Background The patients suffering from tuberculosis are receiving shame and unfair treatment from the people living around them within their own society attending DOTS clinic of Dharan municipality. Objective To assess the stigma experienced by tuberculosis patients and to find out the association between stigma experienced by Tuberculosis patient and the selected variables (socio-demographic characteristics, clinical profile and illness experience). Methods Descriptive Cross Sectional study was done among sixty tuberculosis patients. Stratified random sampling was used to select the main center and sub center of Tuberculosis treatment and population proportionate simple random sampling using lottery method was done. Data was collected using predesigned, pretested performa from Explanatory Model Interview Catalogue developed by World Health Organization. Results The study revealed that 63.3% of the subjects were stigmatized. There was association between stigma and variables such as occupation, monthly family income and past history of Tuberculosis. There was also association of stigma with treatment phase, category of the patient and past outcome of illness. Conclusion Due to lack of knowledge and awareness about Tuberculosis, many patients were stigmatized. Efforts should be made to educate the public about Tuberculosis to reduce stigma experienced by Tuberculosis patients and improve the compliance of the patient. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 48-52 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6914

Background: HIV, the disease, whose mode of transmission is known and is largely preventable, but due to lack of knowledge and practices about HIV/AIDS in general population causes its rapid spread. Aims & Objective: To assess and compare the knowledge, attitude and practices about HIV in patients group, care giver and in general population. Material and Methods: A total of 102 HIV/AIDS patients, 60 care givers (35 attendant, 19 nurses, 6 doctors) and 40 general population (control) were included in the present study. The patients who were registered for study were followed up for three visits. The responses were recorded on a pre-designed and pre-tested, semi-structured questionnaire. Results: Illiteracy was more common in HIV patient group (27.5%). A high proportion of HIV/AIDS cases were engaged in transport/ production industry (24.5%). Electronic media and print media are major source of information. 35.3% patients, 22.9% care givers and 47.5% general population group thought that with medication HIV is curable. Sexual contact (63.8%) was the commonest mode of transmission. 80.0% medical staff thought that a newly diagnosed HIV person, first to talk with doctor. After 6 month follow up: 82% patients write sexual contact as major mode of transmission, and Use of condom was most important preventive measure (68%). Conclusion: Understanding the KAP about HIV/AIDS of Patients, care givers and in general populations will help us in formulating strategy for prevention and treatment.

Background Coronavirus Disease 2019 (COVID-19) is a respiratory infection with a high rate of transmission primarily via airborne route and direct contact. Proper use of personal protective equipment (PPE) is a proven and effective way to prevent COVID-19 spread in healthcare settings. This study was done aiming to assess the knowledge, attitude, and reported practice, and identify the associated factors regarding donning and doffing of PPE among frontline healthcare workers in Nepal. Methods A cross-sectional study was conducted from 25th April to 30th July 2021 among 205 frontline healthcare workers of Nepal selected randomly from among the contacts of the investigators. A structured self-administered questionnaire prepared in google form was used as a study tool and shared via social media to the participants to obtain information on socio-demographic and workplace characteristics along with their knowledge, attitude, and reported practice regarding donning and doffing of PPE. Result A total of 79.5% of participants had satisfactory knowledge while 75.6% had satisfactory practice scores regarding donning and doffing of PPE. Factors such as the profession of the participants (p-value = 0.048), their workplace (p-value = 0.005), provision of PPE at workplace (p-value = 0 .009), and availability of designated space at workplace for methodical donning and doffing of PPE (p-value = 0.010) were significantly associated with satisfactory knowledge score whereas availability of designated space at workplace for donning and doffing of PPE was significantly associated with good practice score (p-value = 0.009). Conclusion This study demonstrated an overall good knowledge, attitude, and reported practice regarding donning and doffing of PPE among frontline healthcare workers in Nepal. However, the reported shortcomings like poor knowledge regarding the sequence of donning and doffing and corresponding flawed practice behaviors need to be addressed.

Antigen detection rapid diagnostic tests (Ag-RDTs) used for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid protein are inexpensive, faster and easy to use alternative of Nucleic Acid Amplification Test (NAAT) for diagnosis of Coronavirus disease 2019 (COVID-19). In this systematic review and meta-analysis, we assessed the diagnostic accuracy of Ag-RDTs in low and middle-income countries (LMICs). We included studies that evaluated the diagnostic accuracy of Ag-RDTs (sensitivity and specificity) against reverse transcription-polymerase chain reaction (RT-PCR) as a reference standard. The study population comprised of people living in LMICs irrespective of age and gender, who had undergone testing for COVID-19. We included peer reviewed prospective or retrospective cohort studies, cross-sectional studies, case control studies, randomized clinical trials (RCTs) as well as non-randomized experimental studies which addressed the review question. A systematic search was conducted in PubMed, CINAHL, Embase, Scopus, and Google Scholar to identify studies published between 1 January, 2020 and 15 August, 2021. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool was used to assess the methodological quality of studies. The analysis was done using Review Manager 5.4 and R software 4.0.2. From the total of 12 diagnostic accuracy studies with 4,817 study participants, pooled sensitivity and specificity were 78.2% and 99.5% respectively. Sensitivity was marginally higher in subgroup analysis based on studies with low risk of bias and applicability concerns (78.9%) and studies using SD Biosensor Ag-RDT (79.4%). However, an inverse relation between cycle threshold (Ct) and sensitivity of Ag-RDT was not seen. The review demonstrated pooled sensitivity value approaching the minimum performance requirement for diagnosis of COVID-19 by WHO with specificity value meeting the specified requirement. Ag-RDTs, therefore have the potential to be used as a screening tool for SARS-CoV-2 detection in low resource settings where RT-PCR might not be readily accessible. However, false negative results need to be interpreted with caution.

Depression which is characterized by hopelessness and loss of interest in social activities is common during adolescence. However it is often unrecognized and the burden is even more in low income countries. It also increases the risk of suicide in future. Hence in a developing country like Nepal it is important that such cases are detected at the early stage preventing further worsening of the condition. A simple set of questionnaires like Patient Health Questionnaire (PHQ) 9 can be used to screen for depression. Using this questionnaire screening for depression was carried out in adolescents of Gokarneshwor municipality, ward 4. Four hundred and twenty participants were selected by the process of systematic random sampling. Based on answers to nine questions score was given and adolescents categorized as having no, mild, moderate or severe depression. The PHQ 9 score suggested that 13.1% were suffering from depression, out of which 23.6% from moderate to severe depression which required psychiatric consultation. Out of those shown to have some form of depression 40.0% said they had thought of self harm in last 2 weeks. Late adolescence was significantly associated with depression. Thoughts related to self harm were also six times more in late adolescent age group than the early adolescent age group.