Browsing by Author "Sharma, Samana"
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Publication Epidemiological and Clinical Profile of COVID-19 in Nepali Children: An Initial Experience(Nepal Paediatric Society (JNPS), 2020) Sharma, Arun K; Chapagain, Ram H; Bista, Krishna P; Bohara, Roma; Chand, Bharat; Chaudhary, Nanda K; Mishra, Pradip; Sandeep, Shrestha; Rana, Netra; Singh, Jamun; Baseula, Yuba Nidhi; Sharma, Yog Raj; Sharma, Samana; Ghimire, SunitaAbstract: Introduction: COVID-19 has spread all around the world with huge toll of human lives and suffering since it evolved in China. Nepal had slow rise in morbidity due to COVID 19 in early days but has been gripped by the pandemic's exponential growth lately. This study was conducted with the aim to describe the clinical and epidemiological features of Nepali children in early phase of the pandemic. Methods: This was an observational study conducted at 11 COVID care centres designated by the Government of Nepal with availability of supervision by paediatricians between January and August 2020 in children under 18 years of age diagnosed with COVID 19. Data was collected based on definitions outlined in data collection resources available at WHO-ISARIC Global COVID-19 clinical resources platform and analysed. Results: One hundred and twenty one children diagnosed with COVID 19 who presented to the designated centres were enrolled. Majority of children (83.4%) were identified as a part of contact tracing, 28.1% had an identified contact to a person with COVID 19 prior to their diagnosis and 20.7% had another household member diagnosed with COVID 19. The mean age of admitted children was 8.8 years (SD 5.6 years) with the largest proportion being adolescents (40.5%). Male (58.7%) children were more commonly affected. There were 15 (12.4%) infants and 8 (6%) of them were under two months of age. Most children (87, 71.9%) were asymptomatic, 21 (22.3%) had mild symptoms and six (4.9%) had moderately severe symptoms. Fever (18.2%) was the most commonly reported symptom. All children were discharged after a median of 14 days of hospitalisation. Conclusions: Nepali children of all ages are affected by COVID 19 and present with asymptomatic or mildly symptomatic infection. Fever and respiratory symptoms are the most commonly reported symptoms. Most children do not develop complications. Continued surveillance in larger population of children as the pandemic unfolds will generate more stringent observations.Publication The Economic burden of Neonatal Intensive Care Unit Admission at a Community Hospital of Central Nepal(Nepal Paediatric Society (JNPS), 2020) Sharma, Samana; Chapagain, Ram Hari; Pathak, Om Krishna; Gupta, Arun; Rai, Kavi Raj; Karn, Shruti; Sah, Sandeep KumarAbstract: Introduction: Neonatal sepsis is the commonest cause of neonatal morbidity and mortality and remains a major public health problem especially in developing countries. It is one of the most common causes for admission to neonatal units. The objective of this study was to evaluate the cost of care of neonates admitted in Neonatal Intensive Care Unit. It also compared the cost of care of neonates with sepsis and those with non-sepsis along with the duration of hospital stay and its correlation. Method: A hospital based prospective cross-sectional observational study was carried out over a period of one year. All the neonates admitted at NICU and fulfilling the inclusion criteria formed the study population. Total cost was calculated as the summation of direct and indirect cost. Normally distributed data was analyzed using the Student’s t-test, non-normally distributed data using Mann-Whitney U test. P-value < 0.05 was taken to be statistically significant. Result: Direct cost comprises more than two third of the cost. The median total cost of care of neonates admitted in NICU was USD 222.66 (Range 169.52-280.03). The cost for the ones with sepsis was USD 226.30 (Range 172.19-291.34) and 174.02 (Range 99.67-221.96) in non-sepsis. The mean duration of stay in NICU of the ones having sepsis was 6.6 days and 4.4 days in non-sepsis. Conclusion: The median total cost of care of neonates admitted in NICU was USD 222.66 (Range 169.52-280.03). The duration of stay and the total cost of treatment with sepsis are higher than those with non-sepsis.