Studies from developed countries have reported on host-related risk factors for extra-pulmonary tuberculosis (EPTB). However, similar studies from high-burden countries like Nepal are lacking. Therefore, we carried out this study to compare demographic, life-style and clinical characteristics between EPTB and PTB patients.

Background: The World Health Organization estimates that seeking prompt and appropriate care could reduce child deaths due to acute respiratory infections by 20%. The purpose of our study was to assess care seeking behaviour of the mothers during childhood illness and to determine the predictors of mother's care seeking behaviour. Methods: A cross-sectional survey was conducted in the immunization clinics of Pokhara city, Kaski district, western Nepal. A trained health worker interviewed the mothers of children suffering from illness during the preceding 15 days. Results: A total of 292 mothers were interviewed. Pharmacies (46.2%) were the most common facilities where care was sought followed by allopathic medical practitioners (26.4%). No care was sought for 8 (2.7%) children and 26 (8.9%) children received traditional/home remedies. 'Appropriate', 'prompt' and 'appropriate and prompt' care was sought by 77 (26.4%), 166 (56.8%) and 33 (11.3%) mothers respectively. The mothers were aware of fever (51%), child becoming sicker (45.2%) and drinking poorly (42.5%) as the danger signs of childhood illness. By multiple logistic regression analysis total family income, number of symptoms, mothers' education and perceived severity of illness were the predictors of care seeking behaviour. Conclusion: The results of the present study show that the mothers were more likely to seek care when they perceived the illness as 'serious'. Poor maternal knowledge of danger signs of childhood illness warrants the need for a complementary introduction of community-based Integrated Management of Childhood Illness programmes to improve family's care seeking behaviour and their ability to recognize danger signs of childhood illness. Socioeconomic development of the urban poor may overcome their financial constraints to seek 'appropriate' and 'prompt' care during the childhood illness.

About 98% of newborn deaths occur in developing countries, where most newborns deaths occur at home. In Nepal, approximately, 90% of deliveries take place at home. Information about reasons for delivering at home and newborn care practices in urban areas of Nepal is lacking and such information will be useful for policy makers. A cross-sectional survey was carried out in the immunisation clinics of Pokhara city, western Nepal during January and February, 2006. Two trained health workers administered a semi-structured questionnaire to the mothers who had delivered at home. A total of 240 mothers were interviewed. Planned home deliveries were 140 (58.3%) and 100 (41.7%) were unplanned. Only 6.2% of deliveries had a skilled birth attendant present and 38 (15.8%) mothers gave birth alone. Only 46 (16.2%) women had used a clean home delivery kit and only 92 (38.3%) birth attendants had washed their hands. The umbilical cord was cut after expulsion of placenta in 154 (64.2%) deliveries and cord was cut using a new/boiled blade in 217 (90.4%) deliveries. Mustard oil was applied to the umbilical cord in 53 (22.1%) deliveries. Birth place was heated throughout the delivery in 88 (64.2%) deliveries. Only 100 (45.8%) newborns were wrapped within 10 minutes and 233 (97.1%) were wrapped within 30 minutes. Majority (93.8%) of the newborns were given a bath soon after birth. Mustard oil massage of the newborns was a common practice (144, 60%). Sixteen (10.8%) mothers did not feed colostrum to their babies. Prelacteal feeds were given to 37(15.2%) newborns. Initiation rates of breast-feeding were 57.9% within one hour and 85.4% within 24 hours. Main reasons cited for delivering at home were 'preference' (25.7%), 'ease and convenience' (21.4%) for planned deliveries while 'precipitate labor' (51%), 'lack of transportation' (18%) and 'lack of escort' during labor (11%) were cited for the unplanned ones. High-risk home delivery and newborn care practices are common in urban population also. In-depth qualitative studies are needed to explore the reasons for delivering at home. Community-based interventions are required to improve the number of families engaging a skilled attendant and hygiene during delivery. The high-risk traditional newborn care practices like delayed wrapping, bathing, mustard oil massage, prelacteal feeding and discarding colostrum need to be addressed by culturally acceptable community-based health education programmes.

