ORCID Profile
0000-0003-3007-8901
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UNSW Sydney
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University of Sydney
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Kathmandu Research Institute for Biological Sciences
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Publisher: Springer Science and Business Media LLC
Date: 24-08-2020
DOI: 10.1186/S41182-020-00261-4
Abstract: Intestinal parasitosis, caused by both helminths and protozoans, are among the most prevalent infections, especially in developing countries. Enteric parasites continue to be a major cause of parasitic diseases which is the most common among street and school going children with poor sanitation. This cross-sectional study was carried out to determine the prevalence and potential risk factors of intestinal parasitosis among school going children of two schools of Saptari district of southern Nepal. Stool s les were collected in a clean, dry, screw-capped, and wide-mouthed plastic container, fixed with 10% formal-saline solution, and transported to the laboratory for further microscopic analysis by following concentration technique. Out of the 285 stool s les analysed, 94 (33%) were positive for the parasitosis. Presence of intestinal parasites was marginally more in rural school (44.6%) than in urban (30%) ( P 0.05). Giardia lamblia was highly prevalent (15.4%) followed by Entamoeba histolytica -like (7.7%), E . coli (7%), Ascaris lumbricoides (1.8%), and Hymenolepis nana (1.08%), respectively. Children of the age group 11–15 years were highly affected (44.2%) compared to younger age groups. The findings of intestinal parasitosis in the study population were statistically significant with family income, hand-washing habit, type of drinking water, and availability of a toilet facility at home ( P 0.05). Over 85% of infection was associated with parasitosis that indicated mainly waterborne infection rather than soil-borne helminths. Poor hygiene measures and farming occupation are identified as major risk factors of parasitic infections, so sanitation especially focusing on safe drinking water along with multi intervention strategies must be emphasized in the Saptari district of Nepal to reduce the burden of parasitic diseases in school children.
Publisher: Hindawi Limited
Date: 19-07-2022
DOI: 10.1155/2022/9675041
Abstract: Arsenic contamination in soil and water is one of the major environmental problems in multiple countries including Nepal imposing a serious threat to the ecosystem and public health. Many soil bacteria can detoxify arsenic, including genus Bacillus. With an objective to gauge the plant growth-promoting activities of arsenic-resistant Bacillus species, 36 s les (soil, rice, cauliflower, and beans) were collected from the Terai region of Nepal. For selective isolation of Bacillus species, each s le was heated at 80°C for 15 min before the inoculation into nutrient agar (NA). Following the standard protocol, arsenic-resistant Bacillus species were screened using NA supplemented with 100 ppm sodium arsenate and sodium arsenite. Among 158 randomly selected isolates, only five isolates were able to tolerate sodium arsenite concentration up to 600 ppm. Notably, all five isolates were able to produce indole acetic acid (IAA), a plant hormone, and solubilize phosphate. Based on biochemical analysis and 16S rRNA gene sequencing, isolates N4-1, RW, KR7-12, Bhw1-4, and BW2-2 were identified as B. subtilis subsp. stercosis, B. flexus, B. licheniformis, B. cereus, and B. flexus, respectively. To the best of our knowledge, this is the first study showing the presence of arsenic-resistant B. flexus in Nepalese soil with plant growth-promoting traits. Possible utilization of these Bacillus strains could facilitate the novel bioremediation pathway to reduce the toxic effect of arsenic from the soil and water in the Terai region of Nepal.
Publisher: Hindawi Limited
Date: 29-10-2021
DOI: 10.1155/2021/4120697
Abstract: The multidrug- or extensively drug-resistant (MDR/XDR) Pseudomonas aeruginosa carrying some virulence genes has become a global public health threat. However, in Nepal, there is no existing report showing the prevalence of oprL and toxA virulence genes among the clinical isolates of P. aeruginosa. Therefore, this study was conducted for the first time in the country to detect the virulence genes (oprL and toxA) and antibiotic susceptibility pattern of P. aeruginosa. A total of 7,898 clinical specimens were investigated following the standard microbiological procedures. The antibiotic susceptibility testing was examined by the modified disc diffusion method, and virulence genes oprL and toxA of P. aeruginosa were assessed using multiplex PCR. Among the analyzed specimens, 87 isolates were identified to be P. aeruginosa of which 38 (43.68%) isolates were reported as MDR. A higher ratio of P. aeruginosa was detected from urine s les 40 (45.98%), outpatients’ specimens 63 (72.4%), and in patients of the age group of 60–79 years 36 (41.37%). P. aeruginosa was more prevalent in males 56 (64.36%) than in female patients 31 (35.63%). Polymyxin (83.90%) was the most effective antibiotic. P. aeruginosa (100%) isolates harboured the oprL gene, while 95.4% of isolates were positive for the toxA gene. Identification of virulence genes such as oprL and toxA carrying isolates along with the multidrug resistance warrants the need for strategic interventions to prevent the emergence and spread of antimicrobial resistance (AMR). The findings could assist in increasing awareness about antibiotic resistance and suggest the judicious prescription of antibiotics to treat the patients in clinical settings of Nepal.
Publisher: Elsevier BV
Date: 11-2022
Abstract: The opportunistic protist Acanthamoeba, which interacts with other microbes such as bacteria, fungi, and viruses, shows significant similarity in cellular and functional aspects to human macrophages. Intracellular survival of microbes in this microbivorous amoebal host may be a crucial step for initiation of infection in higher eukaryotic cells. Therefore, Acanthamoeba-microbe adaptations are considered an evolutionary model of macrophage-pathogen interactions. This paper reviews Acanthamoeba as an emerging human pathogen and different ecological interactions between Acanthamoeba and microbes that may serve as environmental training grounds and a genetic melting pot for the evolution, persistence, and transmission of potential human pathogens.
