|
|
<?xml version="1.0" encoding="utf-8"?> |
|
|
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.1d3 20150301//EN" "http://jats.nlm.nih.gov/publishing/1.1d3/JATS-journalpublishing1.dtd"> |
|
|
<article article-type="research-article" dtd-version="1.1d3" xml:lang="en" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> |
|
|
<front> |
|
|
<journal-meta> |
|
|
<journal-id journal-id-type="nlm-ta">PLOS Glob Public Health</journal-id> |
|
|
<journal-id journal-id-type="publisher-id">plos</journal-id> |
|
|
<journal-id journal-id-type="pmc">plosgph</journal-id> |
|
|
<journal-title-group> |
|
|
<journal-title>PLOS Global Public Health</journal-title> |
|
|
</journal-title-group> |
|
|
<issn pub-type="epub">2767-3375</issn> |
|
|
<publisher> |
|
|
<publisher-name>Public Library of Science</publisher-name> |
|
|
<publisher-loc>San Francisco, CA USA</publisher-loc> |
|
|
</publisher> |
|
|
</journal-meta> |
|
|
<article-meta> |
|
|
<article-id pub-id-type="doi">10.1371/journal.pgph.0000278</article-id> |
|
|
<article-id pub-id-type="publisher-id">PGPH-D-21-00572</article-id> |
|
|
<article-categories> |
|
|
<subj-group subj-group-type="heading"> |
|
|
<subject>Research Article</subject> |
|
|
</subj-group> |
|
|
<subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>People and places</subject><subj-group><subject>Population groupings</subject><subj-group><subject>Families</subject><subj-group><subject>Mothers</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>Medicine and health sciences</subject><subj-group><subject>Epidemiology</subject><subj-group><subject>Pandemics</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>Medicine and health sciences</subject><subj-group><subject>Medical conditions</subject><subj-group><subject>Infectious diseases</subject><subj-group><subject>Viral diseases</subject><subj-group><subject>COVID 19</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>People and places</subject><subj-group><subject>Geographical locations</subject><subj-group><subject>Asia</subject><subj-group><subject>Nepal</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>Medicine and health sciences</subject><subj-group><subject>Health care</subject><subj-group><subject>Socioeconomic aspects of health</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>Medicine and health sciences</subject><subj-group><subject>Public and occupational health</subject><subj-group><subject>Socioeconomic aspects of health</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>Biology and life sciences</subject><subj-group><subject>Organisms</subject><subj-group><subject>Viruses</subject><subj-group><subject>RNA viruses</subject><subj-group><subject>Coronaviruses</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>Biology and life sciences</subject><subj-group><subject>Microbiology</subject><subj-group><subject>Medical microbiology</subject><subj-group><subject>Microbial pathogens</subject><subj-group><subject>Viral pathogens</subject><subj-group><subject>Coronaviruses</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>Medicine and health sciences</subject><subj-group><subject>Pathology and laboratory medicine</subject><subj-group><subject>Pathogens</subject><subj-group><subject>Microbial pathogens</subject><subj-group><subject>Viral pathogens</subject><subj-group><subject>Coronaviruses</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>Biology and life sciences</subject><subj-group><subject>Organisms</subject><subj-group><subject>Viruses</subject><subj-group><subject>Viral pathogens</subject><subj-group><subject>Coronaviruses</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>Medicine and health sciences</subject><subj-group><subject>Mental health and psychiatry</subject><subj-group><subject>Mood disorders</subject><subj-group><subject>Depression</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"> |
|
|
<subject>Social sciences</subject><subj-group><subject>Sociology</subject><subj-group><subject>Human families</subject></subj-group></subj-group></subj-group></article-categories> |
|
|
<title-group> |
|
|
<article-title>Impact of the COVID-19 pandemic on daily life and worry among mothers in Bhaktapur, Nepal</article-title> |
|
|
<alt-title alt-title-type="running-head">Impact and worry of the COVID-19 pandemic in Nepal</alt-title> |
|
|
</title-group> |
|
|
<contrib-group> |
|
|
<contrib contrib-type="author" xlink:type="simple"> |
|
|
<contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-0797-1286</contrib-id> |
|
|
<name name-style="western"> |
|
|
<surname>Ranjitkar</surname> |
|
|
<given-names>Suman</given-names> |
|
|
</name> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/data-curation/">Data curation</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/formal-analysis/">Formal analysis</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/investigation/">Investigation</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/methodology/">Methodology</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/project-administration/">Project administration</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-original-draft/">Writing – original draft</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review & editing</role> |
|
|
<xref ref-type="aff" rid="aff001"><sup>1</sup></xref> |
|
|
</contrib> |
|
|
<contrib contrib-type="author" corresp="yes" xlink:type="simple"> |
|
|
<contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-4038-151X</contrib-id> |
|
|
<name name-style="western"> |
|
|
<surname>Strand</surname> |
|
|
<given-names>Tor A.</given-names> |
|
|
</name> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/data-curation/">Data curation</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/formal-analysis/">Formal analysis</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/funding-acquisition/">Funding acquisition</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-original-draft/">Writing – original draft</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review & editing</role> |
|
|
<xref ref-type="aff" rid="aff002"><sup>2</sup></xref> |
|
|
<xref ref-type="aff" rid="aff003"><sup>3</sup></xref> |
|
|
<xref ref-type="corresp" rid="cor001">*</xref> |
|
|
</contrib> |
|
|
<contrib contrib-type="author" xlink:type="simple"> |
|
|
<contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-6193-4849</contrib-id> |
|
|
<name name-style="western"> |
|
|
<surname>Ulak</surname> |
|
|
<given-names>Manjeswori</given-names> |
|
|
</name> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/investigation/">Investigation</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/project-administration/">Project administration</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review & editing</role> |
|
|
<xref ref-type="aff" rid="aff001"><sup>1</sup></xref> |
|
|
<xref ref-type="aff" rid="aff002"><sup>2</sup></xref> |
|
|
</contrib> |
|
|
<contrib contrib-type="author" xlink:type="simple"> |
|
|
<contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-7737-1497</contrib-id> |
|
|
<name name-style="western"> |
|
|
<surname>Kvestad</surname> |
|
|
<given-names>Ingrid</given-names> |
|
|
</name> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/funding-acquisition/">Funding acquisition</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/methodology/">Methodology</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-original-draft/">Writing – original draft</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review & editing</role> |
|
|
<xref ref-type="aff" rid="aff003"><sup>3</sup></xref> |
|
|
<xref ref-type="aff" rid="aff004"><sup>4</sup></xref> |
|
|
</contrib> |
|
|
<contrib contrib-type="author" xlink:type="simple"> |
|
|
<contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0003-2304-0577</contrib-id> |
|
|
<name name-style="western"> |
|
|
<surname>Shrestha</surname> |
|
|
<given-names>Merina</given-names> |
|
|
</name> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review & editing</role> |
|
|
<xref ref-type="aff" rid="aff001"><sup>1</sup></xref> |
|
|
</contrib> |
|
|
<contrib contrib-type="author" xlink:type="simple"> |
|
|
<contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0003-3457-3379</contrib-id> |
|
|
<name name-style="western"> |
|
|
<surname>Schwinger</surname> |
|
|
<given-names>Catherine</given-names> |
|
|
</name> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review & editing</role> |
|
|
<xref ref-type="aff" rid="aff002"><sup>2</sup></xref> |
|
|
</contrib> |
|
|
<contrib contrib-type="author" xlink:type="simple"> |
|
|
<name name-style="western"> |
|
|
<surname>Chandyo</surname> |
|
|
<given-names>Ram K.</given-names> |
|
|
</name> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/data-curation/">Data curation</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/funding-acquisition/">Funding acquisition</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/investigation/">Investigation</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/methodology/">Methodology</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/project-administration/">Project administration</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/supervision/">Supervision</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review & editing</role> |
|
|
<xref ref-type="aff" rid="aff005"><sup>5</sup></xref> |
|
|
</contrib> |
|
|
<contrib contrib-type="author" xlink:type="simple"> |
|
|
<contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-6059-5080</contrib-id> |
|
|
<name name-style="western"> |
|
|
<surname>Shrestha</surname> |
|
|
<given-names>Laxman</given-names> |
|
|
</name> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/funding-acquisition/">Funding acquisition</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review & editing</role> |
|
|
<xref ref-type="aff" rid="aff001"><sup>1</sup></xref> |
|
|
</contrib> |
|
|
<contrib contrib-type="author" xlink:type="simple"> |
|
|
<name name-style="western"> |
|
|
<surname>Hysing</surname> |
|
|
<given-names>Mari</given-names> |
|
|
</name> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/funding-acquisition/">Funding acquisition</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/methodology/">Methodology</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/supervision/">Supervision</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-original-draft/">Writing – original draft</role> |
|
|
<role content-type="http://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review & editing</role> |
|
|
<xref ref-type="aff" rid="aff006"><sup>6</sup></xref> |
|
|
</contrib> |
|
|
</contrib-group> |
|
|
<aff id="aff001"><label>1</label> <addr-line>Department of Pediatrics, Child Health Research Project, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal</addr-line></aff> |
|
|
<aff id="aff002"><label>2</label> <addr-line>Center for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, Bergen, Norway</addr-line></aff> |
|
|
<aff id="aff003"><label>3</label> <addr-line>Department of Research, Innlandet Hospital Trust, Lillehammer, Norway</addr-line></aff> |
|
|
<aff id="aff004"><label>4</label> <addr-line>Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway</addr-line></aff> |
|
|
<aff id="aff005"><label>5</label> <addr-line>Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal</addr-line></aff> |
|
|
<aff id="aff006"><label>6</label> <addr-line>Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway</addr-line></aff> |
|
|
<contrib-group> |
|
|
<contrib contrib-type="editor" xlink:type="simple"> |
|
|
<name name-style="western"> |
|
|
<surname>Hall-Clifford</surname> |
|
|
<given-names>Rachel</given-names> |
|
|
</name> |
|
|
<role>Editor</role> |
|
|
<xref ref-type="aff" rid="edit1"/> |
|
|
</contrib> |
|
|
</contrib-group> |
|
|
<aff id="edit1"><addr-line>Emory University, UNITED STATES</addr-line></aff> |
|
|
<author-notes> |
|
|
<fn fn-type="conflict" id="coi001"> |
|
|
<p>The authors have declared that no competing interests exist.</p> |
|
|
</fn> |
|
|
<corresp id="cor001">* E-mail: <email xlink:type="simple">tor.strand@uib.no</email></corresp> |
|
|
</author-notes> |
|
|
<pub-date pub-type="epub"> |
|
|
<day>18</day> |
|
|
<month>4</month> |
|
|
<year>2022</year> |
|
|
</pub-date> |
|
|
<pub-date pub-type="collection"> |
|
|
<year>2022</year> |
|
|
</pub-date> |
|
|
<volume>2</volume> |
|
|
<issue>4</issue> |
|
|
<elocation-id>e0000278</elocation-id> |
|
|
<history> |
|
|
<date date-type="received"> |
|
|
<day>25</day> |
|
|
<month>8</month> |
|
|
<year>2021</year> |
|
|
</date> |
|
|
<date date-type="accepted"> |
|
|
<day>2</day> |
|
|
<month>3</month> |
|
|
<year>2022</year> |
|
|
</date> |
|
|
</history> |
|
|
<permissions> |
|
|
<copyright-year>2022</copyright-year> |
|
|
<copyright-holder>Ranjitkar et al</copyright-holder> |
|
|
<license xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple"> |
|
|
<license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p> |
|
|
</license> |
|
|
</permissions> |
|
|
<self-uri content-type="pdf" xlink:href="info:doi/10.1371/journal.pgph.0000278"/> |
|
|
<abstract> |
|
|
<p>The COVID-19 pandemic has affected many aspects of daily life worldwide, but the impact may be higher for impoverished populations. The main aim of this study is to describe the impact of the COVID-19 pandemic on different aspects of daily life in mothers in Nepal. We included 493 mothers of children aged 54–71 months participating in a randomized controlled trial on vitamin B12 supplementation. Mothers answered questions regarding the exposure and impact of the pandemic on their daily lives, and pandemic-related worries and sleep problems. We examined the extent to which worry, and sleep problems differed between mothers according to their exposure to COVID-19, socioeconomic status, and previous symptoms of depression. The mean age (SD) of the mothers was 32.3 (4.6) years and 54% had education below the secondary level. Of the mothers, 5.4% had either been exposed to someone who had tested positive or who had a family member with COVID-19. One-third of the participants responded that the pandemic had affected their economic situation, employment, and family life to a great deal. Both mothers and fathers with educational levels above 10 years or households with higher socioeconomic status had significantly higher average worry scores (maternal <italic>p</italic> = 0.020 and paternal <italic>p</italic> = 0.005). Mothers with a history of symptoms of depression had significantly more worry-related sleep problems during the pandemic (<italic>p</italic> = 0.020) than those without a history of depressive symptoms. Our study underlines the negative impact of the COVID-19 pandemic on diverse aspects of everyday life of mothers in Nepal.</p> |
|
|
</abstract> |
|
|
<funding-group> |
|
|
<award-group id="award001"> |
|
|
<funding-source> |
|
|
<institution>Innlandet Hospital Trust</institution> |
|
|
</funding-source> |
|
|
</award-group> |
|
|
<award-group id="award002"> |
|
|
<funding-source> |
|
|
<institution-wrap> |
|
|
<institution-id institution-id-type="funder-id">http://dx.doi.org/10.13039/100005627</institution-id> |
|
|
<institution>Thrasher Research Fund</institution> |
|
|
</institution-wrap> |
|
|
</funding-source> |
|
|
<award-id>11512</award-id> |
|
|
<principal-award-recipient> |
|
|
<contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-6193-4849</contrib-id> |
|
|
<name name-style="western"> |
|
|
<surname>Ulak</surname> |
|
|
<given-names>Manjeswori</given-names> |
|
|
</name> |
|
|
</principal-award-recipient> |
|
|
</award-group> |
|
|
<award-group id="award003"> |
|
|
<funding-source> |
|
|
<institution>Centre for Intervention Science in Maternal and Child Health (CISMAC)</institution> |
|
|
</funding-source> |
|
|
<principal-award-recipient> |
|
|
<contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0003-3457-3379</contrib-id> |
|
|
<name name-style="western"> |
|
|
<surname>Schwinger</surname> |
|
|
<given-names>Catherine</given-names> |
|
|
</name> |
|
|
</principal-award-recipient> |
|
|
</award-group> |
|
|
<award-group id="award004"> |
|
|
<funding-source> |
|
|
<institution>South-Eastern Norway Regional Health Authority</institution> |
|
|
</funding-source> |
|
|
<award-id>2012090</award-id> |
|
|
<principal-award-recipient> |
|
|
<contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-4038-151X</contrib-id> |
|
|
<name name-style="western"> |
|
|
<surname>Strand</surname> |
|
|
<given-names>Tor A.</given-names> |
|
|
</name> |
|
|
</principal-award-recipient> |
|
|
</award-group> |
|
|
<funding-statement>This study was funded by grants from the Innlandet Hospital Trust, the Thrasher Research Fund (award # 11512), and the South-Eastern Norway Regional Health Authority (grant # 2012090). TAS reports funding from the South-Eastern Norway Regional Health Authority (grant # 2012090), MU from Thrasher Research Fund (award # 11512), and CS from the Research Council of Norway through a grant to Centre for Intervention Science in Maternal and Child Health (CISMAC) for conducting this research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement> |
|
|
</funding-group> |
|
|
<counts> |
|
|
<fig-count count="1"/> |
|
|
<table-count count="5"/> |
|
|
<page-count count="15"/> |
|
|
</counts> |
|
|
<custom-meta-group> |
|
|
<custom-meta id="data-availability"> |
|
|
<meta-name>Data Availability</meta-name> |
|
|
