care professionals. Prehypertension is defined as SBP 120-139mm Hg and DBP 80-89mm Hg. The overall prevalence of hypertension and prehypertension from the studies was found to be 27% and 29.6%, respectively. Hypertension varied between the studies, which ranged from 13.6% to 47.9% and was found to be higher in the studies conducted in urban areas than in rural areas. The prevalence of hypertension from the latest studies was: Bangladesh: 17.9%; Bhutan: 23.9%; India: 31.4%; Maldives: 31.5%; Nepal: 33.8%; Pakistan: 25%; and Sri Lanka: 20.9%. Eight out of 19 studies with information about prevalence of hypertension in both sexes showed that the prevalence was higher among women than men. Meta-analyses showed that sex (men: odds ratio [OR] 1.19; 95% confidence interval [CI]: 1.02, 1.37), obesity (OR 2.33; 95% CI: 1.87, 2.78), and central obesity (OR 2.16; 95% CI: 1.37, 2.95) were associated with hypertension. Our study found a variable prevalence of hypertension across SAARC countries, with a number of countries with blood pressure above the global average. We also noted that studies are not consistent in their data collection about hypertension and related modifiable risk factors. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Neupane D.,University of Aarhus | Panthi B.,Nobel College | McLachlan C.S.,University of New South Wales | Mishra S.R.,Nepal Development Society | And 2 more authors.
PLoS ONE | Year: 2015

Background: Despite an increasing number of studies exploring prevalence of depression among hypertensive patients in high income countries, limited data is available from low and middle income countries, particularly Nepal. Our aim was to investigate the prevalence of undiagnosed (sub clinical) depression and associated risk factors among hypertensive patients attending a tertiary health care clinic in Nepal. Methods: The study was based on a cross-sectional study design, with 321 hypertensive patients attending the Out-Patient Department of a central hospital in Nepal. Blood measure was recorded via a mercury column sphygmomanometer. Depression levels were assessed using the Beck Depression Inventory-Ia (BDI) scale. Demographics and risk factors were assessed. Result: The proportion of participants with undiagnosed depression was 15%. Multivariable analyses demonstrated an increase in BDI scores with increased aging. Approximately a 1 point increase in the BDI score was observed for each additional decade of aging in hypertensive patients. Additional factors associated with increased risk of depression included being female (4.28 point BDI score increase), smoking (5.61 point BDI score increase), being hypertensive with no hypertensive medication (4.46 point BDI score increase) and being illiterate (4.46 point BDI score increase). Conclusions: Among persons with hypertension in outpatient settings in Nepal, demographic (age, sex, education), behavioural (smoking,) and adherence factors (anti-hypertensive medication) were associated with undiagnosed depression. Screening programs in Nepal may assist early intervention in hypertensive patients with sub clinical depression. © 2015 Neupane et al.


Khanal V.,Nepal Development Society | Scott J.A.,Curtin University Australia | Lee A.H.,Curtin University Australia | Karkee R.,BP Koirala Institute of Health science | Binns C.W.,Curtin University Australia
BMC Pediatrics | Year: 2016

Background: While the initiation of breastfeeding is universal in Nepal, little has been reported on formula feeding practices. This study aimed to report the prevalence of, and factors associated with, the use of infant formula as supplementary feeds in the Western region of Nepal. Methods: A community-based cohort study was conducted to collect infant feeding information among 735 postpartum mothers using structured questionnaires. Complete formula feeding data were collected from 711 women in the first, fourth and sixth month postpartum. Factors independently associated with formula feeding were investigated using multiple logistic regression. Results: All mothers were breastfeeding their infants at the time of recruitment. The prevalence of formula feeding was 7.5 % in the first month and 17 % in the sixth month. About a quarter of mothers (23.8 %) reported providing infant formula at least once during the first six months of life. Infant formula was used commonly as top-up food. Stepwise logistic regression showed that infants born to families residing in urban areas (adjusted odds ratio (aOR): 2.14; 95 % confidence interval (CI): 1.37 to 3.33), mothers with higher education (aOR: 2.08; 95 % CI: 1.14 to 3.80), and infants born by caesarean section (aOR: 1.96; 95 % CI: 1.21 to 3.18) were at greater risk of formula feeding. Conclusion: The current findings indicate that health workers should support mothers to initiate and continue exclusive breastfeeding particularly after caesarean deliveries. Furthermore, urban health programs in Nepal should incorporate breastfeeding programs which discourage the unnecessary use of formula feeding. The marketing of formula milk should be monitored more vigilantly especially in the aftermath of the April 2015 earthquakes or other natural disasters. © 2016 Khanal et al.

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