Publisher: Hindawi Limited
Date: 09-07-2022
DOI: 10.1155/2022/5398239
Abstract: Medicinal plants have been used from the beginning of human civilization against various health complications. Dengue virus (DENV) has emerged as one of the most widespread viruses in tropical and subtropical countries. Yet no clinically approved antiviral drug is available to combat DENV infection. Consequently, the search for novel antidengue agents from medicinal plants has assumed more insistence than in previous days. This study has focused on 31 potential antidengue molecules from secondary metabolites to examine their inhibitory activity against DENV nonstructural proteins through molecular docking and pharmacokinetics studies. In this research, the wet lab experiments were tested on a computational platform. Agathisflavone and pectolinarin are the top-scored inhibitors of DENV NS2B/NS3 protease and NS5 polymerase, respectively. Epigallocatechin gallate, Pinostrobin, Panduratin A, and Pectolinarin could be potential lead compounds against NS2B/NS3 protease, while acacetin-7-O-rutinoside against NS5 polymerase. Moreover, agathisflavone (LD50= 1430 mg/kg) and pectolinarin (LD50= 5000 mg/kg) exhibited less toxicity than nelfinavir (LD50= 600 mg/kg) and balapiravir (LD50 = 824 mg/kg), and the reference drugs. Further research on clinical trials is required to analyze the therapeutic efficacy of these metabolites to develop new potential drug candidates against different serotypes of DENV.
Publisher: Biotechnology Society of Nepal
Date: 29-12-2019
Abstract: Histoplasmosis, a fungal infection caused by Histoplasma capsulatum (H. capsulatum), acquired from contaminated soil with droppings of chicken or birds and found to be distributed in many parts of the world. The prevalence of histoplasmosis has not well studied in Nepal. The common symptoms of acute and epidemic histoplasmosis include high fever, cough, and asthenia and weight loss. Most of the infections associated with histoplasmosis are asymptomatic. People with compromised immune systems such as HIV/AIDS (PLWHA), cancer, and organ transplant recipients are at risk of developing this disease. In this review, we have summarised the current status of histoplasmosis in Nepal and molecular techniques available for its identification. To date, the significant outbreak is not reported in Nepal, but the risk of infection for the vulnerable population cannot be undermined. Appropriate preventive measures and treatment on time can reduce the burden of this fungal disease. Further, this review is also focused on molecular identification of H. capsulatum. Hence, careful considerations by concerned stakeholders for national surveillance programs and the treatment of patients on time after proper diagnosis is highly recommended.
Publisher: Springer Science and Business Media LLC
Date: 24-10-2022
DOI: 10.1186/S13071-022-05409-1
Abstract: Dengue is one of the common arboviral infections and is a public health problem in South East Asia. The aim of this systematic review and meta-analysis was to evaluate the prevalence and distribution of dengue in SAARC (South Asian Association for Regional Cooperation) countries. The PubMed, PubMed Central, Embase and Scopus databases were searched for relevant studies. Statistical analysis on data extracted from the selected studied was conducted using the Comprehensive Meta-Analysis Software (CMA) version 3 software package. Proportions were used to estimate the outcome with a 95% confidence interval (CI). Across all studies, among cases of suspected dengue, 30.7% were confirmed dengue cases (proportion: 0.307, 95% CI: 0.277–0.339). The seroprevalence of dengue immunoglobulin (Ig)G, IgM or both (IgM and IgG) antibodies and dengue NS1 antigen was 34.6, 34.2, 29.0 and 24.1%, respectively. Among the different strains of dengue, dengue virus (DENV) strains DENV-1, DENV-2, DENV-3 and DENV-4 accounted for 21.8, 41.2, 14.7 and 6.3% of cases, respectively. The prevalence of dengue fever, dengue hemorrhagic fever and dengue shock syndrome was 80.5, 18.2 and 1.5%, respectively. Fever was a commonly reported symptom, and thrombocytopenia was present in 44.7% of cases. Mortality was reported in 1.9% of dengue cases. Dengue is a common health problem in South East Asia with high seroprevalence. DENV-2 was found to be the most common strain causing infection, and most dengue cases were dengue fever. In addition, thrombocytopenia was reported in almost half of the dengue cases.
Publisher: Hindawi Limited
Date: 27-08-2020
DOI: 10.1155/2020/8817467
Abstract: Streptomyces are widely used for the production of secondary metabolites with erse biological activities, including antibiotics. The necessity of alternative antimicrobial agents against multidrug-resistant pathogens is indispensable. However, the production of new therapeutics is delayed in recent days. Thus, the isolation of new Streptomyces species has drawn attention. Nepal—a country rich in bio ersity—has got high possibilities for the discovery of members of actinomycetes, especially in the higher altitudes. However, in vain, only a few screening research works have been reported from Nepal to date. Streptomyces species were isolated on ISP4 media, and characterization was performed according to morphological similarity and 16S rRNA sequence similarity using bioinformatic tools. Ethyl acetate extracts of Streptomyces species were prepared, and the antimicrobial activity was carried out using agar well diffusion technique. In this report, 18 Streptomyces species isolated from the soil were reported based on sequence analysis of 16S rRNA. Among them, 12 isolates have shown antibacterial activity against extended-spectrum beta-lactamase- (ESBL-) producing Escherichia coli. Here, we have also analyzed 16S rRNA in 27 Streptomyces species whose whole-genome sequence is available, which has revealed that some species have multiple copies of the 16S gene (∼1.5 kb) with significant variation in nucleotides. In contrast, some Streptomyces species shared identical DNA sequences in multiple copies of 16S rRNA. The sequencing of numerous copies of 16S rRNA is not necessary, and the molecular sequencing of this region is not sufficient for the identification of bacterial species. The Streptomyces species-derived ethyl acetate extracts from Nepalese soil demonstrate potential activity against ESBL-producing E. coli. Thus, they are potential candidates for antibiotics manufacturing in the future.
