No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Study of enteropathogens and its predisposing factors in gastroenteritis suspected children attending Kanti Children Hospital, Kathmandu, Nepal
Abstract
The study on enteropathogens and its pre-disposing factors was performed among gastroenteritis suspected childen (n = 301, M = 177, F = 124, Age 1 to 15 years) attending Kanti Children Hospital, Kathmandu. Fecal samples were subjected for isolation and identification of Salmonella sps and Shigella sps. Parasites were detected by saline and iodine preparation. A questionnaire was done to reveal pre-disposing factors. The overall prevalence of enteropathogen was (33.6%) with marginally higher in male than female (P>0.05). Salmonella sps and Shigella sps were isolated from 1.7% and 4.0% respectively. The prevalence of bacterial enteropathogen was found higher (41.2%) in September and found to be negatively correlated with age of patients (r = -0.3). Ciprofloxacin was most sensitive against the bacterial isolates. Among the parasites Giardia lamblia (12.0%) was the most common followed by Entamoeba histolytica (9.6%), Cyclospora cayetanensis (7.6%). The prevalence of parasite was found higher in August (35.9%) and found negatively correlated with the age of children (r = -0.6). Tibeto-Burman (31.2%) children have higher prevalence of parasitic infestation followed by Indo-Aryan (30.2%) and Dalit (P>0.05). The prevalence of enteropathogens were significantly higher (67.7%) in people consuming tap-water and (100%) in people consuming chlorinated water (P<0.05). The family having children number three had significantly higher (47.9%) prevalence of enteropathogens (P<0.05). The prevalence of enteropathogens could not be correlated with the education and occupational status of guardian. The faith on superstition was significantly higher in illiterate (20%) followed by having school education (19.8%) and least in having higher education (P<0.05).
... An examination of mixed effects logistic regression models did not find any significant noncollinear predictors for prevalence of GI symptoms from the predictors listed above (data not shown). Lower SES and less education have been associated with increased diarrhea prevalence in Kathmandu Valley [111,115], while Rai et al. (2004) found that prevalence of gastroenteritis was greater in children from larger households [116]. ...
... An examination of mixed effects logistic regression models did not find any significant noncollinear predictors for prevalence of GI symptoms from the predictors listed above (data not shown). Lower SES and less education have been associated with increased diarrhea prevalence in Kathmandu Valley [111,115], while Rai et al. (2004) found that prevalence of gastroenteritis was greater in children from larger households [116]. ...
Residents of Nepal’s Kathmandu Valley draw drinking water from tube wells, dug wells, and stone spouts, all of which have been reported to have serious water quality issues. In this study, we analyzed drinking water samples from 35 tube wells, dug wells, stone spouts, and municipal tap water for bacterial and chemical contaminants, including total and fecal coliform, aluminum, arsenic, barium, beryllium, boron, cadmium, cobalt, chromium, copper, fluoride, iron, mercury, manganese, molybdenum, nickel, lead, antimony, selenium, thallium, uranium, vanadium, and zinc. We also asked a sampling of households who used these specific water sources to rate the taste of their water, list any waterborne diseases they were aware of, and share basic health information about household members. This survey provided us with information from 146 households and 603 individuals. We found widespread bacterial contamination of water sources, with 94% of sources having detectable total or fecal coliform. Nepal Drinking Water Quality Standards and World Health Organization (WHO) Drinking-Water Guidelines or health-based values were exceeded for aluminum (max = 0.53 mg/L), arsenic (max = 0.071 mg/L), iron (max = 7.22 mg/L), and manganese (max = 3.229 mg/L). The distribution of water sources with high arsenic, iron, and manganese appeared to be associated with floodplain deposits. Mixed effects logistic regression models were used to examine the interactions between social factors and water contaminants and their effects on household members’ health. Consumers of water sources with both high and low concentrations of manganese were less likely to have a positive attitude towards school than those whose water sources had moderate concentrations of manganese. Social factors, especially education, played a large role in predicting individual health outcomes. Household taste ratings of drinking water were not correlated with iron or manganese concentrations, suggesting that WHO’s reliance on aesthetic criteria for these contaminants instead of formal drinking-water guidelines may not be sufficient to protect public health.
... In addition, this variation is probably due to difference in time, place, method used, personal hygienic habits, sanitary facilities, socio-economic status, and health awareness about intestinal parasites. There was no significant difference between males and females regarding parasitic infections which is in agreement with the observations made from Nepal and other countries regarding gender independence of parasitic infection [11][12][13][14][15][16][17] . (This aspect looks more like conclusion and summary of the study. ...
Introduction: Parasitic infestations are the major causes of morbidity and mortality in developing countries like Nepal. It is an established fact that intestinal parasitic infections can lead to a number of adverse effects like anemia, reduced physical growth, abdominal colic, cholestasis, cholecystitis and pancreatitis. This study aims to assess the distribution pattern of intestinal parasites among patients attending Manipal Teaching Hospital.
... 10,14,15 In direct contrast to this, other studies have reported children and elderly people mostly affected by cholera. 16,17 About 37.2% (123/331) of the collected stool samples and rectal swabs from various health facilities in the metropolis were confirmed positive for cholera. All the isolates were biochemically identified as V. cholerae and serologically confirmed as O1 Ogawa. ...
Objective:
On 24th October 2016, the Central Regional Health Directorate received report of a suspected cholera outbreak in the Cape Coast Metropolis (CCM). We investigated to confirm the diagnosis, identify risk factors and implement control measures.
Design:
We used a descriptive study followed by 1:2 unmatched case-control study.
Data source:
We reviewed medical records, conducted active case search and contact tracing, interviewed case-patients and their contacts and conducted environmental assessment. Case-patients' stool samples were tested with point of care test kits (SD Bioline Cholera Ag 01/0139) and sent to the Cape Coast Teaching Hospital Laboratory for confirmation.
