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Arun Kumar Koirala

Other affiliations: Kathmandu
Bio: Arun Kumar Koirala is an academic researcher from Pokhara University. The author has contributed to research in topics: Population & Reproductive health. The author has an hindex of 3, co-authored 6 publications receiving 38 citations. Previous affiliations of Arun Kumar Koirala include Kathmandu.

Papers
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Journal ArticleDOI
TL;DR: There were varied beliefs among the mothers about the types, causes and severity of diarrhea, classification of foods/fluids and beliefs and barriers about preventing or treating diarrhea, and several barriers regarding diarrhea prevention and/or management.
Abstract: In developing countries, mothers usually manage diarrhea at home with the pattern of management depending on perceived disease severity and beliefs. The study was carried out with the objective of determining mothers’ beliefs and barriers about diarrhea and its management. Qualitative methods involving two focus group discussions and eight in-depth interviews were used to collect the data. The study was conducted at the following places: Tankisinuwari, Kanchanbari and Pokhariya of Morang district, Nepal during the months of February and March 2010. Purposive sampling method was adopted to recruit twenty mothers based on the inclusion criteria. A semi-structured interview guide was used to conduct the interviews. Written informed consent was obtained from all of the participants before conducting the interviews. The interviews were moderated by the main researcher with the support of an expert observer from Nobel Medical College. The interviews were recorded with the permission of the participants and notes were written by a pre trained note-taker. The recordings were transcribed verbatim. All the transcribed data was categorized and analyzed using thematic content analysis. Twenty mothers participated in the interviews and most (80%) of them were not educated. About 75% of the mothers had a monthly income of up to 5000 Nepalese rupees (US$ 60.92). Although a majority of mothers believed diarrhea to be due to natural causes, there were also beliefs about supernatural origin of diarrhea. Thin watery diarrhea was considered as the most serious. There was diversity in mothers’ beliefs about foods/fluids and diarrhea management approaches. Similarly, several barriers were noted regarding diarrhea prevention and/or management such as financial weakness, lack of awareness, absence of education, distance from healthcare facilities and senior family members at home. The elderly compelled the mothers to visit traditional healers. There were varied beliefs among the mothers about the types, causes and severity of diarrhea, classification of foods/fluids and beliefs and barriers about preventing or treating diarrhea.

26 citations

Journal ArticleDOI
TL;DR: The proportion of low-birth-weight babies was high in hospital delivery, and ethnicities, Hindu religion, education, nonformal employment, food habit, rest during pregnancy, and type of delivery were found to influence the birth weight.
Abstract: Background Birth weight is an important indicator of a population's health and is associated with numerous interrelated factors in the infant, mother, and physical environment. The objective of this study was to assess the proportion of low birth weight and identify the associated factors for low birth weight in a liveborn infant among the women in Morang, Nepal. Methods A cross-sectional survey was carried out from December 2010 to March 2011 among 255 mothers who gave birth during the study period at the Koshi Zonal Hospital, Nepal. Data were collected using a structured questionnaire with face-to-face interviews. Data were analyzed through logistic regression and presented with crude and adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results The study showed that the prevalence of low-birth-weight babies was 23.1% (95% CI: 17.9-28.1). The mean (standard deviation) age of mothers was 23.23 (4.18) years. The proportion of low birth weight of previous baby was 3.9% (95% CI: 0.1-7.9), and 15.7% (95% CI: 11.5-20.5) of the respondents had preterm delivery. Nearly one-third (36.1%; 95% CI: 26.4-45.6) of the respondents had >2 years' gap after the previous delivery. Nonformal employment (AOR: 2.14; 95% CI: 0.523-8.74), vegetarian diet (AOR: 1.47; 95% CI: 0.23-9.36), and no rest during pregnancy (AOR: 1.38; 95% CI: 0.41-4.39) were factors more likely to determine low birth weight. However, none of the variables showed a significant association between low birth weight and other dependent variables. Conclusion Low birth weight is an important factor for perinatal morbidity and mortality and is a common problem in the developing world. The proportion of low-birth-weight babies was high in hospital delivery, and ethnicities, Hindu religion, education, nonformal employment, food habit, rest during pregnancy, and type of delivery were found to influence the birth weight. Hence, it is important to strengthen health education services at the basic level of a community to solve this problem.