Publisher: MDPI AG
Date: 18-02-2021
DOI: 10.3390/PATHOGENS10020225
Abstract: Acanthamoeba, an opportunistic pathogen is known to cause an infection of the cornea, central nervous system, and skin. Acanthamoeba feeds different microorganisms, including potentially pathogenic prokaryotes some of microbes have developed ways of surviving intracellularly and this may mean that Acanthamoeba acts as incubator of important pathogens. A systematic review of the literature was performed in order to capture a comprehensive picture of the variety of microbial species identified within Acanthamoeba following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Forty-three studies met the inclusion criteria, 26 studies (60.5%) examined environmental s les, eight (18.6%) studies examined clinical specimens, and another nine (20.9%) studies analysed both types of s les. Polymerase chain reaction (PCR) followed by gene sequencing was the most common technique used to identify the intracellular microorganisms. Important pathogenic bacteria, such as E. coli, Mycobacterium spp. and P. aeruginosa, were observed in clinical isolates of Acanthamoeba, whereas Legionella, adenovirus, mimivirus, and unidentified bacteria (Candidatus) were often identified in environmental Acanthamoeba. Increasing resistance of Acanthamoeba associated intracellular pathogens to antimicrobials is an increased risk to public health. Molecular-based future studies are needed in order to assess the microbiome residing in Acanthamoeba, as a research on the hypotheses that intracellular microbes can affect the pathogenicity of Acanthamoeba infections.
Publisher: Wiley
Date: 09-10-2020
DOI: 10.1002/PTR.6893
Publisher: Springer Science and Business Media LLC
Date: 08-10-2018
DOI: 10.1186/S13756-018-0408-Z
Abstract: Treatment and prevention of wound infection continues to be a challenging issue in clinical settings of Nepal especially in the context of globally growing problem of antimicrobial resistance. Study on opportunistic pathogens and sensitivity to commonly prescribed local antimicrobial agents are cardinal to reduce the disease burden of wound infections. The aim of this study was to determine the prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus (MRSA) and extended spectrum β-lactamase (ESBL) producing bacteria from wound infections of patients at a tertiary care hospital in Nepal. Pus specimens were processed using standard microbiological procedures. Antimicrobial susceptibility test was performed following the modified Kirby Bauer disc diffusion technique. Clinical information of patients was obtained from preformed questionnaire and hospital record. One hundred eighty two pus specimens from wounds of different body parts: leg, hand, backside, abdominal part, foot, breast and chest, head and neck region were collected and analyzed 113 bacterial isolates were isolated showing the overall bacterial growth rate of 62%, where the highest rate was among patients of ≤10 years age group (82.1%). A higher rate (68.5%) of bacterial isolates were from inpatients ( p 0.05). Among 116 bacterial isolates, Staphylococcus aureus was the most predominant bacteria (56.9%) followed by Escherichia coli (8.6%), coagulase negative staphylococci (7.8%), Acinetobacter spp. (5.2%), Klebsiella pneumoniae (5.2%), Pseudomonas aeruginosa (4.3%), Enterococcus spp. (4.3%), Citrobacter freundii (2.6%), Proteus vulgaris (1.6%) and P. mirabilis (0.9%). Both Gram positive (73.3%) and negative (78.8%) isolates showed high frequency of sensitive to gentamycin. Among S. aureus isolates , 60.6% were MRSA strains, whereas 40% of K. pneumoniae and 33.3% of C. freundii were ESBL producing bacteria followed by E. coli (25%). It is thus paramount to address the burden of silently and speedily increasing infections caused by drug resistant strains of MRSA and ESBL in Nepal.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Public Library of Science (PLoS)
Date: 26-07-2021
DOI: 10.1371/JOURNAL.PONE.0254825
Abstract: Coronavirus disease 2019 (COVID-19) has affected all age groups worldwide, but older adults have been affected greatly with an increased risk of severe illness and mortality. Nepal is struggling with the COVID-19 pandemic. The normal life of older adults, one of the vulnerable populations to COVID-19 infection, has been primarily impacted. The current evidence shows that the COVID-19 virus strains are deadly, and non-compliance to standard protocols can have serious consequences, increasing fear among older adults. This study assessed the perceived fear of COVID-19 and associated factors among older adults in eastern Nepal. A cross-sectional study was conducted between July and September 2020 among 847 older adults (≥60 years) residing in three districts of eastern Nepal. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S). Multivariate logistic regression identified the factors associated with COVID-19 fear. The mean score of the FCV-19S was 18.1 (SD = 5.2), and a sizeable proportion of older adults, ranging between 12%-34%, agreed with the seven items of the fear scale. Increasing age, Dalit ethnicity, remoteness to the health facility, and being concerned or overwhelmed with the COVID-19 were associated with greater fear of COVID-19. In contrast, preexisting health conditions were inversely associated with fear. Greater fear of the COVID-19 among the older adults in eastern Nepal suggests that during unprecedented times such as the current pandemic, the psychological needs of older adults should be prioritized. Establishing and integrating community-level mental health support as a part of the COVID-19 preparedness and response plan might help to combat COVID-19 fear among them.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Public Library of Science (PLoS)
Date: 21-06-2021
DOI: 10.1371/JOURNAL.PNTD.0009510
