Roshan Mahato | Khon Kaen University (original) (raw)

Papers by Roshan Mahato

Research paper thumbnail of A spatial relationship between density of agricultural land and unmet need for work among elderly in Thailand

Research paper thumbnail of Spatial association of socio-economic status and prevalence of Tuberculosis in Nepal, 2019

Research paper thumbnail of Prevalence and Factors Associated with Coronary Artery Disease (CAD) and Its Associated Factors among People Aged 35 Years and Over in Thailand: A Cross-Sectional Analysis

Research paper thumbnail of Determinants of overnutrition among elderly in Thailand: A Cross sectional study

Research paper thumbnail of Spatial association of the incidence of Hand Foot Mouth disease and its related factors in Guizhou province, China 2019 – 2021

Research paper thumbnail of Prevalence and factors associated with overweight and obesity among adolescents aged 12-15 years in LongNan city,Gansu province,China

Research paper thumbnail of Determinants of Type II Diabetes Mellitus among Tuberculosis Patients in Yangon Region, Myanmar

Research paper thumbnail of Hygiene practice and diarrhea prevalence among underfive children in Myanmar: A cross- sectional study

Research Square (Research Square), Oct 11, 2023

Research paper thumbnail of Safely managed sanitation practice and childhood stunting among under five years old children in Myanmar

medRxiv (Cold Spring Harbor Laboratory), Aug 16, 2023

Research paper thumbnail of Spatial Association between Socioeconomic Factors, Physical Geographic Factors, and Suicide in Thailand

The Open Public Health Journal, Dec 7, 2023

Research paper thumbnail of Safely managed sanitation practice and childhood stunting among under five years old children in Myanmar

PLOS ONE

In 2020, 149 million children under the age of five were estimated to be stunted globally. Around... more In 2020, 149 million children under the age of five were estimated to be stunted globally. Around half of deaths among children under 5 years of age are related to under-nutrition. Objective of this study is to determine the association between safely managed sanitation and childhood stunting among under-five years old children in Myanmar. This cross-sectional analytical study was conducted in 16 townships across three regions and five states in Myanmar. Multiple logistic regressions analysis was performed to determine the associations. This study found that 327 (27.09%) under-five children were stunted among a total of 1207 children in Myanmar. Children with unsafely managed sanitation were 2.88 times more likely to be stunting compared with children who access to safely managed sanitation services (AOR = 2.88, 95% CI: 2.16 to 3.85; p-value <0.01). Other associated factors for childhood stunting were needs 1–15 minutes for water collection (AOR = 2.07, 95% CI: 1.46 to 2.94; p-va...

Research paper thumbnail of Prevalence of Suspected Cholangiocarcinoma Based on Ultrasonography Screening and its Associated Factors in Northeastern Thailand

Kathmandu University Medical Journal, Sep 30, 2022

Background Ultrasonography of the liver allows detection of liver mass and bile duct dilatation w... more 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.

Research paper thumbnail of The Role of Type 2 Diabetes Mellitus on the Clinical Manifestation of Pulmonary Tuberculosis: A Study from Nepal