<meta-value>Data described in the manuscript, code book, and analytic code will be made available upon request pending application and approval by the Nepal Health Research Council (NHRC) and the Regional Committee for Medical and Health Research Ethics in Norway. Requests for data should be sent to the authors, by contacting NHRC (<ext-link ext-link-type="uri" xlink:href="http://nhrc.gov.np" xlink:type="simple">http://nhrc.gov.np</ext-link>), or by contacting the Department of Global Health and Primary Care at the University of Bergen (<email xlink:type="simple">post@igs.uib.no</email>), or contacting the Department of Pediatrics, Tribhuvan University Institute of Medicine, Kathmandu, Nepal (<email xlink:type="simple">chrp2015@gmail.com</email>).</meta-value> |
|
|
</custom-meta> |
|
|
<custom-meta id="outbreaks"> |
|
|
<meta-name>Outbreaks</meta-name> |
|
|
<meta-value>COVID-19</meta-value> |
|
|
</custom-meta> |
|
|
</custom-meta-group> |
|
|
</article-meta> |
|
|
</front> |
|
|
<body> |
|
|
<sec id="sec001" sec-type="intro"> |
|
|
<title>Introduction</title> |
|
|
<p>The first infection with the SARS-CoV-2 virus was identified at the end of 2019 in Wuhan city, China [<xref ref-type="bibr" rid="pgph.0000278.ref001">1</xref>], and it spread worldwide from February 2020 with a devastating impact on society. In addition to the morbidity and mortality related to the infection, the restrictions imposed by governments to control the spread of the virus, such as lockdown, social distancing, isolation, and quarantine measures, have had negative impacts on the people’s economy and mental health [<xref ref-type="bibr" rid="pgph.0000278.ref002">2</xref>, <xref ref-type="bibr" rid="pgph.0000278.ref003">3</xref>]. While these negative consequences are global, populations in low-to-middle-income countries (LMIC) with limited social support and resources to respond to the pandemic may be especially vulnerable [<xref ref-type="bibr" rid="pgph.0000278.ref004">4</xref>].</p> |
|
|
<p>In Nepal, the first case of COVID infection was identified in January and the second case in March 2020. The government of Nepal declared a strict lockdown from the end of March 2020. The level of restrictions to control the spread of the virus varied until August [<xref ref-type="bibr" rid="pgph.0000278.ref005">5</xref>]. The restrictions were related to impacts across many life-domains including economy, health service use and food security. Many Nepalese people lost their jobs as a consequence of the restrictions and lockdowns [<xref ref-type="bibr" rid="pgph.0000278.ref006">6</xref>]. Mothers of infants were especially hard hit by the imposed restrictions, reflected in the increase in stillbirths and neonatal mortality during the pandemic [<xref ref-type="bibr" rid="pgph.0000278.ref007">7</xref>], as well as a reduction in the utilization of health services (4) and the losses to production and supply chain of food resulting in food insecurity [<xref ref-type="bibr" rid="pgph.0000278.ref008">8</xref>].</p> |
|
|
<p>A pandemic also has considerable psychological impact such as increase in worry, fear, distress, and anxiety in the population [<xref ref-type="bibr" rid="pgph.0000278.ref009">9</xref>, <xref ref-type="bibr" rid="pgph.0000278.ref010">10</xref>]. During the early months of the pandemic in Nepal, high rates of psychological distress such as restlessness, fearfulness, anxiety and worry, and sadness due to the COVID-19 outbreak was reported in two questionnaire-based studies [<xref ref-type="bibr" rid="pgph.0000278.ref011">11</xref>, <xref ref-type="bibr" rid="pgph.0000278.ref012">12</xref>]. Worry is a strong driver for sleep problems, and an expected reduced sleep quality during the pandemic has also been reported [<xref ref-type="bibr" rid="pgph.0000278.ref013">13</xref>]. Worry has been associated both directly with the risk of the disease but also indirectly with the restrictions due to the disease [<xref ref-type="bibr" rid="pgph.0000278.ref013">13</xref>]. The studies on impact and worry are mainly limited to the first phase of the pandemic, and less is known about the impact of the pandemic over time and across life domains.</p> |
|
|
<p>Worry and worry-related sleep problems may be more severe for people in high-risk groups. Underlying chronic conditions such as diabetes and cancer affect the severity of the COVID condition [<xref ref-type="bibr" rid="pgph.0000278.ref014">14</xref>], and may give rise to increased worry and distress [<xref ref-type="bibr" rid="pgph.0000278.ref015">15</xref>, <xref ref-type="bibr" rid="pgph.0000278.ref016">16</xref>]. It has been suggested that this pattern may be even more pronounced in countries with limited health care services [<xref ref-type="bibr" rid="pgph.0000278.ref010">10</xref>]. People with depression may be another vulnerable group for psychological impact and sleep problems. This was confirmed among French adults with higher levels of fear and worse sleep quality among adults with depression than those with no or mild mental health-related symptoms [<xref ref-type="bibr" rid="pgph.0000278.ref017">17</xref>].</p> |
|
|
<p>Socioeconomic factors may have an impact on worries related to the COVID-19 [<xref ref-type="bibr" rid="pgph.0000278.ref018">18</xref>]. The social gradient of mental health is well established, and it is thus expected that the negative consequences may be heightened for those with low SES [<xref ref-type="bibr" rid="pgph.0000278.ref019">19</xref>, <xref ref-type="bibr" rid="pgph.0000278.ref020">20</xref>]. However, this may not be generalizable for the negative impact in Nepal as lower psychological impact of COVID-19 in people with low educational qualification compared to those with higher education was suggested in an online survey [<xref ref-type="bibr" rid="pgph.0000278.ref021">21</xref>].</p> |
|
|
<p>In August 2020, there were 39,460 confirmed cases in Nepal, which increased to 77,817 in September 2020, 170,743 in October and 274,143 when reaching February 2021. The number of deaths from COVID-19 was 404 in September 2020 (the start of our study) and slightly increased to 646 in October and 839 in November the same year. There was, however, a drastic decreasing trend from December with only 52 death cases in February 2021 [<xref ref-type="bibr" rid="pgph.0000278.ref014">14</xref>, <xref ref-type="bibr" rid="pgph.0000278.ref022">22</xref>] when we completed our data collection.</p> |
|
|
<p>The present study was conducted in the Bhaktapur municipality of Nepal. The municipality has a population of 83000 [<xref ref-type="bibr" rid="pgph.0000278.ref023">23</xref>] and boarders to the eastern part of Kathmandu, the capital city of Nepal. It is a modern lower income setting characterized by mixed economy in an agriculture-based semi-urban community with many migrant workers from nearby districts. We collected information on COVID-19 exposure, impact on various aspects of daily life, worry for infections, and worry-related sleep problems from September 2020 to February 2021in this district. The objective of the study was to describe the exposure to and the impact of the COVID-19 pandemic on important areas of life as well as related worries and sleep problems.</p> |
|
|
</sec> |
|
|
<sec id="sec002" sec-type="materials|methods"> |
|
|
<title>Materials and methods</title> |
|
|
<sec id="sec003"> |
|
|
<title>Participants and study setting</title> |
|
|
<p>The participants included in the current study were mothers of children participating in a double-blinded clinical trial (ClinicalTrials.gov Identifier: NCT02272842; Universal Trial Number: U1111-1161-5187) entitled “The effect of Vitamin B12 supplementation in Nepali Infants on Growth and Neurodevelopment” [<xref ref-type="bibr" rid="pgph.0000278.ref024">24</xref>]. A total of 600 children of 6–11 months enrolled in the trial were followed every 12 months after a one-year supplementation period. From 9 September 2020 to 10 February 2021, we interviewed 493 of the mothers on COVID-19-related questions. The age of the children of the participating mothers were 54–71 months.</p> |
|
|
<p>A total of 67 children from the original study of 600 children were lost to follow up (due to migration and refusal) when we initiated the COVID-19 exposure interviews with the mothers. Of the remaining 533 participants, we were not able to complete the COVID-19 exposure questionnaire with 40 mothers and thus the final sample consisted of 493 mothers. The flow of participants is depicted in <bold><xref ref-type="fig" rid="pgph.0000278.g001">Fig 1</xref></bold>.</p> |
|
|
<fig id="pgph.0000278.g001" position="float"> |
|
|
<object-id pub-id-type="doi">10.1371/journal.pgph.0000278.g001</object-id> |
|
|
<label>Fig 1</label> |
|
|
<caption> |
|
|
<title>Recruitment of mothers in Bhaktapur, Nepal.</title> |
|
|
</caption> |
|
|
<graphic mimetype="image" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.g001" xlink:type="simple"/> |
|
|
</fig> |
|
|
</sec> |
|
|
<sec id="sec004" sec-type="materials|methods"> |
|
|
<title>Procedures</title> |
|
|
<p>At enrollment, mothers answered questions on demographics and household characteristics. Information on the family members included mother’s age, age category of family members, caste/ethnicity of family, level of education, occupation group, and nutritional status of the mother. Family members were categorized in age groups for which we considered children <16 and adults >60 more vulnerable to consequences of a COVID-19 infection. Caste/ethnicity of the families was categorized as Newar, Brahmin, Chhetri, Tamang and others. The educational level was assessed as illiterate, primary school, secondary school, School Leaving Certificate/intermediate school, bachelor’s degree, and above. For our analysis, we dichotomized education up to 10<sup>th</sup> years (i.e., completed secondary school) and above. For occupation, we categorized the occupation groups of both mothers and fathers as no formal work, agriculture, carpet worker, daily wage earner, self-employed, working in the service, and working abroad. Trained staffs measured height and weight in order to calculate body mass index (BMI) for the nutritional status of the mothers using a stadiometer for height (Prestige, HardikMedi Tech, India) and an electronic scale for weight (Salter/HoMedics Group, UK and Seca, Germany).</p> |
|
|
<p>Socioeconomic status was measured by a multidimensional measure, the WAMI-index with the components; water and sanitation, household assets, maternal education, and income [<xref ref-type="bibr" rid="pgph.0000278.ref025">25</xref>]. In contrast to previous studies, our data did not have income information and hence the index was calculated using the first three dimensions [<xref ref-type="bibr" rid="pgph.0000278.ref026">26</xref>] (see <xref ref-type="supplementary-material" rid="pgph.0000278.s002">S1 Table</xref>). For the current study, we set the cutoff for a low WAMI score at the 33<sup>rd</sup> percentile of our study sample.</p> |
|
|
<p>In follow-ups of the original study when the children were 30–35 months old, the mothers answered the Self-Reporting Questionnaire-20 (SRQ-20). The scores from SRQ-20 were from 2 years prior to the current study and covered previous maternal symptoms of depression.</p> |
|
|
<p>The COVID-19 follow-up was completed during a visit to the study clinic when the children were in between 54 and 71 months old. Trained study staff administered the questionnaires with the mothers in a private room at the study clinic. Women who did not attend this follow-up visit for the present study (approximately 50%) were interviewed through phone calls due to restrictions of movement (lockdown).</p> |
|
|
</sec> |
|
|
<sec id="sec005"> |
|
|
<title>Instruments</title> |
|
|
<p>We assessed COVID-19 exposure through a questionnaire particularly developed for this study (See <xref ref-type="supplementary-material" rid="pgph.0000278.s001">S1 File</xref>). The presence of symptoms during the last two weeks that had been described for COVID-19 was recorded by the major symptom categories (fever, cold/cough/difficulty breathing, sore throat and diarrhea). To identify whether the mother and her family members had a chronic illness or diseases that constituted a risk for severe COVID-19 illness, a checklist with the following illnesses was included; chronic respiratory illness, renal disease, high blood pressure, diabetes, other chronic diseases. If the mother or another family member had such medical condition, we further asked the concerns about the shortage of essential medicines related to the illnesses. Furthermore, we recorded whether the mother had been exposed to someone who was COVID-19 positive, if she or anyone from her family had received COVID-19 positive test results, and how many days she previously had been quarantined or isolated. Prior to the study, our study team had thorough discussion of the items in which physicians and psychologists from Nepal and clinical psychologists from Norway were involved.</p> |
|
|
<p>We also asked if the mothers believed that the life of someone close to her or her own life was in danger (response categories “not at all,” “Some/Just a little,” and “a great deal”). These items of the questionnaire are similar to previous traumatic exposure questionnaires [<xref ref-type="bibr" rid="pgph.0000278.ref027">27</xref>, <xref ref-type="bibr" rid="pgph.0000278.ref028">28</xref>]. The impact of the pandemic on different aspects of life (i.e., economic, food security, employment, health related issues, daily life) was assessed on a five-point scale: “Not at all” (1); “a little” (2); “some” (3); “quite a lot” (4); and “a great deal” (5). This is a similar approach to what was used in the same region in relation to the impact of earthquakes [<xref ref-type="bibr" rid="pgph.0000278.ref028">28</xref>].</p> |
|
|
<p>Worry of contracting the corona virus was measured by two items, of which one was worry about contracting the corona virus yourself, and one was the worry that someone in the family would contract the corona virus. The worry items are based on a previous questionnaire on worry for infections [<xref ref-type="bibr" rid="pgph.0000278.ref029">29</xref>]. Three items were on sleep related problems covering if the mothers slept worse than before due to worry about health-related, social and economic consequences due to the corona virus. Scoring for both worry and sleep problems was recorded on a five-point Likert scale (strongly disagree to strongly agree). The score ranges from 2 to 10 and 3 to 15 for worry and sleep respectively. The internal consistency of the worry and sleep score were excellent, with a Chronbach’s Alpha for itemized data of 0.93 and 0.95 respectively.</p> |
|
|
<p>The Self-Reporting Questionnaire-20 (SRQ-20) [<xref ref-type="bibr" rid="pgph.0000278.ref030">30</xref>] is a brief screening questionnaire for mental health problems consisting of 20 items on symptoms of depression, anxiety and psychosomatic complaints. It can be administrated through interview or the paper-pencil method. The response from each item was recorded as Yes or No depending on whether the symptoms were present or not during the last 30 days. The scores are summed up to a total score that ranges from 0 to 20. It takes 5–10 minutes to administer. In the current study, we used 10 as a cutoff for depression [<xref ref-type="bibr" rid="pgph.0000278.ref031">31</xref>]. The feasibility of the questionnaire has already been confirmed in a previous study within the same population [<xref ref-type="bibr" rid="pgph.0000278.ref032">32</xref>].</p> |
|
|
<p>The instruments were translated into Nepali by a psychologist and medical doctors and then back-translated by a qualified person independent from the study who was fluent in both Nepali and English language, following the standard guidelines for translation processes [<xref ref-type="bibr" rid="pgph.0000278.ref033">33</xref>]. Discrepancies were discussed and adjusted.</p> |
|
|
</sec> |
|
|
<sec id="sec006"> |
|
|
<title>Ethics statement</title> |
|
|
<p>Ethical approvals were obtained from Nepal Health and Research Council (NHRC; #73/2017, #820/2020) and from the Regional Committee for Medical and Health Research Ethics (REC; No.2014/1528) in Norway. Mothers were asked to visit the central clinic and we obtained informed written consent for the extended follow ups.</p> |
|
|
</sec> |
|
|
<sec id="sec007"> |
|
|
<title>Statistical analysis</title> |
|
|
<p>All the continuous variables are presented in means and standard deviations, and categorical variables in numbers and percentages. Exposure variables were categorized into a three-point scale: “Not at all” (1 from original questionnaire), “Some” (merged 2 and 3 from original questionnaire) and “A great deal” (merged 4 and 5 from original questionnaire). We compared the mean worry and sleep scores between groups using the student’s t-test. The high risk groups were dichotomized as follows: education of mother and father (up to 10<sup>th</sup> years vs. above 10<sup>th</sup> years), symptoms similar to COVID-19 (absence vs. presence of at least one symptom), chronic disease of mother (absence vs. presence of at least one chronic disease), chronic disease in family member (absence vs. presence of at least one chronic disease), previous symptoms of depression (scores above 10 vs. 10 and under), and the WAMI-index score (≤33<sup>rd</sup> percentile vs. >33<sup>rd</sup> percentile of the WAMI score). The missing values were handled by listwise deletion. Data was analyzed using the STATA 16.0 software.</p> |