Abstract: Most of the Helicobacter pylori infections occur in developing countries. The risk factors for H . pylori infections are poverty, overcrowding, and unhygienic conditions, which are common problems in under-privileged countries such as Nepal. Despite having a high risk of H . pylori infections, no national level study has been conducted to assess prevalence and correlates of H . pylori infection in Nepal. Therefore, we hypothesized that micronutrients such as iron, vitamin B12 deficiency, socio-economic status, and nutritional status correlate with the prevalence of H . pylori infection in Nepal. We studied prevalence and correlates of H . pylori infection among under-five children, adolescents aged 10–19 years and married non-pregnant women aged 20–49 years using data from the Nepal National Micronutrient Status Survey 2016 (NNMSS-2016). H. pylori infection was examined in stool of 6–59 months old children and 20–49 years old non-pregnant women whereas the rapid diagnostic kit using blood s le was used among adolescent boys and girls. Prevalence of H . pylori infection was 18.2% among 6–59 months old children, 14% among adolescent boys and 16% among adolescent girls aged 10–19 years and 40% among 20–49 years non-pregnant women. Poor socioeconomic status, crowding, and unhygienic condition were found to be positively associated with higher incidence of H . pylori infections. No significant correlation was observed between nutritional and micronutrients status (iron or risk of folate deficiency) with H . pylori infection. Findings from this study suggest that poverty-associated markers are primary contributors of H . pylori infections in Nepalese communities. To control acquisition and persistence of H . pylori infection in Nepal, we suggest improved management of safe drinking water and implementation of sanitation and hygiene programs, with a focus on those of lower socioeconomic status.
Publisher: Springer Science and Business Media LLC
Date: 29-09-2022
DOI: 10.1186/S12879-022-07741-4
Abstract: Acanthamoeba is an emerging pathogen, infamous for its resilience against antiprotozoal compounds, disinfectants and harsh environments. It is known to cause keratitis, a sight-threatening, painful and difficult to treat corneal infection which is often reported among contact lens wearers and patients with ocular trauma. Acanthamoeba comprises over 24 species and currently 23 genotypes (T1-T23) have been identified. This retrospective study was designed to examine the Acanthamoeba species and genotypes recovered from patients with Acanthamoeba keratitis (AK), determine the presence of endosymbionts in ocular isolates of Acanthamoeba and review the clinical presentations. Thirteen culture-confirmed AK patients treated in a tertiary eye care facility in Hyderabad, India from February to October 2020 were included in this study. The clinical manifestations, medications and visual outcomes of all patients were obtained from medical records. The Acanthamoeba isolates were identified by sequencing the ribosomal nuclear subunit ( rns ) gene. Acanthamoeba isolates were assessed for the presence of bacterial or fungal endosymbionts using molecular assays, PCR and fluorescence in situ hybridization (FISH). The mean age of the patients was 33 years (SD ± 17.4 95% CI 22.5 to 43.5 years). Six (46.2%) cases had AK associated risk factors four patients had ocular trauma and two were contact lens wearers. A. culbertsoni (6/13, 46.2%) was the most common species, followed by A. polyphaga and A. triangularis . Most of the isolates (12/13) belonged to genotype T4 and one was a T12 three sub-clusters T4A, T4B, and T4F were identified within the T4 genotype. There was no significant association between Acanthamoeba types and clinical outcomes. Eight (61.5%) isolates harboured intracellular bacteria and one contained Malassezia restricta . The presence of intracellular microbes was associated with a higher proportion of stromal infiltrates (88.9%, 8/9), epithelial defect (55.6%, 5/9) and hypopyon (55.6%, 5/9) compared to 50% (2/4), 25% (1/4) and 25% (1/4) AK cases without intracellular microbes, respectively. Genotype T4 was the predominant isolate in southern India. This is the second report of T12 genotype identified from AK patient in India, which is rarely reported worldwide. The majority of the Acanthamoeba clinical isolates in this study harboured intracellular microbes, which may impact clinical characteristics of AK.
Publisher: Public Library of Science (PLoS)
Date: 05-11-2021
DOI: 10.1371/JOURNAL.PONE.0259021
Abstract: Psychoactive substance use among youth is an emerging public health issue in Nepal. This exploratory study aimed to better understand the drivers of psychoactive substance use among Nepalese youth in Rupandehi district of Nepal. This study used a qualitative approach for data collection. Both in-depth interviews (IDI, seven participants) and focus group discussions (FGD, 13 participants) were conducted among study participants who self-reported as psychoactive substance users or had history of psychoactive substance use. Participants for IDI were aged between 11 and 24 years and between 18 and 35 years old for FGDs. Semi-structured interview guides were prepared separately for IDIs and FDGs. Interviews were conducted in Nepali language and were audio recorded, which were there transcribed and translated into English for coding and analyses. In addition, interviews notes were taken by two research assistants. An inductive thematic analysis was used to analyze the data. This study identified a range of drivers of psychoactive substances use among Nepalese youths. Themes included (i) socio-cultural factors, (ii) in idual factors, (iii) academic environment, (iv) physical environment and the (v) influence of media. The socio-cultural factors were categorized into sub-themes of family relationships, ethnic identity and psychoactive substance use and lack of social acceptance. In idual factors included peer pressure, stress relief and coping with financial challenges. Accessibility and availability of psychoactive substances in the surrounding environment and lack of monitoring and reinforcement of rules/ law and regulations were other drivers to psychoactive substance use among this Nepalese youth cohort. Our study identified several important drivers of psychoactive substance use among youth in the Rupandehi district of Nepal. Future works are anticipated to further explore youth initiation and use of psychoactive substances and support the design of interventions that address these risk factors to reduce and prevent subsequent harms.
