2024
Multilevel determinants of antiretroviral therapy initiation and retention in the test-and-treat era of Nepal: a qualitative study
Shrestha A, Poudel L, Shrestha S, Jha N, Kuikel B, Shakya P, Kunwar R, Pandey L, KC M, Wilson E, Deuba K. Multilevel determinants of antiretroviral therapy initiation and retention in the test-and-treat era of Nepal: a qualitative study. BMC Health Services Research 2024, 24: 927. PMID: 39138448, PMCID: PMC11323673, DOI: 10.1186/s12913-024-11311-6.Peer-Reviewed Original ResearchConceptsAntiretroviral therapy initiationHealthcare providersDenial of HIV statusPerspectives of healthcare providersAntiretroviral therapyCommunity health workersStrengthening healthcare systemsART initiationHealth system levelLong-term health outcomesHealthcare system levelAntiretroviral therapy clientsChanging public health policyFear of disclosureIndividual-level facilitatorsSocio-ecological modelImplementing antiretroviral therapyAvailability of medicationsPublic health policiesAntiretroviral therapy adherencePerceived health benefitsFear of deathClient tracking systemProvision of free treatmentHealth workersCyberbullying and cyber-victimisation among higher secondary school adolescents in an urban city of Nepal: a cross-sectional study
Kunwar S, Sharma S, Marasini S, Joshi A, Adhikari A, Ranjit A, Shrestha I, Shrestha A, Shrestha A, Karmacharya B. Cyberbullying and cyber-victimisation among higher secondary school adolescents in an urban city of Nepal: a cross-sectional study. BMJ Open 2024, 14: e081016. PMID: 38448066, PMCID: PMC10916119, DOI: 10.1136/bmjopen-2023-081016.Peer-Reviewed Original ResearchConceptsPokhara Metropolitan CityMultivariate logistic regression analysisCyber-victimisationSchool adolescentsPrevalence of cyberbullyingLogistic regression analysisCross-sectional studyHealth-related consequencesSecondary school adolescentsPost meanFactors associated with cyberbullyingHigh school adolescentsPeriodic screeningCounseling servicesEducation programmesHurtful commentsOnline Aggression SurveyPrevalenceConsequences of cyberbullyingCity of NepalAssociated with cyberbullyingMetropolitan citiesAnti-bullying policiesRegression analysisExploring knowledge, perceptions, and practices of antimicrobials, and their resistance among medicine dispensers and community members in Kavrepalanchok District of Nepal
Marasini S, Sharma S, Joshi A, Kunwar S, Mahato R, Shrestha A, Karmacharya B. Exploring knowledge, perceptions, and practices of antimicrobials, and their resistance among medicine dispensers and community members in Kavrepalanchok District of Nepal. PLOS ONE 2024, 19: e0297282. PMID: 38241275, PMCID: PMC10798439, DOI: 10.1371/journal.pone.0297282.Peer-Reviewed Original ResearchConceptsFocus group discussionsIn-depth interviewsMedicine dispensingCommunity membersGroup discussionsSelf-medicationGlobal public health issuePublic health issueOver-the-counter salesInappropriate use of antimicrobialsThematic analysisDispensing practicesHealth issuesOver-the-counterInductive approachInappropriate useWeak enforcement of policiesDrug useUrban municipalitiesEducational backgroundAntimicrobial resistanceDispensingConsumers express concernsIn-depthPharmacy
2023
Facilitators and barriers to hypertension management in urban Nepal: findings from a qualitative study
Bhattarai S, Bajracharya S, Shrestha A, Skovlund E, Åsvold B, Mjolstad B, Sen A. Facilitators and barriers to hypertension management in urban Nepal: findings from a qualitative study. Open Heart 2023, 10: e002394. PMID: 37899127, PMCID: PMC10618998, DOI: 10.1136/openhrt-2023-002394.Peer-Reviewed Original ResearchConceptsPrimary healthcare providersHypertension servicesHypertension managementHealthcare providersHypertension patientsHome visitsSocioecological modelCommunity-level barriersUrban NepalFocus group discussionsTreatment measuresControl of hypertensionGender normsHigh blood pressureCommunity health workersMunicipal officialsAspects of careFamily membersDepth interviewsQualitative methodologyPrimary healthcare systemCommunity trustLow-resource countriesQualitative studyAntihypertensive medicationsSolyx Minisling Surgery for Stress Urinary Incontinence: Dhulikhel Hospital Initiative.
