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Browsing by Author "Kunwar, S"

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    Deployment of COVID-19 Vaccines for Refugees and Migrants in Nepal
    (Kathmandu University, 2025) Karmacharya, BM; Joshi, A; Marasini, S; Rai, P; Sharma, S; Kunwar, S; Kampalath, VN; Czapka, EA; Benavente, P; Zan, ML; Tran, NT; Hosseinalipour, SM; Blanchet, K
    ABSTRACT Background The needs and determinants of COVID-19 vaccination uptake and coverage among refugees, migrants in regular situations (MIRS), and migrants in irregular situations (MIIS) remain undocumented. This hinders advocacy toward inclusive vaccination policies and ultimately undermines effective vaccine rollout. Objective To estimate vaccination coverage and produce evidence on the barriers and facilitators to COVID-19 vaccination for refugees and migrants in Nepal. Method Mixed-method study was conducted in Koshi, Bagmati and Gandaki provinces of Nepal. In total, 210 household surveys were conducted among the refugees and migrants, and eight key informant interviews were conducted locally among Nepal’s major stakeholders of COVID-19 vaccination. Result A total of 210 participants were included in this study: 101 refugees, 66 MIRS, and 43 MIIS. Among them, 52.9% (111/210) were fully vaccinated with two or more COVID-19 doses, 43.3% (91/210) were partially vaccinated with one dose, and 3.8% (8/210) were unvaccinated. Inclusive vaccination policies were an enabling factor for wide access to COVID-19 vaccines among refugees and migrants. The availability of vaccines free of cost, timely information on vaccinations, and multiple vaccination centers facilitated COVID-19 vaccine uptake. However, barriers like requirement of identity documents, safety misconceptions, fear of side effects, and language challenges hindered access. Conclusion This study highlights the overlooked issue of vaccination uptake among refugees and migrants, emphasizing the lack of data on their needs and determinants. This gap hinders inclusive vaccination policies and rollout effectiveness. Tailored strategies are crucial to address their specific needs, alongside ongoing research and advocacy for inclusive policies and targeted interventions to overcome barriers. KEY WORDS COVID-19, Immunization, Migrants, Nepal, Refugees, Vaccines
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    Multi-drug Resistant and Extended Spectrum β-lactamase Producing Salmonella Species Isolated from Fresh Chicken Liver Samples
    (Kathmandu University, 2020) Adhikari, S; Khadka, S; Sapkota, S; Sharma, BR; Ghimire, A; Chalise, M; Gurung, D; Kunwar, S
    ABSTRACT Background Emergence of antibiotic resistance among microbes contaminating the fresh meat products is a global public health concern as they can be easily transmitted to humans through their consumption and contact. Objective The current study was conducted to determine the distribution of antimicrobial resistance among Salmonella species isolated from fresh chicken liver samples with special emphasis on extended spectrum beta-lactamase (ESBL) production. Method A total of 200 fresh chicken liver samples were cultivated for the isolation of Salmonella and further subcultivated to detect extended spectrum beta-lactamase production among them. Antimicrobial susceptibility testing (AST) was done by disk diffusion method using a panel of 7 antimicrobials. Result Out of 200 samples analyzed, 61 (30.5%) samples harbored Salmonella species out of which 15 (7.5%) samples showed the presence of Salmonella Typhi. A significant association was noted in the incidence of Salmonella with various factors pertaining to the butchers, such as age, sex, literacy rate, practices of washing knives and chopping board, wearing aprons and gloves and type of water used (p < 0.05). Salmonella isolates were highly sensitive to amikacin (82.0%) and least sensitive to tetracycline (3.3%). All the isolates were resistant to colistin. Sixty (98.4%) isolates were identified as multi-drug resistant (MDR). The total number of extended spectrum beta- lactamase producers reported among Salmonella isolates was 29 (47.5%). Conclusion The results indicate that the fresh chicken liver samples sold in Bharatpur Metropolis are reservoirs of multi-drug resistant Salmonella, including extended spectrum beta- lactamase producers, that could potentially be transmitted to the humans by direct contact or through inadequate cooking. KEY WORDS Antimicrobial susceptibility testing, Extended spectrum beta-lactamase, Fresh chicken liver samples, Multi-drug resistant, Salmonella

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