- Research Article
- 10.1016/j.puhip.2026.100772
Community-based HyPertension Control (CHPC) in Nepal: Cluster randomized implementation trial protocol.
- Jun 01, 2026
- Public health in practice (Oxford, England)
- Archana Shrestha + 17 more +17
Publications from 2021 to 2026
Showing 10 of 938 papers
Community-based HyPertension Control (CHPC) in Nepal: Cluster randomized implementation trial protocol.
What drives methane emissions from sanitation containment systems?
Onsite sanitation coverage has expanded significantly since 2020, driven by global commitments to eliminate open defecation and the need for adaptable solutions in rapidly urbanising small- and medium-sized cities (<1 million inhabitants) in Low- and Middle-Income Countries. Currently, 53% of individuals with access to a toilet depend on onsite sanitation systems. Despite this prevalence, the contribution of greenhouse gas emissions from household-level excreta storage to climate change remains poorly quantified due to limited empirical evidence. We addressed this gap by conducting direct measurements of methane emissions from 146 onsite sanitation containment units locally referred as pit latrines, holding tanks and septic tanks, across Senegal, Ethiopia, Uganda and Nepal. Methane emission rates exhibited strong skewness with a geometric mean of 7.9 g CH₄ capita⁻¹ day⁻¹, indicating that onsite sanitation containment units alone may account for approximately 3.8% of global anthropogenic CH₄ emissions.
Read moreEffectiveness of School Nurses promoting Oral Health among 7-15 Years old School Children in Nepal
Flood Hazard Mapping and Risk Evaluation in the Lower Karnali River Basin of Nepal
This study presents flood hazard mapping and risk assessment using a hydrodynamic simulation in HEC-RAS tool, focusing on a 38 km stretch of the river from Chisapani to the Nepal-India border in the Lower Karnali River Basin (KRB). A time series of daily mean discharge records from the Chisapani gauging station was used for model simulations. Flood magnitudes of 10-, 20-, 50-, and 100- year return periods (YRPs) were estimated using Gumbel’s distribution, with the 100-YRP daily discharge of 20,343 m3/s. Field surveys were conducted in flood-prone areas of Rajapur Municipality using the Vulnerability and Risk Assessment (VRA) framework. Results show that parts of Rajapur Municipality, Wards #1, #3, #4, and #7 are susceptible to inundation, even during normal flood events, with water depths reaching upto 10 m posing significant risk to the communities inhabiting in these areas. Agricultural land is particularly exposed, posing serious risks to food security and livelihoods. Moreover, even after a five-year return period, the 2014 flood simulations (equal to a 100-YRP) indicate that these wards remains highly vulnerable. This findings emphasizes the urgent need for improved settlement planning and the development of effective flood control measures in Rajpur Municipality.
Read moreImmunoregulatory effects of Choerospondias axillaris (Roxb.) B.L.Burtt & A.W.Hill fruit extract in mice with insights on in vitro mechanism.
Lapsi (Choerospondias axillaris), a plant native to Nepal, has been traditionally used in Asian countries to treat cardiovascular conditions. However, its effects on immune regulatory function remain largely unexplored. This study aimed to in vivo evaluate the immunoregulatory properties of Lapsi fruit extract in mice on immunotoxic responses with analysis on in vitro mechanism for immune suppression, oxidative stress, and inflammatory response. Male Balb/c mice were intragastrically administered various doses of the extract for 21 days. In some mice, immune suppression was induced with cyclophosphamide, and subsequent immune recovery was assessed. In addition, RAW264.7 cells and THP-1-derived macrophages were treated in vitro with lipopolysaccharide and different concentrations of the extract. Administration of extract increased the IgG2a/IgG1 ratio while reducing serum IgE and IgG1 level compared with control mice. Tumor necrosis factor (TNF)-α and interleukin (IL)-17 levels were lower in splenic culture supernatants of mice administered extract. Lapsi extract also effectively reversed cyclophosphamide (CP)-induced immunosuppression by enhancing serum levels of IgA and IgG2a, of interferon-γ and interleukin (IL)-4 secreted by splenic T cells, and of IgG1 and IgG2a secreted by B cells, as well as by increasing immune cell counts. In cell cultures, the extract decreased the levels of inflammation markers, including nitric oxide, reactive oxygen species, prostaglandin E2, and pro-inflammatory cytokines (IL-6, TNF-α, and IL-1β). Mechanistic analysis showed that Lapsi extract modulated the NF-κB p65, MAPK, and inflammasome pathways. Lapsi extract may act as both an immunostimulatory and anti-inflammatory agent, indicating its potential as a candidate immunomodulatory activity under polyclonal and CP-suppressed conditions; however, further disease-specific studies, along with isolation and characterization of active phytochemicals, are warranted to evaluate its therapeutic applicability.