Shrestha A, Hagemeier T. Solyx Minisling Surgery for Stress Urinary Incontinence: Dhulikhel Hospital Initiative. Kathmandu University Medical Journal 2023, 21: 227-229. PMID: 38628019.Peer-Reviewed Original ResearchConceptsStress urinary incontinenceLeakage of urineUrinary incontinenceTreat stress urinary incontinenceInvoluntary leakage of urineSingle-incision proceduresWeeks of surgeryMinimally invasive procedureMini slingSling surgeryVaginal incisionMini-slingInvoluntary leakageSolyxInvasive proceduresSurgeryEffective treatmentSlingAdult womenIncisionSuccess rateHospital InitiativeMedical conditionsIncontinenceWomen
2022
Analyzing the Implementation of Policies and Guidelines for the Prevention and Management of Type 2 Diabetes at Primary Health Care Level in Nepal
Shrestha R, Yadav UN, Shrestha A, Paudel G, Makaju D, Poudel P, Iwashita H, Harada Y, Shrestha A, Karmacharya B, Koju R, Sugishita T, Rawal L. Analyzing the Implementation of Policies and Guidelines for the Prevention and Management of Type 2 Diabetes at Primary Health Care Level in Nepal. Frontiers In Public Health 2022, 10: 763784. PMID: 35223722, PMCID: PMC8864089, DOI: 10.3389/fpubh.2022.763784.Peer-Reviewed Original ResearchConceptsPrimary health care levelHealth care levelNon-communicable diseasesHealth care providersCare levelDiabetes preventionCare providersPhase IManagement of NCDsDiabetes care servicesType 2 diabetesPeripheral health servicesProblem of diabetesKey search termsKey informant interviewsDiabetes carePeripheral levelsRelevant grey literatureType 2Care servicesDiabetesHealth servicesPremature deathPreventionQualitative exploratory study
2021
Diabetes Prevention Education Program in a population with pre-diabetes in Nepal: a study protocol of a cluster randomised controlled trial (DiPEP)
Shakya P, Shrestha A, Karmacharya BM, Shrestha A, Kulseng BE, Skovlund E, Sen A. Diabetes Prevention Education Program in a population with pre-diabetes in Nepal: a study protocol of a cluster randomised controlled trial (DiPEP). BMJ Open 2021, 11: e047067. PMID: 34819277, PMCID: PMC8614149, DOI: 10.1136/bmjopen-2020-047067.Peer-Reviewed Original ResearchConceptsDiabetes prevention education programIntervention armPrevention education programControl armRandom blood sugar valuesIndian Diabetes Risk ScoreNepal Health Research CouncilLifestyle intervention programDiabetes Risk ScoreBlood sugar valuesInstitutional Review CommitteeHealth Research CouncilKathmandu University SchoolWorkers/volunteersHealth Research EthicsDiabetes burdenStudy protocolHealthcare workersTwo-armHigh-income countriesOutcome measuresPhysical activityRisk scoreHealth literacyQualitative studyHealth system gaps in cardiovascular disease prevention and management in Nepal
Shrestha A, Maharjan R, Karmacharya BM, Bajracharya S, Jha N, Shrestha S, Aryal A, Baral PP, Bhatt RD, Bhattarai S, Bista D, Citrin D, Dhimal M, Fitzpatrick AL, Jha AK, Karmacharya RM, Mali S, Neupane T, Oli N, Pandit R, Parajuli SB, Pradhan PMS, Prajapati D, Pyakurel M, Pyakurel P, Rai BK, Sapkota BP, Sapkota S, Shrestha A, Shrestha AP, Shrestha R, Sharma GN, Sharma S, Spiegelman D, Suwal PS, Thapa B, Vaidya A, Xu D, Yan LL, Koju R. Health system gaps in cardiovascular disease prevention and management in Nepal. BMC Health Services Research 2021, 21: 655. PMID: 34225714, PMCID: PMC8258928, DOI: 10.1186/s12913-021-06681-0.Peer-Reviewed Original ResearchConceptsHealth systemCardiovascular disease preventionCause of deathHealth system gapsQuality of careResource-limited settingsNational health policyHealth system performanceBackgroundCardiovascular diseaseCVD preventionCVD careCVD servicesHealth outcomesDisease preventionHealth policyHealth insuranceHealth spendingCarePreventionKey informant interviewsTask ForceSystem gapsInformant interviewsService deliverySafetyFactors associated with low back pain among construction workers in Nepal: A cross-sectional study