Journal of Clinical and Diagnostic Research, 2019

Introduction: Tuberculosis (TB) ranks as the seventh leading cause of death in Nepal. Similarly, ... more Introduction: Tuberculosis (TB) ranks as the seventh leading cause of death in Nepal. Similarly, the prevalence of Diabetes Mellitus (DM) has also shown an increasing trend in the country and it has been observed that diabetes is strongly associated with falling treatment outcome of tuberculosis. Hence, the association of tuberculosis with Type 2 Diabetes Mellitus (T2DM) might be higher than the assumption and it needs more attention as well as appropriate measures to improve treatment outcomes of both diseases. Aim: To determine the risk factors of T2DM comorbidity among TB patients in the Central Development Region of Nepal. Materials and Methods: A case-control study was conducted by administration of structured questionnaire interview among all forms of pulmonary tuberculosis patients. A total of 102 tuberculosis patients with T2DM who met the inclusion criteria were considered as cases and 306 non-diabetes tuberculosis cases were considered as controls. The study was conducted among the patients attending the tuberculosis treatment centres of all 19 districts of central Nepal. The risk factors of diabetes among tuberculosis patients was estimated by using unconditional multiple logistic regression, adjusted odds ratio and their 95% CI were measured. Results: This present study found that the risk factors of type 2 DM comorbidity among tuberculosis patients were; age ≥45 years (adj. OR=8.00, 95% CI: 4.21-15.21, p-value <0.001), formal education (adj. OR=2.12, 95% CI: 1.08-4.15, p-value is 0.027), being underweight {Body Mass Index (BMI) <18.5 Kg/m 2 } (adj. OR=2.61, 95% CI: 1.49-4.59, p-value <0.001) and with diastolic blood pressure ≥80 (adj. OR=3.05, 95% CI: 1.72-5.43, p-value <0.001). In addition, tuberculosis patients who visited more than two health facilities for diagnosis and treatments (adj. OR=2.06, 95% CI: 1.10-3.85, p-value is 0.024) and had medium level of knowledge (60-80%) on tuberculosis and diabetes (adj. OR=2.19, 95% CI: 1.09-4.39, p-value is 0.027) were more prone to having tuberculosis and diabetes. Conclusion: Tuberculosis with diabetes is strongly associated with age, education, hypertension comorbidity as well as delayed diagnosis. Therefore, regular DM screening program as well as timely health monitoring system of tuberculosis patients will enhance the tuberculosis control program in reducing TB burden from delayed cure in Nepal.

Research paper thumbnail of Prevalence and Determinants of Type 2 Diabetes among the Pulmonary Tuberculosis Cases in Nepal: A Cross Sectional Study

Kathmandu University Medical Journal, Dec 31, 2021

Background Since prehistoric time to the earlier 20th century, diabetes was accounted as comorbid... more Background Since prehistoric time to the earlier 20th century, diabetes was accounted as comorbidity 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/m 2 (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.

Research paper thumbnail of A collaborative approach to global health training in developing countries: Experience from Kathmandu University, Nepal

Annals of Global Health, 2014

Research paper thumbnail of Spatial association and modelling of under-5 mortality in Thailand, 2020

Geospatial Health

Under-5 mortality rate (U5MR) is a key indicator of child health and overall development. In Thai... more Under-5 mortality rate (U5MR) is a key indicator of child health and overall development. In Thailand, despite significant steps made in child health, disparities in U5MR persist across different provinces. We examined various socio-economic variables, health service availability and environmental factors impacting U5MR in Thailand to model their influences through spatial analysis. Global and Local Moran’s I statistics for spatial autocorrelation of U5MR and its related factors were used on secondary data from the Ministry of Public Health, National Centers for Environmental Information, National Statistical Office, and the Office of the National Economic and Social Development Council in Thailand. The relationships between U5MR and these factors were modelled using ordinary least squares (OLS) estimation, spatial lag model (SLM) and spatial error model (SEM). There were significant spatial disparities in U5MR across Thailand. Factors such as low birth weight, unemployment rate, an...

Research paper thumbnail of Feasibility of implementing public-private mix approach for tuberculosis case management in Pokhara Metropolitan City of western Nepal: a qualitative study

Frontiers in Public Health

BackgroundThe Public-Private Mix (PPM) approach is a strategic initiative that involves engaging ... more BackgroundThe Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal.MethodsWe conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers.ResultsA total of 20 respondents participated in the study. Barriers to PPM were identifie...