|
|
</sec> |
|
|
</sec> |
|
|
<sec id="sec008" sec-type="results"> |
|
|
<title>Results</title> |
|
|
<p>The mean age of the mothers was 32.3 (SD: 4.6) years, more than 75% belonged to the Newar ethnic group, and approximately 50% resided in a joint family. Half of the families owned land, and 57% lived in their own house. Around 55% of both the mothers and fathers had an educational level up to 10 years (<bold><xref ref-type="table" rid="pgph.0000278.t001">Table 1</xref></bold>).</p> |
|
|
<table-wrap id="pgph.0000278.t001" position="float"> |
|
|
<object-id pub-id-type="doi">10.1371/journal.pgph.0000278.t001</object-id> |
|
|
<label>Table 1</label> <caption><title>Socio-demographic and clinical characteristics of 493 mothers in Bhaktapur, Nepal.</title></caption> |
|
|
<alternatives> |
|
|
<graphic id="pgph.0000278.t001g" mimetype="image" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.t001" xlink:type="simple"/> |
|
|
<table> |
|
|
<colgroup> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
</colgroup> |
|
|
<thead> |
|
|
<tr> |
|
|
<th align="left">Characteristics</th> |
|
|
<th align="center">Number N or mean</th> |
|
|
<th align="center">Proportion% or SD</th> |
|
|
</tr> |
|
|
</thead> |
|
|
<tbody> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Demographic Characteristics:</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Age of mother (years), m (sd)</td> |
|
|
<td align="center" style="background-color:#FFFFFF">32.3</td> |
|
|
<td align="center" style="background-color:#FFFFFF">4.6</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Caste/Ethnicity of mother</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Newar</td> |
|
|
<td align="center" style="background-color:#FFFFFF">374</td> |
|
|
<td align="center" style="background-color:#FFFFFF">75.8</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Brahmin</td> |
|
|
<td align="center" style="background-color:#FFFFFF">15</td> |
|
|
<td align="center" style="background-color:#FFFFFF">3.0</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Chhetri</td> |
|
|
<td align="center" style="background-color:#FFFFFF">15</td> |
|
|
<td align="center" style="background-color:#FFFFFF">3.0</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Tamang</td> |
|
|
<td align="center" style="background-color:#FFFFFF">64</td> |
|
|
<td align="center" style="background-color:#FFFFFF">12.9</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Others</td> |
|
|
<td align="center" style="background-color:#FFFFFF">25</td> |
|
|
<td align="center" style="background-color:#FFFFFF">5.1</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Age category of family members</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><1year</td> |
|
|
<td align="center" style="background-color:#FFFFFF">75</td> |
|
|
<td align="center" style="background-color:#FFFFFF">15.2</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">1–16 years</td> |
|
|
<td align="center" style="background-color:#FFFFFF">493</td> |
|
|
<td align="center" style="background-color:#FFFFFF">100.0</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Senior citizens (˃60 year)</td> |
|
|
<td align="center" style="background-color:#FFFFFF">207</td> |
|
|
<td align="center" style="background-color:#FFFFFF">41.9</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Socio-economic status:</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Family staying in joint family</td> |
|
|
<td align="center" style="background-color:#FFFFFF">234</td> |
|
|
<td align="center" style="background-color:#FFFFFF">47.4</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Family having own land</td> |
|
|
<td align="center" style="background-color:#FFFFFF">253</td> |
|
|
<td align="center" style="background-color:#FFFFFF">51.3</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Family living in own house</td> |
|
|
<td align="center" style="background-color:#FFFFFF">281</td> |
|
|
<td align="center" style="background-color:#FFFFFF">57.0</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Remittance from abroad</td> |
|
|
<td align="center" style="background-color:#FFFFFF">47</td> |
|
|
<td align="center" style="background-color:#FFFFFF">9.5</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Number of rooms used (≤ 2)</td> |
|
|
<td align="center" style="background-color:#FFFFFF">259</td> |
|
|
<td align="center" style="background-color:#FFFFFF">52.5</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> WAMI Index, m (sd)</td> |
|
|
<td align="center" style="background-color:#FFFFFF">0.6</td> |
|
|
<td align="center" style="background-color:#FFFFFF">0.1</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Mother’s education</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Up to 10<sup>th</sup> years</td> |
|
|
<td align="center" style="background-color:#FFFFFF">267</td> |
|
|
<td align="center" style="background-color:#FFFFFF">54.2</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Above 10<sup>th</sup> years</td> |
|
|
<td align="center" style="background-color:#FFFFFF">226</td> |
|
|
<td align="center" style="background-color:#FFFFFF">45.8</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Father’s education</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Up to 10<sup>th</sup> years</td> |
|
|
<td align="center" style="background-color:#FFFFFF">275</td> |
|
|
<td align="center" style="background-color:#FFFFFF">55.8</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Above 10<sup>th</sup> years</td> |
|
|
<td align="center" style="background-color:#FFFFFF">218</td> |
|
|
<td align="center" style="background-color:#FFFFFF">44.2</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Mother’s occupation</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> No formal work</td> |
|
|
<td align="center" style="background-color:#FFFFFF">285</td> |
|
|
<td align="center" style="background-color:#FFFFFF">57.8</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Agriculture</td> |
|
|
<td align="center" style="background-color:#FFFFFF">22</td> |
|
|
<td align="center" style="background-color:#FFFFFF">4.5</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Carpet worker</td> |
|
|
<td align="center" style="background-color:#FFFFFF">12</td> |
|
|
<td align="center" style="background-color:#FFFFFF">2.4</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Daily wage earner</td> |
|
|
<td align="center" style="background-color:#FFFFFF">57</td> |
|
|
<td align="center" style="background-color:#FFFFFF">11.6</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Self-employed</td> |
|
|
<td align="center" style="background-color:#FFFFFF">62</td> |
|
|
<td align="center" style="background-color:#FFFFFF">12.6</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Services</td> |
|
|
<td align="center" style="background-color:#FFFFFF">54</td> |
|
|
<td align="center" style="background-color:#FFFFFF">10.9</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Working abroad</td> |
|
|
<td align="center" style="background-color:#FFFFFF">1</td> |
|
|
<td align="center" style="background-color:#FFFFFF">0.2</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Father’s occupation</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> No formal work</td> |
|
|
<td align="center" style="background-color:#FFFFFF">15</td> |
|
|
<td align="center" style="background-color:#FFFFFF">3.0</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Agriculture</td> |
|
|
<td align="center" style="background-color:#FFFFFF">14</td> |
|
|
<td align="center" style="background-color:#FFFFFF">2.8</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Carpet worker</td> |
|
|
<td align="center" style="background-color:#FFFFFF">4</td> |
|
|
<td align="center" style="background-color:#FFFFFF">0.8</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Daily wage earner</td> |
|
|
<td align="center" style="background-color:#FFFFFF">192</td> |
|
|
<td align="center" style="background-color:#FFFFFF">38.9</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Self-employed</td> |
|
|
<td align="center" style="background-color:#FFFFFF">146</td> |
|
|
<td align="center" style="background-color:#FFFFFF">29.6</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Services</td> |
|
|
<td align="center" style="background-color:#FFFFFF">96</td> |
|
|
<td align="center" style="background-color:#FFFFFF">19.5</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Working abroad</td> |
|
|
<td align="center" style="background-color:#FFFFFF">26</td> |
|
|
<td align="center" style="background-color:#FFFFFF">5.3</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Nutritional Status of the mother at baseline:</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Height, m(sd)</td> |
|
|
<td align="center" style="background-color:#FFFFFF">150.0</td> |
|
|
<td align="center" style="background-color:#FFFFFF">5.3</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Weight, m(sd)</td> |
|
|
<td align="center" style="background-color:#FFFFFF">53.9</td> |
|
|
<td align="center" style="background-color:#FFFFFF">8.6</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">BMI, m(sd)</td> |
|
|
<td align="center" style="background-color:#FFFFFF">23.9</td> |
|
|
<td align="center" style="background-color:#FFFFFF">3.6</td> |
|
|
</tr> |
|
|
</tbody> |
|
|
</table> |
|
|
</alternatives> |
|
|
</table-wrap> |
|
|
<p>Among all mothers, 26 (5.4%) had either a positive COVID-19 case in the family or had been exposed to someone who had tested positive in the previous two weeks. Among these 26, the mean (SD) number of days of the quarantine was 15.7 (10.1) (<bold><xref ref-type="table" rid="pgph.0000278.t002">Table 2</xref></bold>).</p> |
|
|
<table-wrap id="pgph.0000278.t002" position="float"> |
|
|
<object-id pub-id-type="doi">10.1371/journal.pgph.0000278.t002</object-id> |
|
|
<label>Table 2</label> <caption><title>COVID-19 exposure in 493 mothers and their family in Bhaktapur, Nepal.</title></caption> |
|
|
<alternatives> |
|
|
<graphic id="pgph.0000278.t002g" mimetype="image" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.t002" xlink:type="simple"/> |
|
|
<table> |
|
|
<colgroup> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
</colgroup> |
|
|
<thead> |
|
|
<tr> |
|
|
<th align="left">Characteristics</th> |
|
|
<th align="center">Yes N</th> |
|
|
<th align="center">Proportion %</th> |
|
|
</tr> |
|
|
</thead> |
|
|
<tbody> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Symptoms within the last 2 weeks:</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Fever</td> |
|
|
<td align="center" style="background-color:#FFFFFF">46</td> |
|
|
<td align="center" style="background-color:#FFFFFF">9.3</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Cough/Cold/Difficulty breathing</td> |
|
|
<td align="center" style="background-color:#FFFFFF">88</td> |
|
|
<td align="center" style="background-color:#FFFFFF">17.8</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Sore Throat</td> |
|
|
<td align="center" style="background-color:#FFFFFF">49</td> |
|
|
<td align="center" style="background-color:#FFFFFF">9.9</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Diarrhea</td> |
|
|
<td align="center" style="background-color:#FFFFFF">14</td> |
|
|
<td align="center" style="background-color:#FFFFFF">2.8</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Health condition of the mother (n = 30<xref ref-type="table-fn" rid="t002fn001">ᵜ</xref></bold>):</td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Chronic respiratory illness</td> |
|
|
<td align="center" style="background-color:#FFFFFF">5</td> |
|
|
<td align="center" style="background-color:#FFFFFF">1.0</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Renal diseases</td> |
|
|
<td align="center" style="background-color:#FFFFFF">2</td> |
|
|
<td align="center" style="background-color:#FFFFFF">0.4</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> High blood pressure</td> |
|
|
<td align="center" style="background-color:#FFFFFF">15</td> |
|
|
<td align="center" style="background-color:#FFFFFF">3.0</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Diabetes</td> |
|
|
<td align="center" style="background-color:#FFFFFF">8</td> |
|
|
<td align="center" style="background-color:#FFFFFF">1.6</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Other chronic illnesses</td> |
|
|
<td align="center" style="background-color:#FFFFFF">9</td> |
|
|
<td align="center" style="background-color:#FFFFFF">1.8</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Health condition of family members (n = 174<xref ref-type="table-fn" rid="t002fn001">ᵜ</xref>)</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Chronic respiratory illness</td> |
|
|
<td align="center" style="background-color:#FFFFFF">44</td> |
|
|
<td align="center" style="background-color:#FFFFFF">8.9</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Renal diseases</td> |
|
|
<td align="center" style="background-color:#FFFFFF">6</td> |
|
|
<td align="center" style="background-color:#FFFFFF">1.2</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> High blood pressure</td> |
|
|
<td align="center" style="background-color:#FFFFFF">122</td> |
|
|
<td align="center" style="background-color:#FFFFFF">24.7</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Diabetes</td> |
|
|
<td align="center" style="background-color:#FFFFFF">73</td> |
|
|
<td align="center" style="background-color:#FFFFFF">14.8</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"> Other chronic illnesses</td> |
|
|
<td align="center" style="background-color:#FFFFFF">38</td> |
|
|
<td align="center" style="background-color:#FFFFFF">7.7</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF"><bold>Corona virus exposure</bold></td> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
<td align="center" style="background-color:#FFFFFF"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Exposure to positive cases</td> |
|
|
<td align="center" style="background-color:#FFFFFF">26</td> |
|
|
<td align="center" style="background-color:#FFFFFF">5.3</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Positive cases in family</td> |
|
|
<td align="center" style="background-color:#FFFFFF">26</td> |
|
|
<td align="center" style="background-color:#FFFFFF">5.3</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left" style="background-color:#FFFFFF">Number of days of quarantine (n = 18), m (sd)</td> |
|
|
<td align="center" style="background-color:#FFFFFF">15.7</td> |
|
|
<td align="center" style="background-color:#FFFFFF">10.1</td> |
|
|
</tr> |
|
|
</tbody> |
|
|
</table> |
|
|
</alternatives> |
|
|
<table-wrap-foot> |
|
|
<fn id="t002fn001"><p>ᵜ One or more chronic diseases.</p></fn> |
|
|
</table-wrap-foot> |
|
|
</table-wrap> |
|
|
<p>Among all mothers, 188 participants, either herself or her family members, had chronic diseases and among these, 1.4% were concerned about the shortage of essential medicines due to the pandemic. Less than 10% believed to a great deal that their life or the life of someone close to them was in danger. Approximately 22% reported that the pandemic had to a great deal a negative effect on family life. More than 29% reported that they had economic problems, and 33% reported that their employment was greatly affected by the pandemic. Approximately 9% were to a great deal concerned that they would experience health related issues. About 16% of the mothers felt that food security and daily life were greatly affected by the pandemic (<bold><xref ref-type="table" rid="pgph.0000278.t003">Table 3</xref></bold>).</p> |
|
|
<table-wrap id="pgph.0000278.t003" position="float"> |
|
|
<object-id pub-id-type="doi">10.1371/journal.pgph.0000278.t003</object-id> |
|
|
<label>Table 3</label> <caption><title>Negative impact of COVID-19 in 493 mothers in Bhaktapur, Nepal.</title></caption> |
|
|
<alternatives> |
|
|
<graphic id="pgph.0000278.t003g" mimetype="image" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.t003" xlink:type="simple"/> |
|
|
<table> |
|
|
<colgroup> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
</colgroup> |
|
|
<thead> |
|
|
<tr> |
|
|
<th align="left"/> |
|
|
<th align="center" colspan="2">Not at all</th> |
|
|
<th align="center" colspan="2">Some</th> |
|
|
<th align="center" colspan="2">A great deal</th> |
|
|
</tr> |
|
|
<tr> |
|
|
<th align="left"/> |
|
|
<th align="center">N</th> |
|
|
<th align="center">%</th> |
|
|
<th align="center">N</th> |
|
|
<th align="center">%</th> |
|
|
<th align="center">N</th> |
|
|
<th align="center">%</th> |
|
|
</tr> |
|
|
</thead> |
|
|
<tbody> |
|
|
<tr> |
|
|
<td align="left">Concerns about shortage of essential medicines</td> |
|
|
<td align="center">409</td> |
|
|
<td align="center">82.9</td> |
|
|
<td align="center">77</td> |
|
|
<td align="center">15.6</td> |
|
|
<td align="center">7</td> |
|
|
<td align="center">1.4</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left">Believe that own life or the life of someone close to mother was in danger</td> |
|
|
<td align="center">307</td> |
|
|
<td align="center">62.3</td> |
|
|
<td align="center">140</td> |
|
|
<td align="center">28.4</td> |
|
|
<td align="center">46</td> |
|
|
<td align="center">9.3</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left">Negative effect on family life</td> |