9 citations

Journal ArticleDOI
TL;DR: Sexual and reproductive health of the adolescents is now growing concern for many developing countries due to increasing trend in sexual activities and unwanted pregnancies among the adolescents.
Abstract: Background: In Nepal, as in other Asian countries, the issue on sexuality still remains a taboo. Despite this, there are increasing numbers of sexual activities reported among Nepalese adolescents. Objective : To know the attitude towards premarital sex and unwanted pregnancy of adolescent students. Methods : Three higher secondary schools were randomly selected and students of those schools were taken purposively with structured self administered questionnaires. Cross-sectional study design was adopted and significance levels were observed with 95% confidence level (pd.0.05 for significant). Descriptive and inferential analyses were done with the sample size 324. Results: Among the total respondents, 32.4% mentioned premarital sex is appropriate and 25% had premarital sex. One third (33.3%) of the total respondents. peers were taking alcohol, 37.7% had smoking habit and 8.3% had drug dependency. Among the respondents having experience of premarital sex, 61.7% had the first sex at the age of mean ± SD 17.72 ± 0.849 years. Among the boys 32.6% and among the girls 13.7% had the premarital sexual intercourse. Majority of boys and girls had first sex with girl friend and boy friend respectively. Among the total respondents who had premarital sex, 16% faced the problem of unwanted pregnancy. Among them, 53.8% managed the unwanted pregnancy by surgical abortion procedure and remaining 46.2% managed by taking medicine (medical abortion). Conclusion: Sexual and reproductive health of the adolescents is now growing concern for many developing countries due to increasing trend in sexual activities and unwanted pregnancies among the adolescents. Health Renaissance, January-April 2013; Vol. 11 No.1; 145-149 DOI: http://dx.doi.org/10.3126/hren.v11i2.8222

9 citations

Journal ArticleDOI
TL;DR: There are disparities in survival among HIV-infected people in Nepal and evidence is offered of the benefits of enrolling early in care in general and ART in particular, and the survival payback of ART is proven.
Abstract: Introduction The advent of antiretroviral therapy (ART) has dramatically slowed down the progression of HIV. This study assesses the disparities in survival, life expectancy and determinants of survival among HIV-infected people receiving ART. Methods Using data from one of Nepal’s largest population-based retrospective cohort studies (in Kathmandu, Nepal), we followed a total of 3191 HIV-infected people aged 15 years and older who received ART over the period of 2004–2015. We created abridged life tables with age-specific survival rates and life expectancy, stratified by sex, ethnicity, CD4 cell counts and the WHO-classified clinical stage at initiation of ART. Results HIV-infected people who initiated ART with a CD4 cell count of >200 cells/cm3 at 15 years had 27.4 (22.3 to 32.6) years of additional life. People at WHO-classified clinical stage I and 15 years of age who initiated ART had 23.1 (16.6 to 29.7) years of additional life. Life expectancy increased alongside the CD4 cell count and decreased as clinical stages progressed upward. The study cohort contributed 8484.8 person years, with an overall survival rate of 3.3 per 100 person years (95% CI 3.0 to 3.7). Conclusions There are disparities in survival among HIV-infected people in Nepal. The survival payback of ART is proven; however, late diagnosis or the health system as a whole will affect the control and treatment of the illness. This study offers evidence of the benefits of enrolling early in care in general and ART in particular.

