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Article ; Online: Determinants of institutional delivery service utilization in Nepal.

Thapa, Bipin / Karki, Anita / Sapkota, Suman / Hu, Yifei

2023 Volume 18, Issue 9, Page(s) e0292054

Abstract: Background: Maternal mortality continues to be a pressing concern in global health, presenting an enduring and unmet challenge for healthcare systems worldwide. Utilization of institutional delivery services has been established as a proven intervention ...

Abstract	Background: Maternal mortality continues to be a pressing concern in global health, presenting an enduring and unmet challenge for healthcare systems worldwide. Utilization of institutional delivery services has been established as a proven intervention to mitigate life-threatening risks for both mothers and newborns. Exploring the determinants of institutional delivery is crucial to improve and enhance maternal and newborn safety. This study aimed to assess the contextual and individual factors associated with institutional delivery in Nepal. Methods: This study utilized that data form Nepal Multiple Indicator Survey 2019, which included a sample of 1,932 women who had given birth within the two years prior to the survey. A multilevel logistic regression analysis was performed to determine the significant external environment, contextual and individual predictors of institutional delivery. Results: The women from Madhesh province [Adjusted Odds Ratio (aOR): 0.32, 95% Confidence Interval (CI): 0.17-0.61], as compared to Bagmati province, women from rural areas (aOR: 0.55, 95% CI: 0.39-0.78) as compared to urban areas, and women from a relatively less-advantaged ethnic groups (aOR: 0.52, 95% CI: 0.35-0.76) as compared to the relatively advantaged ethnic groups were less likely to deliver in health institutions. Similarly, women from the poorest (aOR: 0.09, 95% CI: 0.04-0.22) and second wealth groups (aOR: 0.29, 95% CI: 0.13-0.64) were less likely to attend institute for delivery compared to women from the richest household. Women with formal education (aOR: 1.65, 95% CI: 1.16-2.35) were more likely to deliver in an institution over uneducated women. Moreover, the uptake of institutional delivery increased by 59% (aOR: 1.59, 95% CI: 1.43-1.75) for each additional ANC visit. Conclusion: The findings highlight the importance of stepping up efforts to achieve universal health care from the standpoint of long-term government investment, focusing particularly on illiterate women in rural areas, poorer households, and socially disadvantaged groups. Expanding the benefits of maternal benefit schemes targeting the women from the poorest households in the communities is recommended.
MeSH term(s)	Infant, Newborn ; Humans ; Female ; Nepal ; Academies and Institutes ; Biological Transport ; Ethnicity ; Mothers
Language	English
Publishing date	2023-09-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0292054
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Predictors of diarrhea among children under 24 months in Nepal: A multilevel analysis of multiple indicator cluster survey 2019.

Thapa, Bipin / Sapkota, Suman / Hu, Yifei

PloS one

2023 Volume 18, Issue 7, Page(s) e0287974

Abstract: Background: Diarrhea has remained an unmet challenge in global child health. Its severity may be worse than reported in resource-limited settings. Understanding changing epidemiology is critical to combat diarrheal morbidity. Therefore, this study aimed ...

Abstract	Background: Diarrhea has remained an unmet challenge in global child health. Its severity may be worse than reported in resource-limited settings. Understanding changing epidemiology is critical to combat diarrheal morbidity. Therefore, this study aimed to understand factors associated with diarrhea among under two years children in Nepal. Methods: A total of 2,348 samples from Multiple Indicator Cluster Survey 2019 were used to estimate the significant child, maternal, household and external environmental predictors of diarrhea using multilevel analysis. Results: The prevalence of diarrhea was 11.9% (95% CI: 10.2%-13.6%). Children residing in Koshi Province [AOR (Adjusted Odds Ratio): 2.23, 95% CI: 1.22-4.08], Karnali Province (AOR: 2.28, 95% CI: 1.11-4.70), and Sudurpaschim Province (AOR: 4.49, 95% CI: 2.39-8.42) were at higher risk of diarrhea. Children aged 7-23 months (AOR: 1.56, 95% CI: 1.10-2.20), children with ARI symptoms (AOR: 4.14, 95% CI: 2.21-7.72) and children whose mothers had no access to prenatal care (AOR: 1.87, 95% CI: 1.01-3.45) had a higher risk of diarrhea. Children from below the richest household wealth group (AOR: 1.76, 95% CI: 1.01-3.08) and those from households practicing open defecation, with unimproved or limited sanitation facilities (AOR: 1.52, 95% CI: 1.09-2.11) were more likely to have diarrhea. Conclusion: The findings underscore the need for public health policy-makers to improve sanitation facilities, especially focusing on poor households from Karnali and Sudurpaschim Provinces practicing open defecation to protect the children from the life risk of diarrhea in Nepal.
MeSH term(s)	Female ; Humans ; Child ; Infant ; Multilevel Analysis ; Nepal/epidemiology ; Diarrhea/epidemiology ; Socioeconomic Factors ; Prevalence ; Ethiopia/epidemiology
Language	English
Publishing date	2023-07-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0287974
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Article: Predictors of Minimum Acceptable Diet among Children Aged 6–23 Months in Nepal: A Multilevel Analysis of Nepal Multiple Indicator Cluster Survey 2019