|
|
<td align="center">90</td> |
|
|
<td align="center">18.3</td> |
|
|
<td align="center">296</td> |
|
|
<td align="center">60</td> |
|
|
<td align="center">107</td> |
|
|
<td align="center">21.7</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left">Which aspect of life has the pandemic affected you?</td> |
|
|
<td align="center"/> |
|
|
<td align="center"/> |
|
|
<td align="center"/> |
|
|
<td align="center"/> |
|
|
<td align="center"/> |
|
|
<td align="center"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="center"> Economic</td> |
|
|
<td align="center">122</td> |
|
|
<td align="center">24.8</td> |
|
|
<td align="center">226</td> |
|
|
<td align="center">45.8</td> |
|
|
<td align="center">145</td> |
|
|
<td align="center">29.4</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="center"> Food security</td> |
|
|
<td align="center">221</td> |
|
|
<td align="center">44.8</td> |
|
|
<td align="center">193</td> |
|
|
<td align="center">39.2</td> |
|
|
<td align="center">79</td> |
|
|
<td align="center">16</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="center"> Employment</td> |
|
|
<td align="center">118</td> |
|
|
<td align="center">23.9</td> |
|
|
<td align="center">211</td> |
|
|
<td align="center">42.8</td> |
|
|
<td align="center">164</td> |
|
|
<td align="center">33.3</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="center"> Health related issues</td> |
|
|
<td align="center">263</td> |
|
|
<td align="center">53.4</td> |
|
|
<td align="center">188</td> |
|
|
<td align="center">38.1</td> |
|
|
<td align="center">42</td> |
|
|
<td align="center">8.5</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="center"> Daily life</td> |
|
|
<td align="center">168</td> |
|
|
<td align="center">34.1</td> |
|
|
<td align="center">243</td> |
|
|
<td align="center">49.3</td> |
|
|
<td align="center">82</td> |
|
|
<td align="center">16.6</td> |
|
|
</tr> |
|
|
</tbody> |
|
|
</table> |
|
|
</alternatives> |
|
|
</table-wrap> |
|
|
<p>The mean (SD) worry and sleep score were 5.4 (2.5) and 4.9 (2.8), respectively. The distributions of all the response categories for each item of worry and sleep are shown in <xref ref-type="table" rid="pgph.0000278.t004">Table 4</xref>. Among the mothers, 37.1% reported worry related to contracting the corona virus and 39.5% reported worry that someone in their family would contract the virus. Similarly, 7.5% slept worse due to worry about health-related consequences of the corona virus, 7.1% due to social consequences, and 8.9% due to economic consequences.</p> |
|
|
<table-wrap id="pgph.0000278.t004" position="float"> |
|
|
<object-id pub-id-type="doi">10.1371/journal.pgph.0000278.t004</object-id> |
|
|
<label>Table 4</label> <caption><title>Response characteristics of worry and sleep items in Nepalese mothers (n = 493).</title></caption> |
|
|
<alternatives> |
|
|
<graphic id="pgph.0000278.t004g" mimetype="image" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.t004" xlink:type="simple"/> |
|
|
<table> |
|
|
<colgroup> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
</colgroup> |
|
|
<thead> |
|
|
<tr> |
|
|
<th align="left"/> |
|
|
<th align="center">Mean</th> |
|
|
<th align="center">SD</th> |
|
|
<th align="center">Range</th> |
|
|
<th align="center">Alpha<xref ref-type="table-fn" rid="t004fn001"><sup>1</sup></xref></th> |
|
|
<th align="center"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<th align="left">Total Worry score</th> |
|
|
<th align="center">5.4</th> |
|
|
<th align="center">2.5</th> |
|
|
<th align="center">2–10</th> |
|
|
<th align="center">0.93</th> |
|
|
<th align="center"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<th align="left">Total Sleep score</th> |
|
|
<th align="center">4.9</th> |
|
|
<th align="center">2.8</th> |
|
|
<th align="center">3–15</th> |
|
|
<th align="center">0.95</th> |
|
|
<th align="center"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<th align="left">Items</th> |
|
|
<th align="center" colspan="5">Prevalence</th> |
|
|
</tr> |
|
|
<tr> |
|
|
<th align="left"/> |
|
|
<th align="center">Strongly Disagree</th> |
|
|
<th align="center">Disagree</th> |
|
|
<th align="center">Neither Disagree nor Agree</th> |
|
|
<th align="center">Agree</th> |
|
|
<th align="center">Strongly Agree</th> |
|
|
</tr> |
|
|
</thead> |
|
|
<tbody> |
|
|
<tr> |
|
|
<td align="left"> 1. I worry that I will contract the corona virus.</td> |
|
|
<td align="center">28.6</td> |
|
|
<td align="center">23.3</td> |
|
|
<td align="center">10.9</td> |
|
|
<td align="center">31.2</td> |
|
|
<td align="center">5.9</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> 2. I worry that someone in my family will contract the corona virus.</td> |
|
|
<td align="center">24.7</td> |
|
|
<td align="center">21.5</td> |
|
|
<td align="center">14.2</td> |
|
|
<td align="center">32.8</td> |
|
|
<td align="center">6.7</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> 3. I sleep worse than before due to worry regarding the health consequences of the Corona virus.</td> |
|
|
<td align="center">57</td> |
|
|
<td align="center">31.8</td> |
|
|
<td align="center">3.6</td> |
|
|
<td align="center">4.9</td> |
|
|
<td align="center">2.6</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> 4. I sleep worse than before due to the social consequences of the Corona virus</td> |
|
|
<td align="center">59.6</td> |
|
|
<td align="center">29.8</td> |
|
|
<td align="center">3.4</td> |
|
|
<td align="center">4.5</td> |
|
|
<td align="center">2.6</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> 5.I sleep worse than before due to worry regarding the economical consequences of the Corona virus.</td> |
|
|
<td align="center">57.8</td> |
|
|
<td align="center">30.0</td> |
|
|
<td align="center">3.2</td> |
|
|
<td align="center">5.7</td> |
|
|
<td align="center">3.2</td> |
|
|
</tr> |
|
|
</tbody> |
|
|
</table> |
|
|
</alternatives> |
|
|
<table-wrap-foot> |
|
|
<fn id="t004fn001"><p><sup>1</sup> Chronbach’s alpha.</p></fn> |
|
|
</table-wrap-foot> |
|
|
</table-wrap> |
|
|
<p><xref ref-type="table" rid="pgph.0000278.t005">Table 5</xref> shows the difference in worry and sleep scores based on high- vs. low-risk groups. Mothers and fathers who had more than 10 years of education and high WAMI index score had higher worry scores than those with 10 years of education and with a low WAMI index score. There were no significant differences in the worry score according to the other risk groups. The only risk-group with a significantly higher mean score for sleep problems was mothers who had a previous history of symptoms of depression. There were significant differences in the worry score according to the mode of data collection (in-person vs, phone call) (See <xref ref-type="supplementary-material" rid="pgph.0000278.s003">S2 Table</xref>).</p> |
|
|
<table-wrap id="pgph.0000278.t005" position="float"> |
|
|
<object-id pub-id-type="doi">10.1371/journal.pgph.0000278.t005</object-id> |
|
|
<label>Table 5</label> <caption><title>Mean worry and sleep scores according to the exposure, chronic illness, previous depression, and socioeconomic status of Nepalese mothers (n = 493).</title></caption> |
|
|
<alternatives> |
|
|
<graphic id="pgph.0000278.t005g" mimetype="image" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.t005" xlink:type="simple"/> |
|
|
<table> |
|
|
<colgroup> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
<col align="left" valign="middle"/> |
|
|
</colgroup> |
|
|
<thead> |
|
|
<tr> |
|
|
<th align="left"/> |
|
|
<th align="left"/> |
|
|
<th align="center" colspan="2">Worry Score</th> |
|
|
<th align="center" colspan="2">Sleep Score</th> |
|
|
</tr> |
|
|
<tr> |
|
|
<th align="left">Variables</th> |
|
|
<th align="left">N</th> |
|
|
<th align="left">Mean (SD)</th> |
|
|
<th align="left">p-value</th> |
|
|
<th align="left">Mean (SD)</th> |
|
|
<th align="left">p-value</th> |
|
|
</tr> |
|
|
</thead> |
|
|
<tbody> |
|
|
<tr> |
|
|
<td align="left"><bold>Symptoms similar to COVID-19</bold></td> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Absent</td> |
|
|
<td align="left">365</td> |
|
|
<td align="left">5.31 (2.63)</td> |
|
|
<td align="left">0.343</td> |
|
|
<td align="left">4.80 (2.70)</td> |
|
|
<td align="left">0.131</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Present (At least one)</td> |
|
|
<td align="left">128</td> |
|
|
<td align="left">5.56 (2.37)</td> |
|
|
<td align="left"/> |
|
|
<td align="left">5.23 (2.98)</td> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"><bold>Chronic Disease of mother or other family member</bold></td> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Absent</td> |
|
|
<td align="left">305</td> |
|
|
<td align="left">5.34 (2.56)</td> |
|
|
<td align="left">0.689</td> |
|
|
<td align="left">4.86 (2.73)</td> |
|
|
<td align="left">0.594</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Present (At least one)</td> |
|
|
<td align="left">188</td> |
|
|
<td align="left">5.43 (2.57)</td> |
|
|
<td align="left"/> |
|
|
<td align="left">5 (2.86)</td> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"><bold>Exposed to positive case</bold></td> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> No</td> |
|
|
<td align="left">467</td> |
|
|
<td align="left">5.15 (2.63)</td> |
|
|
<td align="left">0.648</td> |
|
|
<td align="left">4.89 (2.77)</td> |
|
|
<td align="left">0.417</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Yes</td> |
|
|
<td align="left">26</td> |
|
|
<td align="left">5.39 (2.56)</td> |
|
|
<td align="left"/> |
|
|
<td align="left">5.34 (3.00)</td> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"><bold>Previous maternal depression</bold></td> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Score < 10</td> |
|
|
<td align="left">422</td> |
|
|
<td align="left">5.36 (2.58)</td> |
|
|
<td align="left">0.719</td> |
|
|
<td align="left">4.79 (2.68)</td> |
|
|
<td align="left">0.020*</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Score ≥ 10</td> |
|
|
<td align="left">71</td> |
|
|
<td align="left">5.48 (2.50)</td> |
|
|
<td align="left"/> |
|
|
<td align="left">5.62 (3.27)</td> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"><bold>Mother’s education</bold></td> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Up to 10 years</td> |
|
|
<td align="left">267</td> |
|
|
<td align="left">5.13 (2.60)</td> |
|
|
<td align="left">0.020*</td> |
|
|
<td align="left">4.94 (2.78)</td> |
|
|
<td align="left">0.801</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Above 10 years</td> |
|
|
<td align="left">226</td> |
|
|
<td align="left">5.67 (2.49)</td> |
|
|
<td align="left"/> |
|
|
<td align="left">4.88 (2.79)</td> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"><bold>Father’s education</bold></td> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Up to 10 years</td> |
|
|
<td align="left">275</td> |
|
|
<td align="left">5.09 (2.55)</td> |
|
|
<td align="left">0.005*</td> |
|
|
<td align="left">4.91 (2.86)</td> |
|
|
<td align="left">0.985</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> Above 10 years</td> |
|
|
<td align="left">218</td> |
|
|
<td align="left">5.73 (2.54)</td> |
|
|
<td align="left"/> |
|
|
<td align="left">4.91 (2.68)</td> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"><bold>WAMI Index</bold></td> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> ≤ 33percentile</td> |
|
|
<td align="left">143</td> |
|
|
<td align="left">4.98 (2.60)</td> |
|
|
<td align="left">0.030*</td> |
|
|
<td align="left">4.91 (2.88)</td> |
|
|
<td align="left">0.99</td> |
|
|
</tr> |
|
|
<tr> |
|
|
<td align="left"> >33 percentile</td> |
|
|
<td align="left">350</td> |
|
|
<td align="left">5.53 (2.54)</td> |
|
|
<td align="left"/> |
|
|
<td align="left">4.91 (2.74)</td> |
|
|
<td align="left"/> |
|
|
</tr> |
|
|
</tbody> |
|
|
</table> |
|
|
</alternatives> |
|
|
</table-wrap> |
|
|
</sec> |
|
|
<sec id="sec009" sec-type="conclusions"> |
|
|
<title>Discussion</title> |
|
|
<p>The present study revealed a considerable impact on the everyday life of the Nepalese mothers in relation to the COVID pandemic between 9 September 2020 and 10 February 2021. Approximately one third of the mothers were heavily affected by the COVID-19 pandemic in terms of their economy and employment, and for 16% their daily life and food security were perceived as severely affected. Only a small group reported major impact on their health. Worry about contracting the virus showed a social gradient, with more worry in the higher socioeconomic status groups. Sleep problems related worry was not common, but higher for those with a previous history of symptoms of depression.</p> |
|
|
<sec id="sec010"> |
|
|
<title>Negative impacts of COVID-19 on daily life</title> |
|
|
<p>The mothers reported that the economic and employment status were greatly affected by the pandemic. At baseline for the original study, many reported to have no formal work, being in agricultural work, carpet work and being a daily wage earner and about half of their husbands had the same occupations signifying that the type of work in Bhaktapur is mainly based on daily wage earnings. These were occupations that were almost impossible to keep functioning during lock down or other restrictions. Other aspects of the daily life, like food insecurity, health related issues, shortage of essential medicines were also marginally prevalent. These results are in line with a previous review of published articles related to the psychosocial impact of COVID-19 in Nepal showing substantial impact on economy, agriculture, employment and the health sector [<xref ref-type="bibr" rid="pgph.0000278.ref004">4</xref>]. We found a similar pattern of responses in the same study sample during the massive earthquakes in Nepal in 2015, where the most affected aspect of daily life was employment, and less on health-related issues. However, in comparison to the present results, the perceived impact on food insecurity was higher while economic impact was almost not affected [<xref ref-type="bibr" rid="pgph.0000278.ref028">28</xref>].</p> |
|
|
<p>Although many mothers reported that they or someone in their family had a chronic disease, the mothers were not so much concerned about supplies of essential medicines. This could be related to the fact that the study setting is close to the capital city of Nepal where the government made more efforts to prevent the pandemic compared to other regions of the country. In another study from Eastern less urban areas of Nepal, people perceived that medical supply was the most affected aspect of the health care system in Nepal during the pandemic [<xref ref-type="bibr" rid="pgph.0000278.ref004">4</xref>].</p> |
|
|
</sec> |
|
|
<sec id="sec011"> |
|
|
<title>Negative impacts of COVID-19 on worry and sleep</title> |
|
|
<p>Around 10% of the participants believed that their own life or the lives of someone close to them were in danger. Approximately 40% of the participants reported being worried that they themselves or their family members would contract the corona virus. A high rate of worry is expected during a pandemic and in line with previous studies that demonstrated an increase in public anxiety during epidemics or pandemics such as the 2003 SARS pandemic, the 2009/2010 H1N1 pandemic and the 2014/2016 Ebola pandemic [<xref ref-type="bibr" rid="pgph.0000278.ref034">34</xref>–<xref ref-type="bibr" rid="pgph.0000278.ref037">37</xref>]. Worry about the COVID-19 pandemic can also induce negative effects on mental health in the general public [<xref ref-type="bibr" rid="pgph.0000278.ref038">38</xref>].</p> |
|
|
<p>The rate of worry related sleep problems were low in the present study. Despite the major impact of the pandemic on their daily life, the mothers reported that the social, economic and health-related consequences due to the COVID-19 pandemic did not negatively affect their sleep and less than ten percent of the mothers reported these problems. We do not have any possible explanation to the low prevalence of sleep problems since we lack specific information about the sleep patterns of Nepalese women. However, the low prevalence might be due to taking COVID-19 very lightly since most of the people who were infected during the study period were asymptomatic or had mild symptoms.</p> |
|
|
<p>The mothers who had a previous history of depression reported more sleep problems due to concerns with the COVID-19 pandemic. This finding is in accordance with previous studies showing that depressive symptoms is associated with poorer or disrupted quality of sleep during the pandemic [<xref ref-type="bibr" rid="pgph.0000278.ref017">17</xref>, <xref ref-type="bibr" rid="pgph.0000278.ref039">39</xref>], and that previous history of psychological condition such as anxiety, stress and depression is associated with poor sleep [<xref ref-type="bibr" rid="pgph.0000278.ref040">40</xref>].</p> |
|
|
