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Papers by Prakash Ghimire

Research paper thumbnail of Opportunistic Respiratory Infections in HIV Patients Attending Sukraraj Tropical and Infectious Diseases Hospital in Kathmandu, Nepal

HIV/AIDS - Research and Palliative Care, 2019

Introduction: Opportunistic bacterial and fungal infections are the major cause of morbidity and ... more Introduction: Opportunistic bacterial and fungal infections are the major cause of morbidity and mortality among immune suppressed HIV-positive patients. The main objective of this study was to determine bacterial and fungal organisms causing respiratory infections and their susceptibility to commonly prescribed antimicrobials among HIV patients attending a tertiary infectious disease hospital in Kathmandu. Methods: Sputum samples were collected from the HIV-positive patients attending Sukraraj Tropical and Infectious Disease Hospital (STIDH) from August 2017 to March 2018. A total of 100 sputum samples were cultured on conventional bacterial and fungal culture media. Bacterial and fungal isolates were identified based on their colony characteristics, microscopic morphology and various biochemical tests. Antibiotic susceptibility test (AST) of bacterial isolates was performed by modified Kirby Bauer disc diffusion method. Results: Out of 100 sputum samples cultured, 24% (n=24) showed bacterial growth, 42% (n=42) showed fungal growth and 10% (n=10) had both bacterial and fungal growth. Among bacteria, 91.6% (n=22) were monomicrobial and 8.4% (n=2) were polymicrobial in growth, of which, Klebsiella pneumoniae (37.5%) were predominant isolates, followed by Pseudomonas aeruginosa (29.2%), and Escherichia coli (16.7%). The antibiotic susceptibility test (AST) showed 68% (17/25) of bacterial isolates were multi-drug resistant (MDR) and among them 41.2% (7/17) were found to be extended spectrum β lactamase (ESBL) producers. Fungal growth was observed in 42% of samples (42/100). A total of six different species of Candida and four different genera of molds were identified. On species differentiation, Candida albicans (20%) were followed by Candida parapsilosis (4%), and Candida dubliniensis (3%); and various molds were Aspergillus fumigatus (4%), Aspergillus flavus (2%), and Penicillium species (5%). CD4 count was inversely associated with bacterial and fungal infections. Fifty percent of the patients with the fungal infections had a CD4 count below 200. No fungal organisms were isolated from HIV-positive patients under antifungal drug treatment. Conclusion: HIV-positive patients with a CD4 count less than 200 cells/µL are more vulnerable to opportunistic infections of bacterial and fungal origin. Early isolation, identification and appropriate treatment can reduce mortality due to co-infections. Routine screening of opportunistic pathogens is critical to contain the disease progression.

Research paper thumbnail of Characterization of Mycobacteria in HIV/AIDS Patients of Nepal

Journal of Nepal Medical Association, 2008

Besides Mycobacterium tuberculosis, a number of other Mycobacterium species are also occasionalhu... more Besides Mycobacterium tuberculosis, a number of other Mycobacterium species are also occasionalhuman pathogens. Tuberculosis due to Mycobacterium avium complex (MAC) and Mycobacteriumkansasii is particularly prevalent in AIDS patients as compared to the normal population. A crosssectionalstudy was carried out during January 2004 to August 2005 in 100 HIV-infected personsvisiting Tribhuvan University, Teaching Hospital, and about a dozen of HIV/AIDS care centersof Kathmandu with the objectives to characterize the different mycobacterial species in HIV/AIDSpatients. Three sputum specimens from each person were used to investigate tuberculosis by Ziehl-Neelsen staining, culture and identifi cation tests. Among the 100 HIV-infected cases, 66 (66%) weremales and 34 (34%) were females. Sixty percent of the cases were in the age group of 21-30 years.Mycobacteria were detected in 23 (23%) HIV cases of which 15 (65.2%) were in the age group of 21-30years ; 17(74%) were males and 6 (26 %) wer...