Publisher: Frontiers Media SA
Date: 25-09-2020
Publisher: Frontiers Media SA
Date: 27-06-2022
DOI: 10.3389/FPUBH.2022.873881
Abstract: During health emergencies such as the COVID-19 pandemic, healthcare workers face numerous ethical challenges while catering to the needs of patients in healthcare settings. Although the data recapitulating high-income countries ethics frameworks are available, the challenges faced by clinicians in resource-limited settings of low- and middle-income countries are not discussed widely due to a lack of baseline data or evidence. The Nepali healthcare system, which is chronically understaffed and underequipped, was severely affected by the COVID-19 pandemic in its capacity to manage health services and resources for needy patients, leading to ethical dilemmas and challenges during clinical practice. This study aimed to develop a standard guideline that would address syndemic ethical dilemmas during clinical care of COVID-19 patients who are unable to afford standard-of-care. A mixed method study was conducted between February and June of 2021 in 12 government designated COVID-19 treatment hospitals in central Nepal. The draft guideline was discussed among the key stakeholders in the pandemic response in Nepal. The major ethical dilemmas confronted by the study participants (50 healthcare professionals providing patient care at COVID-19 treatment hospitals) could be grouped into five major pillars of ethical clinical practice: rational allocation of medical resources, updated treatment protocols that guide clinical decisions, standard-of-care regardless of patient's economic status, effective communication among stakeholders for prompt patient care, and external factors such as political and bureaucratic interference affecting ethical practice. This living clinical ethics guideline, which has been developed based on the local evidence and case stories of frontline responders, is expected to inform the policymakers as well as the decision-makers positioned at the concerned government units. These ethics guidelines could be endorsed with revisions by the concerned regulatory authorities for the use during consequent waves of COVID-19 and other epidemics that may occur in the future. Other countries affected by the pandemic could conduct similar studies to explore ethical practices in the local clinical and public health context.
Publisher: MDPI AG
Date: 13-05-2021
DOI: 10.3390/TROPICALMED6020078
Abstract: (1) Background: Scrub typhus (ST) is endemic to Nepal. It is often underdiagnosed and misdiagnosed due to non-specific clinical presentation coupled with limited microbiological facilities, leading to adverse clinical outcomes. This study aimed to assess the seroprevalence of scrub typhus in febrile patients attending Sukraraj Tropical and Infectious Disease Hospital (STIDH), Nepal, from August 2018 to April 2019. (2) Materials and Method: Blood/serum s les and clinical and demographic data of adult febrile patients (≥19 years) who attended or were referred to the hospital were collected after obtaining written informed consent from the participants excluding immunocompromised in iduals. Collected blood/serum s les were subjected to hematological, biochemical, and serological tests. A serological test for scrub typhus was performed using the ImmuneMed scrub typhus rapid diagnostic test kit. Data generated were analyzed using SPSS software version 24.0. (3) Results: Amongst the 2070 febrile patients, 462 (22.3%) were seropositive to at least one etiological agent of febrile illnesses (scrub typhus: 253 cases, dengue: 101 cases, leptospirosis: 9, brucellosis: 52, malaria: 9 and kala-azar: 20 cases). Scrub typhus accounted for 12.2% (n = 253) of total febrile illnesses followed by dengue (4.9%, n = 101). Mixed seropositivity of scrub typhus with dengue, brucellosis, and typhoid was found in 12 (0.6%), 9 (0.4%), and 5 (0.2%) cases, respectively. Among 253 scrub typhus patients, 53.4% were female. Among the 154 patients, the most common symptoms were fever (100%), headache (79.2%), sweating (70.1%), breathing difficulty (51.3%), redness of the eye (43.5%), and pathognomonic eschar was observed in 9.1% patients. Fifty percent of scrub typhus patients had low platelet count and % of patients had an elevated level of liver enzymes (such as serum glutamic oxaloacetic transaminase (SGPT) and serum glutamic pyruvic transaminase (SGOT). (4) Conclusion: Scrub typhus is a considerable cause of febrile illness in Nepal. Females apparently have a higher chance of acquiring scrub typhus. ST presents nonspecific clinical presentation. The diagnostic dilemma of typhus patients can be minimized by the early monitoring of ST-associated symptoms. The country’s health system needs to be strengthened for early outbreak detection, and immediate response actions against scrub typhus to control the future outbreak of ST.
