Browsing by Author "Karki, Khem B."
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Publication Community-Based Approach in Vaccine Trials: Insights and Challenges from COVID-19 Vaccine Trials in Nepal(Central Department of Public Health, 2024) Karki, Khem B.; Pradhan, Dina; Shakya, Stela; Acharya, AjitAbstract Vaccine trials in Nepal are not a new phenomenon. However, following the COVID-19 pandemic, there were several vaccine trials for COVID-19 vaccines in Nepal. Unlike previous trials, COVID-19 vaccine studies required swift and large-scale enrollment from communities. These trials aimed to recruit healthy individuals to evaluate the safety and efficacy of the vaccines in preventing the targeted disease. In the clinical trials other than vaccine, researchers can enroll patients with specific medical conditions with their consent from the hospital. In contrast, vaccine trials require researchers to recruit healthy volunteers, who are primarily found in community settings. Recruiting healthy individuals from these communities is challenging because it involves navigating various layers of community stakeholders who must be supportive and grant permission for participation. Therefore, community-wide engagement is crucial for vaccine trials. Communities need to be fully informed and positively engaged, despite potential negative influences from media and misconceptions about the trials. Despite these challenges, effective community interventions and engagement resulted in the successful enrollment of up to 4,600 participants across three trial centers within just two months. Conducting the clinical trial in Nepal with a community-based approach has been both enriching and effective. This strategy facilitated smooth implementation and deepened connections with the local population. Engaging with community leaders, stakeholders, and members helped overcome challenges such as participant recruitment and adverse event management. The active involvement of community members in various trial stages fostered trust, cooperation, and empowerment. This experience underscored the importance of community engagement, cultural sensitivity, and collaboration in achieving successful and sustainable clinical research.Publication Introducing the Nepal Journal of Public Health: Advancing Public Health Knowledge and Practice(Central Department of Public Health, 2024) Karki, Khem B.Greetings to our esteemed readers, contributors, and supporters, It is with great pleasure that we introduce the first issue of the Nepal Journal of Public Health (NJPH). The NJPH is an official publication of Central Department of Public Health, Institute of Medicine, Tribhuvan University. Our aim is to publish and disseminate novel and innovative research articles that contribute to the public health sciences, policies, practices, and outcomes. NJPH seeks to promote interdisciplinary dialogue, support evidence-based public health practice, and inform key stakeholders in decision making at local, national, and international levels.Publication Nutritional Status and Its Associated Factors among Under-Five Children in Bidur Municipality, Nuwakot District, Nepal: A Secondary Data Analysis(Central Department of Public Health, 2024) Pradhan, Pranil Man Singh; Pant, Smriti; Shrestha, Gambhir; Karki, Namrata; Mikrani, Tanweer Ahmad; Joshi, Deepak Raj; Shrestha, Sushan Man; Basel, Prem; Karki, Khem B.Abstract Background: Undernutrition among under-five children is a major public health problem in Nepal. The study's main objective was to assess the nutritional status and its associated factors among under-5 children of Bidur Municipality, Nuwakot district using secondary data analysis. Methods: We analyzed the data of 667 under-five children from 3183 households collected from the Community Health Diagnosis 2023 program database stored in the Kobo toolbox. Nutritional status indicators were measured by using the WHO classification. The chi-square test was applied to find out the association of nutritional status with independent variables such as maternal age at marriage, age at first child, antenatal, delivery, and post-natal care, exclusive breastfeeding, complementary feeding practices, and immunization status. Results: Nearly 32% (95%CI: 28.3-35.8) of the children were stunted, 12.1% (95%CI: 9.7-14.7) wasted, and 13.9% (95%CI: 11.4-16.6) were underweight. Early age at marriage, less than four ANC visits by the mother, history of substance use during pregnancy, and not exclusively breastfeeding were significantly associated with different forms of undernutrition. Conclusion: Promotion of exclusive breastfeeding and a higher number of ANC visits and discouraging early-age marriage and substance use during pregnancy are necessary to prevent undernutrition in under-five children. Keywords: Malnutrition, Nepal, under-five children