Browsing by Author "Prajapati, R"
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Publication Analysis between Vaccinated and Unvaccinated Hospitalized Patients Infected with SARS-CoV-2(Kathmandu University, 2022) Basnet A; Tamang, B; Pokhrel, N; Khadka, S; Shrestha, MR; Ghimire, S; Prajapati, R; Thapa S; Duwal Shrestha, SK; Chand, AB; Amatya, I; Rai, SKABSTRACT Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (≥3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (≥2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients. KEY WORDS COVID-19, Clinical features, SARS-CoV-2, Socio-demographic factors, Vaccine, VariantsPublication Factors Associated with Urinary Tract Infection among Children Aged Less than 5 Years Visiting Department of Pediatrics of Dhulikhel Hospital(Kathmandu University, 2024) Siluwal, N; Bhandari, N; Prajapati, R; Timalsena, DABSTRACT Background Urinary tract infection (UTI) constitutes a significant cause of morbidity, especially among children under five years old. Early diagnosis and management are essential to minimize acute morbidity and prevent the long-term complications associated with urinary tract infections. Objective To identify factors associated with urinary tract infections among children under five years old. Method A quantitative cross-sectional study was conducted at Dhulikhel Hospital, Kathmandu University Hospital in Nepal, involving face-to-face interviews with 105 parents of children under 5 years with suspected or culture-positive Urinary tract infections. Data collection occurred from July 2022 to December 2022, covering both outpatient (OPD) and inpatient cases. Logistic regression was employed to identify factors associated with urinary tract infections. Result The Urinary tract infection prevalence among children under five was 27.12%, with over half (55.2%) were female. Females had a seven times higher urinary tract infection risk than males (95% CI: 1.64 - 30.18; p = 0.009). Children with congenital anomalies faced a 22.8 times higher urinary tract infection risk (95% CI: 1.70 - 286.56, p = 0.01). Diaper changes exceeding 6 hours elevated the risk by 20.09 times (95% CI: 1.14 - 353.95; p = 0.04). Escherichia coli presence in urine culture correlated with a 9.43 times higher urinary tract infection risk (95% CI: 1.34 - 66.16, P = 0.02). Conclusion Implementing preventive measures, including maintaining personal hygiene and changing diapers frequently, can significantly reduce the incidence of urinary tract infections in children, ultimately minimizing medical costs. KEY WORDS Children, Cleaning, Risk factors, Urinary tract infectionPublication Mothers’ Experience of Febrile Convulsions in Their Children(Kathmandu University, 2025) Prajapati, R; Karki, S; Shrestha, B; Manandhar, SABSTRACT Background Febrile convulsion is the most common convulsive disorder in under five children. About 1 in 25 children have suffered from febrile convulsion in at least one episode. It is a very difficult condition for parents to handle their children during convulsion and they worry about the future health of the child. It is one of the frightening, emotionally traumatic, and anxiety conditions experienced by parents. Objective This study intended to explore the experience of mothers on febrile convulsion in their children. Method The qualitative research design was used for the study. A purposive sampling technique was applied. An in-depth interview technique was used for data collection with in-depth interview guide. A total of ten mothers were included whose children were admitted with the diagnosis of febrile convulsion. Content analysis was done for the interpretation of the experience of mothers. Result Mothers expressed febrile convulsion as a serious condition for the child which leads to developing stress, fear, and anxiety among them. The majority of the mothers worried about the child’s condition and they found it difficult to control themselves. Five themes emerged such as perceived threat, loss of control, need for support, utilizing health seeking behavior, and preventive measure. Conclusion Although the febrile convulsion is a life-threatening situation for children and parents. experience it as an extremely fearful and anxious condition health care professionals including nurses should be providing awareness program for preventing febrile convulsions and provide home management during that situation. KEY WORDS Children, Febrile convulsion, Fever, MothersPublication Prevalence and Associated Factors of Low Birth Weight among Newborns in a Tertiary Level Hospital in Nepal(Kathmandu University, 2018) Prajapati, R; Shrestha, S; Bhandari, NABSTRACT Background A United Nations Children’s Fund reported that the global low birth weight was 15.5%, more than 95.6% of them being from developing countries. Low Birth Weight is a major factor associated with neonatal deaths in developing countries. Also, birth weight is one of the major factor in determining child survival, growth and development. Objective The objective of the study was to identify the prevalence and associated factors of low birth weight among newborns delivered in Dhulikhel