Sailesh Bhattarai

A study of prevalence of intestinal parasites and associated risk factors among the school children of Itahari, Eastern Region of Nepal

Introduction: Intestinal parasitic infestation is a major public health problem in children of developing countries Because of poor socio-economic conditions and lack of good hygienic living. The aims of this study were to measure the prevalence of intestinal parasitic infestations and to identify risk factors associated with parasitic infestations among the school children of Itahari Municipality. Materials and Methods: The cross-sectional study was conducted in Grade VI, VII and VIII in Government and private schools of Itahari Municipality. Stratified random sampling method was applied to choose the schools and the study subjects. Semi-structured questionnaire was administered to the study subjects and microscopic examination of stool was done. The Chi-square test was used to measure the association of risk factors and parasitic infestation. Results: Overall intestinal parasitic infestation was found to be 31.5%. Around 13% of the study population was found to be infested with helminthes and 18.5% of the study population was protozoa infected. Not using soap after defecation, not wearing sandals, habit of nail biting and thumb sucking were found to be significantly associated with parasitic infection. Conclusions: The prevalence of intestinal parasitic infestation was found to be high in school children of Itahari. Poor sanitary condition, lack of clean drinking water supply and education is supposed to play an important role in establishing intestinal parasitic infections.

Violence, HIV risk behaviour and depression among female sex workers of eastern Nepal.

Objectives The primary objective of the study was to estimate the prevalence of depression among female sex workers (FSWs) of eastern Nepal. The secondary objective was to search for an association between depression, violence and HIV risk behaviour. Design Cross-sectional/observational study. Study setting This study was carried out in five cities of eastern Nepal (Dharan, Itahari, Biratnagar, Damak and Birtamode). Both restaurant-based and street-based FSWs were recruited in the study. Participants Women who had been involved in commercial sex activity in the past 6 months and gave informed consent were included in the study. Primary outcome measure A score of more than or equal to 16 on the Centre for Epidemiological Studies Depression (CESD) scale was considered as depression. Methodology Face-to-face interviews were conducted with respondents who were sought through a snowball sampling technique. Information regarding their depression status, HIV high-risk behaviour and violence was recorded. The estimated sample size was 210. Results We interviewed 210 FSWs (both restaurant-based and street-based). The prevalence of depression among respondents was 82.4%. FSWs who had experienced violence were five times more likely to be depressed than those who were not victims of violence. The odds of depression were six times higher among respondents who were involved in any HIV risk behaviour compared with those who were not involved. Conclusions The present study reports a high prevalence of depression, HIV risk behaviours and violence among FSWs of eastern Nepal. The mental health of FSWs should also be regarded as an important aspect of HIV prevention efforts which can help to promote the overall health of this population.

Factors Affecting IUCD Discontinuation in Nepal: A Nested Case-Control Study

Information related to contraception discontinuation, especially in the context of Nepal is very limited. A nested case-control study was carried out to determine the factors affecting discontinuation of intrauterine contraceptive devices (IUCDs). A total of 115 cases (IUCD discontinuers) and 115 controls (IUCD continuers) were randomly selected based on the data obtained from the user’s record of a family planning center in Kathmandu. Matching criteria were age during insertion and date of insertion of IUCD. Logistic regression was used to analyze the data. When cases were compared with controls, the results showed that place of residence, sex of last child, reproductive intention, experience of side effects, and follow-up practice were associated with discontinuation of the IUCD. Experience of side effects has been seen as the major reason for discontinuation. The results suggest that side effects after IUCD insertion should be properly discussed and promptly treated to reduce the discontinuation rate.