Sapkota, Suman / Thapa, Bipin / Gyawali, Amrita / Hu, Yifei

Nutrients. 2022 Sept. 05, v. 14, no. 17

2022

Abstract: Background: Minimum Acceptable Diet (MAD), developed by the WHO and UNICEF, is a binary indicator of infant and young child feeding practice that assesses the quality and sufficiency of a child’s diet between the ages of 6 and 23 months. Identifying ... ...

Abstract	Background: Minimum Acceptable Diet (MAD), developed by the WHO and UNICEF, is a binary indicator of infant and young child feeding practice that assesses the quality and sufficiency of a child’s diet between the ages of 6 and 23 months. Identifying factors associated with MAD among children can inform policymakers to improve children’s nutritional status. Methods: We extracted data of 1930 children aged 6–23 months from the Nepal Multiple Indicator Cluster Survey 2019. Multilevel analysis was performed to identify factors associated with MAD. Results: Only 30.1% of the children received MAD. Children aged 13–18 months [aOR (Adjusted odds ratio): 2.37, 95% CI (95% Confidence Interval): 1.77, 3.17] and 19–23 months (aOR: 2.6, 95% CI: 1.95, 3.47) were more likely to receive MAD than children aged 6–12 months. Early breastfed children (aOR: 1.34, 95% CI: 1.05, 1.72), those currently breastfeeding (aOR: 4.13, 95% CI: 2.21, 7.69) and children without siblings aged under five (aOR: 1.33, 95% CI: 1.03, 1.73) were more likely to receive MAD. Younger maternal age (aOR: 0.97, 95% CI: 0.95–1.0), higher level of mother’s education (aOR: 1.04, 95% CI: 1.0–1.08) and more media exposure among mothers (aOR: 1.66, 95% CI: 1.24, 2.21) were positive predictors of MAD. Relatively disadvantaged ethnicity/caste (aOR: 0.71, 95% CI: 0.53, 0.94), rural residence (aOR: 1.45, 95% CI: 1.06, 2.00) and residing in Madhesh province (aOR: 0.61, 95% CI: 0.37, 1.0) were also significant predictors of MAD. Conclusions: Children aged 6–12 months, without appropriate breastfeeding, having under-five years siblings, with older mother or mother without media exposure or low education, from relatively disadvantaged ethnicity/caste, from urban areas and residing in Madhesh Province were less likely to receive MAD. Our findings can inform infant and young child feeding policies and practices in Nepal.
Keywords	breast feeding ; children ; confidence interval ; diet ; low educational status ; nationalities and ethnic groups ; nutritional status ; odds ratio ; surveys ; Nepal
Language	English
Dates of publication	2022-0905
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14173669
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Pericarditis as a Secondary Complication of COVID-19 in a Renal Transplant Patient.

Brockman, Taylor / Hernandez, Leilani / Mehta, Tej / Thapa, Bipin

WMJ : official publication of the State Medical Society of Wisconsin

2022 Volume 120, Issue 4, Page(s) 313–315

Abstract: Introduction: A wide range of complications from COVID-19 are being reported, including cardiac complications.: Case presentation: A 71-year-old woman with systemic lupus erythematosus complicated by focal segmental glomerular sclerosis status post ... ...

