Introduction Oral cancer is common cancer in many low‐ and middle‐income countries (LMICs) with a low five‐year survival rate. It is among the four most common types of cancer in South East Asia region. In South‐Central Asia, lip and oral cavity cancer is the second most common cancer according to the specific cancer types. Methods This scoping review intended to investigate published studies on the current prevalence and incidence of oral cancer in LMICs. The review was conducted applying the search words “Oral Cancer” and “Mouth neoplasm” as the Medical Subject Heading (MeSH) major topic and “Epidemiology” and (“prevalence” OR “incidence”) as the MeSH subheading; the search was supplemented by cross‐references. Included studies met the following criteria: original studies, reporting of prevalence or incidence rates, population‐based studies, studies in English language and studies involving humans. Results The sample sizes ranged from 486 to 101,761 with 213,572 persons included. Buccal mucosa is one of the most common sites of oral cancer, associated with the widespread exposure to chewing tobacco. The incidence is likely to rise in the region where gutkha, pan masala, pan–tobacco and various other forms of chewing tobacco are popular. Conclusion This review contributes to useful information on prevalence and incidence estimates of oral cancer in LMICs.

Hypertension is a rising global burden, and low- and middle-income countries account for 80% of deaths due to complications of hypertension. Hypertension can be controlled by adhering to anti-hypertensive medication. However, non-adherence is an increasing challenge. This review aims to systematically evaluate non-adherence to anti-hypertensive medication among adults in low- and middle-income countries and explore factors affecting non-adherence to anti-hypertensive medication. We performed a systematic search for studies published between 1 January 2000 and 31 August 2015. A selection process was performed for data extraction with a combination of Medical Subject Headings terms: 'hypertension' and 'adherence'. Further search criteria were: language ('english'), species ('humans'), and low- and middle-income countries. A total of 22 studies met the inclusion criteria. The pooled percentage of non-adherence when using the eight-item Morisky Medication Adherence Scale (MMAS) was 63.35% (confidence of interval (CI): 38.78-87.91) and 25.45% (CI:17.23-33.76) when using the 80 and 90% cut-off scales. The factors were classified into the five dimensions of adherence defined by the World Health Organization, and the majority of the studies reported factors from the dimension 'social and economic factors'. This systematic review demonstrated considerable variation of non-adherence to anti-hypertensive medication in low- and middle-income countries depending on the methods used to estimate non-adherence. The results showed a high non-adherence when the MMAS eight-item scale was used and low when the 80 and 90% cut-off scales were used. The majority of factors affecting non-adherence to anti-hypertensive medication fell within the World Health Organization defined dimension 'social and economic factors'.

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Introduction: Diabetes among tuberculosis patients is a growing concern. The prevalence of diabetes among tuberculosis patients in Nepal is not known. The objective of this study was to determine the prevalence of diabetes among tuberculosis patients and to identify the associated risk factors.Methodology: A descriptive, cross-sectional study was conducted in Kathmandu valley of Nepal. Face to face interviews using structured questionnaire were conducted to collect socio-demographic and behavioral risk factors. A random blood sugar test was carried out using glucometer. Measurements on height, weight and waist circumference were taken to obtain the anthropometric information.Results: Out of 407 tuberculosis patients recruited in the study, 37 (9.1%) were found to have diabetes. Among them 28 (6.9%) were self reported cases of diabetes while 9 (2.2%) were found with random blood sugar level >200mg/dl. Tuberculosis patients aged 50 years and above (OR 7.5; 95% CI 2.72-20.66), ever tobacco users (OR 3.5; 95% CI 1.19-10.74), high income status (OR 5.2; 95% CI 1.59-17.26) and self history of high blood pressure (OR 20.0; 95% CI 5.07-79.50) were found significantly associated with diabetes.Conclusion: Overall, the prevalence of diabetes among tuberculosis patients was 9.1%. Older age, tobacco use, high income status and history of high blood pressure were identified as associated risk factors.SAARC J TUBER LUNG DIS HIV/AIDS, 2015 XII (2), Page: 20-27