<p>There was a social gradient in worry, but in the opposite direction than expected from previous studies in other parts of the world. In the present study, there were higher levels of worry for contracting the virus among those who had an educational level higher than secondary. This group with the lowest educational qualifications being least concerned about contracting COVID-19, might be the challenging factor in controlling the pandemic due to less safety measures to protect them from virus infection. Hence, public health practitioners should consider the level of education while addressing the psychological impacts of pandemics since our results suggests that education can be the deciding factor for psychological impact of the individuals. Further, and also in contrast to our expectations and the established social gradient of health that has been evident during the pandemic [<xref ref-type="bibr" rid="pgph.0000278.ref041">41</xref>], we found that those with higher SES (i.e. higher WAMI index) had higher worry scores than those with lower SES. This pattern of higher level of worry and higher socioeconomic status have been reported previously in high risk communities of Africa with higher academic qualification associated with greater level of psychological distress and worry [<xref ref-type="bibr" rid="pgph.0000278.ref042">42</xref>, <xref ref-type="bibr" rid="pgph.0000278.ref043">43</xref>]. This may be related to more access to information about the pandemic and consequences for those with higher education [<xref ref-type="bibr" rid="pgph.0000278.ref044">44</xref>]. Health literacy is an individual’s idea, motivation and capacities to recognize, evaluate and judge health information [<xref ref-type="bibr" rid="pgph.0000278.ref045">45</xref>]. Individuals with low SES may be less sensitive toward health-related and other consequences of the pandemic due to the lack of health literacy resulting in these being less likely to seek help when they experienced symptoms [<xref ref-type="bibr" rid="pgph.0000278.ref046">46</xref>]. Secondly, they might lack the capability of understanding the symptoms and health consequences of the corona virus limiting their interpretation and decision about own health condition [<xref ref-type="bibr" rid="pgph.0000278.ref047">47</xref>].Thus, belonging to a low SES family may lead to less worry scores among mothers in our study. Moreover, all people who were infected from the corona virus during the study period, were asymptomatic or had mild symptoms [<xref ref-type="bibr" rid="pgph.0000278.ref048">48</xref>]. This may have led to a misinterpretation of the disease in people with low SES.</p> |
|
|
<p>One in every three of the mothers reported at least one of the major chronic diseases in herself or in someone in her family. Some of these common conditions such as respiratory diseases, diabetes, and chronic kidney diseases, have been related to increased risk of deaths from COVID-19 in Nepal [<xref ref-type="bibr" rid="pgph.0000278.ref049">49</xref>]. Still there were no differences in the worry and sleep related worry scores between the participants who had these conditions or with family members with these conditions. The lack of associations with worry might be due to the younger age group and the predominance of the less hazardous 1<sup>st</sup> variant of SARS-Cov-2 in Nepal at the time of the data collection [<xref ref-type="bibr" rid="pgph.0000278.ref048">48</xref>].</p> |
|
|
</sec> |
|
|
<sec id="sec012"> |
|
|
<title>Strengths and limitations</title> |
|
|
<p>A major strength of our study is the large sample size in a well-maintained cohort of mothers of young children. A limitation is that due to lockdowns, approximately half of the questionnaires were collected through phone calls which might not be as effective as interviews through direct contact. We also found that the worry score was significantly higher when collecting by an in-person interview compared to through a phone call. The fact that people respond differently if they were interviewed through phone calls rather than through direct contact methods have been demonstrated before [<xref ref-type="bibr" rid="pgph.0000278.ref050">50</xref>].The study population was also limited to mothers whose infants were enrolled in a randomized controlled trial from 2015 to 2017 which limits the generalizability of the results since the sample may differ from general populations. Although the population of the Bhaktapur district covers different migrants from the whole areas of Nepal, the results can only be generalizable to the urban settings of Nepal with similar characteristics such as availability of daily supplies and health facilities, and the restrictions to the pandemic casted by local governments. We have only included mothers in the present study, and whether the results can be generalized to fathers is uncertain. However, since women often have responsibilities for health and care and may also be important role models for children, their perceptions and attitudes may also impact the family’s preventive measures and health. Our data may present only the results from a certain period of the pandemic in Nepal and hence cannot be generalized to the pandemic as a whole. The questionnaire was brief due to the situations for the mothers, and other aspects that would have been of interest such as more detailed information on sleep and current mental health could not be measured due to time constraints. The measure of depression is limited to a self-report questionnaire that we collected 2 years before, and not by a clinical interview. The final sample was better off than those who were lost to follow up. The result can be the strength of our study to differentiate the SES indicating that the losses to follow up were mainly due to the difficult financial situation during the lockdown (See <xref ref-type="supplementary-material" rid="pgph.0000278.s004">S3 Table</xref>).</p> |
|
|
</sec> |
|
|
</sec> |
|
|
<sec id="sec013" sec-type="conclusions"> |
|
|
<title>Conclusions</title> |
|
|
<p>Our study reveals a considerable negative impact of the COVID-19 pandemic on everyday life of mothers across major domains such as economy and employment, food security and everyday life in relation to the restrictions. Mothers with high socioeconomic status were more worried that they might contract the virus.</p> |
|
|
</sec> |
|
|
<sec id="sec014" sec-type="supplementary-material"> |
|
|
<title>Supporting information</title> |
|
|
<supplementary-material id="pgph.0000278.s001" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.s001" xlink:type="simple"> |
|
|
<label>S1 File</label> |
|
|
<caption> |
|
|
<title>Corona virus exposure questionnaire.</title> |
|
|
<p>(DOCX)</p> |
|
|
</caption> |
|
|
</supplementary-material> |
|
|
<supplementary-material id="pgph.0000278.s002" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.s002" xlink:type="simple"> |
|
|
<label>S1 Table</label> |
|
|
<caption> |
|
|
<title>Calculation of the WAMI index.</title> |
|
|
<p>(DOCX)</p> |
|
|
</caption> |
|
|
</supplementary-material> |
|
|
<supplementary-material id="pgph.0000278.s003" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.s003" xlink:type="simple"> |
|
|
<label>S2 Table</label> |
|
|
<caption> |
|
|
<title>Mean Worry and Sleep scores according to the mode of data collection of Nepalese mothers.</title> |
|
|
<p>(DOCX)</p> |
|
|
</caption> |
|
|
</supplementary-material> |
|
|
<supplementary-material id="pgph.0000278.s004" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.s004" xlink:type="simple"> |
|
|
<label>S3 Table</label> |
|
|
<caption> |
|
|
<title>Age and socioeconomic factors according in those that were lost to follow-up compared to those who were included in the study sample.</title> |
|
|
<p>(DOCX)</p> |
|
|
</caption> |
|
|
</supplementary-material> |
|
|
</sec> |
|
|
</body> |
|
|
<back> |
|
|
<ack> |
|
|
<p>We would like to show appreciation to all the field staff and mothers who participated in this study. We are also thankful to the Child Health Research Project Team at the Department of Child Health, Institute of Medicine, Tribhuvan University and Siddhi Memorial Foundation.</p> |
|
|
</ack> |
|
|
<ref-list> |
|
|
<title>References</title> |
|
|
<ref id="pgph.0000278.ref001"><label>1</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Zhu</surname> <given-names>H</given-names></name>, <name name-style="western"><surname>Wei</surname> <given-names>L</given-names></name>, <name name-style="western"><surname>Niu</surname> <given-names>P</given-names></name>. <article-title>The novel coronavirus outbreak in Wuhan, China.</article-title> <source>Global health research and policy.</source> <year>2020</year>;<volume>5</volume>(<issue>1</issue>):<fpage>1</fpage>–<lpage>3</lpage>.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref002"><label>2</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Brooks</surname> <given-names>SK</given-names></name>, <name name-style="western"><surname>Webster</surname> <given-names>RK</given-names></name>, <name name-style="western"><surname>Smith</surname> <given-names>LE</given-names></name>, <name name-style="western"><surname>Woodland</surname> <given-names>L</given-names></name>, <name name-style="western"><surname>Wessely</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Greenberg</surname> <given-names>N</given-names></name>, <etal>et al</etal>. <article-title>The psychological impact of quarantine and how to reduce it: rapid review of the evidence</article-title>. <source>The lancet</source>. <year>2020</year>;<volume>395</volume>(<issue>10227</issue>):<fpage>912</fpage>–<lpage>20</lpage>.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref003"><label>3</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Mukhtar</surname> <given-names>MS</given-names></name>. <article-title>Mental health and psychosocial aspects of coronavirus outbreak in Pakistan: psychological intervention for public mental health crisis.</article-title> <source>Asian journal of psychiatry</source>. <year>2020</year>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.ajp.2020.102069" xlink:type="simple">10.1016/j.ajp.2020.102069</ext-link></comment> <object-id pub-id-type="pmid">32344331</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref004"><label>4</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Poudel</surname> <given-names>K</given-names></name>, <name name-style="western"><surname>Subedi</surname> <given-names>P</given-names></name>. <article-title>Impact of COVID-19 pandemic on socioeconomic and mental health aspects in Nepal.</article-title> <source>International Journal of Social Psychiatry</source>. <year>2020</year>;<volume>66</volume>(<issue>8</issue>):<fpage>748</fpage>–<lpage>55</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1177/0020764020942247" xlink:type="simple">10.1177/0020764020942247</ext-link></comment> <object-id pub-id-type="pmid">32650687</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref005"><label>5</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Devkota</surname> <given-names>JU</given-names></name>. <article-title>Multivariate Analysis of COVID-19 for Countries with Limited and Scarce Data: Examples from Nepal</article-title>. <source>Journal of Environmental and Public Health</source>. <year>2021</year>;<volume>2021</volume>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1155/2021/8813505" xlink:type="simple">10.1155/2021/8813505</ext-link></comment> <object-id pub-id-type="pmid">33564315</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref006"><label>6</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Sharma</surname> <given-names>K</given-names></name>, <name name-style="western"><surname>Banstola</surname> <given-names>A</given-names></name>, <name name-style="western"><surname>Parajuli</surname> <given-names>RR</given-names></name>. <article-title>Assessment of COVID-19 pandemic in Nepal: A lockdown scenario analysis.</article-title> <source>Frontiers in Public Health.</source> <year>2021</year>;<volume>9</volume>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpubh.2021.599280" xlink:type="simple">10.3389/fpubh.2021.599280</ext-link></comment> <object-id pub-id-type="pmid">33898371</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref007"><label>7</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Ashish</surname> <given-names>K</given-names></name>, <name name-style="western"><surname>Gurung</surname> <given-names>R</given-names></name>, <name name-style="western"><surname>Kinney</surname> <given-names>MV</given-names></name>, <name name-style="western"><surname>Sunny</surname> <given-names>AK</given-names></name>, <name name-style="western"><surname>Moinuddin</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Basnet</surname> <given-names>O</given-names></name>, <etal>et al</etal>. <article-title>Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study</article-title>. <source>The Lancet Global Health</source>. <year>2020</year>;<volume>8</volume>(<issue>10</issue>):<fpage>e1273</fpage>–<lpage>e81</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/S2214-109X%2820%2930345-4" xlink:type="simple">10.1016/S2214-109X(20)30345-4</ext-link></comment> <object-id pub-id-type="pmid">32791117</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref008"><label>8</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Singh</surname> <given-names>DR</given-names></name>, <name name-style="western"><surname>Sunuwar</surname> <given-names>DR</given-names></name>, <name name-style="western"><surname>Adhikari</surname> <given-names>B</given-names></name>, <name name-style="western"><surname>Szabo</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Padmadas</surname> <given-names>SS</given-names></name>. <article-title>The perils of COVID-19 in Nepal: Implications for population health and nutritional status</article-title>. <source>Journal of global health</source>. <year>2020</year>;<volume>10</volume>(<issue>1</issue>). <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.7189/jogh.10.010378" xlink:type="simple">10.7189/jogh.10.010378</ext-link></comment> <object-id pub-id-type="pmid">32582440</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref009"><label>9</label><mixed-citation publication-type="book" xlink:type="simple"><name name-style="western"><surname>Taylor</surname> <given-names>S.</given-names></name> <source>The psychology of pandemics: Preparing for the next global outbreak of infectious disease</source>: <publisher-name>Cambridge Scholars Publishing</publisher-name>; <year>2019</year>.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref010"><label>10</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Salari</surname> <given-names>N</given-names></name>, <name name-style="western"><surname>Hosseinian-Far</surname> <given-names>A</given-names></name>, <name name-style="western"><surname>Jalali</surname> <given-names>R</given-names></name>, <name name-style="western"><surname>Vaisi-Raygani</surname> <given-names>A</given-names></name>, <name name-style="western"><surname>Rasoulpoor</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Mohammadi</surname> <given-names>M</given-names></name>, <etal>et al</etal>. <article-title>Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis.</article-title> <source>Globalization and health.</source> <year>2020</year>;<volume>16</volume>(<issue>1</issue>):<fpage>1</fpage>–<lpage>11</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1186/s12992-019-0531-5" xlink:type="simple">10.1186/s12992-019-0531-5</ext-link></comment> <object-id pub-id-type="pmid">31898532</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref011"><label>11</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Gautam</surname> <given-names>K</given-names></name>, <name name-style="western"><surname>Adhikari</surname> <given-names>RP</given-names></name>, <name name-style="western"><surname>Gupta</surname> <given-names>AS</given-names></name>, <name name-style="western"><surname>Shrestha</surname> <given-names>RK</given-names></name>, <name name-style="western"><surname>Koirala</surname> <given-names>P</given-names></name>, <name name-style="western"><surname>Koirala</surname> <given-names>S</given-names></name>. <article-title>Self-reported psychological distress during the COVID-19 outbreak in Nepal: findings from an online survey.</article-title> <source>BMC psychology.</source> <year>2020</year>;<volume>8</volume>(<issue>1</issue>):<fpage>1</fpage>–<lpage>10</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1186/s40359-019-0349-1" xlink:type="simple">10.1186/s40359-019-0349-1</ext-link></comment> <object-id pub-id-type="pmid">31898551</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref012"><label>12</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Devkota</surname> <given-names>HR</given-names></name>, <name name-style="western"><surname>Sijali</surname> <given-names>TR</given-names></name>, <name name-style="western"><surname>Bogati</surname> <given-names>R</given-names></name>, <name name-style="western"><surname>Ahmad</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Shakya</surname> <given-names>KL</given-names></name>, <name name-style="western"><surname>Adhikary</surname> <given-names>P</given-names></name>. <article-title>The impact of COVID-19 on mental health outcomes among hospital fever clinic attendants across Nepal: A cross-sectional study.