No abstract

The number of medical students trained in Nepal each year has increased nearly fifty-fold in the last 15 years, primarily through the creation of private medical schools. It is unknown where this expanding cohort of new physicians will ultimately practice. We distributed an anonymous survey to students in their last 2 years of medical school at four medical schools in Nepal to examine two dimensions of career intention: the intention to practice in Nepal and the intention to practice in rural areas. Eighty-five per cent of the eligible study population participated, for a total of 469 medical students. Of these, 88% thought it was likely they would practice in Nepal and 88% thought it likely they would practice in urban areas. Those students who indicated a greater likelihood of practicing abroad came from families with higher incomes, were more likely to think earning a good salary was very important to their decision to become a physician, and were less likely to think they could earn a good salary in Nepal. Students whose tuition was paid by the government were no more likely to indicate an intention to practice in Nepal than students paying their own tuition at private medical schools. Students who indicated a greater likelihood of practicing in rural areas were more likely to be male, to have gone to a government secondary school, to have been born in a village, or to have received a scholarship from the Ministry of Education that requires rural service. Based on our findings, we suggest the following policy changes: (1) medical schools consider selecting for students from rural backgrounds or government secondary schools who are more likely to intend to practice in rural areas, and (2) increase the number of post-graduate positions--weighted toward rural health needs--to retain students in Nepal.

Diarrheal diseases are major problem of developing countries. Though precise data on childhood mortality associated with diarrheal diseases in Nepal is not available, it has been estimated that approximately 25% of child death are associated with diarrheal disease, particularly acute diarrhea. The purpose of this study was to assess the incidence of parasitic pathogens causing acute diarrhea in children under 5 years of age. A total of 525 children with acute diarrhea in a children's hospital of Kathmandu, Nepal were enrolled between April 2011 and September 2011. The higher prevalence of diarrhea was in the age group of less than 2 years. Out of total 525 enrolled cases, protozoal parasites were found in 10.7% (56/525) of cases and helminthic parasites were found in 1.3% (7/525) of cases. Highest prevalence of 60.3% (38/63) of parasitic infection was found in the age group of 6 -24 months followed by 7.9% (5/63) in the age group of less than 6 months. Of the total enrolled cases E. histolytica were 6.7% (35/525) followed by Giardial lamblia 3.4% (18/525) and the least frequency was due to A. lumbricoides constituting 0.6% (3/525). The aim of this study was to know the parasitic agents causing acute diarrhea in children.