Adhikari B, Ghimire A, Jha N, Karkee R, Shrestha A, Dhakal R, Niraula A, Majhi S, Pandit AK, Bhandari N. Factors associated with low back pain among construction workers in Nepal: A cross-sectional study. PLOS ONE 2021, 16: e0252564. PMID: 34061897, PMCID: PMC8168885, DOI: 10.1371/journal.pone.0252564.Peer-Reviewed Original ResearchConceptsLow back painCross-sectional studyBack painFactors of LBPCommunity-based cross-sectional studyPrevalence of LBPOne-year prevalenceConfidence intervalsHealthcare servicesPublic health professionalsConstruction workersEligible participantsCommon causeHigher oddsSleep qualityHealth promotionHealth professionalsSemi-structured questionnaireLogistic regressionPrevalencePainFace interviewsR programming softwareKavre districtPreventive techniquesKnowledge, attitude, preventive practices and utilization of cervical cancer screening among women in Nepal: a community-based cross-sectional study
Shrestha AD, Gyawali B, Shrestha A, Shrestha S, Neupane D, Ghimire S, Campbell C, Kallestrup P. Knowledge, attitude, preventive practices and utilization of cervical cancer screening among women in Nepal: a community-based cross-sectional study. European Journal Of Cancer Prevention 2021, 31: 73-81. PMID: 34871200, DOI: 10.1097/cej.0000000000000670.Peer-Reviewed Original ResearchConceptsCervical cancer screeningCervical cancerPreventive practicesCancer screeningCommunity-based cross-sectional studyCommunity-based cross-sectional surveyCommunity-based educational interventionGlobal public health concernAvailability of screeningUtilization of screeningCross-sectional studyMedian knowledge scoreYears of agePublic health concernCross-sectional surveySystematic random samplingMean ageCancer deathMedian attitude scoreWomen 30Home visitsPractice scoresTreatment servicesKnowledge scoreCancerPatient satisfaction and its socio-demographic correlates in a tertiary public hospital in Nepal: a cross-sectional study
Adhikari M, Paudel NR, Mishra SR, Shrestha A, Upadhyaya DP. Patient satisfaction and its socio-demographic correlates in a tertiary public hospital in Nepal: a cross-sectional study. BMC Health Services Research 2021, 21: 135. PMID: 33579283, PMCID: PMC7881603, DOI: 10.1186/s12913-021-06155-3.Peer-Reviewed Original ResearchConceptsPatient satisfactionCross-sectional studyTertiary public hospitalSocio-demographic characteristicsPublic hospitalsLow health literacyPatient Satisfaction Questionnaire IIISystematic random sampling methodLow-income settingsSocio-demographic correlatesGeneral satisfactionHealth care qualityOutpatient departmentBackgroundPatient satisfactionSectional studyHealth facilitiesHealth literacyPatientsSociodemographic factorsProportion of satisfactionLogistic regressionCare qualityHospitalSociodemographic variablesPercentage of satisfactionNational Needs Assessment of Health Information System to Address Cardiovascular Diseases in Nepal: A Mixed Method Study.
Shrestha A, Parajuli S, Aryal A, Shrestha A, Maharjan R, Jha N, Bajracharya S, Shrestha S, Neupane T, Poudel U, Karmacharya B, Koju R, Dhimal M. National Needs Assessment of Health Information System to Address Cardiovascular Diseases in Nepal: A Mixed Method Study. Kathmandu University Medical Journal 2021, 19: 58-67. PMID: 35526137.Peer-Reviewed Original ResearchConceptsHealth financingOut-of-pocketCardiovascular diseaseRising burden of cardiovascular diseasesHealth system building blocksIntegrated health care servicesAssessment of Health Information SystemsNepal Health Research CouncilBurden of cardiovascular diseaseTotal health care expendituresHealth care servicesFiscal year 2015/16Health system financingHealth information systemsMixed methods studyNational needs assessmentHealth Research CouncilSystem building blocksProvider payment mechanismsKey informant interviewsBurden of diseaseHealth care expendituresHigher out-of-pocketsHealth Insurance BoardHealth Insurance ProgramMedical Products for Cardiovascular Disease Management in Nepal: a needs assessment study.