Research paper thumbnail of The role of Diabetes mellitus comorbidity on Tuberculosis treatment outcomes in Nepal: A prospective cohort study

South Eastern European Journal of Public Health

Aim: The Objective of this study was to assess the effect of Diabetes Mellitus (DM) on treatment ... more Aim: The Objective of this study was to assess the effect of Diabetes Mellitus (DM) on treatment outcomes of tuberculosis (TB) patients in the Central Development Region of Nepal. Methods: A prospective cohort study was conducted in central Nepal. The study population of n=408 was consecutively recruited from treatment centers of all 19 districts of central Nepal. The TB cases (n=306) and TB with DM (n=102) cases were followed up for the estimation of blood glucose level, HbA1c level, and sputum examination on 2, 5, and 6 months after TB treatment started. The Generalized Estimating Equation (GEE) was performed to identify the risk ratio among TB and TB with DM cases on treatment outcome. Results: Our study identified that the magnitude of treatment failure among the tuberculosis cases was 19.7% (95% CI: 17.44-21.95). The GEE analysis observed that factors associated with the treatment failure had uncontrolled DM (HbA1C ≥7 %) (adj.RR=5.24, 95% CI: 2.58-10.62, P value <0.001), age...

Research paper thumbnail of Spatial pattern and heterogeneity of chronic respiratory diseases and relationship to socio-demographic factors in Thailand in the period 2016 to 2019

Geospatial Health

Chronic respiratory diseases (CRDs) constitute 4% of the global disease burden and cause 4 millio... more Chronic respiratory diseases (CRDs) constitute 4% of the global disease burden and cause 4 million deaths annually. This cross-sectional study used QGIS and GeoDa to explore the spatial pattern and heterogeneity of CRDs morbidity and spatial autocorrelation between socio-demographic factors and CRDs in Thailand from 2016 to 2019. We found an annual, positive, spatial autocorrelation (Moran’s I >0.66, p<0.001) showing a strong clustered distribution. The local indicators of spatial association (LISA) identified hotspots mostly in the northern region, while coldspots were mostly seen in the central and north-eastern regions throughout the study period. Of the socio-demographic factors, the density of population, households, vehicles, factories and agricultural areas, correlated with the CRD morbidity rate, with statistically significant negative spatial autocorrelations and coldspots in the north-eastern and central areas (except for agricultural land) and two hotspots between f...

Research paper thumbnail of The role of Diabetes mellitus comorbidity on Tuberculosis treatment outcomes in Nepal: A prospective cohort study

DOAJ (DOAJ: Directory of Open Access Journals), Mar 1, 2022

Research paper thumbnail of A spatial relationship between density of agricultural land and unmet need for work among elderly in Thailand

Research paper thumbnail of Spatial association of socio-economic status and prevalence of Tuberculosis in Nepal, 2019

Research paper thumbnail of Prevalence and Factors Associated with Coronary Artery Disease (CAD) and Its Associated Factors among People Aged 35 Years and Over in Thailand: A Cross-Sectional Analysis

Research paper thumbnail of Determinants of overnutrition among elderly in Thailand: A Cross sectional study

Research paper thumbnail of Spatial association of the incidence of Hand Foot Mouth disease and its related factors in Guizhou province, China 2019 – 2021

Research paper thumbnail of Prevalence and factors associated with overweight and obesity among adolescents aged 12-15 years in LongNan city,Gansu province,China

Research paper thumbnail of Determinants of Type II Diabetes Mellitus among Tuberculosis Patients in Yangon Region, Myanmar

Research paper thumbnail of Hygiene practice and diarrhea prevalence among underfive children in Myanmar: A cross- sectional study

Research Square (Research Square), Oct 11, 2023

Research paper thumbnail of Safely managed sanitation practice and childhood stunting among under five years old children in Myanmar

medRxiv (Cold Spring Harbor Laboratory), Aug 16, 2023

Research paper thumbnail of Spatial Association between Socioeconomic Factors, Physical Geographic Factors, and Suicide in Thailand

The Open Public Health Journal, Dec 7, 2023

Research paper thumbnail of Safely managed sanitation practice and childhood stunting among under five years old children in Myanmar

PLOS ONE

In 2020, 149 million children under the age of five were estimated to be stunted globally. Around... more In 2020, 149 million children under the age of five were estimated to be stunted globally. Around half of deaths among children under 5 years of age are related to under-nutrition. Objective of this study is to determine the association between safely managed sanitation and childhood stunting among under-five years old children in Myanmar. This cross-sectional analytical study was conducted in 16 townships across three regions and five states in Myanmar. Multiple logistic regressions analysis was performed to determine the associations. This study found that 327 (27.09%) under-five children were stunted among a total of 1207 children in Myanmar. Children with unsafely managed sanitation were 2.88 times more likely to be stunting compared with children who access to safely managed sanitation services (AOR = 2.88, 95% CI: 2.16 to 3.85; p-value <0.01). Other associated factors for childhood stunting were needs 1–15 minutes for water collection (AOR = 2.07, 95% CI: 1.46 to 2.94; p-va...