Read moreDynamic Variations in Soil Properties in Different Land Use Types in Doti District, Nepal
Soil quality is one of the primary factors influencing how many and what kind of crops can be grown and what success ecosystems will have over the long term. Knowledge about how gradients of agroecology and land-use systems affect soil quality is essential in proposing sustainable farming practices. This study assesses the spatial variability of selected physical and chemical properties of soil across three ecological zones—lowland, midland, and highland—and three land use types: traditional agricultural practice, commercial vegetable cultivation, and barren land. The research was carried out in the Doti district of Nepal. A total of 144 soil samples were collected from four depths (0-15, 15-30, 30-60, and >60 cm intervals) for the purpose and were then tested for temperature, moisture, bulk density, pH, total nitrogen, available potassium, available phosphorus, organic carbon, and cation exchange capacity. The data collected indicated a significant variousness (p < 0.05) of characteristics under different land uses, signifying that chemically all the land-use types were chemically variable in nature. Another low value witnessed was in the bulk density of the soils, which was 0.88±0.04 g/cm3. This means that the structure and nutrients will be better due to the high amount of organic matter. The highest organic carbon and cation exchange capacity were in the highland zones. In contrast, the barren land soils had a trend indicating a decline in nutrient status and increasing compaction and acidity. Nutrient concentration significantly decreased with increasing depth, pointing to the fact that the most sensitive layer to management changes is the uppermost layer. The study emphasized the need to develop zone-specific soil management strategies, through which one seeks to enhance the organic matter available in soil, protect against erosion, and achieve sustainable intensification to make the soil resilient and productive in agriculture in the case of Doti.
Read moreMulti-instrument geophysical monitoring of a km-scale slow-moving landslide in Nepal: Technical insights and preliminary results
Himalayan slopes are highly exposed to landslides, primarily triggered by earthquakes and monsoon precipitation. Satellite methods offer unrivalled spatial coverage of surface displacements on a weekly scale. However, they do not directly provide details of deformation at depth, nor do they offer sufficient temporal resolution to elucidate the continuity or intermittent nature of the landslide deformation during phases of heavy rainfall, strong rise in the water table or during intermediate seismic shaking. To address these issues in the context of the ANR/FNR project "SLIDE", we have recently deployed in late October 2025 a geophysical network at the level of one active, km-scale cultivated landslide in Nepal consisting in 16 co-located seismic and GNSS stations and one metereological station.In this presentation, we will present the practical aspects of deploying and maintaining these instruments in remote Himalayan terrain. Each system required specific installation techniques and careful site selection to ensure stable measurements and long-term performance. Field operations were challenged by difficult access, variable road conditions, limited power availability, and unpredictable weather. Beyond technical challenges, community engagement is essential and close collaboration with local residents guided several site choices. We will also show the preliminary analysis of seismic, GNSS and meteorological data over the first 6 months of operation, which will be applied in the next three years to derive temporal and spatial changes of the landslide properties.