Abstract	Introduction: A wide range of complications from COVID-19 are being reported, including cardiac complications. Case presentation: A 71-year-old woman with systemic lupus erythematosus complicated by focal segmental glomerular sclerosis status post kidney transplant presented with worsening left-sided chest pain after receiving treatment for COVID-19 pneumonia at an outside hospital. She was subsequently diagnosed with acute pericarditis, likely secondary to viral infection with COVID-19, and was successfully treated with aspirin and colchicine for 90 days without complications. Discussion: NSAIDs and colchicine are mainstays in acute pericarditis treatment. Though treatment presented a potential challenge given this patient's prior kidney transplant, aspirin and colchicine proved to be effective in treating her case of COVID-19-associated pericarditis. Conclusion: This report has implications for future treatment of renal transplant patients with COVID-19-related pericarditis and emphasizes the need for research into the pathophysiology of pericarditis in the context of COVID-19, including risk factors and treatment.
MeSH term(s)	Aged ; COVID-19 ; Colchicine/therapeutic use ; Female ; Humans ; Kidney Transplantation/adverse effects ; Pericarditis/drug therapy ; Pericarditis/etiology ; SARS-CoV-2
Chemical Substances	Colchicine (SML2Y3J35T)
Language	English
Publishing date	2022-01-13
Publishing country	United States
Document type	Case Reports
ZDB-ID	441051-8
ISSN	2379-3961 ; 0043-6542 ; 1098-1861
ISSN (online)	2379-3961
ISSN	0043-6542 ; 1098-1861
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Article ; Online: Predictors of Minimum Acceptable Diet among Children Aged 6-23 Months in Nepal: A Multilevel Analysis of Nepal Multiple Indicator Cluster Survey 2019.

Sapkota, Suman / Thapa, Bipin / Gyawali, Amrita / Hu, Yifei

Nutrients

2022 Volume 14, Issue 17

Abstract: Background: Minimum Acceptable Diet (MAD), developed by the WHO and UNICEF, is a binary indicator of infant and young child feeding practice that assesses the quality and sufficiency of a child's diet between the ages of 6 and 23 months. Identifying ... ...

Abstract	Background: Minimum Acceptable Diet (MAD), developed by the WHO and UNICEF, is a binary indicator of infant and young child feeding practice that assesses the quality and sufficiency of a child's diet between the ages of 6 and 23 months. Identifying factors associated with MAD among children can inform policymakers to improve children's nutritional status. Methods: We extracted data of 1930 children aged 6-23 months from the Nepal Multiple Indicator Cluster Survey 2019. Multilevel analysis was performed to identify factors associated with MAD. Results: Only 30.1% of the children received MAD. Children aged 13-18 months [aOR (Adjusted odds ratio): 2.37, 95% CI (95% Confidence Interval): 1.77, 3.17] and 19-23 months (aOR: 2.6, 95% CI: 1.95, 3.47) were more likely to receive MAD than children aged 6-12 months. Early breastfed children (aOR: 1.34, 95% CI: 1.05, 1.72), those currently breastfeeding (aOR: 4.13, 95% CI: 2.21, 7.69) and children without siblings aged under five (aOR: 1.33, 95% CI: 1.03, 1.73) were more likely to receive MAD. Younger maternal age (aOR: 0.97, 95% CI: 0.95-1.0), higher level of mother's education (aOR: 1.04, 95% CI: 1.0-1.08) and more media exposure among mothers (aOR: 1.66, 95% CI: 1.24, 2.21) were positive predictors of MAD. Relatively disadvantaged ethnicity/caste (aOR: 0.71, 95% CI: 0.53, 0.94), rural residence (aOR: 1.45, 95% CI: 1.06, 2.00) and residing in Madhesh province (aOR: 0.61, 95% CI: 0.37, 1.0) were also significant predictors of MAD. Conclusions: Children aged 6-12 months, without appropriate breastfeeding, having under-five years siblings, with older mother or mother without media exposure or low education, from relatively disadvantaged ethnicity/caste, from urban areas and residing in Madhesh Province were less likely to receive MAD. Our findings can inform infant and young child feeding policies and practices in Nepal.
MeSH term(s)	Breast Feeding ; Child ; Child, Preschool ; Diet ; Female ; Humans ; Infant ; Mothers/education ; Multilevel Analysis ; Nepal
Language	English
Publishing date	2022-09-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14173669
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Article ; Online: Predictors of Depression and Anxiety among Medical Students.

Thapa, Bipin / Sapkota, Suman / Khanal, Anil / Aryal, Binod Kumar / Hu, Yifei

Journal of Nepal Health Research Council

2023 Volume 21, Issue 1, Page(s) 63–70

Abstract: Background: Medical undergraduates are more prone to emotional distress in comparison to the general population and non-medical undergraduates. This study aimed to identify the prevalence and factors associated with depression and anxiety symptoms among ...

