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  • 1
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    Impact of maternal vaccination timing and influenza virus circulation on birth outcomes in rural Nepal
    Wiley ; 2018
    In:  International Journal of Gynecology & Obstetrics Vol. 140, No. 1 ( 2018-01), p. 65-72
    Details
    In: International Journal of Gynecology & Obstetrics, Wiley, Vol. 140, No. 1 ( 2018-01), p. 65-72
    Abstract: Maternal influenza vaccination in rural Nepal increased birth weight, particularly among pregnancies with high levels of influenza virus circulation during the third trimester.
    Type of Medium: Online Resource
    ISSN: 0020-7292 , 1879-3479
    URL: Issue
    URL: Article
    DOI: 10.1002/ijgo.2018.140.issue-1
    DOI: 10.1002/ijgo.12341
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 1500480-6
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  • 2
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    Community‐based stillbirth rates and risk factors in rural Sarlahi, Nepal
    Wiley ; 2011
    In:  International Journal of Gynecology & Obstetrics Vol. 113, No. 3 ( 2011-06), p. 199-204
    Details
    In: International Journal of Gynecology & Obstetrics, Wiley, Vol. 113, No. 3 ( 2011-06), p. 199-204
    Abstract: To assess stillbirth rates and antepartum risk factors in rural Nepal. Methods Data were collected prospectively during a cluster‐randomized, community‐based trial in Sarlahi, Nepal, from 2002 to 2006. Multivariate regression modeling was performed to calculate adjusted relative risk estimates. Results Among 24 531 births, the stillbirth rate was 35.4 per 1000 births (term stillbirth rate 21.2 per 1000 births). Most births occurred at home without a skilled birth attendant. The majority (69%) of intrapartum maternal deaths resulted in stillbirth. The adjusted RR (aRR) of stillbirth was 2.74 among nulliparas and 1.47 among mothers with history of a child death. Mothers above the age of 30 years carried a 1.59‐fold higher risk for stillbirth than mothers who were 20–24 years old. The stillbirth risk was lower among households where the father had any formal education (aRR 0.70). Land ownership (aRR 0.85) and Pahadi ethnicity (aRR 0.67; reference: Madhesi ethnicity) were associated with significantly lower risks of stillbirth. Conclusion Stillbirth rates were high in rural Nepal, with the majority of stillbirths occurring at full‐term gestation. Nulliparity, history of prior child loss, maternal age above 30 years, Madhesi ethnicity, and socioeconomic disadvantage were significant risk factors for stillbirth. Clinicaltrials.gov NCT00 109616
    Type of Medium: Online Resource
    ISSN: 0020-7292 , 1879-3479
    URL: Article
    DOI: 10.1016/j.ijgo.2010.12.015
    Language: English
    Publisher: Wiley
    Publication Date: 2011
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  • 3
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    Nasopharyngeal carriage of S. pneumoniae among young children in rural Nepal
    Wiley ; 2009
    In:  Tropical Medicine & International Health Vol. 14, No. 9 ( 2009-09), p. 1025-1033
    Details
    In: Tropical Medicine & International Health, Wiley, Vol. 14, No. 9 ( 2009-09), p. 1025-1033
    Abstract: Objetivos:  Proveer datos epidemiológicos sobre los portadores de S. pneumoniae ( Spn ) en Nepal. Métodos:  Estudio prospectivo, basado en la población, con niños de Sarlahi, Nepal para estimar la prevalencia de portadores, identificar los factores de riesgo, y determinar los patrones de susceptibilidad antibiótica y distribución de serotipos. Entre Diciembre del 2003 y Julio del 2004, se recolectaron muestras nasofaríngeas de 604 niños con edades comprendidas entre los 1‐ 36 meses, que presentaban infección aguda de las vías respiratorias inferiores (IAVRI) y 604 controles sanos pareados por edad y estación. Resultados:  De las 1100 muestras analizadas, la prevalencia de portadores en ambos grupos era de aproximadamente un 80%. En un análisis multivariable, los factores de riesgo significativos, entre los controles, para ser portador de Spn, eran la religión musulmana (odds ratio adjustado [AOR]: 2.93) y el no tener letrina en casa (AOR: 2.41). Aquellos que habían recibido tratamiento para una enfermedad reciente tenían una menor tasa de porte (AOR: 0.37). Los resultados fueron similares para todos los casos IAVRI, con la edad ≥12 meses ([AOR] : 1.68), e infección sintomática (AOR: 3.78) como factores de riesgo. Los antibióticos y la proporción de aislados resistentes a ellos fue la siguiente: penicilina 4.5%, cotrimoxazol 89.2%, cloranfenicol 1.4%, eritromicina 1.5% y tetraciclina 22.7%. Los serogrupos/tipos más prevalentes fueron 6, 19, 23, 15, 9, y 10. Conclusiones:  Los niños pequeños en Nepal rural experimentan una alta tasa de incidencia de Spn . La mayoría de los aislados eran resistentes al cotrimoxazol. Las actuales vacunas conjugadas de Spn podrían reducir sustancialmente el riesgo de neumonía severa y otras infecciones por Spn .