Introduction: Biologically male and female have similar diabetes prevalence. Gender differences in the social structure bring differences in life style modifications and all other self care behaviors in type 2 diabetes. The primary purpose of this study was to assess the gender difference in care of type 2 diabetes in Western region, Nepal.   Methods: Hundred men and hundred women respondents participated in a cross-sectional study conducted in two hospitals in Pokhara, Nepal. A pre-tested questionnaire was administered to each of the respondents. Results: Dry mouth (χ2 = 3.977, P = 0.046) and abdominal pain (χ2 = 3.840, P = 0.050) were reported as symptoms of diabetes in 51% and 31% women compared to 37% and 19% men respectively. The study revealed that women had low self-efficacy with respect to their diabetes care (35%) in comparison to men (65%). There was significant association between gender and diet practices which showed men have 0.328 (95% CI: 0.184 - 0.585) times less chances of bad dietary practices compared to women. After adjusting for age, education, occupation and self-efficacy, men were less likely to have bad dietary practices (OR= 0.513, 95% CI: 0.266, 0.992). Conclusions: The result of this study provided evidence that there are gender differences in reporting of symptoms, mode of diagnosis and certain self-management behaviors. Therefore there is a need to design gender specific behavior change communication strategies for better management of type 2 diabetes.Keywords: diabetes care; gender; self-efficacy; self-management.

Background Cervical cancer continues to be a global public health concern and a leading cause of cancer deaths among Nepalese women. In spite of the availability of screening and treatment services in Nepal, the utilization of screening has been low. This study investigated knowledge, attitude, preventive practices and utilization of cervical cancer screening among women in a semi-urban area of Pokhara Metropolitan City of Nepal.Methods A community-based cross-sectional survey was carried out among 729 women 30-60 years of age, between April and June 2019. Participants were selected by systematic random sampling, and a door-to-door home visit was conducted for data collection. A pretested interviewer-administered Nepali questionnaire was used to collect information on sociodemographic variables, knowledge, attitude and preventive practices regarding cervical cancer screening. ResultsThe mean age of the participants was 45.9 years (SD ±7.7); the majority were married (86.7%). Among the participants, 44.9% were ever screened for cervical cancer. However, only 10.4% of participants received timely repeated screening for cervical cancer. The median knowledge score achieved by participants was 2.0 [interquartile range (IQR) 1-4] on a scale of maximum score 36, the median attitude score was 31.0 on a scale of 40 and the median preventive practice score was 3.0 (IQR 3-4) on a scale of five. ConclusionThis study showed low knowledge and low utilization of cervical cancer screening among women in Nepal. We recommend a community-based educational intervention to educate and empower women to increase knowledge and utilization of cervical cancer screening.

Hypertension is the leading risk factor of mortality in Nepal accounting for ∼33 000 deaths in 2016. However, more than 50% of the hypertensive patients are unaware of their status. We participated in the May Measurement Month 2017 (MMM17) project initiated worldwide by the International Society of Hypertension to raise the awareness on the importance of blood pressure (BP) screening. In this paper, we discuss the screening results of MMM17 in Nepal. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2017 following the standard MMM protocol. Data were collected from 18 screening sites in 7 districts covering 5 provinces. Screenings were conducted either in health facilities, public places, or participants’ homes. Trained volunteers with health science background and female community health volunteers were mobilized to take part in the screening. A total of 5972 individuals were screened and of 5968 participants, for whom a mean of the 2nd and 3rd readings was available, 1456 (24.4%) participants had hypertension; 908 (16.8%) of those not receiving treatment were hypertensive; and 248 (45.2%) of those being treated had uncontrolled BP. MMM17 is the first nationwide BP screening campaign undertaken in Nepal. Given the suboptimal treatment and control rates identified in the study, there is a strong imperative to scale up hypertension prevention, screening, and management programmes. These results suggest that opportunistic screening can identify significant numbers with hypertension. Mobilization of existing volunteer networks and support of community stakeholders, would be necessary to improve the overall impact and sustainability of future screening programmes.

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