</article-title> <source>Plos one</source>. <year>2021</year>;<volume>16</volume>(<issue>3</issue>):<fpage>e0248684</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1371/journal.pone.0248684" xlink:type="simple">10.1371/journal.pone.0248684</ext-link></comment> <object-id pub-id-type="pmid">33750955</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref013"><label>13</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Gupta</surname> <given-names>R</given-names></name>, <name name-style="western"><surname>Grover</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Basu</surname> <given-names>A</given-names></name>, <name name-style="western"><surname>Krishnan</surname> <given-names>V</given-names></name>, <name name-style="western"><surname>Tripathi</surname> <given-names>A</given-names></name>, <name name-style="western"><surname>Subramanyam</surname> <given-names>A</given-names></name>, <etal>et al</etal>. <article-title>Changes in sleep pattern and sleep quality during COVID-19 lockdown</article-title>. <source>Indian journal of psychiatry</source>. <year>2020</year>;<volume>62</volume>(<issue>4</issue>):<fpage>370</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.4103/psychiatry.IndianJPsychiatry%5F523%5F20" xlink:type="simple">10.4103/psychiatry.IndianJPsychiatry_523_20</ext-link></comment> <object-id pub-id-type="pmid">33165382</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref014"><label>14</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Basnet</surname> <given-names>BB</given-names></name>, <name name-style="western"><surname>Pant</surname> <given-names>RR</given-names></name>, <name name-style="western"><surname>Bishwakarma</surname> <given-names>K</given-names></name>, <name name-style="western"><surname>Paudel</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Pandey</surname> <given-names>N</given-names></name>, <name name-style="western"><surname>Adhikari</surname> <given-names>SK</given-names></name>, <etal>et al</etal>. <article-title>A Year Trend Analysis and Spatial Distribution of COVID-19</article-title> <source>Cases in Nepal. Asia Pacific Journal of Public Health</source>. <year>2021</year>:<fpage>10105395211012233</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1177/10105395211012233" xlink:type="simple">10.1177/10105395211012233</ext-link></comment> <object-id pub-id-type="pmid">33938266</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref015"><label>15</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Addis</surname> <given-names>SG</given-names></name>, <name name-style="western"><surname>Nega</surname> <given-names>AD</given-names></name>, <name name-style="western"><surname>Miretu</surname> <given-names>DG</given-names></name>. <article-title>Psychological impact of COVID-19 pandemic on chronic disease patients in Dessie town government and private hospitals, Northeast Ethiopia.</article-title> <source>Diabetes & Metabolic Syndrome: Clinical Research & Reviews.</source> <year>2021</year>;<volume>15</volume>(<issue>1</issue>):<fpage>129</fpage>–<lpage>35</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.dsx.2020.12.019" xlink:type="simple">10.1016/j.dsx.2020.12.019</ext-link></comment> <object-id pub-id-type="pmid">33338951</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref016"><label>16</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Jia</surname> <given-names>R</given-names></name>, <name name-style="western"><surname>Ayling</surname> <given-names>K</given-names></name>, <name name-style="western"><surname>Chalder</surname> <given-names>T</given-names></name>, <name name-style="western"><surname>Massey</surname> <given-names>A</given-names></name>, <name name-style="western"><surname>Broadbent</surname> <given-names>E</given-names></name>, <name name-style="western"><surname>Coupland</surname> <given-names>C</given-names></name>, <etal>et al</etal>. <article-title>Mental health in the UK during the COVID-19 pandemic: cross-sectional analyses from a community cohort study</article-title>. <source>BMJ open</source>. <year>2020</year>;<volume>10</volume>(<issue>9</issue>):<fpage>e040620</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1136/bmjopen-2020-040620" xlink:type="simple">10.1136/bmjopen-2020-040620</ext-link></comment> <object-id pub-id-type="pmid">32933965</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref017"><label>17</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Martinelli</surname> <given-names>N</given-names></name>, <name name-style="western"><surname>Gil</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Chevalère</surname> <given-names>J</given-names></name>, <name name-style="western"><surname>Belletier</surname> <given-names>C</given-names></name>, <name name-style="western"><surname>Dezecache</surname> <given-names>G</given-names></name>, <name name-style="western"><surname>Huguet</surname> <given-names>P</given-names></name>, <etal>et al</etal>. <article-title>The Impact of the COVID-19 Pandemic on Vulnerable People Suffering from Depression: Two Studies on Adults in France.</article-title> <source>International Journal of Environmental Research and Public Health</source>. <year>2021</year>;<volume>18</volume>(<issue>6</issue>):<fpage>3250</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3390/ijerph18063250" xlink:type="simple">10.3390/ijerph18063250</ext-link></comment> <object-id pub-id-type="pmid">33801095</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref018"><label>18</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Zhou</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Guo</surname> <given-names>W</given-names></name>. <article-title>Social Factors and Worry Associated with COVID-19: Evidence from a Large Survey in China.</article-title> <source>Social Science & Medicine</source>. <year>2021</year>:<fpage>113934</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.socscimed.2021.113934" xlink:type="simple">10.1016/j.socscimed.2021.113934</ext-link></comment> <object-id pub-id-type="pmid">33878665</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref019"><label>19</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Adler</surname> <given-names>NE</given-names></name>, <name name-style="western"><surname>Newman</surname> <given-names>K</given-names></name>. <article-title>Socioeconomic disparities in health: pathways and policies.</article-title> <source>Health affairs.</source> <year>2002</year>;<volume>21</volume>(<issue>2</issue>):<fpage>60</fpage>–<lpage>76</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1377/hlthaff.21.2.60" xlink:type="simple">10.1377/hlthaff.21.2.60</ext-link></comment> <object-id pub-id-type="pmid">11900187</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref020"><label>20</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Salami</surname> <given-names>TK</given-names></name>, <name name-style="western"><surname>Walker</surname> <given-names>RL</given-names></name>. <article-title>Socioeconomic status and symptoms of depression and anxiety in African American college students: The mediating role of hopelessness</article-title>. <source>Journal of black psychology</source>. <year>2014</year>;<volume>40</volume>(<issue>3</issue>):<fpage>275</fpage>–<lpage>90</lpage>.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref021"><label>21</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Shrestha</surname> <given-names>DB</given-names></name>, <name name-style="western"><surname>Thapa</surname> <given-names>BB</given-names></name>, <name name-style="western"><surname>Katuwal</surname> <given-names>N</given-names></name>, <name name-style="western"><surname>Shrestha</surname> <given-names>B</given-names></name>, <name name-style="western"><surname>Pant</surname> <given-names>C</given-names></name>, <name name-style="western"><surname>Basnet</surname> <given-names>B</given-names></name>, <etal>et al</etal>. <article-title>Psychological distress in Nepalese residents during COVID-19 pandemic: a community level survey.</article-title> <source>BMC psychiatry.</source> <year>2020</year>;<volume>20</volume>(<issue>1</issue>):<fpage>1</fpage>–<lpage>8</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1186/s12888-019-2374-2" xlink:type="simple">10.1186/s12888-019-2374-2</ext-link></comment> <object-id pub-id-type="pmid">31898506</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref022"><label>22</label><mixed-citation publication-type="other" xlink:type="simple">Worldometers. coronavirus/country/nepal. 2021 <ext-link ext-link-type="uri" xlink:href="https://www.worldometers.info/coronavirus/country/nepal/" xlink:type="simple">https://www.worldometers.info/coronavirus/country/nepal/</ext-link></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref023"><label>23</label><mixed-citation publication-type="other" xlink:type="simple">Nepal C. National Population and Housing Census, National Report. Government of Nepal Kathmandu. 2011.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref024"><label>24</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Strand</surname> <given-names>TA</given-names></name>, <name name-style="western"><surname>Ulak</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Chandyo</surname> <given-names>RK</given-names></name>, <name name-style="western"><surname>Kvestad</surname> <given-names>I</given-names></name>, <name name-style="western"><surname>Hysing</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Shrestha</surname> <given-names>M</given-names></name>, <etal>et al</etal>. <article-title>The effect of vitamin B 12 supplementation in Nepalese infants on growth and development: study protocol for a randomized controlled trial</article-title>. <source>Trials</source>. <year>2017</year>;<volume>18</volume>(<issue>1</issue>):<fpage>187</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1186/s13063-017-1937-0" xlink:type="simple">10.1186/s13063-017-1937-0</ext-link></comment> <object-id pub-id-type="pmid">28431557</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref025"><label>25</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Psaki</surname> <given-names>SR</given-names></name>, <name name-style="western"><surname>Seidman</surname> <given-names>JC</given-names></name>, <name name-style="western"><surname>Miller</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Gottlieb</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Bhutta</surname> <given-names>ZA</given-names></name>, <name name-style="western"><surname>Ahmed</surname> <given-names>T</given-names></name>, <etal>et al</etal>. <article-title>Measuring socioeconomic status in multicountry studies: results from the eight-country MAL-ED study.</article-title> <source>Population health metrics.</source> <year>2014</year>;<volume>12</volume>(<issue>1</issue>):<fpage>1</fpage>–<lpage>11</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1186/1478-7954-12-1" xlink:type="simple">10.1186/1478-7954-12-1</ext-link></comment> <object-id pub-id-type="pmid">24479861</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref026"><label>26</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Schwinger</surname> <given-names>C</given-names></name>, <name name-style="western"><surname>Kvestad</surname> <given-names>I</given-names></name>, <name name-style="western"><surname>Chandyo</surname> <given-names>RK</given-names></name>, <name name-style="western"><surname>Ulak</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Shrestha</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Ranjitkar</surname> <given-names>S</given-names></name>, <etal>et al</etal>. <article-title>The association between biomass fuel use for cooking and linear growth in young children in Bhaktapur, Nepal.</article-title> <source>Environment International</source>. <year>2022</year>;<volume>161</volume>:<fpage>107089</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.envint.2022.107089" xlink:type="simple">10.1016/j.envint.2022.107089</ext-link></comment> <object-id pub-id-type="pmid">35063791</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref027"><label>27</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Rubin</surname> <given-names>GJ</given-names></name>, <name name-style="western"><surname>Brewin</surname> <given-names>CR</given-names></name>, <name name-style="western"><surname>Greenberg</surname> <given-names>N</given-names></name>, <name name-style="western"><surname>Hughes</surname> <given-names>JH</given-names></name>, <name name-style="western"><surname>Simpson</surname> <given-names>J</given-names></name>, <name name-style="western"><surname>Wessely</surname> <given-names>S</given-names></name>. <article-title>Enduring consequences of terrorism: 7-month follow-up survey of reactions to the bombings in London on 7 July 2005</article-title>. <source>The British Journal of Psychiatry</source>. <year>2007</year>;<volume>190</volume>(<issue>4</issue>):<fpage>350</fpage>–<lpage>6</lpage>.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref028"><label>28</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Kvestad</surname> <given-names>I</given-names></name>, <name name-style="western"><surname>Ranjitkar</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Ulak</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Chandyo</surname> <given-names>RK</given-names></name>, <name name-style="western"><surname>Shrestha</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Shrestha</surname> <given-names>L</given-names></name>, <etal>et al</etal>. <article-title>Earthquake exposure and post-traumatic stress among Nepalese mothers after the 2015 earthquakes.</article-title> <source>Frontiers in psychology.</source> <year>2019</year>;<volume>10</volume>:<fpage>734</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyg.2019.00734" xlink:type="simple">10.3389/fpsyg.2019.00734</ext-link></comment> <object-id pub-id-type="pmid">31001178</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref029"><label>29</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Mesch</surname> <given-names>GS</given-names></name>, <name name-style="western"><surname>Schwirian</surname> <given-names>KP</given-names></name>, <name name-style="western"><surname>Kolobov</surname> <given-names>T</given-names></name>. <article-title>Attention to the media and worry over becoming infected: the case of the Swine Flu (H1N1) Epidemic of 2009.</article-title> <source>Sociology of health & illness.</source> <year>2013</year>;<volume>35</volume>(<issue>2</issue>):<fpage>325</fpage>–<lpage>31</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1111/j.1467-9566.2012.01500.x" xlink:type="simple">10.1111/j.1467-9566.2012.01500.x</ext-link></comment> <object-id pub-id-type="pmid">23030743</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref030"><label>30</label><mixed-citation publication-type="book" xlink:type="simple"><name name-style="western"><surname>Beusenberg</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Orley</surname> <given-names>JH</given-names></name>, <name name-style="western"><surname>Organization</surname> <given-names>WH</given-names></name>. <source>A User’s guide to the self reporting questionnaire (SRQ.</source> <publisher-name>World Health Organization</publisher-name>, <year>1994</year>.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref031"><label>31</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Chincholikar</surname> <given-names>S.</given-names></name> <article-title>Use of SRQ in psychiatric epidemiology</article-title>. <source>Indian journal of Community medicine</source>. <year>2004</year>;<volume>29</volume>(<issue>4</issue>):<fpage>190</fpage>.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref032"><label>32</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Pendergast</surname> <given-names>LL</given-names></name>, <name name-style="western"><surname>Scharf</surname> <given-names>RJ</given-names></name>, <name name-style="western"><surname>Rasmussen</surname> <given-names>ZA</given-names></name>, <name name-style="western"><surname>Seidman</surname> <given-names>JC</given-names></name>, <name name-style="western"><surname>Schaefer</surname> <given-names>BA</given-names></name>, <name name-style="western"><surname>Svensen</surname> <given-names>E</given-names></name>, <etal>et al</etal>. <article-title>Postpartum depressive symptoms across time and place: structural invariance of the Self-Reporting Questionnaire among women from the international, multi-site MAL-ED study</article-title>. <source>Journal of affective disorders</source>. <year>2014</year>;<volume>167</volume>:<fpage>178</fpage>–<lpage>86</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.jad.2014.05.039" xlink:type="simple">10.1016/j.jad.2014.05.039</ext-link></comment> <object-id pub-id-type="pmid">24981251</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref033"><label>33</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Wild</surname> <given-names>D</given-names></name>, <name name-style="western"><surname>Grove</surname> <given-names>A</given-names></name>, <name name-style="western"><surname>Martin</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Eremenco</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>McElroy</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Verjee-Lorenz</surname> <given-names>A</given-names></name>, <etal>et al</etal>. <article-title>Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation.</article-title> <source>Value in health.