BackgroundViolence against women is a global public health problem occurring in multitude of contexts and domestic violence is considered to be the most pervasive one. Poor enforcement of policies, limitation of researches and expertise in this field largely accounts for persistence of this problem and nature of domestic violence and its associated factors are poorly understood.ObjectivesThis research aimed to estimate the magnitude of different forms of domestic violence and identify its associated factors.MethodsCommunity based cross sectional study was conducted among 355 married women of reproductive age group of Kusheshwor, Sindhuli, Nepal. The questionnaire adapted from the World Health Organization Multi-Country Study was used for the face to face interviews. Occurrence of current domestic violence was used as outcome variable in logistic regression. Descriptive and multivariate analysis were performed in order to assess the magnitude of domestic violence and to identify its associated factors respectively.ResultsSelf-reported lifetime prevalence of physical violence was 29.6 % and past year prevalence was 15.2 %, while corresponding figures for sexual violence were 6.8 and 2.3 %, and for psychological violence were 31.0 and 18.3 %. Lifetime domestic violence was 38.6 % while in past 12 months, prevalence was 23.1 %. Furthermore, 12.4 % of women were experiencing all forms of violence concurrently. Women with controlling husband and having poor mental health were found to be at higher risk of domestic violence.ConclusionsDomestic violence is still rampant in our society with several forms of violence occurring together. In a country like Nepal, differentials power in relationship and poor mental health was found to be positively associated with violent episodes. This study highlights the infringement of women rights which can be the cause for serious public health consequences.

ObjectivesThe 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.DesignCross-sectional/observational study.Study settingThis 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.ParticipantsWomen who had been involved in commercial sex activity in the past 6 months and gave informed consent were included in the study.Primary outcome measureA score of more than or equal to 16 on the Centre for Epidemiological Studies Depression (CESD) scale was considered as depression.MethodologyFace-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.ResultsWe 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.ConclusionsThe 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.

BackgroundAlcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire developed by WHO identifies individuals along the full spectrum of alcohol misuse and hence provides an opportunity for early intervention in non-specialty settings. This study aims to validate a Nepali version of AUDIT among patients attending a university hospital and assess the prevalence of alcohol use disorders along the full spectrum of alcohol misuse.MethodsThis cross-sectional study was conducted in patients attending the medicine out-patient department of a university hospital. DSM-IV diagnostic categories (alcohol abuse and alcohol dependence) were used as the gold standard to calculate the diagnostic parameters of the AUDIT. Hazardous drinking was defined as self reported consumption of ≥21 standard drink units per week for males and ≥14 standard drink units per week for females.ResultsA total of 1068 individuals successfully completed the study. According to DSM-IV, drinkers were classified as follows: No alcohol problem (n=562; 59.5%), alcohol abusers (n= 78; 8.3%) and alcohol dependent (n=304; 32.2%). The prevalence of hazardous drinker was 67.1%. The Nepali version of AUDIT is a reliable and valid screening tool to identify individuals with alcohol use disorders in the Nepalese population. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥11 for both the gender) and hazardous drinkers (with AUDIT ≥5 for males and ≥4 for females). For alcohol dependence/abuse the cut off values was ≥9 for both males and females.ConclusionThe AUDIT questionnaire is a good screening instrument for detecting alcohol use disorders in patients attending a university hospital. This study also reveals a very high prevalence of alcohol use disorders in Nepal.

BackgroundAgriculture work is one of the most hazardous occupations across countries of all income groups. In Nepal, 74 % of people are working in the agricultural sector. This study aims to identify patterns and factors associated with injuries among farmers of rural Nepal.MethodsA community-based cross-sectional study was conducted in a rural village in eastern Nepal. House to house visit was done to collect data from the farmers. The study included 500 farmers from Shanishchare village in Morang district of Nepal. A pre-tested semi-structured questionnaire was used to collect data on socioeconomic profile, agriculture work and injury. Prevalence of injuries among farmers in the last 12 months was calculated along with factors associated with the injuries.ResultsThe overall prevalence of work- related injuries among farmers was 69 % in the last 12 months. Common injuries among the farmers were cuts (79.7 %), puncture wound (11.3 %) and laceration (7.5 %). Hand tools were responsible for most of the injuries followed by slipping at work, sharp instruments, animals and fall from height. Upper limb injury comprised of 67 % of all injuries and the most involved part was fingers (43 %). The average number of years worked in farming by the respondents was 23.6 ± 13.6 years. Age and working experience of the farmers was found to be significantly associated with the occurrence of injuries among the farmers.ConclusionsThe prevalence of injury among farmers in this study was high. Further research is needed to identify interventions to reduce the agricultural injuries in Nepal.

BackgroundDepression is the most common form of mental disorder among inmates, with a prevalence much higher than in the general population. This study aims to estimate the prevalence of depression among inmates and identify factors associated with it.MethodsThis cross-sectional study was conducted in Jhumka Regional Prison, the largest prison in eastern Nepal, from September 2014 to August 2015. A total of 434 randomly selected inmates were interviewed using a semi-structured questionnaire examining socio-demographic characteristics, detention status, self-reported health problems, substance use status, and suicidal ideation. Depression was screened using the Center for Epidemiologic Studies Depression scale. Chi-square tests and multiple logistic regression analysis were applied to determine the association between depression and related variables.ResultsThe mean age of the participants was 35.7 years (SD 13.3). The prevalence of depression among the inmates was 35.3%. Approximately 2.3% reported suicidal ideation during imprisonment and 0.9% had attempted suicide inside the prison. In bivariate analysis, depression was significantly associated with previous incarceration (OR = 1.91, 95% CI = 1.05–3.47, p = 0.033), poor self-rated health (OR = 1.75, 95% CI = 1.16–2.64, p = 0.007), frequent appointments when encountering health problems (OR = 1.66, 95% CI = 1.06–2.61, p = 0.028), suicidal ideation (OR = 4.44, 95%CI = 1.13–17.44, p = 0.038) and loss of weight (OR = 1.49, 95% CI = 1.00–2.23, p = 0.049). However, only previous incarceration (AOR = 1.97, 95% CI = 1.04–3.74, p = 0.037) and frequent appointments when encountering health problems (AOR = 1.61, 95% CI = 1.01–2.57, p = 0.046) remained significant in a multivariate model.ConclusionsThis study showed a high rate of depression among inmates in Nepal. The results suggest a need for psychiatric and rehabilitative care in correctional settings to improve the health status of the inmates.