Helicobacter pylori associated gastroduodenal problem among the Nepalese.

Present study was undertaken during a period of eighteen months (April 2001 to October 2002) to see an association of Helicobacter pylori with the gastric problems among the Nepalese. This study comprised of 203 subjects (Males: 154 and Females: 49) aged 21 to 71 years with gastric problems. The biopsy samples taken from the stomach and duodenum using endoscope were tested for the presence of H. pylori by in-house rapid urease test (RUT) and culture. Representative samples were also tested by PCR. Of the total 203, 60 (29.5%) were RUT positive. Marginally high RUT positive rate was observed in males compared with females (P>0.95). Same was true with ethnic group with a marginally higher positive rate among Tibeto-Burmans compared with Indo-Aryans (P>0.05). Age-wise, higher incidence (34.4%) was observed in the age group of 36 to approximately 50 years followed by over 50 years (29.0%), and 21 to approximately 35 years (24.4%) (P>0.05). Both RUT and culture positive rate increased with the severity of the problem. RUT results were confirmed also by PCR. All RUT positive patients were given a full course of new triple therapy (combination of two antibiotics: Clarythromycin and Amoxycillin and a proton-pump inhibitor: Omeprazole) for two weeks followed by extended monotherapy with Omeprazole for up to six weeks. Of the total, 168 (82.7%) patients were available for follow-up and all of them showed an improved condition with negative RUT.

Evaluation of rapid diagnostic methods for pediatric viral diarrhea using samples collected in Nepal and Japan.

We evaluated real time PCR, ELISA and immunochromatography (ICG) test systems for detection of diarrheagenic viruses (Rotavirus, Adenovirus and Norovirus) in pediatric diarrheal fecal samples collected in Kathmandu, Nepal (n = 23) and in Kobe, Japan (n = 25) in summer of 2004. Of the 23 samples collected in Nepal, one (4.3%) was positive for Rotavirus and two (8.7%) for Adenovirus whereas six out of 25 samples (24.0%) collected in Japan were positive for Norovirus. Of the Japanese samples, 11 (44.0%) showed diarrheagenic bacteria (Campylobacter jejuni, Salmolella enteritidis) while six (26.1%) samples from Nepal showed parasites like Ascaris lumbricoides, Giardia intestinalis, Trichuris trchiura and Vampirolepis nana. Viral pathogens were not common during summer season in both Nepal and Japan. Real time RT-PCR was found to be relatively more sensitive compared with ELISA for Norovirus. However, immunological methods are simple and less time consuming (three hours for ELISA, 15 minutes for ICG) and appeared to be useful for rapid diagnosis of viral gastroenteritis especially in developing countries.

Parasites detected from diarrheal stool samples collected in Nepal.

Intestinal parasites were investigated in 396 diarrheal stool samples collected from individuals aged 1 to 68 years (males: 239 and females: 157) in Nepal. Samples were collected at different medical centers located in Kathmandu and from two public schools in a village setting in Kathmandu Valley and outside, during October 1999 to January 2001. The stool samples were mixed with 2% dichromate solution and transported to Japan for investigations. Parasites were detected by employing the formal-ether sedimentation technique. Of a total of 396 fecal samples investigated, 193 (49%) were positive for some kind of parasite. Altogether, 15 species of parasites were detected. Giardia intestinalis topped the list of protozoa, whereas Trichuris trichiura was the most frequently detected among helminth parasites. Of the 193 positive samples, 109 (56%) had single parasite infections, whereas 84 (43%) had multiple infections with a maximum of five species. Of the total positive, 45 (23%) had both protozoa and helminths whereas 37 (19%) had only protozoa. Females (52%) and children (15 years and under) (52%) had a marginally higher prevalence compared with males (46%) and adults (45%), respectively (p > 0.05). Samples collected from two public schools in a village setting inside Kathmandu Valley and outside had a significantly higher positive rate compared with those observed in individuals visiting different medical centers in the city and suburban areas in Kathmandu (p < 0.05).

Small-scale study on intestinal parasitosis in a remote hilly village in Nepal.

A small-scale cross sectional study on intestinal parasitosis was conducted in a remote hilly village in western Nepal in January 2001. Stool samples collected from 115 inhabitants (M: 41 and F: 74; Aged: 1 to 89 years) were examined by direct smear method in duplicate. Overall positive rate was 27.0% with a marginally high positive rate in males (P>0.05). Dalits (the lower caste people) had highest prevalence (71.4%) than Tibeto-Burman and Indo-Arvan ethnic (P>0.05). Higher prevalence was observed in adults than in children. Eighty percent of subjects had single parasite infection. Altogether, six types of parasites were detected of which Ascaris lumbricoides was most common. People having toilet had marginally low positive rate. All subjects included in this study were drinking raw water. Occupation wise, farmers had marginally high prevalence.