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NCT ID: NCT03723837 Not yet recruiting - Poliomyelitis Clinical Trials

Persistence of IPV Immunity

Start date: November 15, 2018
Phase: Phase 4
Study type: Interventional

In 2015, Strategic Advisory Group of Experts in Immunization (SAGE) recommended the global switch from trivalent to bivalent oral poliovirus vaccine (OPV) that does not contain type 2 poliovirus and introduction of a single dose of inactivated poliovirus vaccine (IPV) to maintain population immunity to type 2 polio to reduce the risk of vaccine derived polio. Following SAGE recommendations, Nepal introduced one dose of IPV in routine immunization in 2015 followed by withdrawal trivalent OPV in April 2016. However, Nepal, like many other countries had to stop vaccination by the end of 2016 because of a global shortage of IPV. Single dose of IPV induces detectable antibodies in 34% to 80% of infants, compared to >90% after three doses and most of seronegative children (84-98%) are "immunologically primed" by the first dose. Primed individuals produce protective antibody levels in serum within one week of exposure to a new dose of IPV or OPV. However, it is unknown whether seroconversion or priming responses persist, and for how long they persist after the single dose of IPV. IPV immunogenicity for vaccine delivered low-resource countries may also be inferior to that observed in clinical trials because of program factors that decrease vaccine efficacy. This cross sectional study aims to determine whether the immune response provided by a single dose of IPV delivered through routine immunization services persists for more than a year. The study will be implemented in three study sites in Kathmandu, Nepal during November 2018- July 2019. Information generated from this study is expected to allow better estimation of children partially protected (primed) or fully protected against type 2 poliovirus depending on coverage and time since last IPV vaccination. These estimates will help inform the Global Polio Eradication Initiative on vaccine choices for responding to type 2 vaccine derived poliovirus (VDPV) outbreaks and will help guide decisions on polio immunization schedules for Nepal and for other countries in future.

NCT ID: NCT03723525 Recruiting - HIV Clinical Trials

Package of Care to Improve Retention in ART and Mortality Among Treatment Naive HIV Infected Individuals

PRAN
Start date: March 1, 2018
Phase: Phase 4
Study type: Interventional

This is a cluster randomized trial to determine whether a package of care including rapid antiretroviral therapy (ART) initiation, as compared to standard ART initiation, improves mortality, retention in care and viral suppression among treatment naive people living with HIV (PLHIV) in Nepal. Package of care includes immediate screening and treatment of opportunistic infections (OIs), rapid ART initiation and enhanced retention in care using mobile health (mHealth) and weekly/biweekly home-based adherence/ retention support linked to community care centre. Standard of care includes screening and management of common OIs, baseline assessment (CD4, viral load and other tests), antiretroviral drugs and ART follow up.

NCT ID: NCT03700034 Not yet recruiting - Clinical trials for Gestational Diabetes

mHealth Integrated Model of Hypertension, Diabetes and Antenatal Care in India and Nepal

Start date: November 2019
Phase: N/A
Study type: Interventional

The trial aims to enhance antenatal care (ANC) to address the changing disease burden affecting pregnant women in India and Nepal. The enhancement includes using a tablet-based electronic decision support system that prompts front line health workers to provide evidence-based routine ANC, enhances detection and management of pregnancy-induced hypertension and gestational diabetes, facilitates record-keeping and reporting, and links across levels of care providers.

NCT ID: NCT03668977 Recruiting - Clinical trials for Pregnancy and Early Lactation Among Women Living in an Area Endemic for Malnutrition

Balanced Protein-Energy Supplement in Pregnancy and Early Lactation on Birth Outcomes and Growth in Southern Nepal

Start date: July 16, 2018
Phase: N/A
Study type: Interventional

This project will test the acceptability and efficacy of a balanced protein energy supplement for daily use during pregnancy and the first 6 months after delivery on the outcomes of pregnancy and growth of infants during the first 6 months of life. Approximately 1600 pregnant women from a district in southern Nepal will be recruited and randomly assigned to one of 4 groups, control in pregnancy & post-partum, supplementation in pregnancy & control post-partum, control in pregnancy & supplementation post-partum, or supplementation in pregnancy & post-partum. Pregnancies will be followed until delivery and the infants through 6 months of age. Outcomes of interest include birth size (weight and length), gestational age at delivery, maternal weight gain in pregnancy, maternal weight at 6 months post-partum, infant growth, and breast milk composition.