Main outcomes:
Cause of outbreak, risk factors associated with spread of outbreak.
Results:
Vibrio cholerae serotype Ogawa caused the outbreak. There was no mortality. Of 704 case-patients, 371(52.7%) were males and 55(7.8%) were aged under-five years. The median age was 23 years (interquartile range: 16-32 years). About a third 248(35.2%) of the case patients were aged 15-24 years. The University of Cape Coast subdistrict was the epicenter with 341(48.44%) cases. Compared to controls, cholera case-patients were more likely to have visited Cholera Treatment Centers (CTC) (aOR=12.1, 95%CI: 1.5-101.3), drank pipe-borne water (aOR=11.7, 95%CI: 3.3-41.8), or drank street-vended sachet water (aOR=11.0, 95%CI: 3.7-32.9). Open defecation and broken sewage pipes were observed in the epicenter.
Conclusion:
Vibrio cholerae serotype Ogawa caused the CCM cholera outbreak mostly affecting the youth. Visiting CTC was a major risk factor. Prompt case-management, contact tracing, health education, restricting access to CTC and implementing water sanitation and hygiene activities helped in the control.
Funding:
This work was supported by Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana.
... [18][19][20] On the other hand previous studies reported higher prevalence rate among children. 8,21,22 Altogether 9 species of intestinal parasites were detected, two were protozoa and the remaining seven were helminthes. In the present study Protozoan positive rate was (17.76%), whereas Helminthis parasites were found to be 82.19% and was in higher prevalent rate. ...
Background: Intestinal parasitic infections are important public health problem and are globally endemic. These parasites are responsible for the major share of morbidity and mortality in those communities where there is overcrowding, poor environmental sanitation and personal hygienic practices. Intestinal parasitic infection is highly prevalent among the general population in Nepal. This study was aimed to evaluate the burden of the intestinal parasitic infections and the pattern of distributions among patients attending in a tertiary care setting in Bharatpur, Nepal, over a period of one year (August 2017 to July 2018). Methods: Stool samples of patients received in the Microbiology laboratory, COMS that were subjected for routine stool investigations were included in this study. Naked eye physical examination, microscopic examination was carried out and parasites were identified in the received stool samples. The results were recorded, and data were entered into excel spreadsheet 2007. The percentages of the parasites present were calculated to find out the frequency and distribution. Results: A total of 1,558 fresh stool samples were screened, of which 20.60% (n=321) were positive for various intestinal parasites. Overall, helminthic infections (81.30%) were higher than protozoal infections (18.70%). On the whole, Ascaris lumbricoides showed higher prevalence (39.56%) followed by Ancylostoma duodenale (19.31%) and Giardia lamblia (9.97%). 17(1.09%) of the samples showed more than one parasite. Highest prevalence was seen in age group 15 to 25 years of age (27.40%). Conclusions: Parasitic infection is endemic. Apart from the early diagnosis and effective treatment, health education is a requisite to control infections in this area and awareness of sanitation to reduce and control parasitic infection.
... Our study suggested the prevalence of intestinal parasitosis was highest among the age group 15-60 years, which is in contrast to other similar studies where prevalence rate was higher in children. 5,6,14,15 This may be due to large number of study population which was highest for age group 15-60, moreover patient attending our hospital are mainly adult. ...
IntroductIon: Prevalence of intestinal parasitic infestation is still high in developing countries like Nepal. This study aims to determine the prevalence of intestinal parasitic infestation in stool sample received in microbiology lab of Kathmandu Medical College Teaching Hospital in two years duration.
... The gender wise prevalence seems almost equal among boys and girls. Gender independence of intestinal worm infestation 17,18 has been reported by others . However, higher infection 13 19 rate in girls has been shown by Khadka et al ; Sherchan et al , 20 4 while Ishiyama et al , and ThapaMagar et al , reported higher rate of infection in males. ...
p> INTRODUCTION: Soil-transmitted helminths (STHs), are the common intestinal parasites among school age children in Nepal. Periodic epidemiological studies and transmission dynamics in parasitic infections will provide accurate understanding. The aim of this study is to find out the prevalence of intestinal parasitic infections among primary school children at Rupandehi district Nepal.
MATERIALS AND METHODS: This is a school based cross-sectional descriptive study including 217 students studying at primary level in two Government School in Rupandehi. The demographic data and anthropometric data was collected. Routine Stool examination was done and concentration techniques were used for maximum recovery of parasites.
RESULTS: The prevalence of parasitic infection was 60% (130/217). Statistically significant association was found between parasitic infection and source of drinking water (p<0.05) A. lumbricoides was most common followed by Taenia spp, Hymenolepsis nana and others. Parasitic infection was highest 70% (21/30) in age group 13-15 years and lowest i.e. 38.1% (8/21) in age group 4-6 years. The mean height and weight of children was found to be 1.28 m and 26.5 kg respectively. Among total children 90.8% (197/217) of the children were malnourished (BMI<18.5 kg/m2) and among infected children 90% (117/130) were malnourished.
CONCLUSION: The intestinal parasitosis was found comparatively higher in school children in this region. Higher rate of infection was found in malnourished children.
Journal of Universal College of Medical Sciences (2016) Vol.04 No.02 Issue 14, page: 30-34</p
... 11 Similarly, the prevalence rate reported among children was also much lower than that reported in Kanti Children Hospital, Kathmandu and that among children elsewhere in Nepal, nearly a decade back. 6,8,9,19 The declining trend may be attributed to regular deworming program conducted during recent years especially in schools and the improved hygienic behavior as mentioned earlier. ...
... Children and the elderly people are mostly affected by cholera [7,17,18]. Contrary to this, young populations (age group 20-29 years) were affected in the present studywhich was in similar with study done by Kansakar et al., 2011 andYadav et al., 2012, in which most affected population were 20 to 29 years and 15 to 30 years respectively [14,19]. ...
