Suchergebnisse

Background: It is imperative to have adequate knowledge about medicines being used for their proper administration so as to obtain desirable therapeutics effects. This study aims to assess the medicine prescribing pattern and patients' knowledge about medicine use at different level of health care settings in Nepal.
Methods: A cross sectional study was conducted in randomly selected 88 health facilities in Nepal. Altogether 2200 patients, taken randomly after the doctor visit, were interviewed and assessed for the prescription.
Results: Out of total drugs prescribed from 88 health facilities (6,175), 68.91% were essential drugs, 23.74 % were antibiotics and 61 % of medicines were prescribed in generic names. And among patients receiving medicines, adequate response on medicine use was received on 49% of medicines out of 3,806 medicines dispensed.
Conclusions: Greater percentages of medicines were prescribed from essential drug list in health facilities. Knowledge on medicine use was poor among people.
Keywords: Antibiotics use; drug prescribing pattern; knowledge; rational use of drugs

Health research in Nepal initiated with a survey in malaria in 1952. The first regulatory body for health research was Nepal Medical Research Committee formed under Ministry of Health. Ethical Review Body is the first ethical review structure. Nepal Health Research Council is now an independent body to regulate health research in Nepal. Development of research ethics in Nepal is clearly evident with the development of ethical guidelines; functioning of Ethical Review Board; expansion of institutional review committees and initiation of online submission system. However, monitoring compliance with research ethics could be a challenge for the NHRC.

Background: Poor quality drugs result minor to detrimental effect on human health. The drug should be of standard quality and should be used appropriately in order to meet its therapeutic efficacy. This study aims to assess the quality of drug in Nepal. Methods: A cross sectional study was conducted in randomly selected 88 health facilities in Nepal from 10th April to 30th June 2016. Selective medicines were collected from both private licensed pharmacies and selected public health facilities. Face to face interview with health facility in-charge of selected health facilities was carried out along with the direct observation of the medicine storage room. The collected medicine samples were dispatched to two laboratories for in-vitro analysis. The labels of the collected medicine were analyzed. The obtained data were entered in Epidata version 3.1, cleaned in Microsoft excel 2007 and analyzed in SPSS version 20.Results: Out of 172 brands, nine brands of medicines were found substandard. Information regarding storage conditions, direction for use and category of the drug were lacking in the label of some brands of medicines. Some selected health facilities were found not meeting major requirements for drug storage: protection from sunlight, moisture, heat, well ventilation and proper sanitation.Conclusions: Few drugs were found to be substandard in Nepalese market from both public and private sectors. Adequate labeling and proper storage condition of medicines in health facilities were lacking.Keywords: Drug quality; private pharmacies; public health facilities; substandard drugs.

Background: Medical waste is considered as a major public health hazard. In a developing country like Nepal, there is much concern about the management practice of medical waste. This study aimed to assess Health Care Waste Management practice among Health Care Institutions in Nepal.Methods: A cross sectional study was carried out between July 2012 to June 2013 in 62 different Health Care Institutions, selected from stratified proportionate random sampling technique from all administrative regions of Nepal. A structured questionnaire and observation checklist were used for data collection.Results: The waste generation rate is found significantly correlated with bed capacity, patient flow rate and annual budget spent in the hospital. It is found significantly higher in Teaching hospital than other Health Care Institutions of Nepal. An average of 3.3 kg/day/patient of medical waste (2.0 kg/day/patient non-hazardous and 1.0 kg/day/patient hazardous waste) was generated during the study period. Further, it was found that most of the Health care wastes were not disinfected before transportation to waste disposal sites. Very limited number of Health Care Institutions had conducted Environmental Assessment. Similarly, some of the Health Care Institutions had not followed Health care waste management guideline 2009 of Nepal Government.Conclusions: We found poor compliance of medical waste management practice as per existing legislation of Government of Nepal. Hence, additional effort is needed for improvement of Health care waste management practice at Health Care Institutions of Nepal.