Hospital. Method A cross sectional research design was carried out among all newborns delivered at the maternity ward of Dhulikhel Hospital within a period of one year. Data were collected using delivery record register as well as its electronic version which was available in the ward. The collected data were entered and analyzed using software SPSS 20 version with descriptive and inferential statistics. Result Total 2,798 numbers of newborns delivered in the hospital during the period of one year met the inclusion criteria for the study. Among them, 21.6% had low birth weight. We found that low birth weight of newborns was significantly affected by younger age of the mother and lesser weeks of gestation at birth. There were no significantly affected by antenatal clinic visit, parity, sex of the baby, type of delivery. Conclusion The study found that more than one fifth of babies had Low Birth Weight. The study findings suggest that special emphasis should be given to minimize early pregnancy to avoid low birth weight babies. KEY WORDS Delivery, Hospital, Low birth weight, NewbornPublication Prevalence and Predictors of Incomplete Immunization among Children Residing in the Slums of Kathmandu Valley: A Community Based Door-to-Door Survey(Kathmandu University, 2018) Manandhar, K; Bajcharya, K; Prajapati, R; Shrestha, NCABSTRACT Background Expanded program on immunization is one of the most cost-effective and widely applied public health interventions in worldwide. It is priority program for government of Nepal. Objective To estimate the incomplete immunization and identify predictors of incomplete immunization among age of 12-60 months children residing in the slum areas of Kathmandu Valley. Method This cross sectional, community based door-to-door survey was carried out in slum areas of Kathmandu Valley in months of January to February, 2017. Among nine squatters; having more than 100 households, five were selected by using stratified random sampling. The total 505 children age of 12-60 months was included for study. The face-to-face interview with selected mothers was performed using the structured questionnaire. Mean and standard deviation was calculated for continuous variables and proportions with 95% confidence interval level for categorical variables. The chi-square analyses were used to evaluate association between selected variables with incomplete immunization. The p-value <0.05 was considered as statistically significant. Result The mean age of children was 34.7±17.8 months. Nearly half of the children (43.6%) were within age of 12-24 months. The mean age of mothers was 27.1±5.3 years and more than three quarters (82.2%) were literate. The incomplete immunization was 13.0%; it was found higher among female (14.7%) than male children (11.4%). The incomplete immunization was highly associated with poor knowledge on immunization schedule of mothers (p=0.001). Conclusion The incomplete immunization was higher than national mean. It was found association with poor knowledge on immunization schedule of mothers. So, the immunization program should be more strengthen in slum areas and need to expand the education program focusing on immunization schedule. KEY WORDS Children, Door-to-door survey, Incomplete immunization, SlumsPublication Prevalence of Exclusive Breast Feeding and its Associated Factors among Mothers(Kathmandu University, 2018) Bhandari, N; Prajapati, RABSTRACT Background Breast feeding is the priceless gift given by mother to her newborn. It also has benefits to both mothers and baby. Prevalence of exclusive breast feeding varies from 26.4% in one study to that of 82.2% in another study. Objective To assess the factors associated with exclusive breast feeding among mothers. Method A prospective cross-sectional study using systematic random sampling method, was carried out in Dhulikhel Municipality for two months in November and December 2017 after taking permission from KUSMS IRC and from Dhulikhel Municipality. The study sample was 218 mothers whose infants between 6 months to 1 year were included in the study. A structured and semi-structured interview schedule was used in order to collect the information. Descriptive statistics including frequency and percentage was calculated to summarize mothers’ socio-demographic information. Chi-square test was used for non-parametric categorical data in order to find out the association between variables. P-value less than 0.05 were considered significant. Result The prevalence of exclusive breast feeding was 75.7% in the present study. Maternal age found to be varied from 17 years to 40 years. Maternal age, parity of mother and types of family found to be significantly associated with the practice of exclusive breast feeding (p < 0.05). Mothers’ occupation and education level was not associated with the practice of exclusive breast feeding. Conclusion Majority of the mothers practice exclusive breast feeding (75.7%). Finding of this study i.e. the factors influencing the practice of exclusive breast feeding will help the health care workers to plan the community awareness program on it. KEY WORDS Exclusive breast feed, Infants, Mothers