Browsing by Author "Mahato, RK"
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Publication A Spatial Model of Socioeconomic and Demographic Determinants of Dengue Hemorrhagic Fever in Nepal(Kathmandu University, 2025) Mahato, RK; Htike, KM; Yadav, A; Baral, S; Yadav, RK; Kafle, A; Sharma, VABSTRACT Background Dengue hemorrhagic fever (DHF) has re-emerged across the global South, particularly in tropical and subtropical urban areas, driven by environmental changes alongside local demographic and socioeconomic factors. Objective To investigate the spatial patterns and socioeconomic determinants of dengue fever in Nepal from 2020 to 2023. Method Using Geographic Information Systems (GIS), Gi* cluster analysis, and Local Moran’s I statistics, the study examined the relationship between socio-economic variables and dengue incidence across districts. Key factors analyzed included population density, urbanization, and night-time light (NTL) intensity. Result Bivariate Local Indicators of Spatial Association (LISA) analysis showed fluctuating correlations between dengue hemorrhagic fever incidence and factors such as population density, urbanization, and night-time light intensity. Moran’s I value for population density were -0.083 in 2020, -0.082 in 2021, 0.526 in 2022, and -0.020 in 2023. Similarly, for urbanization, Moran’s I values shifted from -0.103 in 2020 to -0.090 in 2021, 0.458 in 2022, and 0.007 in 2023. Night-time light intensity also demonstrated changing correlations, with Moran’s I values of -0.091 in 2020, -0.102 in 2021, 0.415 in 2022, and -0.068 in 2023. A notable shift from negative to positive correlations occurred between 2020 and 2022. In 2022, high-incidence dengue hemorrhagic fever clusters emerged in densely populated areas, while distinct spatial patterns were observed in 2020 and 2021. Conclusion Dengue hemorrhagic fever risk spatial models are useful tools for detecting high-risk locations and driving proactive public health initiatives. The study emphasized the importance of dynamic, targeted public health interventions based on spatial and socio-economic factors to effectively manage evolving dengue outbreak patterns. KEY WORDS Dengue, Gi* statistics, Local indicators of spatial association, Socio-economic status, Spatial analysisPublication Co-infection of COVID-19 with Malaria and Dengue -A Hospital based Study in Kathmandu, Nepal(Kathmandu University, 2024) Bajracharya, B; Shrestha, P; Shrestha, D; Karna, AK; Mahato, RK; Shrestha, S; Baral,B; Bhandari, P; Sah, P; Bastola, A; Pandey, BDABSTRACT Background In tropical countries like Nepal, the COVID-19 pandemic unfolded within a population already grappling with various tropical infectious diseases. Co-infection with malaria and dengue holds clinical significance when managing COVID-19 patients in regions endemic to these diseases. Objective To identify malaria and dengue infections in febrile or symptomatic patients suspected of COVID-19 at the Sukraraj Tropical and Infectious Disease Hospital, Kathmandu. Method Over two months, a prospective study was conducted on febrile or symptomatic patients suspected of COVID-19 visiting Sukraraj Tropical and Infectious Disease Hospital, Kathmandu. One hundred and twenty-three patients suspected of COVID-19 were tested for SARS-CoV-2 through RT-PCR as well as for malaria and dengue infection using rapid diagnostic test kits. Result Out of 123 patients suspected of COVID-19, 64 were confirmed to have COVID-19. No evidence of SARS-CoV-2 and malaria co-infection was found among the 123 tested patients. However, two patients admitted for COVID-19 tested positive for dengue virus infection. The patients with co-infections with dengue or scrub typhus were likely to have a longer hospital stays (OR 2.5; 95% CI: 0.22-29.26), though lacking a significant association. Conclusion The two patients diagnosed with dengue virus and SARS-CoV-2 were identified during their hospital visit and both recovered after receiving treatment. Given that COVID-19 patients manifest symptoms resembling many tropical infectious diseases, the study underscores the clinical importance of testing for multiple circulating infections in patients from endemic areas. This approach ensures appropriate and timely management reducing the risk of severity or mortality. KEY WORDS Co-infection, COVID-19, Dengue, Malaria, NepalPublication Determinants of Hypertension among Middle-aged and Elderly