The COVID-19 pandemic currently expanded its roots to the 206 countries in the world. The morbidity and mortality are not only threat to humans but also its impact on economy is indirectly affecting us. The current review was done to find trend in various states of India. Data was collected from Ministry of Health and Family Welfare and descriptive analysis of the distribution of COVID-19 cases in different states of India. First case of COVID-19 was diagnosed in southern most state Kerala and after that it has spread to all other states but situations are more worsen in states with high international migration. Maharashtra is now the most affected state followed by Delhi. Among epidemic curve of all these states, Maharashtra has rapidly growing epidemic curve with highest slope, whereas Kerala has the lowest. When we compared the day wise cumulative case fatality rate, it was found that the case fatality rate of the states like Maharashtra, Madhya Pradesh & Rajasthan showed decrease in the case fatality rate over the period. Population density is also one of the key determinants of social interaction and thus the spread of disease specifically in communicable diseases. Government of India had taken many strong initiatives e.g. 40 days nation-wide lockdown, thermal screening at airport, announcement of relief packages for poor and quarantine of outsiders but still there are many missed opportunities like, early stoppage of international traffic, compulsory quarantine for all international travellers, better contact tracing, strong law and order and better preparedness plan.

Uttar Pradesh, India's largest state, faces critical pollution levels, necessitating urgent action. The National Clean Air Programme (NCAP) targets a 40% reduction in particulate pollution by 2026. This study assesses the impact of NCAP on 15 non-attainment cities in Uttar Pradesh using the Prophet forecasting model. Monthly data on AQI and ${\text{PM}}_{10}$ concentrations from 2016 to 2023 were sourced from the Uttar Pradesh Pollution Control Board. Significant changes in mean AQI and ${\text{PM}}_{10}$ levels from 2017 to 2023 were evaluated using the Friedman test. Prophet models forecast ${\text{PM}}_{10}$ concentrations for 2025–26, with relative percentage changes calculated and model evaluation metrics assessed. Most cities exhibited unhealthy air quality. Jhansi had the lowest AQI (72.73) in 2023, classified as ‘moderate’ by WHO standards. Gorakhpur consistently showed ‘poor’ AQI levels, peaking at 249.31 in 2019. Western Uttar Pradesh cities such as Ghaziabad, Noida, and Moradabad had significant pollution burdens. Predictions showed Bareilly with over a 70% reduction in ${\text{PM}}_{10}$ levels, Raebareli 58%, Moradabad 55%, Ghaziabad 48%, Agra around 41%, and Varanasi 40%, meeting NCAP targets. However, Gorakhpur and Prayagraj predicted increases in ${\text{PM}}_{10}$ levels by 50% and 32%, respectively. Moradabad's model showed the best performance with an ${\mathrm{R}}^2$ of 0.81, MAE of 17.27 $\mu \mathrm{g}/{\mathrm{m}}^3$, and MAPE of 0.10. Forecasting ${\text{PM}}_{10}$ concentrations in Uttar Pradesh's non-attainment cities offers policymakers substantial evidence to enhance current efforts. While existing measures are in place, our findings suggest that intensified provisions may be necessary for cities predicted to fall short of meeting program targets. The Prophet model's forecasts can pinpoint these at-risk areas, allowing for targeted interventions and regional adjustments to strategies. This approach will help promote sustainable development customized to each city's specific needs. No funding was issued for this research.

Objectives: To assess the immunization status of children in the age group 12-23 months and to know the reasons for non-immunization of children. Method: - A cross-sectional survey was conducted using WHO’s thirty cluster sampling technique in rural and urban areas of Bareilly district from August 2008 to January 2009. Rural areas were divided into blocks and blocks were divided into villages. Urban areas were divided into wards. Villages and wards were taken as clusters. During the house-to-house survey, a total of 240 children of age 12-23 months were included in the present study. Result: only around 50% of children were fully immunized while 27.5% were partially and 22.5 % were not immunized at all. Immunization coverage was highest for BCG (62.5%) and lowest for measles (39.2%). Dropout rates were 37.3%, 19.7% and 18.2% for BCG to measles, DPT1 to DPT3 and OPV1 to OPV3 respectively. Vitamin A prophylaxis showed a decline from 38.3 % to 16.7%. Amongst the various reasons for not immunizing the child, the most common in both rural (78.7%) and urban areas (28.6%) was lack of awareness for the need of vaccination. However in rural areas lack of availability of services (87.2%) was the major cause for not immunizing the child. Conclusion: The present study shows a low coverage of immunization and Vitamin A prophylaxis in both rural and urban areas. Important reasons for non-immunization were lack of awareness about vaccination and availability of immunization services in rural areas and urban areas.Key Words: Immunization coverage; Children between 12-23 months; Vitamin A Prophylaxis.DOI: http://dx.doi.org/10.3126/nje.v1i2.5091 Nepal Journal of Epidemiology 2011;1 (2):47-50