Corona-virus disease (COVID-19) related research proposals approved and being implemented by Nepal Health Research Council:
Title: Assessment of COVID-19 specific symptoms in those people returned from foreign countries to Nepal.
Summary: At the phase of having only imported cases, Nepal should make utmost effort to prevent local transmission and subsequently community transmission. For this, we need to identify our base population, i.e., all people who have recently returned from abroad and their contacts. We should detect the primary cases and their contacts, orient them (on home-quarantine; health facilities visit requirements), and follow-up with them (to monitor the compliance to home-quarantine). We also have to ensure best possible measures to protect the high-risk individuals (e.g. the elderly, those with comorbidities). This proposal will gather the information of COVID symptoms, quarantine, perceived risk and family members on people who have returned from foreign countries.
Title: Assessment of Country preparedness of Nepal for responding to COVID-19 pandemic.
There has been a continuous increase in SARS COV-2 (COVID-19) infected cases which is rapidly expanding to many countries and territories. Considering this pandemic, Nepal Health Research Council is conducting research that aims to assess and explore the present situation of COVID designated hospitals and clinics in terms of readiness for responding to COVID-19 pandemic. This study also aims to assess and explore emergency preparedness and readiness for responding to COVID-19 pandemic, by the Government of Nepal at Federal and Provincial level. Assessment domains align with WHO guidelines for COVID-19 preparedness and response. The methodology used in this study is semi-structured face to face/ phone interview with the concerned stakeholders/focal persons actively involved in COVID-19 related tasks. Descriptive and thematic analysis will be done to present the study outcomes. The study outcomes will be disseminated at all levels using seminars and webinars and a report will be prepared for the Government of Nepal to prepare a Strategic Plan.
Title: Comparative Evaluation of Commercially available Rapid Diagnostic Test Kits for the use of Screening of Suspected Cases of Novel Corona virus infection in Nepal.
Summary: Corona viruses are a large family of viruses that mostly cause respiratory illness in humans. Recently identified corona viruses caused illness like Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS) and, most recently, Corona Virus Disease- 19 (COVID – 19). The virus (which was initially called the novel corona virus 2019) has been named SARS- CoV2, and was first identified in the Hubei province in China. The World Health Organization (WHO) has declared the COVID -19 as a global pandemic. More than 160 countries have been affected by the virus, with about 250, 000 individuals infected by it and the number of deaths has exceeded 10, 000. While various clinical features of the diseases have been documented (based on various individual case reports and case series), the complete clinical profile is yet to be understood. A recent study has shown the serial interval for COVID- 19 to be around 4 days, making silent transmission a potential threat for the spread of the disease.1 Considering these facts, diagnostic tests play a vital role in identifying cases and preventing the further spread of the virus in the community. The most widely used confirmatory test for COVID 19 is real-time reverse transcriptase Polymerase Chain Reaction (rRT-PCR). However, the rRT-PCR is a time intensive test and one that requires professional laboratory setting. Hence, several countries have been using Rapid Diagnostic Tests (RDT) to screen for possible COVID 19 infection In Nepal, there are currently no RDTs that have been evaluated for efficacy against the most sensitive rRT-PCR test. In case of an outbreak, community screening of suspected cases needs to be done to establish the presence of COVID-19 transmission in the community. The findings from this study will help the Ministry of Health and Population to develop policy regarding RDT kit use detect and diagnoses cases of COVID- 19 in areas where RT-PCR is not practical or possible. This research aims to evaluate commercially available RDTs for SARS-CoV2 (COVID 19) against the most sensitive and WHO/CDC standardized rRT-PCR and to establish the laboratory based confirmation of the COVID19 cases among the clinically suspected refereed cases. Study area is Kathmandu Valley. Study Design is community based quantitative cross-sectional study. For sample Size, a minimum of 150 cases and about 50% of asymptomatic people as controls will be selected uprposively. Cases will be included if they are suspected, probable and confirmed cases/specimens of COVID- 19. Selection will also be done with the indication of Emergency Health Care Covid 19 Triage Scale Clinical Specimen will be whole blood for RDT and Naso/ Oropharyngeal swab or sputum for rRT-PCR. For the safety of Data Collectors, Training will be provided, PPE will be provided and Health Insurance will be covered. Data will be cleaned, coded and analyzed using descriptive and analytical statistics.
Title: An online survey on Stress, anxiety, depression and their associated factors among health care workers during COVID 19 pandemic in Nepal.