</source> <year>2005</year>;<volume>8</volume>(<issue>2</issue>):<fpage>94</fpage>–<lpage>104</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1111/j.1524-4733.2005.04054.x" xlink:type="simple">10.1111/j.1524-4733.2005.04054.x</ext-link></comment> <object-id pub-id-type="pmid">15804318</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref034"><label>34</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Jalloh</surname> <given-names>MF</given-names></name>, <name name-style="western"><surname>Li</surname> <given-names>W</given-names></name>, <name name-style="western"><surname>Bunnell</surname> <given-names>RE</given-names></name>, <name name-style="western"><surname>Ethier</surname> <given-names>KA</given-names></name>, <name name-style="western"><surname>O’Leary</surname> <given-names>A</given-names></name>, <name name-style="western"><surname>Hageman</surname> <given-names>KM</given-names></name>, <etal>et al</etal>. <article-title>Impact of Ebola experiences and risk perceptions on mental health in Sierra Leone, July 2015</article-title>. <source>BMJ global health</source>. <year>2018</year>;<volume>3</volume>(<issue>2</issue>):<fpage>e000471</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1136/bmjgh-2017-000471" xlink:type="simple">10.1136/bmjgh-2017-000471</ext-link></comment> <object-id pub-id-type="pmid">29607096</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref035"><label>35</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Goodwin</surname> <given-names>R</given-names></name>, <name name-style="western"><surname>Haque</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Neto</surname> <given-names>F</given-names></name>, <name name-style="western"><surname>Myers</surname> <given-names>LB</given-names></name>. <article-title>Initial psychological responses to Influenza A, H1N1 (" Swine flu").</article-title> <source>BMC Infectious Diseases</source>. <year>2009</year>;<volume>9</volume>(<issue>1</issue>):<fpage>1</fpage>–<lpage>6</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1186/1471-2334-9-166" xlink:type="simple">10.1186/1471-2334-9-166</ext-link></comment> <object-id pub-id-type="pmid">19807908</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref036"><label>36</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Coughlin</surname> <given-names>SS</given-names></name>. <article-title>Anxiety and depression: linkages with viral diseases.</article-title> <source>Public health reviews.</source> <year>2012</year>;<volume>34</volume>(<issue>2</issue>):<fpage>7</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1007/BF03391675" xlink:type="simple">10.1007/BF03391675</ext-link></comment> <object-id pub-id-type="pmid">25264396</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref037"><label>37</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>McAlonan</surname> <given-names>GM</given-names></name>, <name name-style="western"><surname>Lee</surname> <given-names>AM</given-names></name>, <name name-style="western"><surname>Cheung</surname> <given-names>V</given-names></name>, <name name-style="western"><surname>Cheung</surname> <given-names>C</given-names></name>, <name name-style="western"><surname>Tsang</surname> <given-names>KW</given-names></name>, <name name-style="western"><surname>Sham</surname> <given-names>PC</given-names></name>, <etal>et al</etal>. <article-title>Immediate and sustained psychological impact of an emerging infectious disease outbreak on health care workers</article-title>. <source>The Canadian Journal of Psychiatry</source>. <year>2007</year>;<volume>52</volume>(<issue>4</issue>):<fpage>241</fpage>–<lpage>7</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1177/070674370705200406" xlink:type="simple">10.1177/070674370705200406</ext-link></comment> <object-id pub-id-type="pmid">17500305</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref038"><label>38</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Blix</surname> <given-names>I</given-names></name>, <name name-style="western"><surname>Birkeland</surname> <given-names>MS</given-names></name>, <name name-style="western"><surname>Thoresen</surname> <given-names>S</given-names></name>. <article-title>Worry and mental health in the Covid-19 pandemic: vulnerability factors in the general Norwegian population.</article-title> <source>BMC Public Health</source>. <year>2021</year>;<volume>21</volume>(<issue>1</issue>):<fpage>1</fpage>–<lpage>10</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1186/s12889-020-10013-y" xlink:type="simple">10.1186/s12889-020-10013-y</ext-link></comment> <object-id pub-id-type="pmid">33388037</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref039"><label>39</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Yuksel</surname> <given-names>D</given-names></name>, <name name-style="western"><surname>McKee</surname> <given-names>GB</given-names></name>, <name name-style="western"><surname>Perrin</surname> <given-names>PB</given-names></name>, <name name-style="western"><surname>Alzueta</surname> <given-names>E</given-names></name>, <name name-style="western"><surname>Caffarra</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Ramos-Usuga</surname> <given-names>D</given-names></name>, <etal>et al</etal>. <article-title>Sleeping when the world locks down: Correlates of sleep health during the COVID-19 pandemic across 59 countries.</article-title> <source>Sleep Health.</source> <year>2021</year>;<volume>7</volume>(<issue>2</issue>):<fpage>134</fpage>–<lpage>42</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.sleh.2020.12.008" xlink:type="simple">10.1016/j.sleh.2020.12.008</ext-link></comment> <object-id pub-id-type="pmid">33509687</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref040"><label>40</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Tasnim</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Rahman</surname> <given-names>M</given-names></name>, <name name-style="western"><surname>Pawar</surname> <given-names>P</given-names></name>, <name name-style="western"><surname>Chi</surname> <given-names>X</given-names></name>, <name name-style="western"><surname>Yu</surname> <given-names>Q</given-names></name>, <name name-style="western"><surname>Zou</surname> <given-names>L</given-names></name>, <etal>et al</etal>. <article-title>Epidemiology of sleep disorders during COVID-19 pandemic: A systematic scoping review.</article-title> <source>medRxiv</source>. <year>2020</year>.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref041"><label>41</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Marzo</surname> <given-names>RR</given-names></name>, <name name-style="western"><surname>Ismail</surname> <given-names>Z</given-names></name>, <name name-style="western"><surname>Htay</surname> <given-names>MNN</given-names></name>, <name name-style="western"><surname>Bahari</surname> <given-names>R</given-names></name>, <name name-style="western"><surname>Ismail</surname> <given-names>R</given-names></name>, <name name-style="western"><surname>Villanueva</surname> <given-names>EQ</given-names> <suffix>III</suffix></name>, <etal>et al</etal>. <article-title>Psychological distress during pandemic Covid-19 among adult general population: Result across 13 countries.</article-title> <source>Clinical Epidemiology and Global Health</source>. <year>2021</year>;<volume>10</volume>:<fpage>100708</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.cegh.2021.100708" xlink:type="simple">10.1016/j.cegh.2021.100708</ext-link></comment> <object-id pub-id-type="pmid">33619459</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref042"><label>42</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Pandey</surname> <given-names>D.</given-names></name> <article-title>The prevalence of general anxiety disorder and its associated factors among women’s attending at the perinatal service of Dilla University referral hospital, Dilla town, Ethiopia, April, 2020 in Covid pandemic.</article-title> <source>Heliyon</source>. <year>2020</year>;<volume>6</volume>(<issue>11</issue>):<fpage>e05593</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.heliyon.2020.e05593" xlink:type="simple">10.1016/j.heliyon.2020.e05593</ext-link></comment> <object-id pub-id-type="pmid">33294715</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref043"><label>43</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Kassaw</surname> <given-names>C.</given-names></name> <article-title>The magnitude of psychological problem and associated factor in response to COVID-19 pandemic among communities living in Addis Ababa, Ethiopia, March 2020: a cross-sectional study design.</article-title> <source>Psychology Research and Behavior Management</source>. <year>2020</year>;<volume>13</volume>:<fpage>631</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.2147/PRBM.S256551" xlink:type="simple">10.2147/PRBM.S256551</ext-link></comment> <object-id pub-id-type="pmid">32848481</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref044"><label>44</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Chekole</surname> <given-names>YA</given-names></name>, <name name-style="western"><surname>Yimer Minaye</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Mekonnen Abate</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Mekuriaw</surname> <given-names>B</given-names></name>. <article-title>Perceived Stress and Its Associated Factors during COVID-19 among Healthcare Providers in Ethiopia: A Cross-Sectional Study.</article-title> <source>Advances in Public Health.</source> <year>2020</year>;<volume>2020</volume>.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref045"><label>45</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Sørensen</surname> <given-names>K</given-names></name>, <name name-style="western"><surname>Van den Broucke</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Fullam</surname> <given-names>J</given-names></name>, <name name-style="western"><surname>Doyle</surname> <given-names>G</given-names></name>, <name name-style="western"><surname>Pelikan</surname> <given-names>J</given-names></name>, <name name-style="western"><surname>Slonska</surname> <given-names>Z</given-names></name>, <etal>et al</etal>. <article-title>Health literacy and public health: a systematic review and integration of definitions and models.</article-title> <source>BMC public health.</source> <year>2012</year>;<volume>12</volume>(<issue>1</issue>):<fpage>1</fpage>–<lpage>13</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1186/1471-2458-12-80" xlink:type="simple">10.1186/1471-2458-12-80</ext-link></comment> <object-id pub-id-type="pmid">22276600</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref046"><label>46</label><mixed-citation publication-type="book" xlink:type="simple"><name name-style="western"><surname>Burström</surname> <given-names>B</given-names></name>, <name name-style="western"><surname>Tao</surname> <given-names>W</given-names></name>. <source>Social determinants of health and inequalities in COVID-19</source>. <publisher-name>Oxford University Press</publisher-name>; <year>2020</year>.</mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref047"><label>47</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Zhong</surname> <given-names>B-L</given-names></name>, <name name-style="western"><surname>Luo</surname> <given-names>W</given-names></name>, <name name-style="western"><surname>Li</surname> <given-names>H-M</given-names></name>, <name name-style="western"><surname>Zhang</surname> <given-names>Q-Q</given-names></name>, <name name-style="western"><surname>Liu</surname> <given-names>X-G</given-names></name>, <name name-style="western"><surname>Li</surname> <given-names>W-T</given-names></name>, <etal>et al</etal>. <article-title>Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey</article-title>. <source>International journal of biological sciences</source>. <year>2020</year>;<volume>16</volume>(<issue>10</issue>):<fpage>1745</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.7150/ijbs.45221" xlink:type="simple">10.7150/ijbs.45221</ext-link></comment> <object-id pub-id-type="pmid">32226294</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref048"><label>48</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Pun</surname> <given-names>SB</given-names></name>, <name name-style="western"><surname>Mandal</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Bhandari</surname> <given-names>L</given-names></name>, <name name-style="western"><surname>Jha</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Rajbhandari</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Mishra</surname> <given-names>AK</given-names></name>, <etal>et al</etal>. <article-title>Understanding COVID-19 in Nepal.</article-title> <source>Journal of Nepal Health Research Council</source>. <year>2020</year>;<volume>18</volume>(<issue>1</issue>):<fpage>126</fpage>–<lpage>7</lpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.33314/jnhrc.v18i1.2629" xlink:type="simple">10.33314/jnhrc.v18i1.2629</ext-link></comment> <object-id pub-id-type="pmid">32335607</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref049"><label>49</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Rayamajhee</surname> <given-names>B</given-names></name>, <name name-style="western"><surname>Pokhrel</surname> <given-names>A</given-names></name>, <name name-style="western"><surname>Syangtan</surname> <given-names>G</given-names></name>, <name name-style="western"><surname>Khadka</surname> <given-names>S</given-names></name>, <name name-style="western"><surname>Lama</surname> <given-names>B</given-names></name>, <name name-style="western"><surname>Rawal</surname> <given-names>LB</given-names></name>, <etal>et al</etal>. <article-title>How Well the Government of Nepal Is Responding to COVID-19? An Experience From a Resource-Limited Country to Confront Unprecedented Pandemic.</article-title> <source>Frontiers in Public Health.</source> <year>2021</year>;<volume>9</volume>:<fpage>85</fpage>. <comment>doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpubh.2021.597808" xlink:type="simple">10.3389/fpubh.2021.597808</ext-link></comment> <object-id pub-id-type="pmid">33681124</object-id></mixed-citation></ref> |
|
|
<ref id="pgph.0000278.ref050"><label>50</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Block</surname> <given-names>ES</given-names></name>, <name name-style="western"><surname>Erskine</surname> <given-names>L</given-names></name>. <article-title>Interviewing by telephone: Specific considerations, opportunities, and challenges</article-title>. <source>International journal of qualitative methods</source>. <year>2012</year>;<volume>11</volume>(<issue>4</issue>):<fpage>428</fpage>–<lpage>45</lpage>.</mixed-citation></ref> |
|
|
</ref-list> |
|
|
</back> |
|
|
<sub-article article-type="aggregated-review-documents" id="pgph.0000278.r001" specific-use="decision-letter"> |
|
|
<front-stub> |
|
|
<article-id pub-id-type="doi">10.1371/journal.pgph.0000278.r001</article-id> |
|
|
<title-group> |
|
|
<article-title>Decision Letter 0</article-title> |
|
|
</title-group> |
|
|
<contrib-group> |
|
|
<contrib contrib-type="author"> |
|
|
<name name-style="western"> |
|
|
<surname>Hall-Clifford</surname> |
|
|
<given-names>Rachel</given-names> |
|
|
</name> |
|
|
<role>Academic Editor</role> |
|
|
</contrib> |
|
|
</contrib-group> |
|
|
<permissions> |
|
|
<copyright-year>2022</copyright-year> |
|
|
<copyright-holder>Rachel Hall-Clifford</copyright-holder> |
|
|
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"> |
|
|
<license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p> |
|
|
</license> |
|
|
</permissions> |
|
|
<related-object document-id="10.1371/journal.pgph.0000278" document-id-type="doi" document-type="article" id="rel-obj001" link-type="peer-reviewed-article"/> |
|
|
<custom-meta-group> |
|
|
<custom-meta> |
|
|
<meta-name>Submission Version</meta-name> |
|
|
<meta-value>0</meta-value> |
|
|
</custom-meta> |
|
|
</custom-meta-group> |
|
|
</front-stub> |
|
|
<body> |
|
|
<p> |
|
|
<named-content content-type="letter-date">13 Dec 2021</named-content> |
|
|
</p> |
|
|
<p>PGPH-D-21-00572</p> |
|
|
<p>Impact of the COVID-19 pandemic on daily life among mothers in Bhaktapur, Nepal</p> |
|
|
<p>PLOS Global Public Health</p> |
|
|
<p>Dear Dr. Ranjitkar,</p> |
|
|
<p>Thank you for submitting your manuscript to PLOS Global Public Health. After careful consideration, we feel that it has merit but does not fully meet PLOS Global Public Health’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.</p> |
|
|
<p>Please submit your revised manuscript by Jan 27 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at <email xlink:type="simple">globalpubhealth@plos.org</email>. When you're ready to submit your revision, log on to <ext-link ext-link-type="uri" xlink:href="https://www.editorialmanager.com/pgph/" xlink:type="simple">https://www.editorialmanager.com/pgph/</ext-link> and select the 'Submissions Needing Revision' folder to locate your manuscript file.</p> |
|
|
<p>Please include the following items when submitting your revised manuscript:</p> |
|
|
<p><list list-type="bullet"><list-item><p>A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.</p></list-item><list-item><p>A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.</p></list-item><list-item><p>An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.</p></list-item></list></p> |
|
|
<p>Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.</p> |
|
|
<p>We look forward to receiving your revised manuscript.</p> |
|
|
<p>Kind regards,</p> |
|
|
<p>Rachel Hall-Clifford</p> |
|
|
<p>Academic Editor</p> |
|
|
<p>PLOS Global Public Health</p> |
|
|
<p>Journal Requirements:</p> |
|
|