Background: Cholera is an acute diarrheal illness caused by the toxigenic bacteria Vibrio cholerae serogroup O1 and O139 and is associated with rapid loss of body fl uids leading to dehydration, electrolyte disturbances and hypovolemic shock; without treatment, death can occur within hours. V. cholerae is classifi ed into more than 200 serogroups based on the O antigen of the lipopolysaccharide; of these, only O1 and O139 serogroups cause epidemic cholera. Again, V. cholerae O1 is further classifi ed into two biotypes: classical and El Tor and contain two major serotypes: Ogawa, Inaba and additional serotype Hikojima contains both specifi c antigens, is rare.
... Children and the elderly people are mostly affected by cholera [7,17,18]. Contrary to this, young populations (age group 20-29 years) were affected in the present studywhich was in similar with study done by Kansakar et al., 2011 andYadav et al., 2012, in which most affected population were 20 to 29 years and 15 to 30 years respectively [14,19]. ...
Background: Cholera is an acute diarrheal illness caused by the toxigenic bacteria Vibrio cholerae serogroup O1 and O139 and is associated with rapid loss of body fl uids leading to dehydration, electrolyte disturbances and hypovolemic shock; without treatment, death can occur within hours. V. cholerae is classifi ed into more than 200 serogroups based on the O antigen of the lipopolysaccharide; of these, only O1 and O139 serogroups cause epidemic cholera. Again, V. cholerae O1 is further classifi ed into two biotypes: classical and El Tor and contain two major serotypes: Ogawa, Inaba and additional serotype Hikojima contains both specifi c antigens, is rare.
... The studies by Kansakar et al. [29] and Yadav et al. [30] found similar results in which most of the infected patients were adults aged 20 to 29 years and 15 to 29 years respectively. Contrary to this, other studies found children and elderly people mostly affected by cholera [31][32][33]. ...
... In addition, this variation is probably due to difference in time, place, method used, personal hygienic habits, sanitary facilities, socio-economic status, and health awareness about intestinal parasites. There was no significant difference between males and females regarding parasitic infections which is in agreement with the observations made from Nepal and other countries regarding gender independence of parasitic infection [11][12][13][14][15][16][17] . (This aspect looks more like conclusion and summary of the study. ...
BSTRACT
Introduction:
Parasitic infestations are the major causes of morbidity and mortality in developing countries like Nepal. It is an established fact that intestinal parasitic infections can lead to a number of adverse effects like anemia, reduced physical growth, abdominal colic, cholestasis, cholecystitis and pancreatitis. This study aims to assess the distribution pattern of intestinal parasites among patients attending Manipal Teaching Hospital.
Method:
A retrospective study of results of stool samples analysis was carried out for intestinal parasite examination in a tertiary care Hospital, Pokhara. The records were collected from Microbiology Laboratory for a period of five years (2009 to 2013).
Result:
Eight different types of parasites were encountered. The most common parasite Giardia lamblia, accounted for 140 (46.36%) followed by Entamoeba histolytica 53 (17.55%), Ancylostoma duodenale 30 (9.93%) Ascaris lumbricoides 22 (7.28%), Trichuris trichuria 22 (7.28%), Hymenolepsis nana 19 (6.29%), Taenia species 9 (2.98%), and Strongyloides stercoralis 7 (2.32%). In our study the prevalence of intestinal parasitic infection is low.
Conclusion:
The notable finding from this study is the high prevalence of Giardiasis. Since parasitic infestations are important public health problem, it is necessary to develop effective prevention and control strategies including health education and environmental hygiene
... 11 Similarly, the prevalence rate reported among children was also much lower than that reported in Kanti Children Hospital, Kathmandu and that among children elsewhere in Nepal, nearly a decade back. 6,8,9,19 The declining trend may be attributed to regular deworming program conducted during recent years especially in schools and the improved hygienic behavior as mentioned earlier. ...
Introduction: Intestinal parasitosis is highly prevalent among general population and hospital patients in Nepal. The study aimed to assess the prevalence of intestinal parasitosis among patients in a hospital of Nepal. Methods: A retrospective study was done by analyzing the findings of stool examined from April 2006 to March 2008 at Department of Microbiology of the hospital. χ2-test was used for analytical assessment. Results: Out of 2221 fecal samples, 20.7% were positive, the positivity being 23.9% and 15.8%, respectively in first and second year (P<0.05). Overall infection rate was nearly equal in male and female (20.2% vs. 21.2%). The infection rate was highest among patients of >60 years (25.3%) followed by those of <15 years (21.2%) and 15-59 years (20.1%) ( P>0.05). Ascaris lumbricoides (31.8%) and Entamoeba histolytica (38.0%) were the commonest helminth and protozoa, respectively. Other parasites were Hookworm (18.3%), Hymenolepis nana (2.6%), Taenia solium (2.6%), Strongyloides stercoralis (1.3%) and Giardia lamblia (5.5%). Conclusions: Though, the prevalence of intestinal parasitosis among hospital visiting patients is declining, high detection of A. lumbricoides and E. histolytica signifies the need of public awareness regarding latrine use, water source protection from fecal contamination, proper sanitation and hygienic behavior. Keywords: Ascaris lumbricoides, Entamoeba histolytica, intestinal parasites. DOI: 10.3126/joim.v31i3.2974 Journal of Institute of Medicine, December, 2009; 31(3) 13-16
... Gender wise prevalence of parasitic infection was observed almost equal among males and females, though slightly higher in males (15.65% vs 14.62%) which shows agreement with reports from Nepal and other countries regarding gender independence of parasitic infection. 13,14,[19][20][21][22][23] Based on the age, prevalence of parasitic infection was highest among patients aged 5-14 years (20.66%) followed by > 45 years (16.20%) . ...
