title: Non-communicable diseases at a regional hospital in Nepal: Findings of a high burden of alcohol-related disease.
abstract: Recent global burden of disease reports find that a major proportion of global deaths and disability worldwide can be attributed to alcohol use. Thus, it may be surprising that very few studies have reported on the burden of alcohol-related disease in low income settings. The evidence of non-communicable disease (NCD) burden in Nepal was recently reviewed and concluded that data is still lacking, particularly to describe the burden of alcohol-related diseases (ARDs). Therefore, here we report on NCD burden and specifically ARDs, in hospitalized patients at a regional hospital in Nepal. We conducted a retrospective chart-review that included detailed information on all discharged patients during a four month period. A local database that included sociodemographic information and diagnoses at discharge was established. All doctor-assigned discharge diagnoses were retrospectively assigned ICD-10 codes. A total of 1,139 hospitalized adult patients were included in the study and one third of these were NCDs (n = 332). The main NCDs were chronic obstructive pulmonary disease (COPD) (n = 148, 45%) and ARDs (n = 57, 17%). Patients with ARD often presented with signs of liver cirrhosis and were typically younger men, with a median age at 43 years, from specific ethnic groups. These data demonstrate that severe alcohol-related organ failure in relatively young men contributed to a high proportion of NCDs in a regional hospital in Nepal. These findings are novel and alarming and warrant further studies that can establish the burden of ARDs and alcohol use in Nepal and other similar low-income countries.
authors.affiliation: Norwegian University of Science and Technology, NTNU, P.O. Box No.: 7491, Trondheim, Norway; St. Olavs Hospital, Children's Clinic, Olav Kyrres Gate 11, P.O. Box 7030, Trondheim, Norway. Electronic address: mariesolamu@gmail.com.
authors.forename: M S
authors.initials: MS
authors.lastname: Amundsen
authors.affiliation: Norwegian University of Science and Technology, NTNU, P.O. Box No.: 7491, Trondheim, Norway; St. Olavs Hospital, Clinic of Emergency Medicine and Prehospital Care, Prinsesse Kristinas Gate 3, P.O. Box. No: 7030, Trondheim, Norway. Electronic address: thine_89@hotmail.com.
authors.forename: T M G
authors.initials: TM
authors.lastname: Kirkeby
authors.affiliation: Dhulikel Hospital, Kathmandu, P.O. Box No.: 11008, Nepal; Norwegian University of Science and Technology, NTNU, Institute of Circulation and Medical Imaging, NTNU, P.O. Box No.: 7491, Trondheim, Norway. Electronic address: samita.giri2009@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Giri
authors.affiliation: Dhulikel Hospital, Kathmandu, P.O. Box No.: 11008, Nepal. Electronic address: rajendrakoju@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Koju
authors.affiliation: Dhulikel Hospital, Kathmandu, P.O. Box No.: 11008, Nepal. Electronic address: drsan7@gmail.com.
authors.forename: S S
authors.initials: SS
authors.lastname: Krishna
authors.affiliation: St. Olavs Hospital, P.O. Box 3250, Sluppen, 7006, Trondheim, Norway. Electronic address: brynjulf.ystgaard@stolav.no.
authors.forename: B
authors.initials: B
authors.lastname: Ystgaard
authors.affiliation: Norwegian University of Science and Technology, NTNU, Institute of Circulation and Medical Imaging, NTNU, P.O. Box No.: 7491, Trondheim, Norway; St. Olavs Hospital, Clinic of Emergency Medicine and Prehospital Care, Prinsesse Kristinas Gate 3, P.O. Box. No: 7030, Trondheim, Norway. Electronic address: erik.solligard@ntnu.no.
authors.forename: E
authors.initials: E
authors.lastname: Solligård
authors.affiliation: Norwegian University of Science and Technology, Institute of Public Health and General Practice, NTNU, P.O. Box No.: 7491, Trondheim, Norway; St. Olavs Hospital, Children's Clinic, Olav Kyrres Gate 11, P.O. Box 7030, Trondheim, Norway. Electronic address: kari.risnes@ntnu.no.
authors.forename: K
authors.initials: K
authors.lastname: Risnes
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000208:ethnology / Q000628:therapy; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D017281:Cost of Illness; D005260:Female; D006785:Hospitals, University / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009390:Nepal; D000073296:Noncommunicable Diseases / Q000208:ethnology* / Q000628:therapy; D012189:Retrospective Studies
keywords: Alcohol-related diseases; Epidemiology; Low- and middle income countries; Nepal; Non communicable diseases