Research paper thumbnail of Micro-stratification of malaria risk in Nepal: implications for malaria control and elimination

Tropical Medicine and Health, 2019

Background: A significant reduction in malaria cases over the recent years in Nepal has encourage... more Background: A significant reduction in malaria cases over the recent years in Nepal has encouraged the government to adopt a goal of "malaria-free nation by 2025." Nevertheless, to achieve this goal, it is critical to identify the epidemiological burden of malaria by specific regions and areas for an effective targeted intervention. The main objective of this study was to estimate the risk of malaria at Village Development Committee (VDC) level in Nepal based on disease, vector, parasite, and geography. Methods: In 2012, the micro-stratification of malaria risk was carried out in 75 districts of Nepal. Instruments such as a questionnaire, case record forms, and guidelines for malaria micro-stratification were developed and pre-tested for necessary adaptations. Village Development Committee (VDC)-wise malaria data were analyzed using exploratory statistics and were stratified by geographical variables that contributed to the risk of malaria. To understand the transmission risk at VDC level, overlay analysis was done using ArcGIS 10. To ensure transparent, reproducible, and comprehensible risk assessment, standard scoring method was selected and utilized for data from 2009 to 2011. Thus identified, three major variables (key determinants) were given weights (wt.) accordingly to stratification of the malaria risk (disease burden, "0.3" wt.; ecology/vector transmission, "0.5" wt.; and vulnerability-population movement, "0.2" wt.). Malaria risk in a VDC was determined based on the overall scores and classified into four categories: no risk, low risk, moderate risk, and high risk. Results: Analyzing the overall risk based on scoring of the total VDCs (n = 3976), 54 (1.36%), 201 (5.06%), 999 (25.13%), and 2718 (68.36%) were identified as high-, moderate-, low-, and no-risk categories for malaria, respectively. Based on the population statistics, 3.62%, 9.79%, 34.52%, and 52.05% of the country's total population live in high-risk, moderaterisk, low-risk, and no-risk VDCs for malaria, respectively. Our micro-stratification study estimates are 100,000 population at high risk. Regional distribution showed that the majority of the high-risk VDCs were identified in the Far-and Midwestern regions (19 and 18 VDCs) followed by Central and Western regions (10 and 7 VDCs) with no high-risk VDCs in the Eastern region. Similarly, 77, 59, 27, 24, and 14 VDCs of the Central, Mid-western, Western, Eastern, and Far-western regions, respectively, were found under moderate malaria risk. Of the low-risk VDCs, 353, 215, 191, 148, and 92 were respectively from the Central, Eastern, Western, Far-western, and Mid-western regions.

Research paper thumbnail of Trends in hepatitis B and hepatitis C seroprevalence among blood donors - Haiti, 2005-2014

ISBT Science Series, 2018

Background and Objectives-Data on the seroprevalence of viral hepatitis are limited in Haiti; con... more Background and Objectives-Data on the seroprevalence of viral hepatitis are limited in Haiti; consequently, the epidemiology is poorly described. This study aims to provide a descriptive analysis of hepatitis B virus (HBV) and hepatitis C virus (HCV) seroprevalence of blood donations in Haiti. Materials and Methods-Using Haiti's National Blood Safety Program and Haitian Red Cross reports from 2005 to 2014, we analysed the results of screening tests of donor serum samples to assess HBV and HCV seroprevalence among adults aged 17 to 65 years. Results-A total of 198 758 donor samples were screened from 2005 to 2014, of which 0•56% were positive for antibody to hepatitis C virus (anti-HCV) and 3•80% were positive for hepatitis B surface antigen. Over the 10-year study period, anti-HCV seroprevalence among blood donors increased by 31% from 0.66% to 0.86% (95% CI: 1•01-1•70); however, this trend was not uniform over time, with a significant decrease from 0•66% in 2005 to 0•39% in 2009 (95% CI: 0•43-0•82) and 0•43% in 2012 (95% CI: 0•50-0•90). Conversely, HBV decreased significantly by 13% from 3•95% in 2005 to 3•42% in 2014 (95% CI: 0•77-0•97), a trend that was also observed in 2012 and 2013. Conclusion-The significant, uniform decrease in HBV seroprevalence in more recent years may represent the positive impact of public health interventions in preventing the transmission of blood-borne infections. More research is needed to understand why the trends in HCV transmission are non-uniform and to investigate the significant increase in more recent years.