Intestinal parasitosis is highly prevalent among the general population in Nepal. This study aimed to evaluate the distribution of intestinal parasites among patients attending Nobel Medical College Teaching Hospital, Biratnagar, Nepal. A total of 5,524 stool samples examined by direct smear and Formal-Ether concentration technique were reported. The overall prevalence of intestinal parasitic infection was found to be 15.17% (M=15.65% vs F=14.62%). The overall prevalence of intestinal parasitosis was found to be highest among patients aged 5-14 years (20.66%), followed by elderly people aged > 45 years (16.20%) and least among children aged < 5 years (9.09%). Among various parasites detected, the most common was Entamoeba histolytica (44.86%) followed by Giardia lamblia (33.65%), hookworm (10.50%), Ascaris lumbricoides (5.72%), Strongyloides stercoralis (4.77%), Hymenolepis nana (3.34%), Trichuris trichiura (0.95%) and Enterobius vermicularis (0.23%) respectively.
Journal of Nobel Medical College Vol. 2, No.1 Issue 3 Nov.-April 2013 Page 13-17
DOI: http://dx.doi.org/10.3126/jonmc.v2i1.7666
... Other research conducted in Nepal had reported the occurrence of both Ogawa and Inaba serotypes with an interval of several years [21,[27][28][29]. Children and the elderly people are mostly affected by cholera [2,30,31]. Contrary to this, adult populations of age group 20-30 years were highly infected accounting for 8.7% as compared to all other aged groups (3.4%) in our context (p = 0.018). The studies by Kansakar et al. [22] and Yadav et al. [32] found similar results in which most of the infected patients were adults aged 20 to 29 years and 15 to 29 years respectively. ...
... 7,10,12,[17][18][19] So, our study shows agreement with suggestions of various studies regarding gender independence of parasitic infection. 10,12,13,14,17,[20][21][22][23][24] Based on the age of patients included in the study, parasitic infection was found to be highest among children aged <15 yrs (32.1%) followed by > 60 yrs age (22.2%) and it was lowest among middle aged people of 15-60 yrs (16.8%). This finding is similar to the reports of studies done in various places of Nepal outside Kathmandu Valley. ...
Intestinal parasitosis is highly prevalent among the general population in Nepal. This study aimed to assess the status of intestinal parasitosis among patients attending Deukhury Community Hospital, Lamahi, Dang, situated in the mid western region of Nepal. A total of 210 stool samples examined by direct smear technique were reported. The overall prevalence of intestinal parasitic infection was found to be 21.4% (M = 23.5% vs F = 19.3%). Children < 15 yrs age were infected more often as compared to > 60 yrs and 15-60 yrs aged people. Among adults, Entamoeba histolytica infection was found to be very high compared to high helminthic infection found among children. Finding showed that, the prevalence was significantly high (68.8%) among people having low socio-economic status compared to others (31.1%) (p < 0.05). Among various parasites detected, E. histolytica was the most common parasite (48.8%) followed by helminths, mainly Ascaris lumbricoides (31.1%), hookworm (13.3%), Trichuris trichiura (4.4%) and Taenia species (2.2%) respectively in the locality.
... [12][13][14][15] On the other hand, however, this result was in contrast with other reports from the country. 16,17 This indicated that the association of gender with parasitic infection differs from one community to another and might be attributed to the socio-behavioral activities. ...
Keeping in view of heavy burden of intestinal parasitosis, present study was done to find out the prevalence of intestinal parasitic infection in children (aged <16 years) of Sukumbasi (people living without land ownership) Basti (community) in Kathmandu Valley. A total of 279 stool samples collected in clean, dry and screw capped plastic container were firstly examined for the presence of adult worm and/or segments of worms. Samples fixed in 10% formal-saline were then examined microscopically after concentration by formal-ether sedimentation technique. Overall parasite positive rate was 43.3% (121/279) with no significant difference in two genders (Boys: 48.3%, 73/151; Girls: 37.5%, 48/128) (p=0.07). Altogether 11 species of parasites were detected. Of them Giardia lamblia was most common followed by Entamoeba histolytica, Trichuris trichiura and others. Positive rate was higher in Tibeto-Burman (55.0%, 77/140) and the least in Indo-Aryan (25.4%, 27/ 106) (p=0.01) ethnic groups. Children taking anti-parasitic drug in last six months had significantly low positive rate (25.4%, 15/59) than others (48.2%, 106/220) (p=0.002). Results of this study suggestive of periodic administration of anti-parastic drugs and need for improvement of sanitary/hygienic practice.
... Another report from Kavrepalanchok district, a region near Kathmandu valley, also found the most common age group to be 11 to 20 years, followed by ages 21 to 30 years [14]. However, our results contrast those of other studies [6,15] which report diarrhoeal diseases to be prevalent in children. One of the major reasons for this difference is associated with the predominance of samples received from patients above nine years old. ...
The prevalence and antimicrobial susceptibility patterns of the bacterial enteropathogens Vibrio cholerae, Salmonella species and Shigella species were investigated.
A total of 877 stool samples were received for culture at the National Public Health Laboratory (NPHL), Kathmandu, Nepal, during January 2002 to December 2004, from diarrhoea patients attending Shukraraj Tropical Infectious Hospital and referral outpatients. All samples collected were processed for isolation and antibiotic susceptibility testing of Vibrio cholerae, Salmonella spp. and Shigella spp.
Of the 877 stool samples, 148 (16.8%) were culture positive for one of the three bacterial enteropathogens investigated. Among them, Vibrio cholerae, Shigella spp. and Salmonella spp. accounted for 98/877 (11.1%), 41/877 (4.6%), 9/877 (1.02%) of the isolates respectively. A year-to-year variation was seen in the type of predominant organism, with Shigella spp. being the most prevalent in 2002 and 2003 and Vibrio spp. in 2004. In all three years, Vibrio cholerae were encountered only during the months of April to June while Salmonella spp. and Shigella spp. were isolated throughout the whole year. All Vibrio cholerae and Salmonella isolates were susceptible to ciprofloxacin. All Shigella isolates were susceptible to ceftriaxone. Ciprofloxacin resistance was observed among isolates of Shigella dysenteriae type-1 isolated after 2003.