    Type of Medium: Online Resource
    ISSN: 1360-2276 , 1365-3156
    URL: Issue
    URL: Article
    DOI: 10.1111/tmi.2009.14.issue-9
    DOI: 10.1111/j.1365-3156.2009.02331.x
    Language: English
    Publisher: Wiley
    Publication Date: 2009
    detail.hit.zdb_id: 2018112-7
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  • 4
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    Community survey on awareness and use of obstetric ultrasonography in rural Sarlahi District, Nepal
    Wiley ; 2016
    In:  International Journal of Gynecology & Obstetrics Vol. 134, No. 2 ( 2016-08), p. 126-130
    Details
    In: International Journal of Gynecology & Obstetrics, Wiley, Vol. 134, No. 2 ( 2016-08), p. 126-130
    Abstract: To assess levels of awareness and use of obstetric ultrasonography in rural Nepal. Methods Between March 2014 and March 2015, a cross‐sectional survey was conducted among married women aged 15–40 years residing in rural Sarlahi District, Nepal, regarding their knowledge and use of obstetric ultrasonography during their most recent pregnancy. Regression analyses were conducted to identify reproductive health, socioeconomic, and other characteristics that increased the likelihood of undergoing an obstetric ultrasonographic examination. Results Among 6182 women, 1630 (26.4%) had undergone obstetric ultrasonography during their most recent pregnancy, of whom 1011 (62.0%) received only one examination. Odds of receiving an ultrasonographic examination were higher among women with post‐secondary education than among those with none (≥ 11 years' education: adjusted odds ratio [aOR] 10.28, 95% confidence interval [CI] 5.55–19.04), and among women whose husbands had post‐secondary education than among those with husbands with none (≥ 11 years' education: aOR 1.99, 95% CI 1.47–2.69). Odds were lower among women younger than 18 years than among those aged 18–34 years (aOR 0.72, 95% confidence interval 0.59–0.90). Conclusion Utilization of obstetric ultrasonography in rural Nepal was very limited. Further research is necessary to assess the potential health impact of obstetric ultrasonography in low‐resource settings, while addressing limitations such as cost and misuse.
