Globalization and urbanization in Nepal have driven a nutritional transition from an agricultural-based diet to an ultra-processed, sugary diet. This study assessed the nutrition and oral health of 836 children age 6 months to 6 years and their families in rural and urban Nepal. Mothers were interviewed about maternal–child oral health and nutrition, and children received dental exams and height and weight measurements. Analyses utilized SPSS statistical software. Most families lived within a 5-minute walk to a store selling ultra-processed snacks and sugary drinks. While most mothers knew sweets caused tooth decay, half of the children were given sweets daily, and 58.2% of children had dental caries. Caries began in the first 2 years and increased in prevalence and severity to age 6, when 74.3% had caries and 20% experienced mouth pain. Despite greater health knowledge and resources among urban mothers, urban children’s increased access to junk food and frequency of consumption was associated with higher prevalence and severity of caries compared to rural children. Severe caries was associated with malnutrition, especially in rural children. Preventive strategies are needed in early childhood to incorporate nutrition and oral health education and dental care into maternal–child health services, and develop policies to prohibit the sale of junk food around schools.

Background: Tea workers have the risk of being exposed to agro chemicals. Farm workers engaged in pesticide spraying reported symptoms potentially associated with exposures to pesticides. Diverse morbid conditions and deviation in blood parameters have been reported. Effect of pesticide exposure and safety precaution among farm workers is alarming in developing countries. Aim: To find out health problems and level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), haemoglobin, white blood cells, creatinine, blood sugar and acetyl cholinesterase among tea workers. Methods: A cross-sectional study was done to enroll voluntarily participated 262 tea workers of Haldibari, Danabari and Kanyam tea estates of Nepal They were interviewed by using semi-structured questionnaire. General health check-up and measurement of blood pressure, height and weight were done. Laboratory investigations comprised acetyl cholinesterase, alanine transaminase, asparate transaminase, haemoglobin, white blood cell, creatinine and blood sugar. Data was analyzed in SPSS V 16.0. Findings: Among 262 workers, maximum number of workers (60.7%) had work experience of more than 10 years. Most common personal protective equipment used by the workers (10.3%) was simple cloth masks. Eye irritation (34.4%), headache (30.9%), nausea (15.6%), low back pain (32.4%), gastritis and duodenitis (17.6%), arthralgia (14.9%), injury (14%), underweight (11.1%), mild anaemia (31.9%) and leucopenia (9.3%) were prevalent. The difference in means of creatinine level between directly exposed group of workers and those who were not was statistically significant. The ALT level or AST level between directly exposed group of workers and those who were not was statistically significant. The difference in means of acetyl cholinesterase level between directly exposed group of workers and those who were not was statistically non-significant. Interpretation: Workers reported symptoms potentially associated with exposures to pesticides. Musculoskeletal problems, gastritis and duodonitis, injury and anaemia were common among tea workers. Pesticides might have affected liver and kidney function of the workers. Abnormal liver function of the workers might be a hint to guess the effect of organophosporus or carbamates pesticides in the workers exposed to the pesticides. A worker with history of exposure to pesticides and abnormal alanine aminotranferase (ALT) and aspartate aminotransferease level (AST) might be looked with suspicion as a case suffering from adverse effect of pesticides Effect of organophosphates or carbamates on cholinesterase activity could not be shown among tea workers. We could not ignore falsely depressed blood parameters which could have happen because of co-morbid conditions. However, the possible effect of pesticides on health was shown in this study. Funding: SEAM-Nepal. Abstract #: 02SEDH032A deeper look at oral health and malnutrition in Nepal