6 citations

Journal ArticleDOI
12 May 2020
TL;DR: Older age, business as occupation, consumption of fast foods for three or more times per week, low or moderate physical activity level, energy intake above the RDA and multiparty had higher odds of being overweight/obesity, while fruits and vegetables consumption were found to be protective against overweight/Obesity.
Abstract: Introduction: Overweight and obesity are associated with numerous comorbidities so they are of great public health concern In Nepal, the proportion of overweight and obese women of reproductive age has been gradually increasing which marks obesity as a serious public health challenge The study aimed to assess the factors associated with overweight and obesity among reproductive aged women residing in Pokhara metropolitan Methods: A cross-sectional study was conducted among 278 married women of reproductive age at Pokhara metropolitan, Kaski district, Nepal using probability proportional to size sampling method Face to face interview was conducted among respondents through pretested questionnaire Similarly, height and weight were also measured Based on anthropometric measurements, Body Mass Index was computed and defined according to the World Health Organization criteria The association between overweight /obesity and the explanatory variables were assessed in bivariate analysis using the Chi-square test and the association was further explored by using multivariate logistic regression Results: The prevalence of overweight and obesity was 496%; with 337% of overweight and 159 % of obesity Factors associated with overweight/obesity were age (AOR= 1385, 95% CI: 577-4080), business as occupation (AOR=739, 95%CI: 225-1417), fast food consumption of three or more times a week (AOR=342, 95%CI: 101-1163), energy intake above the RDA (AOR=545; 95%CI: 219-1355), low or moderate physical activity level (AOR=284; 95%CI: 118-683) and multiparity (AOR=1780; 95%CI: 404-8906) Conclusions: The study provides evidence that the prevalence of overweight, obesity is remarkably high in married women of reproductive age in Pokhara metropolitan The study concluded older age, business as occupation, consumption of fast foods for three or more times per week, low or moderate physical activity level, energy intake above the RDA and multiparty had higher odds of being overweight/obesity On the other hand fruits and vegetables consumption were found to be protective against overweight/obesity

1 citations


Cited by
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Journal ArticleDOI
TL;DR: Interventions aimed at reducing the prevalence of diarrhea should take into consideration the integration of family planning activities in the prevention of childhood diarrhea and the deployed of health personals to educate the community to adopt a hygienic behavior.
Abstract: Introduction: Diarrhea remains the second leading cause of death among children under five years globally. Nearly one in five child deaths, about 1.5 million each year, are due to diarrhea. It kill ...

56 citations

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TL;DR: Available evidence suggests that harmful practices in diarrhea treatment are common in some countries with a high burden of diarrhea-related mortality and the need to document harmful practices using standard methods of measurement and reporting for the continued reduction of diarrhea mortality is highlighted.
Abstract: Harmful practices in the management of childhood diarrhea are associated with negative health outcomes, and conflict with WHO treatment guidelines. These practices include restriction of fluids, breast milk and/or food intake during diarrhea episodes, and incorrect use of modern medicines. We conducted a systematic review of English-language literature published since 1990 to assess the documented prevalence of these four harmful practices, and beliefs, motivations, and contextual factors associated with harmful practices in low- and middle-income countries.

42 citations

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TL;DR: It was found that Dalit caste/ethnicity, illiteracy, manual labor, a female baby, and having more than four family members were significantly positively associated with LBW, and the MATRI-SUMAN intervention and availability of a kitchen garden at home, were found to reduce the risk of LBW.
Abstract: Low birth weight (LBW) remains a major public health problem in developing countries, including Nepal. This study was undertaken to examine the association between LBW and maternal factors and antenatal care service utilization, in rural Nepal, using data obtained for a capacity-building and text-messaging intervention, designed to enhance maternal and child health service utilization among pregnant women, in rural Nepal (“MATRI-SUMAN”). The study used a clustered randomized controlled design and was conducted during 2015–2016. We investigated maternal and antenatal care service utilization determinants of LBW, using a logistic regression model. Of the four hundred and two singleton babies, included in the present study, seventy-eight (19.4%) had an LBW (mean (SD), 2210.64 (212.47)) grams. It was found that Dalit caste/ethnicity, illiteracy, manual labor, a female baby, and having more than four family members were significantly positively associated with LBW. In addition, mothers who did not visit an antenatal care (ANC) unit, visited an ANC < 4 times, did not take iron and folic acid (IFA), de-worming tablets, and mothers that did not consume additional food, during pregnancy, were more likely to have an LBW baby, than their counterparts. The MATRI-SUMAN intervention and availability of a kitchen garden at home, were found to reduce the risk of LBW. Nepalese child survival policies and programs should pay attention to these maternal and antenatal care service utilization factors, while designating preventive strategies to improve child health outcomes.