    Type of Medium: Online Resource
    ISSN: 0020-7292 , 1879-3479
    URL: Article
    DOI: 10.1016/j.ijgo.2016.01.015
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 1500480-6
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  • 5
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    Adherence to and acceptability of three alcohol‐free, antiseptic oral rinses: A community‐based pilot randomized controlled trial among pregnant women in rural Nepal
    Wiley ; 2020
    In:  Community Dentistry and Oral Epidemiology Vol. 48, No. 6 ( 2020-12), p. 501-512
    Details
    In: Community Dentistry and Oral Epidemiology, Wiley, Vol. 48, No. 6 ( 2020-12), p. 501-512
    Abstract: Antiseptic oral rinses have been evaluated as interventions to reduce the risk of adverse pregnancy outcomes associated with periodontal disease in pregnant women. Oral rinse use is not common in Nepal or other countries in South Asia, where the prevalence of adverse pregnancy outcomes is high. Understanding whether pregnant women in rural communities in this region would incorporate rinse use into their daily teeth cleaning routine is an important prerequisite to future research on this topic in South Asia. Methods We conducted a community‐based pilot randomized controlled trial of three alcohol‐free, antiseptic oral rinses among pregnant women 〈 22 weeks pregnant in rural Nepal with the aim of assessing rinse acceptability, adherence, and effect on clinical periodontal measures. At baseline, participants underwent a clinical periodontal examination, and then were classified as healthy or having at least mild gingivitis (≥1 site with probing depth (PD) 3 mm and bleeding on probing (BOP) or ≥4 mm (PD)). Participants were stratified by periodontal status and randomized within each exposure category to chlorhexidine (CHX) (0.12%), cetylpyridinium chloride (CPC) (0.05%), salt and water (NaCl), or control (no rinse). Rinse participants were followed weekly for 12 weeks, and all participants underwent a second periodontal examination and answered a questionnaire. Results Pregnant women in the rural Terai region of Nepal showed high adherence to (mean weekly rinse use: 185 mL (standard deviation: 66 mL)) a recommended 210 mL and acceptability of all three rinses. Participants reported greater frequency of tooth brushing with toothpaste and improvements in other recommended oral hygiene behaviours. CHX significantly reduced rates of gingivitis (defined as a participant with BOP ≥ 10% of sites) and the extent of BOP (gingivitis at the end of follow‐up for CHX vs control: RR 0.37, 95% CI: 0.16, 0.84). CPC and NaCl rinse groups had rates of gingivitis and extent of BOP similar to the control group (gingivitis at the end of follow‐up for CPC: RR 0.81, 95% CI: 0.47, 1.38; NaCl: RR 0.92, 95% CI: 0.55, 1.56). Conclusions Adherence to and acceptability of three alcohol‐free, antiseptic oral rinses were high among pregnant women in rural Nepal. Among participants with mild gingivitis at baseline, CHX rinse was most effective at reducing signs of disease compared to the control group. Oral rinse should be considered as a supplement to current oral self‐care routines for pregnant women in settings where rinse use is uncommon and access to oral health services is limited.
    Type of Medium: Online Resource
    ISSN: 0301-5661 , 1600-0528
    URL: Issue
    URL: Article
    DOI: 10.1111/cdoe.v48.6
    DOI: 10.1111/cdoe.12562
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2027101-3
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  • 6
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    Incidence of and risk factors for neonatal jaundice among newborns in southern N epal
    Wiley ; 2013
    In:  Tropical Medicine & International Health Vol. 18, No. 11 ( 2013-11), p. 1317-1328
    Details
    In: Tropical Medicine & International Health, Wiley, Vol. 18, No. 11 ( 2013-11), p. 1317-1328