<p>1. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.</p> |
|
|
<p>2. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information.</p> |
|
|
<p>3. Please ensure you have included the registration number for the clinical trial referenced in the manuscript.</p> |
|
|
<p>4. Please provide separate figure files in .tif or .eps format only, and remove any figures embedded in your manuscript file.</p> |
|
|
<p>For more information about figure files please see our guidelines: </p> |
|
|
<p><ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/globalpublichealth/s/figures" xlink:type="simple">https://journals.plos.org/globalpublichealth/s/figures</ext-link></p> |
|
|
<p>5. Please update the completed 'Competing Interests' statement, including any COIs declared by your co-authors. If you have no competing interests to declare, please state "The authors have declared that no competing interests exist". Otherwise please declare all competing interests beginning with the statement "I have read the journal's policy and the authors of this manuscript have the following competing interests:</p> |
|
|
<p>6. In the online submission form, you indicated that [Insert text from online submission form here]. All PLOS journals now require all data underlying the findings described in their manuscript to be freely available to other researchers, either 1. In a public repository, 2. Within the manuscript itself, or 3. Uploaded as supplementary information.</p> |
|
|
<p>This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If your data cannot be made publicly available for ethical or legal reasons (e.g., public availability would compromise patient privacy), please explain your reasons by return email and your exemption request will be escalated to the editor for approval. Your exemption request will be handled independently and will not hold up the peer review process, but will need to be resolved should your manuscript be accepted for publication. One of the Editorial team will then be in touch if there are any issues.</p> |
|
|
<p>7. Please amend your] detailed Financial Disclosure statement. This is published with the article, therefore should be completed in full sentences and contain the exact wording you wish to be published.</p> |
|
|
<p>i) Please include all sources of funding (financial or material support) for your study. List the grants (with grant number) or organizations (with url) that supported your study, including funding received from your institution. </p> |
|
|
<p>ii). State the initials, alongside each funding source, of each author to receive each grant.</p> |
|
|
<p>iii). State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”</p> |
|
|
<p>Additional Editor Comments (if provided):</p> |
|
|
<p>This is an important contribution to our understanding of the COVID-19 pandemic on daily life and well-being. In addition to the suggestions of the reviewers, I would add:</p> |
|
|
<p>1) Since your framing of the paper and discussion focus on worry, please title the paper accordingly. This is a very interesting framing, and the title should reflect that. Please further incorporate in the introduction that you are considering "worry" not just about COVID-19 itself but many of its sequelae in Nepal (i.e., financial outcomes, loss of childcare, etc.).</p> |
|
|
<p>2) Please indicate the age range of children in the abstract. This is very clear in the methods, but after reading the abstract, I thought certainly outcomes would vary by age of children (which turned out to not be relevant as I saw the study design).</p> |
|
|
<p>3) In the discussion, please include more thinking about the gendered experience of women.</p> |
|
|
<p>Thank you for this submission!</p> |
|
|
<p>[Note: HTML markup is below. Please do not edit.]</p> |
|
|
<p>Reviewers' comments:</p> |
|
|
<p>Reviewer's Responses to Questions</p> |
|
|
<p><bold>Comments to the Author</bold></p> |
|
|
<p>1. Does this manuscript meet PLOS Global Public Health’s <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/globalpublichealth/s/criteria-for-publication" xlink:type="simple">publication criteria</ext-link>? Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe methodologically and ethically rigorous research with conclusions that are appropriately drawn based on the data presented.</p> |
|
|
<p>Reviewer #1: Yes</p> |
|
|
<p>Reviewer #2: Yes</p> |
|
|
<p>**********</p> |
|
|
<p>2. Has the statistical analysis been performed appropriately and rigorously?</p> |
|
|
<p>Reviewer #1: Yes</p> |
|
|
<p>Reviewer #2: Yes</p> |
|
|
<p>**********</p> |
|
|
<p>3. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)?</p> |
|
|
<p>The <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/globalpublichealth/s/data-availability" xlink:type="simple">PLOS Data policy</ext-link> requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.</p> |
|
|
<p>Reviewer #1: Yes</p> |
|
|
<p>Reviewer #2: Yes</p> |
|
|
<p>**********</p> |
|
|
<p>4. Is the manuscript presented in an intelligible fashion and written in standard English?</p> |
|
|
<p>PLOS Global Public Health does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.</p> |
|
|
<p>Reviewer #1: Yes</p> |
|
|
<p>Reviewer #2: No</p> |
|
|
<p>**********</p> |
|
|
<p>5. Review Comments to the Author</p> |
|
|
<p>Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)</p> |
|
|
<p>Reviewer #1: This study uses cross-sectional survey data to assess the impact of the COVID-19 pandemic on various aspects of daily life for mothers in Bhaktapur, Nepal. While previous studies in Nepal have assessed psychological impacts during the early pandemic period, this study centers on a later phase of the pandemic (September 2020–February 2021, prior to the predominance of the SARS-CoV-2 Delta variant). Findings of higher pandemic-associated worry in mothers with higher educational attainment and socioeconomic status are concordant with a prior, national-level study assessing pandemic distress in April-May 2020 (Shrestha et al. 2020). Readers of PLOS Global Public Health may be interested in implications of these findings for health education efforts in Nepal, as well as suggestions for addressing these psychological impacts.</p> |
|
|
<p>Major and minor comments for the authors are provided below.</p> |
|
|
<p>INTRODUCTION</p> |
|
|
<p>The authors provide a comprehensive overview of previous literature on the impact of COVID-19 on psychological health in general and in Nepal specifically.</p> |
|
|
<p>Additional contextual information about Bhaktapur municipality (e.g. population demographics, geographical location within Nepal) would be appreciated in the Introduction, as well as in the Discussion of the study findings.</p> |
|
|
<p>METHODS</p> |
|
|
<p>The authors have clearly described the participant recruitment strategy and reasons for loss to follow up.</p> |
|
|
<p>Definition of variables is easily understood, but what is meant by “age category of family members” is not immediately clear.</p> |
|
|
<p>The methods for statistical analysis are technically sound, although authors should discuss explicitly their strategy for handling any missing data.</p> |
|
|
<p>The authors received ethical approvals from the Nepal Health and Research Council (NHRC) and Regional Committee for Medical and Health Research Ethics (REC) and described obtaining written consent from study participants. Authors have made data available upon request in accordance with requirements of NHRC and REC.</p> |
|
|
<p>RESULTS</p> |
|
|
<p>Results are communicated clearly.</p> |
|
|
<p>Did the authors note any difference in key findings (negative impacts of COVID-19) by mode of data collection (phone vs. in-person interview)?</p> |
|
|
<p>TABLES</p> |
|
|
<p>Tables 1-5 and Supplemental Table 1 are well-organized and easily comprehensible.</p> |
|
|
<p>DISCUSSION/CONCLUSIONS</p> |
|
|
<p>The authors appropriately situate their findings within a broader discussion of previous literature on pandemic distress in Nepal and in other LMICs.</p> |
|
|
<p>Authors have thoughtfully considered the Strengths and Limitations of the study, including generalizability, variability in the mode of data collection (phone and in-person interviews), and inability to collect data on depressive symptoms through clinical interview. Authors should additionally address how the study setting in Bhaktapur affects generalizability.</p> |
|
|
<p>Authors should expound on implications of their findings for readers of PLOS Global Public Health. What are the implications for health education efforts in Nepal if those least concerned about COVID-19 are those who with the lowest educational attainment? What should public health practitioners consider when aiming to address the psychological impacts the findings highlight?</p> |
|
|
<p>FIGURES</p> |
|
|
<p>Figure 1 is easily comprehensible. The title should be reworded to reflect the participants of the current study, e.g. “Recruitment of mothers in Bhaktapur, Nepal”.</p> |
|
|
<p>MINOR COMMENTS:</p> |
|
|
<p>Use of the term “Corona” should be replaced with “Coronavirus” or “COVID-19,” including in the title of Table 2.</p> |
|
|
<p>This article satisfies the below criteria for acceptance to PLOS Global Public Health:</p> |
|
|
<p>1. The study presents the results of primary scientific research.</p> |
|
|
<p>2. Results reported have not been published elsewhere.</p> |
|
|
<p>3. Experiments, statistics, and other analyses are performed to a high technical standard and are described in sufficient detail.</p> |
|
|
<p>4. Conclusions are presented in an appropriate fashion and are supported by the data.</p> |
|
|
<p>5. The article is presented in an intelligible fashion and is written in standard English.</p> |
|
|
<p>6. The research meets all applicable standards for the ethics of experimentation and research integrity.</p> |
|
|
<p>7. The article adheres to appropriate reporting guidelines and community standards for data availability.</p> |
|
|
<p>Reviewer #2: The authors present findings of a study that assessed effect of COVID-19 in an urban district of Nepal. The article is largely coherent however it would benefit with some specific detail in few places. I would strongly recommend the article to be professionally edited for language as there are typos and grammatical errors in the article (e.g., line 90, 207, 255-256).</p> |
|
|
<p>Line number Comments</p> |
|
|
<p>103 Suggest to include some information on characteristics of respondents who were lost to follow up. Was it different from the final sample?</p> |
|
|
<p>106 Need to specific and consistent in using the term. Caregivers or mothers. Grandparents, father or other members of an extended family can also be a caregiver</p> |
|
|
<p>113 What was the definition for” no work” specially for mothers (57.8%)? Did it also include housewife or household work? Strongly suggest to use alternative word</p> |
|
|
<p>135 Recommend including information tool development of Corona Exposure questionnaire. Was this questionnaire pre-tested?</p> |
|
|
<p>213-215 Convoluted sentence. Please make this sentence easier to read</p> |
|
|
<p>269 What could be the possible explanation about the low prevalence of sleep problem – What do authors think about that? - more resilience because of repeated stressors? or taking COVID-19 lightly?</p> |
|
|
<p>287-289 Argument here is really not clear. Please add more reasoning about why they could be less sensitive</p> |
|
|
<p>**********</p> |
|
|
<p>6. PLOS authors have the option to publish the peer review history of their article (<ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/globalpublichealth/s/editorial-and-peer-review-process#loc-peer-review-history" xlink:type="simple">what does this mean?</ext-link>). If published, this will include your full peer review and any attached files.</p> |
|
|
<p><bold>Do you want your identity to be public for this peer review?</bold> If you choose “no”, your identity will remain anonymous but your review may still be made public.</p> |
|
|
<p>For information about this choice, including consent withdrawal, please see our <ext-link ext-link-type="uri" xlink:href="https://www.plos.org/privacy-policy" xlink:type="simple">Privacy Policy</ext-link>.</p> |
|
|
<p>Reviewer #1: No</p> |
|
|
<p>Reviewer #2: No</p> |
|
|
<p>**********</p> |
|
|
<p>[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]</p> |
|
|
<p>While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, <ext-link ext-link-type="uri" xlink:href="https://pacev2.apexcovantage.com/" xlink:type="simple">https://pacev2.apexcovantage.com/</ext-link>. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at <email xlink:type="simple">figures@plos.org</email>. Please note that Supporting Information files do not need this step.</p> |
|
|
</body> |
|
|
</sub-article> |
|
|
<sub-article article-type="author-comment" id="pgph.0000278.r002"> |
|
|
<front-stub> |
|
|
<article-id pub-id-type="doi">10.1371/journal.pgph.0000278.r002</article-id> |
|
|
<title-group> |
|
|
<article-title>Author response to Decision Letter 0</article-title> |
|
|
</title-group> |
|
|
<related-object document-id="10.1371/journal.pgph.0000278" document-id-type="doi" document-type="peer-reviewed-article" id="rel-obj002" link-type="rebutted-decision-letter" object-id="10.1371/journal.pgph.0000278.r001" object-id-type="doi" object-type="decision-letter"/> |
|
|
<custom-meta-group> |
|
|
<custom-meta> |
|
|
<meta-name>Submission Version</meta-name> |
|
|
<meta-value>1</meta-value> |
|
|
</custom-meta> |
|
|
</custom-meta-group> |
|
|
</front-stub> |
|
|
<body> |
|
|
<p> |
|
|
<named-content content-type="author-response-date">20 Feb 2022</named-content> |
|
|
</p> |
|
|
<supplementary-material id="pgph.0000278.s005" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document" position="float" xlink:href="info:doi/10.1371/journal.pgph.0000278.s005" xlink:type="simple"> |
|
|
<label>Attachment</label> |
|
|
<caption> |
|
|
<p>Submitted filename: <named-content content-type="submitted-filename">Response to Reviewers.docx</named-content></p> |
|
|
</caption> |
|
|
</supplementary-material> |
|
|
</body> |
|
|
</sub-article> |
|
|
<sub-article article-type="editor-report" id="pgph.0000278.r003" specific-use="decision-letter"> |
|
|
<front-stub> |
|
|
<article-id pub-id-type="doi">10.1371/journal.pgph.0000278.r003</article-id> |
|
|
<title-group> |
|
|
<article-title>Decision Letter 1</article-title> |
|
|
</title-group> |
|
|
<contrib-group> |
|
|
<contrib contrib-type="author"> |
|
|
<name name-style="western"> |
|
|
<surname>Robinson</surname> |
|
|
<given-names>Julia</given-names> |
|
|
</name> |
|
|
<role>Staff Editor</role> |
|
|
</contrib> |
|
|
<contrib contrib-type="author"> |
|
|
<name name-style="western"> |
|
|
<surname>Hall-Clifford</surname> |
|
|
<given-names>Rachel</given-names> |
|
|
</name> |
|
|
<role>Academic Editor</role> |
|
|
</contrib> |
|
|
</contrib-group> |
|
|
<permissions> |
|
|
<copyright-year>2022</copyright-year> |
|
|
<copyright-holder>Robinson, Hall-Clifford</copyright-holder> |
|
|
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"> |
|
|
<license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p> |
|
|
</license> |
|
|
</permissions> |
|
|
<related-object document-id="10.1371/journal.pgph.0000278" document-id-type="doi" document-type="article" id="rel-obj003" link-type="peer-reviewed-article"/> |
|
|
<custom-meta-group> |
|
|
<custom-meta> |
|
|
<meta-name>Submission Version</meta-name> |
|
|
<meta-value>1</meta-value> |
|
|
</custom-meta> |
|
|
</custom-meta-group> |
|
|
</front-stub> |
|
|
<body> |
|
|
<p> |
|
|
<named-content content-type="letter-date">2 Mar 2022</named-content> |
|
|
</p> |
|
|
<p>Impact of the COVID-19 pandemic on daily life and worry among mothers in Bhaktapur, Nepal</p> |
|
|
<p>PGPH-D-21-00572R1</p> |
|
|
<p>Dear Mr. Ranjitkar,</p> |
|
|
<p>We are pleased to inform you that your manuscript 'Impact of the COVID-19 pandemic on daily life and worry among mothers in Bhaktapur, Nepal' has been provisionally accepted for publication in PLOS Global Public Health.</p> |
|
|
<p>Before your manuscript can be formally accepted you will need to complete some formatting changes, which you will receive in a follow up email. A member of our team will be in touch with a set of requests.</p> |
|
|
<p>Please note that your manuscript will not be scheduled for publication until you have made the required changes, so a swift response is appreciated.</p> |
|
|
<p>IMPORTANT: The editorial review process is now complete. PLOS will only permit corrections to spelling, formatting or significant scientific errors from this point onwards. Requests for major changes, or any which affect the scientific understanding of your work, will cause delays to the publication date of your manuscript.</p> |
|
|
<p>If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they'll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact <email xlink:type="simple">globalpubhealth@plos.org</email>.</p> |
|
|
<p>Thank you again for supporting Open Access publishing; we are looking forward to publishing your work in PLOS Global Public Health.</p> |
|
|
<p>Best regards,</p> |
|
|
<p>Rachel Hall-Clifford</p> |
|
|
<p>Academic Editor</p> |
|
|
<p>PLOS Global Public Health</p> |
|
|
<p>***********************************************************</p> |
|
|
<p>Reviewer Comments (if any, and for reference):</p> |
|
|
</body> |
|
|
</sub-article> |
|
|
</article> |