Research paper thumbnail of Endemic Japanese Encephalitis in the Kathmandu Valley, Nepal

The American Journal of Tropical Medicine and Hygiene, 2007

Japanese encephalitis (JE) is endemic in the Terai region of Nepal. There is little information o... more Japanese encephalitis (JE) is endemic in the Terai region of Nepal. There is little information on the occurrence of JE outside the Terai and particularly in the densely populated Kathmandu valley. Acute encephalitis syndrome (AES) cases were detected using a sentinel surveillance system that has been functioning since 2004. JE was confirmed using anti-JE IgM ELISA. All laboratory-confirmed JE cases that occurred in the Kathmandu valley during 2006 were followed up for verification of residence and travel history. JE was confirmed in 40 residents of the Kathmandu valley, including 30 cases that had no history of travel outside the valley during the incubation period. Incidence was 2.1/100,000 and the case fatality was 20% (8/40). Currently, JE prevention is focused on the Terai region in Nepal; given the evidence, this should be reviewed for the possible inclusion of the Kathmandu valley in the national JE prevention and control program.

Research paper thumbnail of Laboratory-based Japanese Encephalitis Surveillance in Nepal and the Implications for a National Immunization Strategy

The American Journal of Tropical Medicine and Hygiene, 2008

We report on two years of Japanese encephalitis (JE) surveillance in Nepal and the implications f... more We report on two years of Japanese encephalitis (JE) surveillance in Nepal and the implications for a national immunization strategy. From May 2004 to April 2006, 4,652 patients with encephalitis were evaluated. A serum or cerebrospinal fluid specimen was collected from 3198 (69%) patients of which 1,035 (32%) were positive by Japanese encephalitis IgM ELISA. Most cases (N ‫ס‬ 951, 92%) were from the 24 Terai districts (i.e., southern plains, 12.3 million persons) with the majority (N ‫ס‬ 616, 65%) from four western Terai districts (population ‫ס‬ 1.8 million). The case fatality ratio was 14.7% and 6.3% and the proportion of cases under 15 years old was 52% and 62% in the four western and 20 non-western Terai districts, respectively. Japanese encephalitis immunization targeting residents one year of age and older in the western districts and one through 14 years old in the non-western Terai districts may have reduced Japanese encephalitis cases by 84% and deaths by 92%, nationally.

Research paper thumbnail of {"__content__"=>"Epidemiology of Malaria Infection in Nepal.", "i"=>{"__content__"=>"Plasmodium vivax"}}

The American journal of tropical medicine and hygiene, Jan 16, 2018

Malaria is endemic in the southern plain of Nepal which shares a porous border with India. More t... more Malaria is endemic in the southern plain of Nepal which shares a porous border with India. More than 80% cases of malaria in Nepal are caused by . The main objective of this study was to review the epidemiology of malaria infections as recorded by the national malaria control program of Nepal between 1963 and 2016. National malaria data were retrieved from the National Malaria program in the Ministry of Health, Government of Nepal. The epidemiological trends and malariometric indicators were analyzed. Vivax malaria has predominated over falciparum malaria in the past 53 years, with malaria comprising 70-95% of the annual malaria infections. In 1985, a malaria epidemic occurred with 42,321 cases (82% and 17% ). Nepal had experienced further outbreaks of malaria in 1991 and 2002. cases increased from 2005 to 2010 but since then declined. Analyzing the overall trend between 2002 (12,786 cases) until 2016 (1,009 cases) shows a case reduction by 92%. The proportion of imported malaria ca...

Research paper thumbnail of Quantifying primaquine effectiveness and improving adherence: a round table discussion of the APMEN Vivax Working Group

Malaria journal, Jan 20, 2018

The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread ... more The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness i...