Background: Medical waste is considered as a major public health hazard. In a developing country like Nepal, there is much concern about the management practice of medical waste. This study aimed to assess Health Care Waste Management practice among Health Care Institutions in Nepal.Methods: A cross sectional study was carried out between July 2012 to June 2013 in 62 different Health Care Institutions, selected from stratified proportionate random sampling technique from all administrative regions of Nepal. A structured questionnaire and observation checklist were used for data collection.Results: The waste generation rate is found significantly correlated with bed capacity, patient flow rate and annual budget spent in the hospital. It is found significantly higher in Teaching hospital than other Health Care Institutions of Nepal. An average of 3.3 kg/day/patient of medical waste (2.0 kg/day/patient non-hazardous and 1.0 kg/day/patient hazardous waste) was generated during the study period. Further, it was found that most of the Health care wastes were not disinfected before transportation to waste disposal sites. Very limited number of Health Care Institutions had conducted Environmental Assessment. Similarly, some of the Health Care Institutions had not followed Health care waste management guideline 2009 of Nepal Government.Conclusions: We found poor compliance of medical waste management practice as per existing legislation of Government of Nepal. Hence, additional effort is needed for improvement of Health care waste management practice at Health Care Institutions of Nepal.

Background: Infectious disease outbreaks following natural disasters are reported in literature. Outbreaks were documented following natural disasters in many countries including Haiti. Such possibility following 2015 Nepal earthquake was a public health concern. Risk factors needed evaluation by post-disaster outbreak investigation. Hence, present study was undertaken to investigate potentials for such outbreak and to generate evidence for public health intervention.Methods: The study was conducted between April – May, 2015, with the cooperation of National Public Health Laboratory, Epidemiology and Disease Control Division, Nepal Health Research Council and the Chinese team. Rapid Response Teams visited earthquake affected districts and collected samples for analysis. Syndromic surveillance approach was followed. Samples were collected from syndromic patients under supervision. Those sick prior to earthquake or receiving treatment were excluded. Blood, stool and throat swab samples, as indicated, were collected. Drinking water and food samples including captured live mosquitoes from inhabited areas were obtained for study with the help of EDCD. Laboratory analysis was performed at the NPHL.Results: Total samples were 360 (114 biological, 246 environmental). Salmonella spp. was detected in two and Varicella zoster in one blood sample. Influenza B virus was detected in one throat swab. Rota virus was detected in two, Shigella dysenteriae in one and Salmonella spp. in one stool sample. No pathogen detected in water or food samples. Mosquitoes tested negative for dengue virus.Conclusions: Post-earthquake outbreak investigated in disaster phase-2. Diarrheal, enteric fever pathogens and Influenza B virus were detected. Environmental samples tested negative for pathogens. Vigilance is necessary for other risk factors.

Background: The burden of non-communicable diseases has increased in the last few decades in low-and middle-income countries including in Nepal. There is limited data on population based prevalence of non-communicable diseases. Hence, this study aims to determine the nationwide prevalence of selected chronic non-communicable diseases in Nepal.Methods: A nationwide cross-sectional population-based study was conducted from 2016 to 2018. Data was collected electronically on android device inbuilt with research and monitoring software from 13200 eligible participants aged 20 years and above. Data was cleaned in SPSS version 20.0 and analyzed using Stata version 13.1.Results: The overall prevalence of selected non-communicable diseases was found to be chronic obstructive pulmonary disease 11.7% (95% CI: 10.5-12.9), diabetes mellitus 8.5% (95% CI: 7.8-9.3), chronic kidney disease 6.0% (95% CI: 5.5-6.6) and coronary artery disease 2.9% (95% CI: 2.4-3.4) in Nepal. Prevalence of non-communicable diseases varied across provinces. Higher prevalence of chronic obstructive pulmonary disease (25.1%, 95% CI: 18.1-33.8) in Karnali Province, diabetes (11.5%, 95% CI: 9.8-13.4) in Province 3, chronic kidney disease (6.8%, 95% CI: 5.6-8.1) in Gandaki Province and coronary artery disease in Gandaki (3.6%, 95% CI: 2.2-5.7) and Sudurpaschim Province (3.6%, 95% CI: 2.1-6.1) was observed.Conclusions: The study reported substantial proportion of adult population was found to have chronic non-communicable diseases in Nepal. The findings of this study may be useful for revising/updating multi-sectoral action plans on prevention and control of non-communicable diseases in Nepal. Keywords: Chronic kidney disease; chronic obstructive pulmonary disease; coronary artery disease; diabetes mellitus; non-communicable disease.