39 citations

Journal ArticleDOI
TL;DR: Age, gender, hand-washing behaviour, nutritional status of children, education of mothers, water and sanitation, healthcare services, cultural and societal values and income of the household were identified determinants for diarrhoea in under-five children of Nepal.
Abstract: While diarrhoea is the second major killer among the under-five children in the world with an estimation of 760,000 deaths annually, it stands as a major killer in Nepal with an annual incidence of 500 per 1000 under-five children with diarrhoea. Diarrhoea is responsible for a wide range of morbidity and mortality among children in Nepal. The objective of this review work is to identify the eco-social and behavioural determinants of diarrhoea among the under-five children of Nepal. A literature review was conducted using the Dahlgren and Whitehead model (1991) between June and October 2015. PubMed, Nepal Journals online and Google Scholar were used to search for literature published between 1989 and July 2015 using defined keywords. Children of age group 6–23 months are at higher risk, as supplementary diets are introduced to the children from the age of 6 months. Male children have better access to healthcare services. Malnourished children also have a higher chance of developing persistent diarrhoea. Provision of safe water and sanitation has direct link with the prevention and control of diarrhoea. Male gender with high income positively influences the treatment-seeking behaviour. Mother’s education and hand-washing practice have direct influence in child health. Hand-washing practices with soap which are protective are influenced by the cultural beliefs. Involvement of community health volunteers increases the access to the health system, thereby reducing the diarrhoeal burden in the community. Age, gender, hand-washing behaviour, nutritional status of children, education of mothers, water and sanitation, healthcare services, cultural and societal values and income of the household were identified determinants for diarrhoea in under-five children of Nepal.

34 citations

Journal ArticleDOI
TL;DR: The finding of this study showed that the attitude and practice of mothers were unsatisfactory about the prevention and home-based management of under-five diarrheal diseases.
Abstract: Diarrhea remains the 2nd leading cause of death among children under 5 globally. It kills more young children than AIDS. It would have been prevented by simple home management using oral rehydration therapy. Mothers play a central role in its management and prevention. So, the main objective of this study was to assess mothers’ knowledge, attitude & practice in prevention & home-based management of diarrheal disease among under-five children in Dire Dawa, Eastern Ethiopia. Institutional based cross-sectional study was conducted from March 15–April 14, 2016, in Diredawa among 295 Mothers who had under-five child with diarrhea in the last 2 weeks using simple random sampling method. Mothers were interviewed face to face by using pretested, standard and structured questionnaire. The data quality was assured by translation, retranslation and pretesting the questionnaire. Data were checked for completeness, consistency and then entered into Epi Info v3.1 and analyzed using SPSS v20. The descriptive statistical analysis was used to compute frequency, percentages, and mean of the findings of this study. The results were presented using tables, charts, and graphs. In this study, 295 participants were included with 100% response rate. From total 295 mothers, around two-thirds (65.2%) of them had good knowledge, but more than half of mothers (54.9%) had a negative attitude towards home-based management and prevention of diarrhea among under-five children. Regarding the attitude of the mothers, 58% had poor practice towards home-based management and prevention of diarrhea among under-five children. The finding of this study showed that the attitude and practice of mothers were unsatisfactory about the prevention and home-based management of under-five diarrheal diseases. Therefore, Health education, dissemination of information, and community conversation should plan and implement to create a positive attitude and practice towards the better prevention and management of under 5 diarrheal diseases.

34 citations