Biomedical subjects
Krishna C Poudel
Publications and source records attributed to Krishna C Poudel.
HIV/AIDS vulnerability of Nepali migrants to India: whose concern?
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Improving immunization services under the armed conflict in rural Nepal.
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Relationship between mechanisms and activities at the time of pedestrian injury and activity limitation among school adolescents in Kathmandu, Nepal.
This study assessed the relationship between pedestrian activity at the time of injury, the type of vehicle involved and resulting activity limitation among school adolescents in the Kathmandu and Lalitpur districts of Nepal. A cross-sectional study of 1557 students in grades 6-8 across 14 schools was conducted using a self-administered questionnaire from August to September 2003. Twenty-three percent of adolescents reported pedestrian injuries, 38% were from urban and 21% from semi-urban areas. Adolescents were commonly injured by motorcycles and motor vehicles while crossing the road; however, while walking and playing, they were commonly injured by bicycles and motorcycles. Bicycles and motor vehicles were less likely to be involved in injury while crossing the roads and playing, respectively (p < 0.001). Activity was more likely to be limited for a longer period of time (> 7 days) with injuries endured while crossing the road (p < 0.001). In urban areas, boys and girls were more likely to be injured while crossing the road and walking, respectively (p < 0.05), and both were commonly injured by motorcycles. In semi-urban areas, boys and girls were commonly injured while walking and were more likely to be injured by motorcycles and bicycles, respectively (p < 0.05). In both areas, more boys than girls were injured while playing. These findings have important implications for pedestrian safety interventions in poor countries.
Reaching hard-to-reach migrants by letters: an HIV/AIDS awareness programme in Nepal.
We assessed the impact of an HIV/AIDS programme for Nepalese migrants to India that involved writing letters. The programme created opportunities for sending HIV/AIDS-related messages to the migrants in India, and encouraging them practicing safer sex. Initially, they received the messages only from the programme, but later from their colleagues, spouses or other family members. They discussed the messages in groups, disseminated them, and sought more knowledge in their destinations. These findings indicated that using letters could be an effective way to reach inaccessible migrants at their destinations, and help them to improve their HIV/AIDS-related knowledge, and safer sex practices.
AIDS and human rights research.
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Emerging co-infection of HIV and hepatitis B virus in far western Nepal.
We detected a prevalence (11%) of hepatitis B virus (HBV) infection among male adult villagers (n = 149) in far western Nepal where migration to India is common. Although only one migrant-returnee was infected with both HBV and HIV, co-infection may occur more frequently in future as the HIV prevalence is high (8%).
One-journal-for-MEDLINE initiative in Nepal.
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Retention and effectiveness of HIV/AIDS training of traditional healers in far western Nepal.
OBJECTIVE: To evaluate HIV/AIDS training for traditional healers (THs) in far western Nepal. METHODS: We collected data using a structured questionnaire and assessed THs' knowledge of HIV transmission, misconceptions and preventive measures immediately prior to the initial training conducted from June to December 1999, and then 9-12 months after the training in 2000. We also conducted six focus group discussions (FGD) and assessed THs' performances after the training. We interviewed 12 key informants about their perceptions towards the trained THs. RESULTS: THs significantly improved their knowledge of HIV transmission, misconceptions and preventive measures after the training. The FGD and key informant interview results showed that the trained THs provided culturally acceptable HIV/AIDS education to the local people, distributed condoms and played a role in reducing the HIV/AIDS-related stigma. CONCLUSIONS: THs have a potential to work as key players in HIV/AIDS programmes in Nepal.
Lack of occupational health research in Nepal.
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Traffic fatalities in Nepal.
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Day-care centre supplementary feeding effects on child nutrition in urban slum areas of Nepal.
We compared the nutritional status of children aged 1-5 years from slums attending two day-care centres (DCCs) in Nepal (one in an urban slum area) with that of non-attendees to evaluate the impact of supplementary feeding. We measured the anthropometrics of 23 children attending two DCCs and 23 matched controls from the same neighbourhood and interviewed their mothers. We found a better nutritional status, particularly the height-for-age Z-score, among the attendees of the DCC with children's longer attendance, but no difference at the other, although attendees who had been fed for longer tended to show better nutrition. Our study indicates that in the least developed countries good quality day-care of sufficient duration has the potential to improve child nutrition.