Research paper thumbnail of Targeting vivax malaria in the Asia Pacific: The Asia Pacific Malaria Elimination Network Vivax Working Group

Malaria Journal, 2015

The Asia Pacific Malaria Elimination Network (APMEN) is a collaboration of 18 country partners co... more The Asia Pacific Malaria Elimination Network (APMEN) is a collaboration of 18 country partners committed to eliminating malaria from within their borders. Over the past 5 years, APMEN has helped to build the knowledge, tools and in-country technical expertise required to attain this goal. At its inaugural meeting in Brisbane in 2009, Plasmodium vivax infections were identified across the region as a common threat to this ambitious programme; the APMEN Vivax Working Group was established to tackle specifically this issue. The Working Group developed a four-stage strategy to identify knowledge gaps, build regional consensus on shared priorities, generate evidence and change practice to optimize malaria elimination activities. This case study describes the issues faced and the solutions found in developing this robust strategic partnership between national programmes and research partners within the Working Group. The success of the approach adopted by the group may facilitate similar applications in other regions seeking to deploy evidence-based policy and practice.

Research paper thumbnail of Bacteriology of Chronic Dacryocystitis

BACTERIOLOGY OF CHRONIC DACRYOCYSTITIS This book was mainly focussed on the research findings of ... more BACTERIOLOGY OF CHRONIC DACRYOCYSTITIS This book was mainly focussed on the research findings of dacryocystitis, infection and inflammation of lacrimal sac caused by bacteria. The major bacterium causing dacryocystis from our research were coagulase negative staphylococci followed by Staphylococcus aureus, Streptococcus pneumoniae, Viridans streptococci respectively.The findings of research will be useful for clinician for treatment of infection and scientists for further study.. Mr.Rijal has involved in teaching microbiology for M.Sc students in Tribhuvan University and other academic institution. He has published more than two dozens research article in National and International Journals.

Research paper thumbnail of Comparison of Proportion and Resistance Ratio Methods for Drug Susceptibility Testing of <i>Mycobacterium tuberculosis</i> Isolated from Patients Attending National Tuberculosis Centre, Nepal

SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS, 2010

Background: Tuberculosis (TB) is among the most serious infectious cause of global morbidity and ... more Background: Tuberculosis (TB) is among the most serious infectious cause of global morbidity and mortality. Emergence of Multi-drug resistant tuberculosis (MDR-TB) is posing an increased threat to TB control programs. Drug susceptibility testing (DST) of Mycobacterium tuberculosis (M. tuberculosis) isolates is important for tackling such problems. Setting: National Tuberculosis Centre (NTC), Thimi, Bhaktapur, Nepal. Objectives: Comparative evaluation of two in vitro DST methods in determining susceptibility of M. tuberculosis isolates from patients attending NTC, to front-line anti-TB drugs: (Isoniazid-INH, Rifampicin-RFP, Streptomycin-SM, and Ethambutol-EMB). Methodology: This study was conducted from Sep 2006-Jun 2007. A total of 862 sputum samples (diagnosis or follow up cases) collected from patients (type of patients or their categories was not differentiated in this study) attending NTC bacteriology lab for sputum direct smear microscopy were analyzed using fluorescence micros...

Research paper thumbnail of Comparative evaluation of microscopy and polymerase chain reaction (PCR) for the diagnosis in suspected malaria patients of Nepal

Nepal Medical College journal : NMCJ, 2009

Microscopy has been the most common technique for the diagnosis of malaria in Nepal. This study w... more Microscopy has been the most common technique for the diagnosis of malaria in Nepal. This study was undertaken at CDM, TU, Kathmandu, and Department of Clinical Tropical Medicine, Mahidol University, Bangkok to compare the efficiency of microscopy and PCR for malaria diagnosis in Nepalese context. During July-August 2007, blood samples were collected in glass slides and on filter papers from suspected malaria cases of Kanchanpur, Jhapa and Morang Districts. Sample transportation and storage was done using standard protocol. Microscopy was done at the heath posts in the district in Nepal while Nested PCR using previously standardized primers was carried out at Mahidol University. Among 824 malaria suspected cases, 19.2% (157) were laboratory confirmed as malaria cases (P. vivax 10.9%, P. falciparium 7.7% and 0.4% were of mixed infection) by microscopy. The parasite count range was detected as 320-25020 parasites/microl. Among total 132 samples (114 microscopic positive, 18 negative) ...