Read moreAgricultural Runoff and Waterborne Disease in Primary Care: A Review
Contamination of agricultural water poses significant health risks that are often underrecognized in clinical practice. This review synthesizes peer-reviewed literature from biomedical and environmental sciences. It examines the pathways by which nitrates and zoonotic pathogens contaminate rural drinking water and delineates the resulting spectrum of acute and chronic health risks relevant to primary care. Agricultural practices are a primary source of nitrates and pathogens (e.g., Escherichia coli, Cryptosporidium, Giardia) in rural water supplies. Nitrate nitrogen exposure is linked not only to acute infant methemoglobinemia but also to chronic conditions like colorectal and thyroid cancers and adverse birth outcomes. These risks are observed at concentrations below the current United States Environmental Protection Agency regulatory limit of 10 mg L−1 NO3−–N. Pathogen exposure leads to acute gastrointestinal illness and can trigger long-term sequelae, including irritable bowel syndrome. Agricultural communities are uniquely vulnerable because they rely heavily on unregulated private wells, which are more prone to contamination than public systems. Evidence suggests a substantial and often underrecognized burden of waterborne disease in agricultural communities. The findings highlight a critical need for clinical vigilance regarding low-level nitrate nitrogen exposure and long-term post-infectious syndromes. By identifying these patterns, family physicians serve as essential sentinels for both individual patient safety and community public health.
Read moreSeismic enhancement of community housings in Nepal’s mid-Himalayas: Retrofitting and reconstruction scenarios
Nepal lies within the Himalayan seismic belt, making it one of the most earthquake-prone regions globally. Non-engineered masonry structures, though widely used, are highly vulnerable to seismic disasters. Replacing these structures is impractical and culturally insensitive due to their deep traditional and cultural significance. Retrofitting is a practical and culturally appropriate approach to enhance a building’s strength and safety against earthquakes. This study evaluates retrofitting and reinforcement techniques for unreinforced masonry (URM) structures in Nepal's mid-Himalayan region through numerical modelling, non-linear static analysis, and fragility assessment. Pushover analysis revealed that reconstruction models significantly improve base shear capacity compared to the URM model. Although gabion wire retrofitting has a limited effect at the initial stage, it significantly improves strength at larger displacements. Vertical reinforcements and horizontal bands in the reconstruction model consistently enhance performance. The URM model exhibits concentrated cracking near openings and corners, while the retrofitted model improves stress distribution and reduces crack widths. Additionally, the reconstruction model confines cracks within bands, preventing vertical propagation and ensuring superior structural integrity. Fragility curves reveal that reinforcement significantly enhances seismic performance, as the retrofitted model improves resistance across damage states, with exceptional collapse resistance due to its ductility, allowing energy absorption and delayed failure. The reconstruction model offers consistent protection with lower probabilities of damage across all states, underscoring its reliability during seismic events. Although the reconstruction model incurs higher costs than the retrofitted model due to its extensive reinforcement features, both models provide substantial seismic benefits compared to the base URM model.
Read moreNationalism, Unity, and Strategic Resilience: Nepal’s Evolving Security Paradigm
Nepal’s unique geopolitical location, deep social diversity, and enduring history of safeguarding sovereignty situate nationalism and national unity at the core of its security discourse. From the foundational unification campaigns of Prithvi Narayan Shah’s Dibya Upadesh to Nepal’s contemporary leadership in global peacekeeping, national resilience has consistently emerged from the cohesion between the state and its diverse populace. In this light, this paper argues that an inclusive civic nationalism, grounded in respect for cultural plurality and a shared constitutional identity, functions as a strategic capital for national security. Such a strong unity enhances collective capacities, invigorates the country to promptly respond to crises, and strengthens international credibility and legitimacy. Employing a qualitative approach that analyses historical records, official policy documents, and secondary scholarly literature, this study examines how unity enhances resilience against modern multidimensional security threats. These risks include non‑traditional challenges like natural disasters (the 2015 earthquake), public health crises (the COVID‑19 pandemic), digital misinformation, and recent social unrest (the Gen‑Z Movement 2025). The research examines the evolution of Nepal’s security paradigm by analyzing the Nepali Army’s constitutionally defined role under civilian authority to assess how institutional restraint and adherence to constitutional democratic Values contribute to nationalism, national unity, and strategic resilience. The findings conclusively suggest that inclusively cultured nationalism strengthens Nepal’s adaptive capacity and provides the necessary social cohesion to address both internal polarization and complex cross‑border challenges. Ultimately, the study reasserts that the nation’s most enduring guarantee of stability rests upon the confidence and inclusion of its people.
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