Introduction The study aimed at exploring the adverse events following immunization (AEFI) and their incidences among health workers in three different districts of central and western Nepal following the first dose of Covishield vaccine,. It also aimed at studying the association of AEFI with demographic and clinical characteristics of vaccinees, pre-vaccination anxiety level and prior history of COVID-19 infection (RT- PCR confirmed) status. Materials and methods This was a cross-sectional study carried out via face-to-face or telephonic interview among 1006 health workers one week after receiving their first dose of the Covishield vaccine. Incidence of adverse events was calculated in percentage while Chi-square Test was used to check the association of AEFI with independent variables. Logistic regression was used to find out the adjusted odd’s ratio at 95% CI. Results Incidence of AEFI was 79.8% with local and systemic AEFI being 68.0% and 59.7% respectively. Injection site tenderness was the commonest manifestation. Local and systemic symptoms resolved in less than one week among 96.8% and 98.7% vaccinees respectively. Females were more likely to develop AEFI than males (AOR = 1.7, 95% CI = 1.2–2.4). Vaccinees aged 45–59 years were 50% less likely to develop AEFI as compared to those aged less than 30 years (AOR 0.5, 95% CI = 0.3–0.8). Most of the vaccinees had not undergone RT-PCR testing for COVID-19 (59.8%). Those who were not tested for COVID-19 prior were 1.5 odds more likely to develop AEFI compared to those who were negative (AOR = 1.5, 95% CI = 1.1–2.1). Conclusion More than two-third of the vaccinees developed one or more forms of adverse events, but most events were self-limiting. Females and young adults were more prone to develop AEFI.
ObjectiveTo estimate the prevalence of chronic kidney disease (CKD) among patients with type 2 diabetes mellitus (T2DM) and determine the sociodemographic and clinical risk factors associated with CKD.Design and settingsCross-sectional study among diabetic outpatients of a tertiary hospital in Nepal.Participants201 patients with T2DM above 18 years of age.InterventionParticipants completed a questionnaire regarding their socioeconomic information and underwent pertinent physical and haematological examinations.Primary and secondary outcomes measureThe prevalence and risk factors of CKD among patients with T2DM.ResultsThe prevalence of CKD in T2DM was 86.6%. In univariable analysis, the variables like age (p=0.026), hypertension status (p=0.002), duration of diabetes (p=0.009) and haemoglobin levels (p=0.027) were significantly associated with CKD among the participants with T2DM. Kruskal-Wallis H test showed that age was significantly different between various CKD stages. Multivariate analysis demonstrated a significant relationship between CKD with age (Adjusted odds ratio (AOR) 3, 95% CI 1.1 to 8.8) and literacy status (AOR 5.8, 95% CI 1.4 to 24.6)ConclusionAdvancing age, concomitant hypertension, increasing duration of T2DM and presence of anaemia were found to be important risk factors of CKD. Age is the most important predictor of CKD showing increasing prevalence in the elderly population. Periodic screening tests are essential at an early age to identify kidney diseases at incipient stages, thereby preventing progression to end-stage renal disease.
Although COVID-19 pandemic has created a state of alarm worldwide, the downfall in health and economy is rather paramount in low income countries. Nepal, due to its inadequate health resources and poor health system, is more vulnerable to the plight. But on a positive note, the weaknesses that have been exposed can be taken as lessons to learn. With the policies committed to achieving health as the fundamental right of people as per the constitution, capacity building, intersectoral coordination, preventive, promotive and curative facilities, and appropriate strategies and preparedness plan, Nepal can combat the pandemic and develop a resilient and well-functioning health system in future. Now is a moment of historic opportunity. Public health program must be strengthened as soon as possible by ensuring that at least minimum requirement are in place at the province and municipality levels and media partnership should be created to prevent societal fear. Furthermore, this is an opportunity to implement the power devolution in federal republic of Nepal
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