Browsing by Author "Poudyal, Anil"
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Publication Magnitude of Viral Load Suppression and Associated Factors among HIV-positive Patients Receiving Antiretroviral Therapy(Nepal Health Research Council, 2023) Acharya, Priti; Neupane, Anil Prasad; Sigdel, Brihaspati; Ghimire, Laxmi; Pant, Madhab Raj; Budhathoki, Abiruchi; Poudyal, AnilAbstract Background: Viral load assessment is the preferred method for diagnosing and confirming virologic failure for patients on antiretroviral therapy. This study aimed to assess the proportion of viral load suppression and identify associated factors among HIV-positive patients receiving antiretroviral therapy at the Pokhara academy of health science in Nepal. Methods: This institution-based retrospective cohort study was conducted at Pokhara academy of health science in Pokhara, Nepal. The study included 567 HIV patients who were enrolled between January 2016 and December 2019 and had their viral load measured within a one-year period. Statistical analysis was performed using STATA version 13.0. The proportions of viral load suppression and non-suppression were determined. Bivariate and multivariate logistic regressions were performed to identify factors associated with viral load suppression. Statistical significance was determined at a 95% confidence interval and p < 0.05 Results: Out of the 567 HIV patients, 95.76 % (95% CI: 94.10-97.42) achieved viral suppression. In multivariate analysis, longer duration of antiretroviral therapy treatment (> 3 years) was independently associated with higher odds of achieving viral suppression compared to those on antiretroviral therapy for less than 6 months (adjusted odds ratio [aOR] = 11.98, 95% confidence interval: 1.32-108.81, p < 0.0027). Conversely, individuals in second-line treatment had significantly lower odds of viral suppression compared to those in first-line treatment (aOR = 0.19, 95% CI: 0.05-0.66, p < 0.009). Conclusions: Our study demonstrated a high rate of viral suppression among HIV patients receiving antiretroviral therapy, exceeding the UNAIDS 90-90-90 target. Longer duration of antiretroviral therapy and being in second-line treatment were identified as factors influencing viral load suppression. These findings emphasize the importance of early initiation and adherence to first-line treatment for optimal outcomes. Keywords: ART; HIV/AIDS; viral load suppressionPublication Prevalence of Coronary Artery Disease among Adults in Nepal(Nepal Health Research Council, 2024) Karki, Khem Bahadur; Poudyal, Anil; Dhimal, Meghnath; Muller, Ruth; Groneberg, David ABackground: Coronary Artery Disease is a leading cause of death and a major disorder affecting the heart and blood vessels. The aim of this study is to estimate the prevalence of Coronary Artery Disease and its associated risk factors in Nepal. Methods: This population-based descriptive cross-sectional survey involved 12,557 participants aged 20 years and older, selected through a multistage stratified cluster sampling method. Data on demographics and risk factors were collected via face-to-face interviews, physical examinations, and laboratory tests. The association of different variables with Coronary Artery Disease outcomes was assessed using descriptive statistics. Results: The prevalence of definite Coronary Artery Disease among Nepalese adults aged 20 years and older was found to be 0.5% (95% CI: 0.3-0.7). Possible Coronary Artery Disease had a prevalence of 2.1% (95% CI: 1.6-3.4), and probable Coronary Artery Disease had a prevalence of 0.3% (95% CI: 0.2-0.4). Higher prevalence rates were observed among older individuals, urban residents, those with higher education levels, males, and participants with hypertension, diabetes, and elevated total cholesterol levels. Conclusion: This study represents the first comprehensive national population-based assessment of Coronary Artery Disease in Nepal. The findings indicate a significant burden of Coronary Artery Disease and its risk factors among the adult population. Addressing the high prevalence of Coronary Artery Disease and its risk factors requires both individual and population-level interventions. Keyword: Coronary arterial disease; Nepal; prevalence.