    Abstract: Cuantificar la incidencia y los factores de riesgo de la ictericia neonatal en recién nacidos de una cohorte poblacional, derivados para cuidados desde zonas rurales y con pocos recursos en el sur de Nepal. Métodos Los sujetos del estudio eran 18 985 recién nacidos entre Mayo del 2003 y Enero del 2006 en el Distrito de Sarlahi al sur del Nepal, que participaban en un ensayo aleatorizado en conglomerados, controlado con placebo y basado en la comunidad, para evaluar el efecto de la limpieza con clorhexidina sobre la mortalidad y la morbilidad neonatal. La ictericia se evaluó basándose en la observación visual del neonato por parte de un trabajador del estudio y su posterior derivación para recibir los cuidados necesarios. Se calcularon los riesgos relativos ajustados ( RR ) para identificar los factores de riesgo de ser derivados por ictericia neonatal mediante una regresión de Poisson. Resultados La incidencia de ser derivado por ictericia neonatal era de 29.3 por 1000 nacidos vivos (Intervalo de confianza 95%: 26.9, 31.7). Ser de sexo masculino, tener un alto peso al nacer, el patrón de lactancia, una temperatura caliente del aire, la primiparidad, recibir asistencia cualificada durante el parto, el lugar de nacimiento, tener un parto prolongado, el masaje con aceite, la educación paterna y la etnia eran factores de riesgo significativos ( P  〈  0.01). Tras un ajuste multivariable, el sexo, el peso al nacer, la dificultad en la alimentación, el parto prolongado, la primiparidad, el masaje con aceite, la temperatura del ambiente y la etnia continuaron siendo factores importantes. Entre los neonatos con una dificultad a la hora de ser alimentados, la lactancia materna exclusiva era un factor de riesgo para la ictericia neonatal, mientras que la lactancia materna exclusiva era protectora para lactantes que no tenían dificultades en la alimentación. Conclusiones Se han confirmado varios factores de riesgo para la ictericia neonatal en emplazamientos con pocos recursos. Las asociaciones observadas entre la ictericia y la temperatura del medio ambiente o el masaje con aceite se podrían explicar por la oportunidad de recibir fototerapia según las prácticas culturales de la población de estudio. Se requieren nuevos estudios que investiguen el papel que tiene la dificultad del neonato a la hora de alimentarse como modificador potencial de la asociación entre la lactancia materna exclusiva y la ictericia.
    Type of Medium: Online Resource
    ISSN: 1360-2276 , 1365-3156
    URL: Issue
    URL: Article
    DOI: 10.1111/tmi.2013.18.issue-11
    DOI: 10.1111/tmi.12189
    Language: English
    Publisher: Wiley
    Publication Date: 2013
    detail.hit.zdb_id: 2018112-7
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  • 7
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    Injections during labor and intrapartum‐related hypoxic injury and mortality in rural southern Nepal
    Wiley ; 2013
    In:  International Journal of Gynecology & Obstetrics Vol. 122, No. 1 ( 2013-07), p. 22-26
    Details
    In: International Journal of Gynecology & Obstetrics, Wiley, Vol. 122, No. 1 ( 2013-07), p. 22-26
    Abstract: To estimate the association between unmonitored use of injections during labor and intrapartum‐related neonatal mortality and morbidity among home births. Methods Recently delivered women in Sarlahi, Nepal, reported whether they had received injections during labor. Data on breathing and crying status at birth, time to first breath, respiratory rate, sucking ability, and lethargy were gathered. Neonatal respiratory depression (NRD) and encephalopathy (NE) were compared by injection receipt status using multivariate regression models. Results Injections during labor were frequently reported (7108 of 22 352 [31.8%]) and were predominantly given by unqualified village “doctors.” Multivariate analysis (excluding facility births and complicated deliveries) revealed associations with intrapartum‐related NRD (relative risk [RR] 2.52; 95% CI, 2.29–2.78) and NE (RR 3.48; 95% CI, 2.46–4.93). The risks of neonatal death associated with intrapartum‐related NRD (RR 3.78; 95% CI, 2.53–5.66) or NE (RR 4.47; 95% CI, 2.78–7.19) were also elevated. Conclusion Injection during labor was widespread at the community level. This practice was associated with poor outcomes and possibly related to the inappropriate use of uterotonics by unqualified providers. Interventions are required to increase the safety of childbirth in the community and in peripheral health facilities. Parent trial registered at clinicaltrials.gov (NCT00 109616).
