Birth weight of a child is an important indicator of its vulnerability for childhood illness and chances of survival. A large number of infant deaths can be averted by appropriate management of low birth weight babies and prevention of factors associated with low birth weight. The prevalence of low birth weight babies in Nepal is estimated to be about 12-32%.Our study aimed at identifying major determinants of low birth weight among term babies in Nepal. A hospital-based retrospective case control study was conducted in maternity ward of Tribhuvan University Teaching Hospital from February to July 2011. A total of 155 LBW babies and 310 controls were included in the study. Mothers admitted to maternity ward during the study period were interviewed, medical records were assessed and anthropometric measurements were done. Risk factors, broadly classified into proximal and distal factors, were assessed for any association with birth of low-birth weight babies. Regression analysis revealed that a history of premature delivery (adjusted odds ratio; aOR5.24, CI 1.05-26.28), hard physical work during pregnancy (aOR1.48, CI 0.97-2.26), younger age of mother (aOR1.98, CI 1.15-3.41), mothers with haemoglobin level less than 11gm/dl (aOR0.51, CI0.24-1.07) and lack of consumption of nutritious food during pregnancy (aOR1.99, CI 1.28-3.10) were significantly associated with the birth of LBW babies. These factors should be addressed with appropriate measures so as to decrease the prevalence of low birth weight among term babies in Nepal.

ObjectivesThis study investigated the determinants of hypertension in Nepal according to both the Joint National Committee 7 (JNC7) and the American College of Cardiology/American Heart Association (2017 ACC/AHA) guidelines.DesignCross-sectional study.SettingThis study used data collected from the 2016 Nepal Demographic and Health Survey data.Participants13 393 weighted adults aged ≥18 years enrolled by a stratified cluster sampling strategy were included in our analysis.Primary and secondary outcome measuresThe primary outcome was hypertension, which was defined according to JNC7 (systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg) and 2017 ACC/AHA guidelines (SBP ≥130 mm Hg and/or DBP ≥80 mm Hg). Antihypertensive medication users were also classified as hypertensive. After descriptive analysis, multilevel logistic regression was applied to obtain ORs.ResultsAbout 21% (n=2827) and 44% (n=5918) of the individuals aged ≥18 years were classified as hypertensive according to the JNC7 and 2017 ACC/AHA guidelines, respectively. Following factors were found to be significantly associated with hypertension according to the 2017 ACC/AHA guideline: ≥70 years (adjusted OR (AOR) 5.2; 95% CI 4.3 to 6.2), 50–69 years (AOR 3.9; 95% CI 3.4 to 4.4) and 30–49 years (AOR 2.7; 95% CI 2.4 to 3.0) age groups, male gender (AOR 1.7; 95% CI 1.6 to 1.9), being overweight/obese (AOR 3.0; 95% CI 2.7 to 3.3), residence in provinces 4 (AOR 1.5; 95% CI 1.2 to 2.0) and 5 (AOR 1.5; 95% CI 1.2 to 1.9). No significant association was identified with household wealth status and ecological regions of residence using the 2017 ACC/AHA guideline.ConclusionsPer both guidelines, multiple factors were associated with hypertension. Public health programme aiming to prevent and control hypertension in Nepal should prioritise these factors and focus on individuals with a higher likelihood of hypertension irrespective of educational level, household wealth status and ecological regions of residence.

BackgroundPrevalence of non-communicable diseases has been increasing at a greater pace in developing countries and, in particular, the South Asia region. Various behavioral, social and environmental factors present in this region perpetuate common metabolic risk factors of non-communicable diseases. This study will identify social determinants of common metabolic risk factors of major non-communicable diseases in the context of the South Asian region and map their causal pathway.MethodsA systematic review of selected articles will be carried out following Cochrane guidelines. Review will be guided by Social Determinants of Health Framework developed by the World Health Organization to extract social determinants of metabolic risk factors of non-communicable diseases from studies. A distinct search strategy will be applied using key words to screen relevant studies from online databases. Primary and grey literature published from the year 2000 to 2016 and studies with discussion on proximal and distal determinants of non-communicable risk factors among adults of the South Asia region will be selected. They will be further checked for quality, and a matrix illustrating contents of selected articles will be developed. Thematic content analysis will be done to trace social determinants and their interaction with metabolic risk factors. Findings will be illustrated in causal loop diagrams with social determinants of risk factors along with their interaction (feedback mechanism).DiscussionThe review will describe the interplay of social determinants of common NCD metabolic risk factors in the form of causal loop diagram. Findings will be structured in two parts: the first part will explain the linkage between proximal determinants with the metabolic risk factors and the second part will describe the linkage among the risk factors, proximal determinants and distal determinants. Evidences across different regions will be discussed to compare and validate and/or contrast the findings. Possible bias and limitations of this study will also be discussed.Systematic review registrationPROSPERO CRD42017067212 Electronic supplementary materialThe online version of this article (10.1186/s13643-017-0576-6) contains supplementary material, which is available to authorized users.

Background:In Nepal, about 75% people rely on wood and other biomass fuels for cooking. The majority of Nepali families cook on a traditional stove, an open fire in the kitchen resulting in indoor air pollution, one of the key risk factors for Acute Lower Respiratory Infection (ALRI) among under-five children.The study aimed at exploring the association of indoor air pollution due to use of traditional cooking stoves with ALRI among under-five children in Rasuwa, a Himalayan district of Nepal. Methods:A cross-sectional survey was conducted in Rasuwa district from October to November 2011. The mothers with under-five children who lived in household using biomass fuels were interviewed. The totalsample size of 210, calculated on the basis of Proportion to Population Size, was selected by using cluster sampling method. Children who suffered from common cold and fast breathing/higher respiratory rate were defined as having ALRI. Logistic regression was used to find out association of types of cooking stove and other factors with ALRI among the children.Results: Only about 30% of the households used improved stoves for cooking. Nearly one-third (31.4%) of the children under five years of age who lived in household using biomass fuels suffered from ALRI. After adjusting for the factors like mother's group status, ethnic group, age of children, mother's group membership status and father's occupation, use of traditional/open type of cooking stove was found to be highly associated with ALRI [aOR:2.30; 95% CI (1.03-5.10)] among children.Conclusion: Exposure to smoke from a traditional stove is one of the factors leading to ALRI among children. The ALRI could be substantially reduced if these stoves be replaced by improved ones in rural areas of Nepal.