Publisher: MDPI AG
Date: 11-12-2020
DOI: 10.3390/W12123493
Abstract: Acanthamoeba keratitis (AK) is a sight-threatening infection of the cornea, which is caused by soil and the waterborne protist Acanthamoeba spp. AK most commonly occurs during contact lens (CL) wear. Risk factors for AK have been linked to non-optimal lens hygiene practices and Acanthamoeba contamination of domestic water. This study investigated the prevalence of Acanthamoeba species in domestic showers in the greater Sydney region, as well as the perception of water contamination of CL as being a risk factor for AK among previous AK patients and their family and friends. S les from four locations of 13 participants’ shower areas were cultured and Acanthamoeba 18S rRNA was lified by PCR, followed by sequencing. Twenty-six responses were received to the online questionnaire. Fifteen water s les (29%, 15/52) contained amoeba that were morphologically classified as Acanthamoeba spp. PCR lification confirmed the presence of Acanthamoeba spp. in four s les (8%, 4/52). Three isolates belonged to the T4, and one isolate to the T3 genotype. On the questionnaire survey, 96% (25/26) of respondents believed that water contamination was likely to be a risk factor for Acanthamoeba keratitis and 58% rated showering with CL as ‘extremely likely’ to be a risk factor for AK. Acanthamoeba pathogenic genotypes (T3 and T4) in the domestic bathroom water suggest that clinicians should remain vigilant in educating CL wearers about avoiding domestic water contamination of CL.
Publisher: Springer Science and Business Media LLC
Date: 25-05-2021
DOI: 10.1186/S12877-021-02286-8
Abstract: The high burden of chronic conditions, coupled with various physical, mental, and psychosocial changes that accompany the phenomenon of aging, may limit the functional ability of older adults. This study aims to assess the prevalence of poor functional status and investigate factors associated with poor functional status among community-dwelling older adults in rural communities of eastern Nepal. Data on 794 older adults aged ≥ 60 years from a previous community-based cross-sectional study was used. Participants were recruited from rural municipalities of Morang and Sunsari districts of eastern Nepal using multi-stage cluster s ling. Functional status was assessed in terms of participants’ ability to perform activities of daily living using the Barthel Index. Covariates included sociodemographic characteristics, lifestyle factors, and self-reported chronic conditions. A binary logistic regression model was used to investigate factors associated with poor functional status. The overall prevalence of poor functional status was 8.3 % (male: 7.0 % and female: 9.6 %), with most dependence noted for using stairs (17.3 %), followed by dressing (21.9 %) on Barthel Index. In the adjusted model, oldest age group (odds ratio [OR] = 2.83, 95 %CI: 1.46, 5.50), those unemployed (OR = 2.41, 95 %CI: 1.26, 4.65), having memory/concentration problems (OR = 2.32, 95 %CI: 1.30, 4.13), depressive symptoms (OR = 2.52, 95 %CI: 1.28, 4.95), and hypertension (OR = 1.78, 95 %CI: 1.03, 3.06) had almost or more than two times poor functioning. One in 12 older adults had poor functional status as indicated by their dependency on the items of the Barthel Index those in the oldest age bracket were more likely to exhibit poor functional status. We suggest future studies from other geographies of the country to supplement our study from the rural setting for comprehensive identification of the problem, which could guide the development of prevention strategies and comprehensive interventions for addressing the unmet needs of the older adults for improving functional status.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Springer Science and Business Media LLC
Date: 30-11-2019
DOI: 10.1186/S40550-019-0078-5
Abstract: Poultry meat can be contaminated by different types of microorganisms during processing in processing plant. The microbiological quality of chicken carcasses and along with processing steps and environmental condition was analyzed in this study in an ISO 22000:2005 certified poultry processing plant of Kathmandu. Standard plate count method was applied for the enumeration and detection of total mesophilic bacteria, total coliform, total faecal coliform, Staphylococcus load along with selected pathogens like Salmonella spp., S. aureus , Escherichia coli , Clostridium perfringens , and Listeria spp. in chicken meat at four processing step (evisceration, final washing, frozen and market). It was observed that the level of microbial load decreased with subsequent processing phases in poultry processing plant where high level of bacteria were reduced during final washing and frozen phase. After processing poultry meat in an ISO 22000:2005 certified meat processing plant, total aerobic mesophilic count, total coliform count, total faecal coliform count, total Staphylococcus count were decreased from 6.92 to 4.45 log CFU/g, 3.49 to 2.19 log CFU/g, 2.41 to nil log CFU/g, and 3..43 to 1.99 log CFU/g respectively. Pathogenic bacteria like Salmonella spp., C. perfringens , and Listeria spp. were absent in chicken meat at the fourth processing step. Prevalence of E. coli was reduced from 37.4% to 10.2%, whereas S. aureus was decreased from 18.57% to 17.1%. It was concluded that the final washing and freezing steps were the Critical Control Point (CCP) to control microbial hazards in poultry processing phase.
Publisher: Springer Science and Business Media LLC
Date: 24-12-2022
DOI: 10.1038/S41598-022-24634-3
Abstract: Despite having a high risk of soil-transmitted helminths (STHs) infection, no national level study has been conducted to assess incidence and correlates of STHs in Nepal. Thus, we hypothesized that micronutrients and social status are linked with incidence of STHs infection among 6–59 months children and 15–49 years non-pregnant women in Nepal and Kato-Katz technique was adopted to measure the type and intensity of STHs infections using fresh stool specimens and venous blood was used to examine micronutrients biomarkers. Anthropometric measurements such as height and weight, sociodemographic and health status were determined using structured questionnaire. Logistic regression was used to assess unadjusted and adjusted odds ratio (AOR) and the 95% CIs of ORs. The bivariate association of STHs was assessed with the covariates variables. Overall, 12% children and 19% non-pregnant women had STHs infection A. lumbricoides was the predominant helminth in both study participants. In multivariate model age, ethnicity, anaemia and zinc deficiency were associated with STHs infections in children. Similarly, higher odds of STHs occurrence was observed among non-pregnant women with vitamin A deficiency. Findings from this study suggest that high-risk population, with a focus on those of lower socioeconomic status should be on priority of deworming program, nutrition intervention, and mass administration of preventive chemotherapy and sanitation ch ions supplement to reduce the STHs infections in Nepal.
