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Community-Level Screening and Referral Guidelines for Major Non-Communicable Diseases at Primary Healthcare Settings: From Development to Application at the Multi-site ‘NCDs Mega-Campaign 2024’ in Kathmandu Metropolitan City, Nepal

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Abstract Non-communicable diseases (NCDs), mainly cardiovascular conditions like hypertension, diabetes, and chronic kidney disease (CKD) are the major causes of morbidities and mortalities worldwide, with lower- and middle-income countries (LMICs) bearing the highest burden. As the UN 25*25 targets near their final year and the Sustainable Development Goals approach their last trimester, NCD cases continue to rise, leaving a significant undiagnosed population submerged in the communities and households. In Nepal, a few initiatives have been made at the health-facility level over the past decade. However, they lack people-centric strategies and community-focused intervention with appropriate working guidelines. This article outlines the three-phase development of a community-level screening program in Kathmandu Metropolitan City, providing structured guidelines for health workers to screen and appropriately refer cases of hypertension, diabetes, and CKD, implemented during the large-scale community-based campaigns across 256 sites in Kathmandu Metropolitan in 2024.

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Milan Malla Division of Pulmonary Medicine, Mayo Clinic, Florida, USA Richa Nepal Diabetes and Endocrinology Unit, Department of Internal Medicine Medicine, Bir Hospital, Kathmandu, Nepal Sushant Regmi Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal Deewash Neupane Division of Pulmonary Medicine, Mayo Clinic, Florida, USA Dhanendra Shrestha Division of Pulmonary Medicine, Mayo Clinic, Florida, USA Saugat Bhandari Patan Hospital, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal Madhusudan Subedi Department of Community Health Sciences, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal

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