Research paper thumbnail of Tuberculosis co-infection in HIV infected persons of Kathmandu

Nepal Medical College journal : NMCJ, 2008

Tuberculosis is itself a major Public health problem in Nepal and the emergence HIV further compl... more Tuberculosis is itself a major Public health problem in Nepal and the emergence HIV further complicated the issue. A cross-sectional analytical study was conducted between January 2004 and August 2005, with a general objective to determine the Tuberculosis co-infection status in HIV/AIDS cases of Nepal. Altogether 100 HIV infected persons visiting different Voluntary counseling and testing centers (VCT) and HIV/AIDS care centers located in Kathmandu valley were enrolled in the study. Investigation of tuberculosis was done by standard method prescribed by WHO using sputum specimen. Among 100 HIV infected cases, 66 (66.0%) were males and 34 (34.0%) were females. Majority of the HIV cases were in the age group 21-30 (60.0%) followed by 31-40 (31.0%). Tuberculosis was detected in 23 cases with highest prevalence in the age group 21-30 years (65.2%). No significant relationship could be established between gender and TB (c2 = 0.83, p > 0.01).Significant relationship was established be...

Research paper thumbnail of Study on CD4 cell responses in HIV infected subjects in Nepal

Nepal Medical College journal : NMCJ, 2008

HIV infection is characterized by gradual deterioration of immune function mainly the CD4 cells. ... more HIV infection is characterized by gradual deterioration of immune function mainly the CD4 cells. This study was conducted with the objectives to evaluate the kinetics of CD4 cell depletion and duration of HIV infection and the role of ART in improving CD4 cell levels specifically in Nepalese HIV patients. During April 2005 to March 2006, all together 220 blood samples collected from 110 HIV patients visiting National Public Health Laboratory (NPHL), Kathmandu, were analyzed for CD4 cell count using standard protocol. CD4 cell count before and after starting of anti-retro viral therapy showed significant association (P<0.05). The results of this study clearly indicated that antiretroviral therapy has been playing a role in maintenance CD4 cell counts in HIV infected patients.

Research paper thumbnail of Tuberculosis and other clinical presentation of HIV/AIDS in patients with or without undergoing antiretroviral therapy in Kathmandu

Kathmandu University medical journal (KUMJ)

To screen tuberculosis (TB) and examine the clinical presentation of AIDS in HIV sero-positive pe... more To screen tuberculosis (TB) and examine the clinical presentation of AIDS in HIV sero-positive persons. A Cross-sectional study was designed. One hundred HIV infected persons were randomly selected from different parts of the country visiting Tribhuvan University, Teaching Hospital, Kathmandu and different HIV/AIDS care centres. After taking informed consent, questionnaires were filled and three sputum specimens from each person were collected to investigate tuberculosis by Ziehl-Neelsen staining and culture. Data generated were entered into SPSS 11.5 and relevant statistical tools were applied. Among 100 HIV infected cases, 66 (66%) were males and 34 (34%) were females. Sixty percent of the cases were in the age group of 21-30 years. Majority of them were Smokers (41%), alcoholics (34%), illiterates (54%) and unemployed (59%). Heterosexual activity (51%) was found to be the major risk factor for HIV infection. Of the 100 HIV cases, 23 (23%) were co-infected with tuberculosis of whi...

Research paper thumbnail of Prevalence of HIV in Blood Donors

Journal of Nepal Health Research Council, 2009

Background: Nepal is categorized as a country with ‘concentrated' epidemic of HIV Nepal Red C... more Background: Nepal is categorized as a country with ‘concentrated' epidemic of HIV Nepal Red Cross Society, Blood Transfusion Service has implemented considerable efforts to supply the safe blood and blood products according to the increasing demand. A trend analysis might prove valuable to understand the outcome and appropriately plan for further improvements in providing safe blood supply. The study aimed to assess the trends of HIV seroprevalence over the six years in nationwide and in urbanized setting of Kathmandu Valley.Methods: This is a retrospective study conducted among Nepalese blood donors through the years 2001-2007. Serum samples were tested using third generation ELISA tests, strictly following the instructions of manufacturers. The donors' information was collected through the donor record register through the respective Blood Transfusion Services.Results: The overall seroprevalence of HIV among the total blood donors in nation wide and in Central Blood Trans...