Research paper thumbnail of Prevalence of Suspected Cholangiocarcinoma Based on Ultrasonography Screening and its Associated Factors in Northeastern Thailand

Kathmandu University Medical Journal, Sep 30, 2022

Background Ultrasonography of the liver allows detection of liver mass and bile duct dilatation w... more 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.

Research paper thumbnail of The Role of Type 2 Diabetes Mellitus on the Clinical Manifestation of Pulmonary Tuberculosis: A Study from Nepal

Journal of Clinical and Diagnostic Research, 2019

Introduction: Tuberculosis (TB) ranks as the seventh leading cause of death in Nepal. Similarly, ... more Introduction: Tuberculosis (TB) ranks as the seventh leading cause of death in Nepal. Similarly, the prevalence of Diabetes Mellitus (DM) has also shown an increasing trend in the country and it has been observed that diabetes is strongly associated with falling treatment outcome of tuberculosis. Hence, the association of tuberculosis with Type 2 Diabetes Mellitus (T2DM) might be higher than the assumption and it needs more attention as well as appropriate measures to improve treatment outcomes of both diseases. Aim: To determine the risk factors of T2DM comorbidity among TB patients in the Central Development Region of Nepal. Materials and Methods: A case-control study was conducted by administration of structured questionnaire interview among all forms of pulmonary tuberculosis patients. A total of 102 tuberculosis patients with T2DM who met the inclusion criteria were considered as cases and 306 non-diabetes tuberculosis cases were considered as controls. The study was conducted among the patients attending the tuberculosis treatment centres of all 19 districts of central Nepal. The risk factors of diabetes among tuberculosis patients was estimated by using unconditional multiple logistic regression, adjusted odds ratio and their 95% CI were measured. Results: This present study found that the risk factors of type 2 DM comorbidity among tuberculosis patients were; age ≥45 years (adj. OR=8.00, 95% CI: 4.21-15.21, p-value <0.001), formal education (adj. OR=2.12, 95% CI: 1.08-4.15, p-value is 0.027), being underweight {Body Mass Index (BMI) <18.5 Kg/m 2 } (adj. OR=2.61, 95% CI: 1.49-4.59, p-value <0.001) and with diastolic blood pressure ≥80 (adj. OR=3.05, 95% CI: 1.72-5.43, p-value <0.001). In addition, tuberculosis patients who visited more than two health facilities for diagnosis and treatments (adj. OR=2.06, 95% CI: 1.10-3.85, p-value is 0.024) and had medium level of knowledge (60-80%) on tuberculosis and diabetes (adj. OR=2.19, 95% CI: 1.09-4.39, p-value is 0.027) were more prone to having tuberculosis and diabetes. Conclusion: Tuberculosis with diabetes is strongly associated with age, education, hypertension comorbidity as well as delayed diagnosis. Therefore, regular DM screening program as well as timely health monitoring system of tuberculosis patients will enhance the tuberculosis control program in reducing TB burden from delayed cure in Nepal.

Research paper thumbnail of Prevalence and Determinants of Type 2 Diabetes among the Pulmonary Tuberculosis Cases in Nepal: A Cross Sectional Study

Kathmandu University Medical Journal, Dec 31, 2021

Background Since prehistoric time to the earlier 20th century, diabetes was accounted as comorbid... more Background Since prehistoric time to the earlier 20th century, diabetes was accounted as comorbidity 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/m 2 (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.