NCT ID: NCT03630380 Recruiting - Pneumonia Clinical Trials

Accuracy of Clinical and Diagnostic Studies for Pneumonia in Children

Start date: June 1, 2018
Phase:
Study type: Observational

Pneumonia continues to be a leading cause of death in children under five years of age worldwide. Many studies have evaluated clinical signs and symptoms that may predict pneumonia. A recent meta-analysis found that no singular physical exam finding predicted pneumonia. The World Health Organization (WHO) Criteria diagnose pneumonia based on fast breathing; however, tachypnea has not been shown to strongly predict pneumonia. This study will evaluate accuracy of clinical history, physical exam and WHO criteria, laboratory findings, and lung ultrasound compared with chest radiograph for the diagnosis of pneumonia in children under five years of age in a resource limited setting. Determining diagnostic accuracy of these findings may help derive a clinical decision rule that may more accurately predict which children have pneumonia than current WHO guidelines.

NCT ID: NCT03625206 Recruiting - Child Abuse Clinical Trials

Cognitive Bias Modification Training in Adolescents Who Have Experienced Adversity

Start date: April 17, 2018
Phase: N/A
Study type: Interventional

Adolescents who have experienced adversity (childhood maltreatment and other forms of broader victimisation experiences) will be randomly allocated to receive a 5-session cognitive bias modification training (with attention and interpretation bias modification modules) or a control condition. Outcome measures include measures of cognitive biases and symptoms of psychopathology; in addition, in a subset of adolescents, brain activity data will be acquired. All adolescents will complete a feedback form, upon which acceptability of the intervention will be assessed.

NCT ID: NCT03620513 Recruiting - Throat Disorder Clinical Trials

Pretreatment to Reduce Pain and Discomfort During Fiberoptic Nasal Pharyngoscopy and Laryngoscopy

Start date: July 1, 2018
Phase: Phase 4
Study type: Interventional

Fiberoptic laryngoscopy (FOL) is one of the most common procedure done in an Ear Nose Throat (ENT) clinic. Topical anesthesia or decongestant or both have been used to improve patient comfort level during the procedure. Recently, role of these agents has been questioned. The investigators would like to study whether topical anesthesia or decongestant or their combination provide any benefit to the patients undergoing FOL.

NCT ID: NCT03620487 Enrolling by invitation - Dengue Fever Clinical Trials

Detection of Dengue Virus in Plasma of Patients in Nepal

Start date: December 21, 2016
Phase:
Study type: Observational

To test whether Karius Infectious Disease Diagnostic Sequencing assay can detect Dengue Virus in plasma from suspected cases of Dengue or Dengue Fever like-illnesses from samples collected as part of a hospital-based multi-site study conducted in Nepal.

NCT ID: NCT03603626 Withdrawn - Clinical trials for Post-operative Analgesia

Preemptive Pregabalin in Myringoplasty

Start date: September 2015
Phase: N/A
Study type: Interventional

The aim of this study was to investigate the effect of preemptive pregabalin on post-operative pain reduction after myringoplasty.

NCT ID: NCT03602287 Withdrawn - Nasal Pack Removal Clinical Trials

Effect of 2% Lignocaine Solution in Pain During Removal of Nasal Pack

Start date: July 1, 2017
Phase: N/A
Study type: Interventional

To evaluate the efficacy of rehydration of Merocel nasal packs with 2% Lignocaine on reducing pain and discomfort during nasal pack removal in patients undergoing septoplasty.