Migrants' risky sexual behaviours in India and at home in far western Nepal.
OBJECTIVE: To examine Nepali migrants' vulnerability to HIV/sexually transmitted infections (STIs) and their possible role in causing the epidemic in far western Nepal. METHODS: From August to October 2000, we conducted six focus group discussions among 53 returned migrants from India, mainly from Mumbai. Data were analysed by interpretative thematic analysis. RESULTS: Migrants commonly had multiple sexual encounters, changed partners, and used condoms infrequently both in India and at home. Several factors influenced them to practice high-risk sexual behaviours. In India, these included peer norms and pressures, cheaper sex, lack of family restraint, drinking alcohol, and low perceived vulnerability to HIV/STIs. In Nepal, these factors included the migrants' new status, frequent local festivals, and low perceived vulnerability to HIV/STIs. Participants displayed substantial deficits in their knowledge of HIV/STIs. CONCLUSIONS: This study revealed Nepali migrants' high-risk sexual behaviours both abroad and at home. Understanding these realities will assist in the development of culturally appropriate HIV/STI interventions necessary to halt the spread of HIV/STIs in Nepal.
Migration in far western Nepal: a time bomb for a future HIV/AIDS epidemic?
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Mumbai disease in far western Nepal: HIV infection and syphilis among male migrant-returnees and non-migrants.
OBJECTIVE: To measure the seroprevalence of human immunodeficiency virus (HIV) infection and syphilis, and to assess the behavioural risk factors for these infections among migrant-returnees and non-migrants in far western Nepal. METHODS: In April 2001, we recruited 97 male migrant-returnees and 40 non-migrants from five rural villages in Doti district where migration to Mumbai is common. For data collection, we conducted a serological examination for HIV and syphilis, and a perception and behaviour survey on HIV and other sexually transmitted infections. RESULTS: We found that 11 of 137 men (8%) were positive for HIV infection and 30 men (22%) for syphilis. The respondents, especially the migrant-returnees from Mumbai, were engaging in risky behaviours such as pre- or extramarital sex, and sex with multiple partners, including sex workers. CONCLUSIONS: This study revealed high HIV and syphilis prevalence among the male migrant-returnees and non-migrants in far western Nepal where migration to Mumbai is common. The prevalent behaviours, particularly among the migrant-returnees, imply urgent needs of the behavioural modification programme in this area to prevent the spread of HIV infection to general population.
Factors influencing women's use of health services for sexually transmitted infections in eastern Nepal.
This paper explores low levels of women's health service utilization for Sexually Transmitted Infections (STIs) in Nepal. We interviewed 120 women individually and 53 in focus groups. Predictors of lower utilisation were self-medication, consultation with faith healers, inadequate knowledge of STIs, belief about causes, fear, social taboos and stigmatisation, womens secondary status, and presence of male health professionals. Results indicate the importance of peoples belief in their decisions about health care. Strategies to improve access to health services in Nepal should systematically investigate the role of all these factors to improve access to and utilisation of health services for STIs.
Availability of childcare support and nutritional status of children of non-working and working mothers in urban Nepal.
In many developing countries, poor women have multiple roles, and often their time constraints are so severe that their participation in income-generating activities results in reduced childcare time, which in turn affects child health. Previous studies have tended to investigate how childcare support influences nutrition of children with working mothers' based on comparisons with non-working mothers. However, non-working mothers are not a homogeneous group, and we therefore need to distinguish between those who need not work and those who wish to but cannot, for example, due to a lack of substitute caregivers. We examined the association between availability of childcare support and the nutritional status of children of both non-working and working mothers in poor areas of Pokhara, a sub-metropolitan city in Nepal. We recruited 150 children of age 10-24 months from the waiting lists of 17 daycare centers and measured their weights and heights. Those with height-for-age and weight-for-age Z scores of less than -2 were defined as stunted and underweight, respectively. To collect information on childcare practices and socioeconomic characteristics, mothers were interviewed using a pre-tested structured questionnaire. Unavailability of adult childcare support was associated with increased risk of malnutrition among children of both non-working and working mothers. Peer childcare was not significantly associated with child malnutrition among children of non-working mothers, but it was associated with an increased risk of malnutrition among children of working mothers. Although further longitudinal research is required, we suggest that childcare support from adult substitute caregivers is essential for children of non-working mothers with limited resources.