Research paper thumbnail of A collaborative approach to global health training in developing countries: Experience from Kathmandu University, Nepal

Annals of Global Health, 2014

Research paper thumbnail of Spatial association and modelling of under-5 mortality in Thailand, 2020

Geospatial Health

Under-5 mortality rate (U5MR) is a key indicator of child health and overall development. In Thai... more Under-5 mortality rate (U5MR) is a key indicator of child health and overall development. In Thailand, despite significant steps made in child health, disparities in U5MR persist across different provinces. We examined various socio-economic variables, health service availability and environmental factors impacting U5MR in Thailand to model their influences through spatial analysis. Global and Local Moran’s I statistics for spatial autocorrelation of U5MR and its related factors were used on secondary data from the Ministry of Public Health, National Centers for Environmental Information, National Statistical Office, and the Office of the National Economic and Social Development Council in Thailand. The relationships between U5MR and these factors were modelled using ordinary least squares (OLS) estimation, spatial lag model (SLM) and spatial error model (SEM). There were significant spatial disparities in U5MR across Thailand. Factors such as low birth weight, unemployment rate, an...

Research paper thumbnail of Feasibility of implementing public-private mix approach for tuberculosis case management in Pokhara Metropolitan City of western Nepal: a qualitative study

Frontiers in Public Health

BackgroundThe Public-Private Mix (PPM) approach is a strategic initiative that involves engaging ... more BackgroundThe Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal.MethodsWe conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers.ResultsA total of 20 respondents participated in the study. Barriers to PPM were identifie...

Research paper thumbnail of The role of Diabetes mellitus comorbidity on Tuberculosis treatment outcomes in Nepal: A prospective cohort study

South Eastern European Journal of Public Health

Aim: The Objective of this study was to assess the effect of Diabetes Mellitus (DM) on treatment ... more Aim: The Objective of this study was to assess the effect of Diabetes Mellitus (DM) on treatment outcomes of tuberculosis (TB) patients in the Central Development Region of Nepal. Methods: A prospective cohort study was conducted in central Nepal. The study population of n=408 was consecutively recruited from treatment centers of all 19 districts of central Nepal. The TB cases (n=306) and TB with DM (n=102) cases were followed up for the estimation of blood glucose level, HbA1c level, and sputum examination on 2, 5, and 6 months after TB treatment started. The Generalized Estimating Equation (GEE) was performed to identify the risk ratio among TB and TB with DM cases on treatment outcome. Results: Our study identified that the magnitude of treatment failure among the tuberculosis cases was 19.7% (95% CI: 17.44-21.95). The GEE analysis observed that factors associated with the treatment failure had uncontrolled DM (HbA1C ≥7 %) (adj.RR=5.24, 95% CI: 2.58-10.62, P value <0.001), age...

Research paper thumbnail of Spatial pattern and heterogeneity of chronic respiratory diseases and relationship to socio-demographic factors in Thailand in the period 2016 to 2019

Geospatial Health

Chronic respiratory diseases (CRDs) constitute 4% of the global disease burden and cause 4 millio... more Chronic respiratory diseases (CRDs) constitute 4% of the global disease burden and cause 4 million deaths annually. This cross-sectional study used QGIS and GeoDa to explore the spatial pattern and heterogeneity of CRDs morbidity and spatial autocorrelation between socio-demographic factors and CRDs in Thailand from 2016 to 2019. We found an annual, positive, spatial autocorrelation (Moran’s I >0.66, p<0.001) showing a strong clustered distribution. The local indicators of spatial association (LISA) identified hotspots mostly in the northern region, while coldspots were mostly seen in the central and north-eastern regions throughout the study period. Of the socio-demographic factors, the density of population, households, vehicles, factories and agricultural areas, correlated with the CRD morbidity rate, with statistically significant negative spatial autocorrelations and coldspots in the north-eastern and central areas (except for agricultural land) and two hotspots between f...

Research paper thumbnail of The role of Diabetes mellitus comorbidity on Tuberculosis treatment outcomes in Nepal: A prospective cohort study

DOAJ (DOAJ: Directory of Open Access Journals), Mar 1, 2022