Summary: The Novel Corona virus Disease (COVID 19) is a pandemic disease which is contagious and has quickly spread globally through human-to-human transmission. Several studies from various countries suggest that frontline health care workers suffer from stress, anxiety, depression and other psychological problems during a pandemic like COVID 19. This Study aims to assess the level of depression, anxiety and stress among healthcare workers who are on duty round the clock as front line health care workers. Descriptive cross-sectional study design with quantitative methods will be used. The study will be conducted in different health care settings of all 7 provinces of Nepal. Online survey sampling method will be adopted. Required data will be collected using Self Reported Tool. This Tool comprises two parts. Part one includes socio-demographic, socio-economic and Job related information. Part two includes Depression, Anxiety and Stress (DASS 21) self reported validated standard scale. Data will be collected through online method. Collected data will be entered into SPSS (version 16) and analyzed using both descriptive and inferential statistics. Ethical approval will be taken from Nepal Health Research Council (NHRC).
Title: Public understanding and Response about COVID-19 in Nepal.
Summary: Corona virus is an infectious disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The virus is mainly spread between people during close contact, often via small droplets produced during coughing, sneezing, or talking. World Health Organization (WHO) has announced COVID-19 outbreak a global pandemic. No promising treatment modality has been available to date. However, different studies have been conducting in different countries. Social distancing and strictly adhering to the preventive measures (regular hand wash, use of masks and staying at home) to stop or reduce the spread of COVID-19 is the option for now. The public response to the preventive measures to break the chain of transmission depends upon their understanding on COVID-19. Therefore, it is an important role of concerned government authorities in disseminating the appropriate information to general public related to the disease condition to contain the spread the chain of transmission of COVID-19. The aim of present study to assess the public understanding of COVID-19 and their response and provide evidence to guide the national authorities to contain the outbreak through public response.
Title: Assessment on the Psychological Impact of Quarantine in Covid-19 Pandemic in Nepal.
Summary: The recent outbreak of respiratory disease caused by a novel coronavirus (officially named “SARS-CoV-2”) has gained attention globally and was recognized as a significant public health threat by US Centers for Disease Control and Prevention (CDC). The first case was detected in Wuhan City, Hubei Province, China and has since spread rapidly (1). On March 11th 2020, the World Health Organization (WHO) declared the Covid-19 outbreak a global pandemic. The SARS-CoV-2 is the third coronavirus emerging in the human population in the past 20 years, preceded by the SARS-CoV outbreak in 2002 and the MERS-CoV outbreak in 2012. This has put global health institutions on high alert. At present, no antiviral medication or vaccine is available for SARS-CoV-2 infection. Infected patients are managed with supportive care. In spite of the fact that several countries in the West have established procedures for psychological crisis interventions to deal with public health emergencies, mental health care for the patients and health professionals directly suffering from the Covid-19 epidemic has not been paid enough attention. With disease progression, clinical symptoms become severe and psychological problems in infected patients will change; therefore, psychological intervention measures should be targeted and adapted as appropriate. Studies have confirmed that individuals who have experienced public health emergencies still have varying degrees of stress disorders, even after the event is over, or after they have been cured and discharged from hospital, indicating these individuals should not be ignored in both psychological aspect and solution. Therefore, our study is conducted to assess the psychological impact of the Covid-19 quarantine experience and how they cope with stress. This multicenter survey aims to assess the psychological impact of the Covid-19 quarantined experience on people in quarantine areas all over the world and evaluate the ways they confront stress during that period. This will be a Cross-sectional study conducted between April to June 2020 with followed up in April 2021. Quarantined hospital and center will be included. Quarantined people who are suspected or confirmed to have Covid-19 in the quarantine hospitals or areas. We will exclude participants who cannot communicate in the vernacular of the translated questionnaire. The survey will be conducted by convenient sampling. The survey is a structured questionnaire based on the checklist and the previous questionnaire about psychological trauma, Perceived Stress Scale (PSS). Included questions are about demographic, personal medical aspects, and quarantine experience. The questionnaire will be translated into the native languages and back translated. Pretest and post-test will also be conducted for the translated version. To gather the information about the quarantine experience and its psychological effect on the participants from various countries, we developed an online questionnaire using SurveyMonkey© that limits one-time participation per unique IP address. However, participants can choose to use hard-printed copies prepared by the local collaborators. One-year follow up will be conducted in April- June 2021 (optional for local site) to assess the persistent psychological effect.