Vibrio cholerae, Salmonella and Shigella infections are prevalent in Kathmandu, Nepal. A gradual increase in resistance to commonly used antimicrobials was seen among bacterial enteropathogens. Antimicrobial resistance surveillance is necessary to guide empirical treatment.
Cholera, an infectious disease caused by Vibrio cholerae, is a major public health problem and is a particularly burden in developing countries including Nepal. Although the recent worldwide outbreaks of cholera have been due to V. cholerae El Tor, the classical biotypes are still predominant in Nepal. Serogroup O1 of the V. cholerae classical biotype was the primary cause of a cholera outbreak in Kathmandu in 2012. Thus, this study was designed to know serotypes and biotypes of V. cholerae strains causing recent outbreak with reference to drug resistant patterns. Moreover, we also report the toxigenic strains of V. cholerae from both environmental and clinical specimens by detecting the ctx gene.
Twenty four V. cholerae (n = 22 from stool samples and n = 2 from water samples) isolated in this study were subjected to Serotyping and biotyping following the standard protocols as described previously. All of the isolates were tested for antimicrobial susceptibility patterns using the modified Kirby-Bauer disk diffusion method as recommended by CLSI guidelines. The screening of the ctx genes (ctxA2-B gene) were performed by PCR method using a pair of primers; C2F (5'-AGGTGTAAAATTCCTTGACGA-3') and C2R (5'-TCCTCAGGGTATCCTTCATC-3') to identify the toxigenic strains of V. cholerae.
Among twenty four V. cholerae isolates, 91.7% were clinical and 8.3% were from water samples. Higher rate of V. cholerae infection was found among adults of aged group 20-30 years. All isolates were serogroups O1 of the V. cholerae classical biotype and sub serotype, Ogawa. All isolates were resistant to ampicillin, nalidixic acid and cotrimoxazole. 90.9% were resistant to erythromycin however, tetracycline was found to be the most effective drug for the isolates. All isolates were multidrug resistant (MDR) and possessed a ctx gene of approximately 400 base pairs indicating the toxigenic strains.
Hundred percent strains of V. cholerae were MDR possessing a ctx gene. It suggests that toxigenic strains be identified and proper antibiotic susceptibility testing be conducted. This will allow effective empirical therapy to be used to treat and control cholera.
This study was conducted to find out the prevalence of intestinal parasitic infection among patients attending Nepal Medical College Teaching Hospital, Kathmandu from July 2011 to February 2012. A total of 312 stool samples collected in a clean, dry screw capped plastic container were examined using the formal-ether concentration and sucrose-flotation techniques. Overall parasite positivity rate was 30.1% with significant difference between males (34.2%) and Female (26.3%) (p < 0.05). Out of total positive, 90.4% had single parasitism whereas 9.6% had multiple parasitism. Children aged < or = 5 years were found to be highly infected (35.8%), followed by 6-15 years (32.1%) and > 15 years old (26.9%). Rate of infection was significantly higher among patients from inside Kathmandu Valley (31.1%) than outside valley (17.4%) (p < 0.05). E. histolytica (38.5%) and Hookworm (10.6%) were the commonest protozoa and helminthes respectively. Other parasites detected were G. lamblia (26.0%), E. coli (1.0%), T. trichiura (7.7%), A. lumbricoides (6.7%), H. nana (5.8%) and Taenia species (3.8%). Out of total parasites detected, 65.4% were protozoa and 34.6% were helminthes. Positive rate was higher in Dalit (37.5%) and Aadibasi-Janjati (34.3%) than Brahman-Chhetri (22.6%) (p < 0.05).
Background:
On 2011, Cluster of cholera cases was reported in the Tilathi VDC of Saptari, Nepal.
Objective:
The outbreak was investigated to identify the etiological agent and possible source of infection and guiding the prevention and control measures.
Methods:
Demographic and clinical details were collected from the suspected case-patients, and the outbreak was described by time, place, and person. Focus group discussion and Key informant interview were conducted to assess the practice of sanitation, source of drinking water and probable cause of diarrheal disease. Five stool samples and 10 water samples of tube well and ponds were collected and microbiological study was done in BPKIHS Dharan.
Results:
A total of 111 persons suffered with diarrhea and 02 died of it (attack rate 3.05%, case fatality rate 1.8%). All age groups were affected with disease (median age 26 yrs) and males were affected more than females. Descriptive epidemiology suggested the clustering of cases were around the pond where they clean utensils, take bath and wash clothes. The Vibrio cholerae 01 El Tor, Ogawa serotype was isolated in 03 out of 05 suspected stool samples and in all three of the pond water samples. They reported that most of the houses do not have the toilet and people do not wash their hands regularly with soap and water after defecation.
Conclusion:
Vibrio cholerae was the causative agent behind the outbreak and probable source of infection was the problematic pond water which they used for different purpose. Immediate chlorination of the pond was recommended to halt further spread of the epidemics.
Intestinal worm infestation is one of the major childhood health problem in Nepal. This study was done to assess the prevalence of intestinal worm infestations among school children aged 6-16 years in a public high school in Kathmandu Nepal. A total of 142 stool samples from healthy students were collected and reported following formol-ether concentration technique. The overall prevalence of intestinal worm infestation was found to be 17.6% (Boys = 22.0% vs girls = 13.5%). Children aged 6-8 years were found to be highly infected with intestinal worms (21.4%) followed by 9-12 years old (18.6%). Those between 13-16 years of age were significantly less infected (10.7%) compared to others (p < 0.05). Ova/cysts of intestinal parasites detected include Trichuris trichiura (32.0%), Ascaris lumbricoides (20.0%), Hymenolepis nana (16.0%), hookworm (8.0%) and 24.0% cases showed mixed parasitic infections.