Populations: A Study from Myanmar(Kathmandu University, 2025) Htike, KM; Thammasarn, K; Mahato, RKABSTRACT Background Hypertension is a growing global health concern, particularly in low- and middle- income countries (LMICs), driven by demographic shifts, urbanization and lifestyle changes. Myanmar has a 30.1% national wide prevalence, however, data on determinants and management remain limited. Objective To assess the prevalence and associated factors of hypertension among middle-aged and elderly populations in Yangon, Myanmar, to inform strategies for prevention and management. Method A cross-sectional study of 512 individuals aged 40 years and older in Yangon, Myanmar, was conducted from May to November 2024 using multistage random sampling. Statistical analyses including the Generalized Linear Mixed Model (GLMM) using logistic regression were performed using STATA 18.0 to identify the factors associated with hypertension. Result The prevalence of hypertension was 27.54% (95% CI: 23.83-31.58), with a higher prevalence among individuals aged ≥60 years. Risk factors included aged ≥60 years (AOR: 2.17, 95% CI: 1.27-3.70), palm oil usage (AOR: 3.67, 95% CI: 2.05-6.59), current alcohol consumption (AOR: 2.35, 95% CI: 1.19-4.62), elevated waist circumference (AOR: 2.93, 95% CI: 1.80-4.77), chronic illness (AOR: 3.24, 95% CI: 2.08-5.05) and consuming of plant-based protein for 3–7 days per week (AOR: 1.79, 95% CI: 1.13- 2.83). Conclusion Hypertension is prevalent among middle-aged and elderly adults in Yangon with significant associations identified for age, dietary habits, waist circumference and chronic illness. Interventions focusing on lifestyle modifications, dietary improvements, and targeted health education are essential to mitigate the hypertension burden in this population. KEY WORDS Cross-sectional study, Hypertension, MyanmarPublication Determinants of Overnutrition among Urban Adults in Yangon, Myanmar(Kathmandu University, 2024) Tun, SS; Sornlorm, K; Mahato, RKABSTRACT Background Over 1.9 billion adults who are 18 years old and older were overweight and more than 6.5 million adults were said to be obese. In 2014 National Step Survey of Myanmar stated that there were 16.9% and 5.5% of overweight and obesity in adults. Due to altering lifestyle and urbanization, it is important to detect the nutritional status and its most influencing factors among urban adults in Yangon. Objective To assess the determinants of overnutrition among urban adults in Yangon, Myanmar. Method This is a cross-sectional study with a sample of 453 adults aged 18-62 years and structured questionnaires were used. Overweight and obesity were defined according to the WHO classification for Asian adults. Multivariable logistic regression analysis was used to assess independent factors associated with overnutrition. Result A total of 453 participants were included for analysis. The prevalence of overnutrition was 49.89% (95% CI, 45.28-54.50). In multivariable analysis, being male (AOR = 3.56, 95% CI = 2.09-6.08, being married/divorced/widowed/ separated (AOR = 2.95, 95% CI = 1.82–4.77), family history of overnutrition (AOR = 6.49, 95% CI = 3.72–11.33, history of DM (AOR = 1.79, 95% CI = 1.11–2.89, consumption of starchy vegetables ≥5 days (AOR = 2.05, 95% CI = 1.27–3.30), not meeting the WHO recommended physical activity (AOR = 3.57, 95% CI = 2.24–5.70), and moderate and low perception (AOR = 2.15, 95% CI = 1.21–3.84) were associated with overnutrition. Conclusion We observed high prevalence of overnutrition in this study. Socioeconomic status, health behavior and perception were the factors behind overnutrition. These findings offer important information for establishment of appropriate public health interventions and policies to lessen the burden of overnutrition. KEY WORDS Adults, Diet, Low-income country, Overnutrition, Southeast AsiaPublication Prevalence and Determinants of Type 2 Diabetes among the Pulmonary Tuberculosis Cases in Nepal: A Cross Sectional Study(Kathmandu University, 2021) Mahato, RK; Laohasiriwong, W; Koju, RPABSTRACT Background Since prehistoric time to the earlier 20th century, diabetes was accounted as co- morbidity among tuberculosis patients, which is reducing the treatment efficiency. Objective To investigate the prevalence and determinants of type 2 diabetes mellitus among tuberculosis patients in central development region of Nepal. Method An analytical cross-sectional