NCDs in Nepal: Burgeoning Burden amid Low Priority and the Ways Forward

Gautam, Rabin

doi:10.3126/hprospect.v11i0.7420

Cited by 6 publications

(6 citation statements)

References 3 publications

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“… 4-7 Compared to increased disease burden, CVDs receive disproportionately less attention and resources in Nepalese health systems. 8 …”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7] Compared to increased disease burden, CVDs receive disproportionately less attention and resources in Nepalese health systems. 8 Perceived self-efficacy is defined as people's perceptions about their potential to perform an activity that influences over events that have an impact on their lives. According to Bandura's definition, individuals' expectations or their belief for success or failure to perform a task will determine their outcome.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of Cardiac Self-Efficacy among Patients Diagnosed with Coronary Artery Disease in Tertiary Hospitals in Nepal

Shrestha

Rawal

Bajracharya

et al. 2020

Journal of Public Health Research

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Background: Cardiac self-efficacy determines how people feel, think, motivate themselves and behave with regards to improving their cardiac health subsequently preventing complications of coronary artery disease (CAD). Given almost one-third of global death is contributed by CAD with 10% of disability adjusted life years lost in low- and middle-income countries (including Nepal), it is important to identify factors that can promote cardiac self-efficacy. There are no studies in Nepal focusing on predictors of self-efficacy. Therefore, we aim to determine the predictors of cardiac self-efficacy of CAD patients in Nepal.Design and Methods: This is a cross-sectional study where we recruited 170 patients (≥30 years) diagnosed with CAD from two tertiary level hospitals. Multiple linear regression model was used to identify the predictors of cardiac self-efficacy.Results: The mean age of the participants was 60.45±10.39 years (range, 31-83). Most of the participants were diagnosed as myocardial infarction (91.2%), rest with unstable angina (6.5%) and stable angina (2.4%). The multivariate analysis shows age (p<0.001), health behaviors (p<0.001) and knowledge of the disease (p<0.001) were statistically significant predictors to cardiac self-efficacy. Every 1-year increase in age was associated with 0.23 units increase in cardiac self-efficacy score. Similarly, every unit increase in health behavior score and knowledge of disease score was associated with 0.432 units and 0.475 units increase in cardiac self-efficacy score, respectively.Conclusion: Age and health behaviors were the strongest predictors of cardiac self-efficacy followed by knowledge of the disease. We conclude that those with poor health behavior are at a greater risk of poorer cardiac self-efficacy compared to those with relatively good level of self-efficacy. Public health interventions such as awareness raising about cardiac disease and health behavior modification along with early screening, diagnosis and appropriate care are essential to improving self-efficacy and cardiac care outcomes.

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“… 4-7 Compared to increased disease burden, CVDs receive disproportionately less attention and resources in Nepalese health systems. 8 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of Cardiac Self-Efficacy among Patients Diagnosed with Coronary Artery Disease in Tertiary Hospitals in Nepal

Shrestha

Rawal

Bajracharya

et al. 2020

Journal of Public Health Research

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“…The Government of Nepal’s commitment toward the Sustainable Development Goals and the National Health Policy 2014 are the recent policy directives to focus on the prevention and control of NCDs in the country. 15 Similarly, the Government of Nepal, in alignment with the Global commitment for 25% relative reduction in premature mortality from NCDs by 2025, 16 has drafted the Multisectoral Action Plan for the Prevention and Control of NCDs (2014–2020). Along with this the Ministry of Health is currently working to restructure health governance, draft a new health policy and design province based health care delivery system for the new Federal Structure of the country.…”