Abstract	Background: Medical undergraduates are more prone to emotional distress in comparison to the general population and non-medical undergraduates. This study aimed to identify the prevalence and factors associated with depression and anxiety symptoms among undergraduate medical students. Methods: A cross-sectional study was conducted among 204 medical students in a medical institute in Kathmandu. Depression, Anxiety and Stress Scale-42 was used to identify the prevalence of depression and anxiety symptoms. The data were analyzed using multivariable logistic regression models. Results: The prevalence of depression and anxiety symptoms was 30.9% and 38.7% respectively. Depression symptoms were more likely to be prevalent among fourth and fifth-year students, with an adjusted odds ratio (aOR 1.96, 95% CI: 1.03-3.75) compared to second and third-year students, and those who failed in the last academic examination (aOR 2.55, 95% CI: 1.28-5.09). Anxiety symptoms were more prevalent among male students (aOR 2.11, 95% CI: 1.04-4.27), those who were from the relatively less advantaged ethnic group (aOR 2.08, 95% CI: 1.04-4.16) and those who stayed outside the dormitory (aOR 2.90, 95% CI: 1.46-5.78). Conclusions: The prevalence of depression and anxiety symptoms among medical students was high. Psychological support is needed to ensure the mental well-being of medical students.
MeSH term(s)	Humans ; Male ; Students, Medical ; Cross-Sectional Studies ; Depression/epidemiology ; Nepal/epidemiology ; Anxiety/epidemiology
Language	English
Publishing date	2023-09-08
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2551251-1
ISSN	1999-6217 ; 1999-6217
ISSN (online)	1999-6217
ISSN	1999-6217
DOI	10.33314/jnhrc.v21i1.4514
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Article ; Online: Depression, anxiety and stress among high school students: A cross-sectional study in an urban municipality of Kathmandu, Nepal.

Karki, Anita / Thapa, Bipin / Pradhan, Pranil Man Singh / Basel, Prem

PLOS global public health

2022 Volume 2, Issue 5, Page(s) e0000516

Abstract: Depression and anxiety are the most widely recognized mental issues affecting youths. It is extremely important to investigate the burden and associated risk factors of these common mental disorders to combat them. Therefore, this study was undertaken ... ...

Abstract	Depression and anxiety are the most widely recognized mental issues affecting youths. It is extremely important to investigate the burden and associated risk factors of these common mental disorders to combat them. Therefore, this study was undertaken with the aim to estimate the prevalence and identify factors associated with depression, anxiety, and stress among high school students in an urban municipality of Kathmandu, Nepal. A cross-sectional study was conducted among 453 students of five randomly selected high schools in Tokha Municipality of Kathmandu. Previously validated Nepali version of depression, anxiety, and stress scale (DASS-21) was used to assess the level of symptoms of depression, anxiety and stress (DAS). Multivariable logistic regression was carried out to decide statistically significant variables of symptoms of DAS at p-value<0.05. The overall prevalence of DAS was found to be 56.5% (95% CI: 51.8%, 61.1%), 55.6% (95%CI: 50.9%, 60.2%) and 32.9% (95%CI: 28.6%, 37.4%) respectively. In the multivariable model, nuclear family type, students from science or humanities faculty, presence of perceived academic stress, and being electronically bullied were found to be significantly associated with depression. Female sex, having mother with no formal education, students from science or humanities faculty and presence of perceived academic stress were significantly associated with anxiety. Likewise, female sex, currently living without parents, and presence of perceived academic stress were significantly associated with stress. Prevention and control activities such as school-based counseling services focusing to reduce and manage academic stress and electronic bullying are recommended in considering the findings of this research.
Language	English
Publishing date	2022-05-31
Publishing country	United States
Document type	Journal Article
ISSN	2767-3375
ISSN (online)	2767-3375
DOI	10.1371/journal.pgph.0000516
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Article ; Online: Blastomycosis in solid organ transplant recipients-A retrospective series from southeastern Wisconsin.

Mehta, Tej I / Kurman, Jonathan / Dolan, Stephen / Gill, Harpreet / Thapa, Bipin

Transplant infectious disease : an official journal of the Transplantation Society

2021 Volume 23, Issue 4, Page(s) e13671

Abstract: Blastomycosis is a fungal infection caused primarily by Blastomyces dermatitis. The fungus is endemic to the Ohio, Mississippi, and St. Lawrence River areas of the United States. Organ transplant recipients are at risk of blastomycosis due to ... ...