Intestinal parasitosis is a major public health problem of developing countries, children being major victims. Higher prevalence has been reported among school children, mostly in hilly regions of Nepal. This study aims at assessing prevalence of intestinal parasitosis among school children of a school in a border town of Nepal and the associated factors.
Fecal samples from the students were examined by direct smear technique and result was correlated with their socioeconomic status and hygienic behavior. The chi-square test was used for analytical assessment.
The prevalence rate was 13.9%, girls being highly infected (19.1%) than boys (10.3%) (P>0.05). Entamoeba histolytica (36.0%) was the commonest parasite followed by A. lumbricoides (28.0%). The highest positive rate was found among children of 5 years and less age (29.2%) and least among those above 12 years (5.3%) (P>0.05). Those from family size 5 and less than 5 were least infected (10.5%). Children of illiterate parents (16.7%) and farmers (17.1%) were more infected than literate ones and non-farmers (P>0.05). 8.7% of positive children had multi-parasitic infection. Children drinking untreated water (15.0%) were more infected than those drinking treated water (5.5%) (P>0.05).
Intestinal parasitic infection was found among 17% school children. Awareness on infectious diseases, improving hygiene, and application of supportive programs for parents to elevate socioeconomic conditions may reduce the burden of infection.
A cross-sectional parasitological survey was conducted in Asendabo elementary and Junior Secondary Schools, Omo-Nada Woreda, Jimma Zone. From 1322 students, 282 faecal specimens were collected by stratified random sampling and were examined for ova, larva and cysts of intestinal parasites using Kato-thick and direct wet mount techniques. The overall prevalence rate was 86.2%. A total of 10 species were identified with Ascaris lumbricoides leading (56.4%) followed by hookworm (25.5%), and Trichuris trichuria (21.6%), and with Hymnolepis dimunita as the lowest (0.4%). A statistically significant difference was observed in the prevalence rate of intestinal parasites by sex, (p<0.01). However, there was no statistically significant difference in prevalence of polyparasites by sex, (P>0.5). No statistically significant associations were observed between family size and infection, latrine usage and infection, source of drinking water and rate of infection, and habit of wearing shoes and rate of hookworm infection (P>0.1 in each case). However, there was significant association between status of personal hygiene and rate of infection (p<0.001) where poor personal hygiene favours infection. A multi-disciplinary action is recommended to minimize the risk factors emphasizing on repeated mass chemotherapy for school children.
We aimed to determine the possible risks associated with raw wastewater use for agricultural purposes, particularly the transmission of helminthic infections among children. In a randomly-selected sample of 1343 children, 740 of them were from five regions using raw wastewater for agriculture, while 603 were from four control regions that do not use such water. The prevalence of helminthic infection was found to be significantly higher among children in regions using wastewater, compared to control regions. Behavioural characteristics and public water supply were found to be associated with higher infection rates. Adequate treatment of wastewater as well as public health education are highly recommended.
A total of 6414 mothers in a rural Ethiopian district were sampled and interviewed about the presence of under-5 yr children and the prevalence of diarrhea in the previous 2 weeks. There were 707 cases of diarrhea among the 6384 under-5 yr children, yielding a period prevalence of 11.07%. The diarrhea associated mortality rate was 11.4/1000 children. A structured questionnaire on home and professional treatment as well as knowledge about diarrhea was completed by the mothers of 619 of these cases. Over 50% of the mothers restricted the child's fluid intake and 70% stopped or decreased food intake; only 20% used ORS or cereal based ORT. The major factor associated with adequate home treatment was the mother's knowledge about the causes and treatment of diarrhea. Only 26.8% of the mothers had sufficient knowledge. Many of the mothers believed that teething and accidental falls caused diarrhea and that diarrhea helped to clean out the bowels. They also believed that only water should be given to the child, but that too much fluid worsened diarrhea. Half of the mothers did not seek professional treatment; 20% went to a traditional healer and only 7.3% took the child to a health institution. The outcome of the diarrhea was positively associated with having sought modern treatment and negatively associated with having gone to a traditional healer.
A case-control design has been applied in the evaluation of improved environmental sanitation on diarrhoeal diseases in rural Malawi. The study demonstrates the feasibility of using such an approach to evaluate two levels of water supply and sanitation service quickly and at moderate cost. Sample sizes would need to be increased substantially to evaluate multiple levels of service or to investigate interactions between water supply and sanitation. The results indicate that children living in families who use good quality water supplies and latrines experience 20% less diarrhoea as reported to the health clinics during the warm, rainy season.
A community based prospective study was conducted among randomly selected 300 children aged less than five years selected from three camps of the police force in Khartoum from 534 households representing a total population of 4962 individuals. The study was planned to determine the prevalence and type of parasitic infestations and the related risk factors in that community. From the 300 children, 298 stools specimens were examined: 116 were positive for a single parasite, while samples from 15 children showed ova and cysts for two types of parasites giving a prevalence rate of 44%. The commonest infestations were Giardiasis (21.1%), Taeniasis (10.4%) and Enterobiasis (7.4%). Non pathogenic E. coli, E. histolytica and Taenia saginata were detected in 2.7%, 0.7% and 1.7% of stools specimen respectively. Children aged between 3 years and above were the most affected group and the infection rate was highest among the illiterate, overcrowded and large sized families. Malnourished children comprised 9.4% of the study group but there was no significant association between undernutrition and the overall prevalence of intestinal infestations, although Giardia lamblia significantly affected the undernourished group.
