Depression and anxiety are the most widely recognized mental issues affecting youths. It is extremely important to investigate the burden and associated risk factors of these common mental disorders to combat them. Therefore, this study was undertaken with the aim to estimate the prevalence and identify factors associated with depression, anxiety, and stress among high school students in an urban municipality of Kathmandu, Nepal. A cross-sectional study was conducted among 453 students of five randomly selected high schools in Tokha Municipality of Kathmandu. Previously validated Nepali version of depression, anxiety, and stress scale (DASS-21) was used to assess the level of symptoms of depression, anxiety and stress (DAS). Multivariable logistic regression was carried out to decide statistically significant variables of symptoms of DAS at p-value<0.05. The overall prevalence of DAS was found to be 56.5% (95% CI: 51.8%, 61.1%), 55.6% (95%CI: 50.9%, 60.2%) and 32.9% (95%CI: 28.6%, 37.4%) respectively. In the multivariable model, nuclear family type, students from science or humanities faculty, presence of perceived academic stress, and being electronically bullied were found to be significantly associated with depression. Female sex, having mother with no formal education, students from science or humanities faculty and presence of perceived academic stress were significantly associated with anxiety. Likewise, female sex, currently living without parents, and presence of perceived academic stress were significantly associated with stress. Prevention and control activities such as school-based counseling services focusing to reduce and manage academic stress and electronic bullying are recommended in considering the findings of this research.

Background: Minimum Acceptable Diet (MAD), developed by the WHO and UNICEF, is a binary indicator of infant and young child feeding practice that assesses the quality and sufficiency of a child’s diet between the ages of 6 and 23 months. Identifying factors associated with MAD among children can inform policymakers to improve children’s nutritional status. Methods: We extracted data of 1930 children aged 6–23 months from the Nepal Multiple Indicator Cluster Survey 2019. Multilevel analysis was performed to identify factors associated with MAD. Results: Only 30.1% of the children received MAD. Children aged 13–18 months [aOR (Adjusted odds ratio): 2.37, 95% CI (95% Confidence Interval): 1.77, 3.17] and 19–23 months (aOR: 2.6, 95% CI: 1.95, 3.47) were more likely to receive MAD than children aged 6–12 months. Early breastfed children (aOR: 1.34, 95% CI: 1.05, 1.72), those currently breastfeeding (aOR: 4.13, 95% CI: 2.21, 7.69) and children without siblings aged under five (aOR: 1.33, 95% CI: 1.03, 1.73) were more likely to receive MAD. Younger maternal age (aOR: 0.97, 95% CI: 0.95–1.0), higher level of mother’s education (aOR: 1.04, 95% CI: 1.0–1.08) and more media exposure among mothers (aOR: 1.66, 95% CI: 1.24, 2.21) were positive predictors of MAD. Relatively disadvantaged ethnicity/caste (aOR: 0.71, 95% CI: 0.53, 0.94), rural residence (aOR: 1.45, 95% CI: 1.06, 2.00) and residing in Madhesh province (aOR: 0.61, 95% CI: 0.37, 1.0) were also significant predictors of MAD. Conclusions: Children aged 6–12 months, without appropriate breastfeeding, having under-five years siblings, with older mother or mother without media exposure or low education, from relatively disadvantaged ethnicity/caste, from urban areas and residing in Madhesh Province were less likely to receive MAD. Our findings can inform infant and young child feeding policies and practices in Nepal.

Influenza vaccination rates among Chinese middle school students are low. This study aims to explore the influencing factors of vaccination among middle school students and promote vaccination. We conducted a mixed-methods study, integrating a questionnaire survey among 9145 middle school students in four cities in China and semi-structured interviews with 35 middle school students to understand their attitudes and perceptions toward vaccination based on the Health Belief Model. We found the overall vaccination rate was 38.2% (3493/9145), with students in Beijing, boarding at school, or senior high school showing higher values than their counterparts (p < 0.05). Multiple logistic regression results showed that non-boarding (OR = 0.46, 95%CI: 0.42–0.51) and perceived barriers (OR = 0.97, 95%CI: 0.96–0.98) were unfavorable factors for influenza vaccination, whereas perceived susceptibility (OR = 1.07, 95%CI: 1.05–1.08), perceived benefits (OR = 1.02, 95%CI: 1.01–1.04), cues to action (OR = 1.08, 95%CI: 1.05–1.11), and self-efficacy (OR = 1.04, 95%CI: 1.02–1.07) were facilitators. Qualitative results indicated that positive health beliefs, school, and the home environment contribute to vaccination. In conclusion, the influenza vaccination rate among middle school students remains low. The concerns about the safety and potential side effects of vaccines are the main barriers to vaccination, underscoring the need for strengthening communication, education, and information among students and their teachers/parents.

Background Diarrhea has remained an unmet challenge in global child health. Its severity may be worse than reported in resource-limited settings. Understanding changing epidemiology is critical to combat diarrheal morbidity. Therefore, this study aimed to understand factors associated with diarrhea among under two years children in Nepal. Methods A total of 2,348 samples from Multiple Indicator Cluster Survey 2019 were used to estimate the significant child, maternal, household and external environmental predictors of diarrhea using multilevel analysis. Results The prevalence of diarrhea was 11.9% (95% CI: 10.2%-13.6%). Children residing in Koshi Province [AOR (Adjusted Odds Ratio): 2.23, 95% CI: 1.22–4.08], Karnali Province (AOR: 2.28, 95% CI: 1.11–4.70), and Sudurpaschim Province (AOR: 4.49, 95% CI: 2.39–8.42) were at higher risk of diarrhea. Children aged 7–23 months (AOR: 1.56, 95% CI: 1.10–2.20), children with ARI symptoms (AOR: 4.14, 95% CI: 2.21–7.72) and children whose mothers had no access to prenatal care (AOR: 1.87, 95% CI: 1.01–3.45) had a higher risk of diarrhea. Children from below the richest household wealth group (AOR: 1.76, 95% CI: 1.01–3.08) and those from households practicing open defecation, with unimproved or limited sanitation facilities (AOR: 1.52, 95% CI: 1.09–2.11) were more likely to have diarrhea. Conclusion The findings underscore the need for public health policy-makers to improve sanitation facilities, especially focusing on poor households from Karnali and Sudurpaschim Provinces practicing open defecation to protect the children from the life risk of diarrhea in Nepal.