Publisher: Springer Science and Business Media LLC
Date: 28-11-2017
Publisher: Biotechnology Society of Nepal
Date: 31-07-2021
Abstract: Medicinal plants are important reservoirs of bioactive compounds that need to be explored systematically. Because of their chemical ersity, natural products provide limitless possibilities for new drug discovery. This study aimed to investigate the biochemical properties of crude extracts from fifteen Nepalese medicinal plants. The total phenolic contents (TPC), total flavonoid contents (TFC), and antioxidant activity were evaluated through a colorimetric approach while the antibacterial activities were studied through the measurement of the zone of inhibition (ZoI) by agar well diffusion method along with minimum inhibitory concentrations (MIC) by broth dilution method. The methanolic extracts of Acacia catechu and Eupoterium adenophorum showed the highest TPC (55.21 ± 11.09 mg GAE/gm) and TFC (10.23 ± 1.07 mg QE/gm) among the studied plant extracts. Acacia catechu showed effective antioxidant properties with an IC50 value of 1.3 μg/mL, followed by extracts of Myrica esculenta, Syzygium cumini, and Mangifera indica. Morus australis exhibited antibacterial activity against Klebsiella pneumoniae (ZoI: 25mm, MIC: 0.012 mg/mL), Staphylococcus aureus ATCC 25923 (ZoI: 22 mm, MIC: 0.012 mg/mL), Pseudomonas aeruginosa (ZoI 20 mm, MIC: 0.05 mg/mL), and methicillin-resistant Staphylococcus aureus (MRSA) (ZoI: 19 mm, MIC: 0.19 mg/mL). Morus australis extract showed a broad-spectrum antibacterial activity, followed by Eclipta prostrata, and Hypericum cordifolium. Future study is recommended to explore secondary metabolites of those medicinal plants to uncover further clinical efficacy.
Publisher: Springer Science and Business Media LLC
Date: 21-07-2021
DOI: 10.1038/S41598-021-94344-9
Abstract: Nationally representative population data on zinc status in Nepal is lacking at present. This study analyzed data from the recent Nepal National Micronutrient status survey 2016 to determine the prevalence of zinc deficiency and associated risk factors among children aged 6–59 months (n = 1462) and non-pregnant women aged 15–49 years (n = 1923). Venous blood was collected from the participants to measure micronutrients such as zinc, markers of anemia, RBP (vitamin A), and markers of inflammation. Stool s les were collected to assess soil-transmitted helminths and Helicobacter pylori infection. Socio-demographic, household, and other relevant factors were collected by a structured questionnaire. Serum zinc concentration was measured by Microwave Plasma Atomic Emission Spectrometry, and zinc deficiency was defined according to the International Zinc Nutrition Consultative Group’s guidelines. Logistic regression was used to examine the predictors of zinc deficiency among the participants. The overall zinc deficiency in children was 22.9%, while it was higher in non-pregnant women (24.7%). The prevalence of anemia among zinc-deficient children was higher (21.3%) than the zinc non-deficit children (18.7%). The prevalence of anemia was 18% among zinc-deficient non-pregnant women compared to 22% non-deficit non-pregnant women. Predictors associated with zinc deficiency among the study children were living in rural areas (AOR = 2.25, 95% CI, [1.13, 4.49]), the occurrence of diarrhea during the two weeks preceding the survey (AOR = 1.57, 95% CI, [1.07, 2.30]), lowest household wealth quintile (AOR = 0.48, 95% CI, [0.25, 0.92]) and lower vitamin A status (AOR = 0.49, 95% CI, [0.28, 0.85]. The predictors associated with zinc deficiency among non-pregnant women were: being underweight (AOR = 1.55, 95% CI, [1.12, 2.15]), fever occurrence during two weeks preceding the survey (AOR = 1.43, 95% CI, [1.04, 1.98]), H. pylori in the stool (AOR = 1.33, 95% CI, [1.04, 1.71]), lowest household wealth quintile (AOR = 0.62, 95% CI,[0.40, 0.94]) and being at risk of folate deficiency (AOR = 0.58, 95% CI,[0.36, 0.94]). We conclude that community-level intervention programs focused on rural children and women to prevent diarrhea, improve nutrition counseling, and provide economic opportunities in rural communities may help to lower zinc deficiency and other micronutrient deficiencies in the Nepalese population. We believe that intervention programs to address zinc deficiency should not be isolated. Instead, integrated approaches are beneficial to improve overall micronutrient status, such as encouraging dietary ersity, providing livelihood opportunities to the unemployed, micronutrient supplementation to vulnerable populations, and consumption of zinc-rich animal-based foods.