Section: Introductionmentioning

confidence: 99%

Burden of COPD in Nepal

Adhikari¹,

Neupane²,

Kallestrup³

2018

COPD

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BackgroundCOPD is a globally significant public health problem and is the second leading cause of mortality. This study presents the health burden of COPD in Nepal using the Global Burden of Disease (GBD) study 2016 dataset.MethodsThis study used the data from the GBD repository presenting morbidity and mortality attributed to COPD, by sex and age. In GBD 2016, due to a lack of the primary source of data in Nepal, estimations on morbidity and mortality of COPD were based on its predictive covariates. Years of life lost (YLLs) were calculated based on the cause of death estimations, applying GBD’s Cause of Death Ensemble modeling. Likewise, years lived with disability (YLDs) were calculated by multiplying the prevalence of each sequela by the disability weight. Disability-adjusted life years (DALYs) were derived as the sum of YLLs and YLDs.ResultsBetween 1990 and 2016, the estimated age-standardized mortality rate due to COPD was decreasing for both genders, but the decline was much higher among males. Unlike the high rate of incidence among males, the age-standardized DALYs were found to be high among females (2,274.9 [95% UI: 1,702.0–2,881.5] per 100,000). YLLs contributed around 80% of DALYs due to COPD in 2016. Age-standardized YLLs rate was higher among females, with a value of 1,860 (95% uncertainty interval (UI): 1,282.8–2,472.8) vs 1,547.6 (95% UI: 992.1–2,018.5) among the males per 100,000 population.ConclusionThe prevalence and incidence of COPD remained almost stationary over the years, but still very high. Though the incidence and prevalence of disease were high among males, the death rate and DALYs were more significant among females throughout the years. If the current situation prevails, the burden of COPD will continue to increase in the country. Hence, comprehensive social, environmental, and behavioral approaches to curtail the risk factors along with early identification, treatment, and management of COPD is of utmost importance.

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“…33 The trend analysis of the metabolic risk factors in Nepal between 1980 and 2008 illustrates high blood pressure, body mass index and blood glucose level as major risk factors for diabetes. 33 A survey showed that a family history of diabetes was present in about one-third of the patients. The highest prevalence of diabetes was seen among the elderly (25.9%).…”

Section: Diabetes and Its Risk Factors In Nepalmentioning

confidence: 99%

Tuberculosis and Diabetes Mellitus Comorbidity among the Ageing Population: A Threat to the Public Health System of Nepal

Maharjan¹,

Chalise

Thapa³

2018

J Nepal Health Res Council

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Ageing population is attributable to the growing trend of diabetes mellitus. Diabetic patients are three times greater risk of developing tuberculosis. The review aims to describe the state of tuberculosis and diabetes mellitus comorbidity, risk factors for the comorbidity from the perspective of the ageing in Nepal. It is a systematic narrative review of literature in Google Scholar and Pubmed. At first, title and abstract of an article was reviewed for relevance, and then full article was reviewed for validity. The secondary data was retrieved from the Central Bureau of Statistics of Nepal and WHO, and analysed in the Ms-Excel. In Nepal, the population is ageing. The risk factors associated with diabetes are escalating. On the other hand, tuberculosis is endemic and about 45% of the Nepalese people are infected with tuberculosis bacteria. These circumstances have laid the foundation that fosters tuberculosis and diabetes co-epidemic in the future. The clinical management of patients with the comorbid condition is a difficult task because diabetes and tuberculosis interact with each other, one worsening the other. The upsurge of the co-morbidity needs the provision of more health services threatening the public health system of Nepal. It is fundamental to create a mechanism to integrate diabetes and tuberculosis program such as screening, diagnosis and management of the both diseases at the all levels of health service delivery. Furthermore, increase awareness of healthy lifestyle and the prevention of the risk factors for tuberculosis and diabetes could reduce the occurrence of the comorbidity in the future.

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NCDs in Nepal: Burgeoning Burden amid Low Priority and the Ways Forward

Abstract: DOI: http://dx.doi.org/10.3126/hprospect.v11i0.7420Health Prospect 2012 Vol.11

Cited by 6 publications

References 3 publications

Predictors of Cardiac Self-Efficacy among Patients Diagnosed with Coronary Artery Disease in Tertiary Hospitals in Nepal

Predictors of Cardiac Self-Efficacy among Patients Diagnosed with Coronary Artery Disease in Tertiary Hospitals in Nepal

Burden of COPD in Nepal

Tuberculosis and Diabetes Mellitus Comorbidity among the Ageing Population: A Threat to the Public Health System of Nepal

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