Sapkota S, Shrestha S, Bista D, Shrestha A, Maharjan R, Bajracharya S, Jha N, Koju R, Shrestha R. Medical Products for Cardiovascular Disease Management in Nepal: a needs assessment study. Kathmandu University Medical Journal 2021, 19: 18-29. PMID: 35526133.Peer-Reviewed Original ResearchConceptsCardiovascular disease managementDisease managementHealth systemHealth System Assessment ApproachMedicines regulationMedical productsDesk review of documentsNepal’s health systemNational level guidelinesLack of effective implementationCardiovascular diseaseNeeds assessment studyHealth facilitiesHow-to manualReview of documentsInformant interviewsDesk reviewMarket surveillanceQuality medicinesProvisionEffective implementationNational FormularyPharmaceutical expenditureTopic areasHealth
2020
Worksite intervention study to prevent diabetes in Nepal: a randomised trial protocol
Pyakurel P, Shrestha A, Karmacharya BM, Budhathoki SS, Chaudhari RK, Tamrakar D, Shrestha A, Karmacharya RM, Shrestha A, Sharma S, Sharma SK, Spiegelman D. Worksite intervention study to prevent diabetes in Nepal: a randomised trial protocol. Open Heart 2020, 7: e001236. PMID: 32847993, PMCID: PMC7451278, DOI: 10.1136/openhrt-2019-001236.Peer-Reviewed Original ResearchMeSH KeywordsAdultBiomarkersBlood GlucoseDiabetes MellitusGlycated HemoglobinHealth BehaviorHealth Knowledge, Attitudes, PracticeHealthy LifestyleHumansMaleMiddle AgedMulticenter Studies as TopicNepalOccupational Health ServicesPatient Education as TopicPrediabetic StatePrimary PreventionRandomized Controlled Trials as TopicRisk Reduction BehaviorTime FactorsTreatment OutcomeConceptsBehavioral interventionsControl periodDiabetes risk reductionMonth control periodNepal Health Research CouncilBehavioral intervention groupWorksite intervention studiesT-testHealth Research CouncilInstitutional review boardTwo-sample t-testBlood sugarTrial protocolIntervention groupEthical approvalControl groupIntervention studiesType 2More monthsReview boardInterventionDiabetesParticipant changesPublic healthRisk reductionPilot Educational Intervention to Promote Safe Pesticide Use Practices Among Farmworkers in Nepal
Koju P, Shakya PR, Shrestha A, Karmacharya BM, Shrestha S, Jaacks LM. Pilot Educational Intervention to Promote Safe Pesticide Use Practices Among Farmworkers in Nepal. Annals Of Work Exposures And Health 2020, 64: 866-875. PMID: 32491155, DOI: 10.1093/annweh/wxaa054.Peer-Reviewed Original ResearchConceptsPilot educational interventionEducational interventionSimple educational interventionMultivariable logistic regressionPersonal hygiene practicesCross-sectional convenience samplePersonal protective equipmentHealth outcomesBaseline samplesLogistic regressionHygiene practicesProtective equipmentConvenience samplePesticide exposure levelsExposure levelsPesticide exposureInterventionBehavioral factorsSuch interventionsPesticide handling practicesBaselineKavre districtFarmworkersSocioeconomic characteristicsKey messagesNUrse-led COntinuum of care for people with Diabetes and prediabetes (NUCOD) in Nepal: study protocol for a cluster randomized controlled trial
Xu D, Dev R, Shrestha A, Zhang L, Shrestha A, Shakya P, Hughes JP, Shakya PR, Li J, Liao J, Karmacharya BM. NUrse-led COntinuum of care for people with Diabetes and prediabetes (NUCOD) in Nepal: study protocol for a cluster randomized controlled trial. Trials 2020, 21: 442. PMID: 32471476, PMCID: PMC7257188, DOI: 10.1186/s13063-020-04372-5.Peer-Reviewed Original ResearchMeSH KeywordsCluster AnalysisContinuity of Patient CareCost-Benefit AnalysisDiabetes Mellitus, Type 2Glycated HemoglobinHumansMulticenter Studies as TopicNepalNurse's RoleNursing ServicesOutcome and Process Assessment, Health CarePatient Education as TopicPrediabetic StateProgram EvaluationRandomized Controlled Trials as TopicRisk FactorsRisk Reduction BehaviorConceptsUsual treatment groupPrimary care centersType 2 diabetesManagement of diabetesRE-AIM frameworkImplementation outcomesContinuum of careUnit of randomizationLow-income settingsPrediabetes individualsTreat basisDiabetes nursesDiabetes preventionPrimary outcomeClinical outcomesHemoglobin levelsDiabetes individualsDiabetes programParallel groupStudy protocolCare centerIntervention groupTwo-armCare modelCare approachProbable Exit Strategy Against COVID-19 of Low Resource Country like Nepal: Open Floor Discussion