A retrospective evaluation of the status of soil-transmitted helminthic infection in Nepal during the period from 1985 to 1992 was conducted at the Parasitology Laboratory, Department of Pathology, TU Teaching Hospital in Kathmandu. An average of 6,537 faecal samples were examined each year for the presence of various types of intestinal parasites. The annual rate of positivity of these samples for soil-transmitted helminthiasis ranged from 18.0 to 36.6%. The annual incidence decreased every successive calendar year in both adults and children, irrespective of sex. Among the various types of helminths, the most common was Ascaris lumbricoides (roundworm), followed by hookworm. The incidence of A. lumbricoides remained constant throughout the study period, while that of other parasites markedly decreased each year.
This study was undertaken to investigate the pattern of utilization of medical and dental health care services in rural Tanzania. Two hundred adults, 91 men and 109 women aged 20 or over, were interviewed. Nearly all subjects reported using modern dental and medical health care services. Home remedy was the only indigenous method of treatment used for dental problems while for medical problems a traditional healer was the most commonly used indigenous alternative. The use of both indigenous and modern health care services was significantly lower for dental than for medical problems (P < 0.05). It seems that the pattern of utilization of health care services differs for medical and dental problems. This should be taken into account when planning comprehensive health care services for rural African societies.
Stool samples of 1488 children suffering from acute diarrhoea were studied for bacterial culture and sensitivity. Shigella culture was positive in 143 (10 per cent) children and 53 hospitalized children could be studied in detail. Thirty-six (68 per cent) children were under 2 years of age and peak prevalence was observed in summer months. Fever and diarrhoea were universal features; 96 per cent had blood and mucus in the stools, but 32 per cent started with watery diarrhoea lasting 1-3 days followed by dysentery. Two cases (4 per cent) had watery diarrhoea. Abdominal pain dehydration, and malnutrition were present in more than two-thirds of the cases. Central nervous systemic (CNS) manifestations, renal failure, respiratory manifestations, and subacute intestinal obstruction were seen in 45, 25, 17, and 5 per cent of cases, respectively. Shigella dysenteriae was the commonest organism grown in 57 per cent, followed by Shigella flexneri in 36 per cent, Shigella boydii in 4 per cent, and Shigella sonnei in 4 per cent cases. In the majority, the organisms were sensitive to neomycin (83 per cent), furazolidine (86 per cent), and cephaloridine (87 per cent), whereas Shigella strains were resistant to tetracycline in 93 per cent, ampicillin in 83 per cent, chloramphenicol in 91 per cent and cotrimoxazole in 66 per cent cases. Proctosigmoidoscopy was useful in defining the nature of mucosal lesion, to collect swabs for culture and biopsy specimen for histopathology. Four (8 per cent) cases had pseudomembrane and in two cases Clostridium difficile could be identified. Eight (15 per cent) cases died and two of them had shigellaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
The present study on intestinal parasites from the Kathmandu area of Nepal found that in subjectively healthy children (HC) and adults (HA) the total parasite load was 28.1% and 38.8%, respectively, whereas children (ADC) and adults (ADA) with abdominal discomfort had a load of 62.7% and 67.8%. The prevalence of nematodes in the 4 groups was significantly higher in those with abdominal discomfort, particularly of Hookworm, Enterobius, and Ascaris. Hymenolepis nana was the most common tapeworm, and also with the highest incidence in patients with abdominal complaints. Taenia solium and T. saginata were only found in the two adult groups, but with low prevalence rates. The highest incidence of Cryptosporidium was found in both groups with abdominal discomfort, notably among children. No "healthy" carriers were found among the adults, whereas the prevalence of "healthy" carriers among children corresponded to that of sick adults. The presence of Giardia was highest among the sick children, many "healthy" carriers among both children and adults were noted. E. histolytica and E. dispar had a surprisingly low prevalence in all 4 groups. In "healthy" children the parasite was twice as common than in sick, supporting earlier findings of morphologically identical species with and without pathogenicity. "Healthy" adults had the lowest prevalence and sick adults the highest in the 4 groups studies. Blastocystis hominis was most common among adults with abdominal complaints (2.8%). Trichomonas was also more common in this group, in which of 34 positive specimen, 28 were from women. In "healthy" children the prevalence of mixed parasite infection was 2.1%, in "healthy" adults more than 7%, while in sick children and adults the prevalence was 13.3% and 11.5%, respectively.
We report the prevalence of intestinal helminthiasis and its impact on health of Nepalese in two different rural Village Development Committees (VDC) in Nepal. A total of 261 school children from Okharpauwa VDC in Nuwakot district (Central Region) and 242 inhabitants of Boya VDC in Bhojpur district (Eastern Region) in Nepal were included in this study. The overall prevalence in these two different districts were 57.5% and 55.4%, respectively. Altogether four types of helminths were detected. In both districts, Ascaris lumbricoides was the commonest helminth. Mixed helminth infection in both study areas accounted for less than 5.0%. All helminth infected subjects were treated with a single dose of albendazole. Heavy Trichuris trichiura infection needed a second dose. Blood hemoglobin and serum total protein level in school children in Okharpauwa VDC increased significantly after chemotherapy (P < 0.05). Eosinophil count (10.1%; SD 5.0325) returned to normal (4.8%; SD 4.6997). Helminth infection in Boya VDC was more common in children than in adults. Serum total protein, albumin, total cholesterol and triglycerides levels were not influenced by the presence or absence of helminths among the inhabitants of Boya VDC. In both districts, more than 80.0% of the household had no latrine. In Boya VDC, 94.0% of inhabitants interviewed were not aware of other intestinal parasite other than A. lumbricoides.