Abstract	Blastomycosis is a fungal infection caused primarily by Blastomyces dermatitis. The fungus is endemic to the Ohio, Mississippi, and St. Lawrence River areas of the United States. Organ transplant recipients are at risk of blastomycosis due to pharmacologic immunosuppression. Over a 20-year period, 30 cases of blastomycosis post-solid organ transplantation were identified at our center. The cumulative incidence of blastomycosis among SOT recipients was 0.99%. There was a male predominance (70% male) and a median age of 59 at the time of diagnosis. Regarding transplant type, 23 patients received kidney transplants, 4 received liver transplants, 2 received pancreas transplants and 1 received a heart transplant. Median time to blastomycosis identification post-transplant was 67.8 months (range: 1-188 months). Amphotericin B was used as initiation therapy in most cases, followed by itraconazole, voriconazole, or in select cases fluconazole or posaconazole maintenance therapy. Regarding comorbid conditions, 87% of patients had diabetes, 50% had congestive heart failure, and 20% had chronic pulmonary disease. Nine patients (30%) developed blastomycosis-related acute respiratory distress syndrome, 33% of these died with a median time to death of 22 days (range 20 days to 2 months); these were the only deaths attributable to blastomycosis.
MeSH term(s)	Antifungal Agents/therapeutic use ; Blastomycosis/drug therapy ; Blastomycosis/epidemiology ; Female ; Humans ; Male ; Organ Transplantation/adverse effects ; Retrospective Studies ; United States ; Wisconsin/epidemiology
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2021-07-12
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.13671
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Article: Predictors of Influenza Vaccination among Chinese Middle School Students Based on the Health Belief Model: A Mixed-Methods Study.

Asihaer, Yeerlin / Sun, Mengyang / Li, Miao / Xiao, Huidi / Amaerjiang, Nubiya / Guan, Mengying / Thapa, Bipin / Hu, Yifei

Vaccines

2022 Volume 10, Issue 11

Abstract: Influenza vaccination rates among Chinese middle school students are low. This study aims to explore the influencing factors of vaccination among middle school students and promote vaccination. We conducted a mixed-methods study, integrating a ... ...

Abstract	Influenza vaccination rates among Chinese middle school students are low. This study aims to explore the influencing factors of vaccination among middle school students and promote vaccination. We conducted a mixed-methods study, integrating a questionnaire survey among 9145 middle school students in four cities in China and semi-structured interviews with 35 middle school students to understand their attitudes and perceptions toward vaccination based on the Health Belief Model. We found the overall vaccination rate was 38.2% (3493/9145), with students in Beijing, boarding at school, or senior high school showing higher values than their counterparts (p < 0.05). Multiple logistic regression results showed that non-boarding (OR = 0.46, 95%CI: 0.42−0.51) and perceived barriers (OR = 0.97, 95%CI: 0.96−0.98) were unfavorable factors for influenza vaccination, whereas perceived susceptibility (OR = 1.07, 95%CI: 1.05−1.08), perceived benefits (OR = 1.02, 95%CI: 1.01−1.04), cues to action (OR = 1.08, 95%CI: 1.05−1.11), and self-efficacy (OR = 1.04, 95%CI: 1.02−1.07) were facilitators. Qualitative results indicated that positive health beliefs, school, and the home environment contribute to vaccination. In conclusion, the influenza vaccination rate among middle school students remains low. The concerns about the safety and potential side effects of vaccines are the main barriers to vaccination, underscoring the need for strengthening communication, education, and information among students and their teachers/parents.
Language	English
Publishing date	2022-10-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines10111802
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Article ; Online: Hearing the Call of Duty: What We Must Do to Allow Medical Students to Respond to the COVID-19 Pandemic.

Kalet, Adina L / Jotterand, Fabrice / Muntz, Martin / Thapa, Bipin / Campbell, Bruce

WMJ : official publication of the State Medical Society of Wisconsin

2020 Volume 119, Issue 1, Page(s) 6–7

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Delivery of Health Care ; Humans ; Pandemics ; Patient Care ; Pneumonia, Viral/epidemiology ; Professional Role ; SARS-CoV-2 ; Students, Medical
Keywords	covid19
Language	English
Publishing date	2020-06-15
Publishing country	United States
Document type	Editorial
ZDB-ID	441051-8
ISSN	2379-3961 ; 0043-6542 ; 1098-1861
ISSN (online)	2379-3961
ISSN	0043-6542 ; 1098-1861
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