Rajbhandari B, Gurung M, Poudel L, Shrestha A, Karmacharya BM. Probable Exit Strategy Against COVID-19 of Low Resource Country like Nepal: Open Floor Discussion. Journal Of Nepal Medical Association 2020, 58: 286-292. PMID: 32417872, PMCID: PMC7580467, DOI: 10.31729/jnma.4974.Peer-Reviewed Original ResearchDrivers of healthy eating in a workplace in Nepal: a qualitative study
Tamrakar D, Shrestha A, Rai A, Karmacharya BM, Malik V, Mattei J, Spiegelman D. Drivers of healthy eating in a workplace in Nepal: a qualitative study. BMJ Open 2020, 10: e031404. PMID: 32102804, PMCID: PMC7045197, DOI: 10.1136/bmjopen-2019-031404.Peer-Reviewed Original ResearchConceptsHealthy eatingHealth personnelDhulikhel Hospital-Kathmandu University HospitalHealthy foodsHospital administratorsHealthy food optionsAffordable healthy foodsFocus group discussionsUniversity HospitalHospital settingQualitative studyCapital KathmanduIndividual food preferencesHospital sitesHealth awarenessHealthy optionsHospital administrationHour shiftsEatingFood optionsGroup discussionsCafeteria operatorsLevel of educationOffice hoursThematic analysis methodAn integrated intervention for chronic care management in rural Nepal: protocol of a type 2 hybrid effectiveness-implementation study
Schwarz D, Dhungana S, Kumar A, Acharya B, Agrawal P, Aryal A, Baum A, Choudhury N, Citrin D, Dangal B, Dhimal M, Gauchan B, Gupta T, Halliday S, Karmacharya B, Kishore S, Koirala B, Kshatriya U, Levine E, Maru S, Rimal P, Sapkota S, Schwarz R, Shrestha A, Thapa A, Maru D. An integrated intervention for chronic care management in rural Nepal: protocol of a type 2 hybrid effectiveness-implementation study. Trials 2020, 21: 119. PMID: 31996250, PMCID: PMC6990567, DOI: 10.1186/s13063-020-4063-3.Peer-Reviewed Original ResearchMeSH KeywordsAlcohol DrinkingAllied Health PersonnelChronic DiseaseCommunity Health WorkersDecision Support Systems, ClinicalDisease ManagementHumansImplementation ScienceMedication AdherenceMotivational InterviewingNepalNoncommunicable DiseasesRisk Reduction BehaviorRural PopulationTobacco Use CessationConceptsHybrid effectiveness-implementation studyEffectiveness-implementation studyChronic care managementMid-level practitionersCare management interventionCommunity health workersCare managementMiddle-income countriesHealth workersChronic care management programWorld Health Organization PackageRisk factor optimizationClinical decision support toolEvidence-based careCare management programPrimary care systemRural NepalTobacco consumption levelsEvidence-based componentsMultiple comorbiditiesSecondary outcomesUniversal health coveragePrimary outcomeMedication adherencePre-post designEstimated cost for cardiovascular disease risk-based management at a primary healthcare center in Nepal
Aryal A, Citrin D, Halliday S, Kumar A, Nepal P, Shrestha A, Nugent R, Schwarz D. Estimated cost for cardiovascular disease risk-based management at a primary healthcare center in Nepal. Global Health Research And Policy 2020, 5: 2. PMID: 32016159, PMCID: PMC6988194, DOI: 10.1186/s41256-020-0130-2.Peer-Reviewed Original ResearchConceptsPrimary healthcare centersNon-communicable diseasesHealthcare centersCardiovascular diseasePrimary preventionCatchment populationPrimary CVD preventionBurden of disabilityDirect medical costsAnnual incremental costCost of screeningMiddle-income country settingsGlobal Hearts InitiativeIncremental work loadEligible patientsCVD preventionMiddle-income countriesTreatment protocolHearts InitiativeMedical costsOne-year time horizonAmount of medicineHealthcare providersLaboratory testsPhysician workload