Publisher: Frontiers Media SA
Date: 20-01-2021
DOI: 10.3389/FPUBH.2020.587374
Abstract: Asymptomatic cases of SARS-CoV-2 can be unknown carriers magnifying the transmission of COVID-19. This study appraised the frequency of asymptomatic in iduals and estimated occurrence by age group and gender by reviewing the existing published data on asymptomatic people with COVID-19. Three electronic databases, PubMed, Embase, and Web of Science (WoS), were used to search the literature following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The study population for this review included asymptomatic in iduals infected with SARS-CoV-2 reported in original articles published up to 30 April 2020. A random effects model was applied to analyze pooled data on the prevalence of asymptomatic cases among all COVID-19 patients and also by age and gender. From the meta-analysis of 16 studies, comprising 2,788 SARS-CoV-2 infected patients, the pooled prevalence according to the random effect size of asymptomatic cases was 48.2% (95% CI, 30–67%). Of the asymptomatic cases, 55.5% (95% CI, 43.6–66.8%) were female and 49.6% (95% CI, 20.5–79.1%) were children. Children and females were more likely to present as asymptomatic COVID-19 cases and could act as unknown carriers of SARS-CoV-2. Symptom-based screening might fail to identify all SARS-CoV-2 infections escalating the threat of global spread and impeding containment. Therefore, a mass surveillance system to track asymptomatic cases is critical, with special attention to females and children.
Publisher: Hindawi Limited
Date: 04-12-2018
DOI: 10.1155/2018/4508757
Abstract: Background . Staphylococcus aureus is a cardinal source of community- and hospital-acquired infection. HIV infection is a well-recognized risk factor for methicillin-resistant S. aureus (MRSA) carriage and infection. Intrinsically developed antibiotic resistance has sharply increased the burden of MRSA which is often associated with morbidity and mortality of the patients. Moreover, nasal carriage of S. aureus plays a significant role in spread of community-associated (CA) S. aureus infections. Methods . This study was conducted from June 2016 to December 2016 at National Public Health Laboratory (NPHL), Kathmandu, with an aim to assess the rate of S. aureus nasal carriage and MRSA carriage among HIV-infected and non-HIV patients. A total of 600 nonrepeated nasal swabs were analyzed following standard microbiological procedures, where 300 swabs were from HIV-infected patients while remaining 300 were from non-HIV patients. The isolates were identified on the basis of colony characteristics and a series of biochemical tests. The antibiotic susceptibility test (AST) was performed by the modified Kirby–Bauer disc diffusion method. Inducible clindamycin resistance in isolates was confirmed by the D-test method. Results . Overall, out of 600 nasal swabs of patients tested, 125 (20.8%) were S. aureus nasal carriers which included 80 out of 300 (26.66%) among HIV-infected patients and 45 (15%) out of 300 among non-HIV patients, and the result was statistically significant ( p = 0.0043 ). Among the isolated S. aureus , 11 (13.8%) MRSA were confirmed in HIV-infected while 3 (6.7%) MRSA were detected from non-HIV patients. A higher number of S. aureus carriers was detected among HIV-infected males 40 (26.49%), whereas MRSA carriage was more prevalent among HIV-infected females 7 (5.1%). Among the HIV-infected, patients of age group 31–40 years were the ones with highest carriage rate 36 (45%), while in non-HIV patients, the highest rate 13 (28.9%) of carriage was detected among the patients of age group 21–30 years. Statistically significant difference was found between S. aureus carriage and HIV infection in patients ( p 0.05 ). Higher rate 2/3 (66.7%) of inducible clindamycin resistance in MRSA was detected from non-HIV patients in comparison to HIV-infected patients 7/11 (63.63%) while the result was statistically insignificant ( p 0.05 ). All the MRSA isolates (100%) were resistant against co-trimoxazole while ciprofloxacin showed high rate of sensitivity towards both MSSA and MRSA. None of the isolates were detected as VRSA. The major factors associated with nasal colonization of S. aureus were close personal contact, current smoking habit, and working or living in a farm ( p 0.05 ). Conclusion . Regular surveillance and monitoring of MRSA nasal carriage and antibiotic susceptibility pattern are of prime importance in controlling S. aureus infections especially in high risk groups like HIV-infected patients.
Publisher: Frontiers Media SA
Date: 17-02-2021
DOI: 10.3389/FPUBH.2021.597808
Abstract: COVID-19, caused by SARS-CoV-2, was first reported in Wuhan, China and is now a pandemic affecting over 218 countries and territories around the world. Nepal has been severely affected by it, with an increasing number of confirmed cases and casualties in recent days, even after 8 months of the first case detected in China. As of 26 November 2020, there were over 227,600 confirmed cases of COVID in Nepal with 209,435 recovered cases and 1,412 deaths. This study aimed to compile public data available from the Ministry of Health and Population (MoHP), Government of Nepal (GoN) and analyse the data of 104 deceased COVID-19 patients using IBM SPSS (Version 25.0). Additionally, this study also aimed to provide critical insights on response of the GoN to COVID-19 and way forward to confront unprecedented pandemic. Figures and maps were created using the Origin Lab (Version 2018) and QGIS (Version 3.10.8). Most of the reported cases were from Bagmati Province, the location of Nepal's capital city, Kathmandu. Among deceased cases, & % of the patients were male and patients ≥54 years accounted for 67.9% ( n = 923). Preliminary findings showed respiratory illness, diabetes, and chronic kidney diseases were the most common comorbid conditions associated with COVID-19 deaths in Nepal. Despite some efforts in the 8 months since the first case was detected, the government's response so far has been insufficient. Since the government eased the lockdown in July 2020, Nepal is facing a flood of COVID-19 cases. If no aggressive actions are taken, the epidemic is likely to result in significant morbidity and mortality in Nepal. The best way to curb the effect of the ongoing pandemic in a resource-limited country like Nepal is to increase testing, tracing, and isolation capacity, and to set up quality quarantine centers throughout the nation. A comprehensive health literacy c aign, quality care of older adults and those with comorbidity will also result in the effective management of the ongoing pandemic.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Binod Rayamajhee.