As part of efforts to develop an informed policy for rotavirus vaccination, this prospective study was conducted to estimate the burden of rotavirus diarrhea among children less than 5 years old attended to the Department of Pediatrics, Jigme Dorji Wangchuk National Referral Hospital (JDWNRH), Thimphu, Bhutan. The duration of the study was three years, extending from February 2010 through December 2012. We estimated the frequency of hospitalization in the pediatric ward and dehydration treatment unit (DTU) for diarrhea and the number of events attributable to rotavirus infection among children under 5 years of age. During the study period, a total of 284 children (1 in 45) were hospitalized in the pediatric ward, and 2,220 (1 in 6) in the DTU with diarrhea among children residing in the Thimphu district. Group A rotavirus was detected in 32.5% and 18.8% of the stool samples from children hospitalized in the pediatric ward, respectively. Overall, 22.3% of the stool samples were rotavirus-positive, and the majority (90.8%) of them was detected in children under 2 years of age. From this study, we estimated that the annual incidence of hospitalization in the pediatric ward and DTU due to rotavirus diarrhea was 2.4/1000 (95% CI 1.7–3.4) and 10.8/1000 (95% CI 9.1–12.7) children, respectively. This study revealed that rotavirus is a major cause of diarrhea in Bhutanese children in Thimphu district and since no study has been performed previously, represents an important finding for policy discussions regarding the adoption of a rotavirus vaccine in Bhutan.

Dengue continues to pose a significant public health problem in tropical and subtropical countries. In Bhutan, first outbreak of dengue fever (DF) was reported in 2004 in a southern border town, followed by sporadic cases over the years. In this study, we analysed DF outbreaks that occurred in 3 different places during the years 2016 and 2017. A total of 533 cases in 2016 and 163 in 2017 were suspected of having of DF, where young adults were mostly affected. A total of 240 acute serum specimens collected and analyzed for serotype by nested RT-PCR revealed predominance of serotypes 1 and 2 (DENV-1 and 2). Phylogenetic analysis using envelope gene for both the serotypes demonstrated cosmopolitan genotype which were closely related to strains from India, indicating that they were probably imported from the neighboring country over the past few years.

Introduction: Compliance of community pharmacies with the national medicines law for proper storage and dispensing of medicines is crucial for ensuring the quality and safety of medicines. Community pharmacies in Bhutan are of two types: retail pharmacies and wholesale pharmacies. Objective: This study was aimed to assess the compliance of community pharmacies with the Medicines Act of the Kingdom of Bhutan 2003 and Bhutan Medicines Rules and Regulation 2012. Methods: This is a retrospective cross-sectional study from the inspection reports of community pharmacies inspected from January 2015 to December 2017. Descriptive statistics in frequency and percentage was used to report the results. Results: The overall compliance level for the regulatory provisions under critical and minor categories was 90.4% followed by 86.74% for major category. Around 32.99% of community pharmacies were found without standard operating procedures for storing and dispensing of medicines while 100% of community pharmacies had technical authorization from the Drug Regulatory Authority. Conclusion: Although the compliance level of community pharmacies in Bhutan for storing and dispensing of medicines was found to be above 80%, there are several areas that need to be corrected to ensure full compliance. This study will serve as a baseline for policymakers, managers, and researchers in developing designs for future interventions.

Samdrup Jongkhar district has reported an increasing trend in infant mortality rates over the recent years. This study aimed to identify its determinants. A population based case-control study was conducted in May 2018. Case group comprised of 79 infants who died between 1st January 2015-30th April 2018 while 158 living children born during the same period and residing closest to the home where infant mortality occurred were recruited as controls. Premature new-borns and those with low birth weight were 5.9 times and 4.1 times more likely to die respectively. New-borns whose mother received better ante-natal and post-natal care were more likely to survive. Over 50% of the deaths occurred at home and around two-thirds of deaths occurred during the post-natal period. Implementing a multi-stakeholder collaborative approach including local leaders, village health workers and religious leaders would be useful in reassuring parents to seek early medical care during childhood illness.

OBJECTIVES: Chief nurse's ward management behavior is a key factor affecting job satisfaction of nurses working directly under them. Therefore, the purpose of this study was to investigate the influence of chief nurse's ward management behavior on job satisfaction of nurses working in major district hospitals in Bhutan. MATERIALS AND METHODS:A cross-sectional study was conducted involving 246 nurses working across 18 district hospitals in Bhutan. Data on nurses' job satisfaction and chief nurse's ward management behavior were collected using Minnesota Satisfaction Questionnaire (MSQ)-short version and Supervisory Behavior Description Questionnaire (SBDQ) respectively. A generalized linear model (GLM) with a binomial distribution was used to indicate the relationship between chief nurse's ward management behavior and nurses' job satisfaction. RESULTS:The result showed that 54.09% of nursing employees were satisfied with their job. In terms of chief nurse's ward management behavior, chief nurses of Bhutan are inclined to display behavior which is more of an autocratic nature than democratic. There was a strong positive correlation between chief nurse's ward management behavior and nurses' job satisfaction. The GLM also indicated a strong positive relationship between the nurses' job satisfaction with chief nurse's ward management behavior. CONCLUSION: Nurses' job satisfaction was significantly and positively associated with chief nurse's ward management behavior. This finding call for an interventional program to promote chief nurse's ward management behavior.