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.

Study on cyclospora cayetanensis associated with diarrheal disease in Nepal and Loa PDR.

A study of diarrheal diseases associated with Cyclospora cayetanensis was conducted in Nepal and Lao PDR. A total of 2083 samples were included in this study. Samples in Nepal were collected from October 1999 to August 2002 whereas samples in Lao PDR were collected from February 2002 to June 2003. C. cayetanensis was detected by direct microscopy using ultraviolet and differential interference contrast microscopy. The overall positive rate in Nepal was 9.2% (128/ 1397). A higher positive rate was observed in children aged 10 years and under (11.1%) and was lowest in the age group of 51-60 years (3.1%). A significantly higher positive rate was observed in the summer (rainy season) (12.6%) with the lowest prevalence in the spring (dry season) (1.8%) (p < 0.05). The positive rate was closely associated with rainfall (ml/month). Interestingly, only one of the total 686 samples (0.1%) from Lao PDR was found to be positive for Cyclospora oocysts.

Intestinal parasitic infections in schoolchildren in a suburban area of Hanoi, Vietnam.

An epidemiological study on intestinal parasitic infections among schoolchildren in a suburban area of Hanoi, Vietnam, was conducted. Of the 217 schoolchildren involved in this study, 166 (76%) were positive for at least one of nine species of parasite (six helminths and three protozoa). Among the helminth parasites, Trichuris trichiura (67%) was detected the most frequently followed by Ascaris lumbricoides (34%) and hookworm (3%). In the case of protozoan parasites, Entamoeba coli (8%) was the most frequently detected followed by E. histolytica (2%). No Cryptosporidium parvum or Cyclospora sp were found. A questionnaire survey revealed that there was no positive relationship between parasite infection and the children's school records, educational background or parental income, which have been known to play a role.

Epidemiological survey of intestinal parasitic infections of diarrhoeal patients in Nepal and Lao PDR.

Intestinal parasitological survey was conducted to clarify the distribution of intestinal parasites in Nepal and Lao Peoples' Democratic Republic (Lao PDR) from 2001 to 2003. A total of 401 diarrheal fecal specimens were collected from patients aged one to 75 years (250 from Nepal and 151 from Lao PDR). The specimens were examined using the formalin-ether sedimentation (FES) and sucrose centrifugal flotation (SCF) techniques. Nine species (3 Nematoda, 1 Cestoda, and 5 Protozoa) of parasites were recovered from Nepal, whereas seven species (3 Nematoda, 1 Trematoda, and 3 Protozoa) from Lao PDR. Of the parasites detected, (14.4%) was the most common in Nepal, and was Opisthorchis viverrini (29.8%) in Lao PDR. Infection rates were markedly different among age groups in both countries; higher rates were observed in age groups of 10-29 years than in 0-9 years group. Scanning electron microscopic observation revealed that trematoda eggs recovered from Lao PDR were identified as O. viverrini, which could not be done by a light microscope.

Study on enteric parasitosis and nutritional status of school children in remote hilly areas in Nepal.

We examined the effect of enteric parasitosis on nutritional status of school children in remote hilly areas in Nepal. A total of 325 school children aged 6 to 19 years (boys: 214; girls: 111) who provided both blood and stool samples were included. The height (Ht) (cm), weight (Wt) (kg), age, sex, ethnic of each child were recorded. Fecal samples were examined by direct smear method in duplicate. The blood hemoglobin (Hb) was estimated by Sahli's method in the field (Nepal) whereas the serum protein (Prot), albumin (Alb), Alb/globulin ratio (A/G), serum glutamate pyruvate transaminase (SGPT), cholesterol (Chol), triglycerides (Trig), and serum iron (SI) were measured in Japan. Of the total, 201 (61.8%) had enteric parasites, predominantly the soil transmitted helminths. Ascaris lumbricoides was the most common parasite detected (72.6%) followed by hookworm (16.2%) and others. Protozoan infections were very low (<6.0%). Of the total 201 parasite positive children, 15.4% had multiple infections. No significant differences in Ht and Wt in parasite positive and negative boys and girls of both age groups (< 11 and 11-19 years) were observed (P>0.05). Overall, no significant differences in levels of Hb, Prot, A/G, SGPT, Chol, Trig and SI in the parasite positive and negative children were observed (P>0. 05) but in Alb level (P<0.05). When, the levels of these parameters were compared in the age groups of <11 and 11-19 years, similar findings were observed in both the age groups. But, in the age group of 11-19 years, a significant difference was observed in Trig level (P<0.05). No differences were found in the levels of these parameters in the parasitic positive and negative children belonging to Dalits and different ethnic namely, Indo-Aryan and Tibeto-Burman, respectively.

Detection of Toxoplasma oocysts from soil by modified sucrose flotation and PCR methods.

A detection method of Toxoplasma gondii oocysts from soil was evaluated using the sucrose flotation technique with modification involving addition of 0.1% gelatin into washing and floating solutions. PCR was performed on untreated samples and after treatment with polyvinylpyrrolidone (PVP), heating and cooling, and NaCl. The addition of gelatin in the sucrose solution yielded a higher number of oocysts. A very thin band was observed when DNA extract was diluted to 1:1024, indicating the presence of PCR inhibitor in the soil. PCR performed on untreated DNA, on PVP-treated, and on PVP-treated with heating and cooling without added bovine serum albumin (BSA) showed a band only at higher dilutions (1:1024 and 1:512) but at a much lower dilution (1:8) with BSA. In contrast, DNA treated with all three agents showed a band at a much lower dilution (1:64), even without added BSA, and no dilution was required when BSA was added. The PCR inhibitors present in the soil were removed by employing various treatment procedures during DNA extraction, and BSA in PCR. Furthermore, the detection limit with the method was 1 oocyst/g of soil, indicating that this method is useful in epidemiological studies.

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.

Intestinal parasitic infections in Bekasi district, West Java, Indonesia and a comparison of the infection rates determined by different techniques for fecal examination.

This study was undertaken to determine the current status of intestinal parasitic infections among schoolchildren in West Java, Indonesia, and to compare the infection rates obtained by three different methods of fecal examination. A total of 285 fecal samples were collected from 131 males and 154 females at a junior high school. Samples were brought to the Department of Parasitology, Faculty of Medicine, University of Indonesia, and were examined for parasites by the Kato-Katz thick smear method (K-K). The residual samples were suspended in more than five volumes of 2% potassium dichromate solution and brought to the Department of Parasitology, Kobe University School of Medicine, Japan, where they were examined for parasites by the Army Medical School method (AMS III) and by the Sucrose Centrifugal Flotation method (SFL). The K-K revealed a total of two helminths with a prevalence of 10% (29/285). In contrast, nine species of parasites, 31% (89/285) positive, were obtained by AMS III, while 10 species, 22% (62/285) were found by SFL. Overall, 12 species of parasites were detected by the three methods: four species of nematoda (Trichuris trichiura, Ascaris lumbricoides, hookworm, and Enterobius vermicularis); five species of protozoa (Giardia intestinalis, Entamoeba histolytica-like cyst, E. coli, Cyclospora sp, Blastocystis hominis); two unidentified species of nematode eggs; and one unidentified species of mite egg.