A questionnaire survey with parasitological study was carried out on the inhabitants of 4 villages in Barru district, Sulawesi, Indonesia from 1994 to 1995. The questionnaire dealt with life style and sanitary conditions. In 482 houses in the 4 villages, interviews for the items of the questionnaire were conducted with the owner, housekeeper and children of the same family. In Pancana and Lalolang, 37.7% and 50% respectively of man inhabitants surveyed were fishermen, while in Lompo Riaja and Pattappa, 38.6% and 65.5% respectively were farmers. The highest proportion of official workers was 33.7% in Lompo Riaja. Educational level was low; 88.4% in Pancana, 90.4% in Lalolang, 62.1% in Lompo Riaja and 91.2% in Pattappa had elementary or below elementary school education. In Lompo Riaja, 30.8% of the inhabitants graduated from senior high school or university. The percentage of families having their own latrine was 30.3% in Pancana, 13.2% in Lalolang, 31.9% in Pattapa and 60% in Lompo Riaja. The people without latrines usually defecated in rice fields, seaside or riverside. A total of 654 fecal samples was examined by the modified Kato-Katz thick smear method. Five nematode species, Ascaris lumbricoides, Trichuris trichiura, Necator americanus, Strongyloides stercoralis and unidentified Rhabditoids of free-living nature were detected. Cestode, Hymenolepis nana infection was confirmed. All the hookworms examined by the modified Harada-Mori culture technic were Necator americanus. Trichuris infection was most common, followed by hookworm and Ascaris infections, both in young (aged 4-14) and older (aged over 15) age groups. The prevalence of hookworm infection was significantly higher in males than in females of older age. Among the older age group, the prevalence of Trichuris infection was significantly lower in Lompo Riaja, while hookworm infection was the highest in Pattappa. Among all the inhabitants examined for parasite infection, 17.4% had 3 kinds of nematode, Ascaris, Trichuris and hookworm. However, egg counts revealed that most of the inhabitants with Trichuris or hookworm had light infections. The inhabitants with higher education background had significantly lower infection rates of Ascaris and Trichuris. The prevalence of hookworm infection was not significantly different between the inhabitants owning latrine and without it, but the prevalence of Ascaris and Trichuris, differed significantly.
Faith healers: a force for change
- Lediard
- Shrestha
Lediard M and Shrestha RM. Faith healers: a force for change. UNFPA/UNICEF 1980.
Intestinal parasitosis among School Children in a Rural Hilly Area of Dhading District, Nepal
- Sk Rai
- K Hirai
- Abe
Rai SK, Hirai K, Abe A et al. Intestinal parasitosis among School Children in a Rural Hilly Area of Dhading District, Nepal. Nepal Med College J 2002; 4: 54-58. University, infection in Nepal. School Children in from N. India: A r7
Bacteriological study of drinking water of Kathmandu valley
- Rk Adhikari
- Sk Rai
- Pokhrel
Adhikari RK, Rai SK, Pokhrel BM et al. Bacteriological study of drinking water of Kathmandu valley. J Inst Med (Nepal) 1986; 8: 313-316.
Intestinal parasitic infection in high school level students of Birgunj city
- Sk Rai
- Gurung
Rai SK, Gurung CK. Intestinal parasitic infection in high school level students of Birgunj city. J Inst Med (Nepal) 1986; 8: 33-38.
Study of Enteropathogens and Its Pre-disposing Factors in a Sub-urban Public Kathmandu, Nepal
- S Ishiyama
- K Ono
- Rai
Ishiyama S, Ono K, Rai CK et al. Study of Enteropathogens and Its Pre-disposing Factors in a Sub-urban Public Kathmandu, Nepal. Nepal Med College J (Nepal) 2001; 3: 5-9.
Status of intestinal parasitoses at TU Teaching Hospital
- Sk Rai
- Bajracharya
- Budhathoki
Rai SK, Bajracharya K Budhathoki S et al. Status of intestinal parasitoses at TU Teaching Hospital. J Inst Med (Nepal) 1995; 17: 134-142.
A Study of an Aetiology of Diarrhoea in Childhood Diarrhoea in Lagos, Ngeria
- Ti Ogunsaya
- Rotimi
- A Adenuga
Ogunsaya TI, Rotimi VO and Adenuga A. A Study of an Aetiology of Diarrhoea in Childhood Diarrhoea in Lagos, Ngeria. J Med Microbiol 1994; 40: 10-14.
Bacteriology of Diarrhoea in Nepal
- Bm Pokhrel
- Br Parasi
- Kubo
Pokhrel BM, Parasi BR, Kubo T et al. Bacteriology of Diarrhoea in Nepal. J Inst Med (Nepal) 1997; 19: 128-221.
Diarrhoea in children in relation to Behavioural and Environmental Factors
- S Piya
- Adhikari
- Rajbhandari
Piya S, Adhikari S and Rajbhandari TP. Diarrhoea in children in relation to Behavioural and Environmental Factors. Nepal J Sci Tech 2001; 3: 85-88.
Parasite infection in Nepal
- Mk Chhetri
Chhetri MK. Parasite infection in Nepal. J Nepal Med Assoc 1997; 35: 60-65.
Children's diarrhoeal diseases in Madagascar: Bacteriological, Parasitilogical and Virological Study
- Am Cassel-Beraud
- J Morvan
- Rakotoarimanana
Cassel-Beraud AM, Morvan J, Rakotoarimanana DR et al. Children's diarrhoeal diseases in Madagascar: Bacteriological, Parasitilogical and Virological Study. Arch Inst Pasteur Madag 1990; 57: 223-254.
Intestinal Parasitism, In: Zein AZ and Kloosh Eds. The Ecology of Health and Disease in Ethopia
- T Tesfamichael
- Kloos
Tesfamichael T, Kloos H. Intestinal Parasitism, In: Zein AZ and Kloosh Eds. The Ecology of Health and Disease in Ethopia, Addis Ababa. Ministry of Health 1988; 214.
Acute Diarrhoea cases in Nepal 1993 An epidemiological Review
- Kd Shrestha
Shrestha KD. Acute Diarrhoea cases in Nepal 1993 An epidemiological Review. J Nep Med Assoc (Nepal) 1994; 32: 8-85.