    Type of Medium: Online Resource
    ISSN: 0020-7292 , 1879-3479
    URL: Article
    DOI: 10.1016/j.ijgo.2013.02.013
    Language: English
    Publisher: Wiley
    Publication Date: 2013
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  • 8
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    Household Wealth and Neurocognitive Development Disparities among School‐aged Children in N epal
    Wiley ; 2013
    In:  Paediatric and Perinatal Epidemiology Vol. 27, No. 6 ( 2013-11), p. 575-586
    Details
    In: Paediatric and Perinatal Epidemiology, Wiley, Vol. 27, No. 6 ( 2013-11), p. 575-586
    Abstract: Wealth disparities in child developmental outcomes are well documented in developed countries. We sought to (1) describe the extent of wealth‐based neurocognitive development disparities and (2) examine potential mediating factors of disparities among a population‐based cohort of children in rural N epal. Methods We investigated household wealth‐based differences in intellectual, executive and motor function of n  = 1692 children aged between 7 and 9 years in N epal. Using linear mixed models, wealth‐based differences were estimated before and after controlling for child and household demographic characteristics. We further examined wealth‐based differences adjusted for three sets of mediators: child nutritional status, home environment, and schooling pattern. Results We observed a positive gradient in child neurocognitive performance by household wealth. After adjusting for child and household control factors, disparities between children in the highest and lowest wealth quintiles persisted in intellectual and motor function, but not executive function. No statistically significant wealth‐based differentials in outcomes remained after accounting for nutritional status, home environment, and schooling patterns. The largest differences in neurocognitive development were associated with schooling pattern. Conclusions Household wealth patterns child neurocognitive development in rural N epal, likely through its influence on nutritional status, the home environment, and schooling. In the current context, improving early and regular schooling in this setting is critical to addressing wealth‐based disparities in outcomes.
    Type of Medium: Online Resource
    ISSN: 0269-5022 , 1365-3016
    URL: Issue
    URL: Article
    DOI: 10.1111/ppe.2013.27.issue-6
    DOI: 10.1111/ppe.12086
    Language: English
    Publisher: Wiley
    Publication Date: 2013
    detail.hit.zdb_id: 2008566-7
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  • 9
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    Acceptability of 11 fortified balanced energy‐protein supplements for pregnant women in Nepal
    Wiley ; 2022
    In:  Maternal & Child Nutrition Vol. 18, No. 3 ( 2022-07)
    Details
    In: Maternal & Child Nutrition, Wiley, Vol. 18, No. 3 ( 2022-07)
    Abstract: Understanding the acceptability of balanced energy protein supplements by pregnant women along with the potential facilitators and barriers to their use is vital to ensure regular consumption and compliance. Pregnant women in rural Nepal liked both the sweet and savoury products and suggested having the option to choose from more than one type of product would facilitate its daily consumption throughout pregnancy. Concerns regarding the cost of the supplements, strong aversion to smell/taste of certain supplements, and the inability to eat the supplement in private were some of the deterrents for possibly not being able to eat the supplement daily
    Type of Medium: Online Resource
    ISSN: 1740-8695 , 1740-8709
    URL: Issue
    URL: Article
    DOI: 10.1111/mcn.v18.3
    DOI: 10.1111/mcn.13336
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2140908-0
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  • 10
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    Compliance with and acceptability of two fortified balanced energy protein supplements among pregnant women in rural Nepal
    Wiley ; 2022
    In:  Maternal & Child Nutrition Vol. 18, No. 2 ( 2022-04)
    Details
    In: Maternal & Child Nutrition, Wiley, Vol. 18, No. 2 ( 2022-04)
    Abstract: Both the lipid‐based peanut paste and the vanilla biscuit were well accepted by pregnant women in rural Nepal during an 8‐week home feeding trial. The compliance measurements showed high overall compliance in both supplement groups with the reasons being the perceived health benefits to the mother and baby, favourable sensory properties, enabling environment at home for product consumption (privacy and family support) and ease of product use. Before an efficacy trial of a nutritional food supplement, it is important to conduct a mixed‐methods feeding trial in the study population to understand the contextual factors that enable and prevent the use of supplements to inform ways to improve compliance with the supplements.
    Type of Medium: Online Resource
    ISSN: 1740-8695 , 1740-8709
    URL: Issue
    URL: Article
    DOI: 10.1111/mcn.v18.2
    DOI: 10.1111/mcn.13306
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2140908-0
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