study was conducted by using structured questionnaire. Face to face interview as well as reviewing of the medical records of the tuberculosis cases has been performed during September 2018 - February 2019. The systematic random sampling was applied to select 306 tuberculosis cases. Then the respondents were examined for blood glucose level as well as Glycated haemoglobin (HbA1c) level to identify TB with Diabetes Mellitus. The proportion of respondents with fasting blood glucose level ≥ 126 mg/dl or a random blood glucose ≥ 200 mg/dl was considered as Tuberculosis with Diabetes Mellitus cases. Similarly, haemoglobin A1C ≥ 7% was accessed as amplified risk for tuberculosis. Multiple logistic regression was performed to analyse the factors associated with Tuberculosis with Diabetes Mellitus by using STATA. P value < 0.05 was taken as statistically significant. Result A total of 306 tuberculosis patients were included in the study. The mean ± standard deviation of age of participants was 36.82±15.94 years. The proportion of male slightly exceeded than that of female with a ratio of 1.73:1. The prevalence of TBDM was 17.32% (95% CI: 13.05-21.58) of all diagnosed tuberculosis cases. Our multivariable analysis identified the factors those were associated with TBDM were age ≥ 45 years (adj.OR=3.97, 95% CI 1.81-8.71, p value 0.001), patients residing in the urban areas (adj.OR=9.75, 95% CI 1.99-47.6, p value 0.005), had Body Mass Index (BMI) <18.5 Kg/m2 (adj.OR=3.20, 95% CI 1.58-6.51, p value 0.001), had diastolic blood pressure ≥ 80 mmHg (adj.OR=2.34, 95% CI 1.17-4.66, p value 0.015) and patients who were treated with Cat II and Cat III tuberculosis treatment regimens (adj.OR=2.65, 95% CI 1.22-5.73, p value 0.013). Conclusion The prevalence of type 2 diabetes mellitus among tuberculosis patients was higher than prevalence of diabetes in general population of Nepal and it was higher among male, urban residents, patients with low BMI and the older aged tuberculosis patients. KEY WORDS Diabetes mellitus, HbA1c, Multiple logistic regression, TuberculosisPublication Prevalence of Suspected Cholangiocarcinoma Based on Ultrasonography Screening and its Associated Factors in Northeastern Thailand(Kathmandu University, 2022) Rayubkul, J; Laohasiriwong, W; Thinkhamrop, B; Mahato, RK; Khantikeo, N; Pongpanich, SABSTRACT Background Ultrasonography of the liver allows detection of liver mass and bile duct dilatation which are findings of suspected Cholangiocarcinoma so that early stage Cholangiocarcinoma can be detected. Objective To estimate the prevalence of suspected Cholangiocarcinoma as well as its associated factors. Method These reported results were obtained from the baseline screening for Cholangiocarcinoma as of July 2013 of an ongoing project the Cholangiocarcinoma Screening and Care Program conducted in Northeastern Thailand. Participants were northeasterners who were at least one of the followings: 40 years or older, ever been infected with liver fluke, ever been treated with praziquantel, or ever been consumed raw fresh water fish. Ultrasonography was done by well-trained medical radiologists. Result Of the total 1,196,685 participants, 58.9% were females with a mean age of 58.2 (standard deviation ± 9.9) years. Suspected Cholangiocarcinoma was found in 15,186 (2.6%; 95% CI: 2.56 to 2.65) individuals. The results observed that the participants with higher age group had high association as compared to younger age group (AOR=1.98; 95% CI: 1.77 to 2.21; p-value < 0.001), hepatitis B infected participants were highly significant as compared to the non- hepatitis B infected (AOR=1.22; 95% CI: 1.07 to 1.39; p-value = 0.002) and participants having Hepatitis C were also significantly associated with Cholangiocarcinoma infection (AOR=1.46; 95% CI: 1.04 to 2.05; p-value = 0.029) based on ultra-sonographic screening respectively. However, patients having diabetes were less likely to be associated with Cholangiocarcinoma (AOR=0.87; 95% CI: 0.81 to 0.93; p-value < 0.001). Conclusion About one out of a hundred cases required further investigations such as Magnetic resonance imaging or Computed Tomography. Early age of ultrasonography screening for Cholangiocarcinoma enhanced the opportunities for early detection of Cholangiocarcinoma and might reduce irrational requests for expensive or invasive methods of diagnosis. KEY WORDS Cholangiocarcinoma, Suspected case, Ultrasonography screening