Research paper thumbnail of Seroprevalence of HIV and hepatitis C co-infection among blood donors in Kathmandu Valley, Nepal

The Southeast Asian journal of tropical medicine and public health, 2009

We assessed the seroprevalence of human immunodeficiency virus (HIV) in different categories of b... more We assessed the seroprevalence of human immunodeficiency virus (HIV) in different categories of blood donors and the hepatitis C virus (HCV) co-infection rate. A total of 33,255 blood samples were screened for HIV using a third generation ELISA test at the Central Blood Transfusion Service, Nepal Red Cross Society, Kathmandu from December 2006 to September 2007. The seroprevalence of HIV was 0.19% (95% CI= 0.15-0.25) and co-infection with HCV was found in 10.8% (95% CI= 4.4-20.9). There were no significant differences in HIV seroprevalence among the different categories of age, sex, type of donation and time of donation. The study revealed a relatively lower seroprevalence of HIV among blood donors in Kathmandu Valley than reported earlier but a higher HCV co-infection rate. The similar seroprevalence between first time and repeat donors suggests the need for more improved donor education and counselling.

Research paper thumbnail of Transfusion-transmissible infections among blood donors in Kathmandu, Nepal

The Journal of Infection in Developing Countries, 2009

Background: Screening of transfusion-transmissible infections (TTIs) among blood donors can be a ... more Background: Screening of transfusion-transmissible infections (TTIs) among blood donors can be a cost-effective approach to monitor the prevalence, distribution, and trends of the infections among healthy-looking individuals. The study aimed to determine the seroprevalence of four TTIs, human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis, among blood donors in Kathmandu, Nepal. Methodology: A total of 21,716 units of blood were tested for the presence of anti-HIV 1/2 IgG/IgM, HBsAg, anti-HCV IgG/IgM, and anti-Treponema pallidum IgG/IgM/IgA using commercial ELISA kits following standard protocols. Statistical analysis was performed using WinPepi Ver 3.8. Results: Seroprevalence of HIV, HBV (HBsAg), HCV and syphilis were observed to be 0.12% (95% CI = 0.08-0.18), 0.47% (95% CI = 0.39-0.57), 0.64% (95% CI = 0.54-0.75) and 0.48% (95% CI = 0.40-0.59) respectively. TTIs were dominant among male blood donors compared to female blood donors. Hig...

Research paper thumbnail of Prevalence and factors associated with hypertension and obesity among civil servants in Kaduna, Kaduna State, June 2012

Pan African Medical Journal, 2014

Introduction: Non-communicable diseases (NCDs) are a leading cause of adult mortality globally, a... more Introduction: Non-communicable diseases (NCDs) are a leading cause of adult mortality globally, accounting for 63% of all deaths in 2008 with nearly 80% of those deaths occurring in developing countries. These NCDs which include hypertension and obesity alongside their complications accounted for 27% of all deaths in Nigeria, in 2008. We conducted a study among Kaduna State civil servants to determine the prevalence of hypertension, overweight/obesity and also to identify associated behavioural factors. Methods: A cross-sectional design, with multi-stage cluster sampling technique was used. A structured questionnaire was used in gathering data on socio-demographics, physical activity, dietary habit, tobacco, and alcohol consumption. Blood pressure, body weight and height were measured, and body mass index (BMI) calculated. Descriptive statistics and logistic regression were used in identifying associations between these behavioural factors and hypertension/overweight/obesity. Results: A total of 801 civil servants, mean age 43±9 years were interviewed, of which 62% were male. Prevalence of hypertension, overweight and obesity were 29%, 35% and 27% respectively. Physical inactivity was the most prevalent behavioural factor, 91%, followed by unhealthy diet 90%, and cigarette smoking 6%. Prevalence of overweight/obesity was higher among the senior cadre than the junior cadre (69% versus 54%, p<0.01). Increasing age was an independent predictor of hypertension. Female respondents were four times more likely to be overweight/obese than males (AOR=3.7, 95%CI 2.5-5.4). Conclusion: Hypertension and overweight/obesity with their behavioural risks are prevalent among civil servants in Kaduna. Age and genderspecific public health strategies to promote healthy-living in the workplace are being advocated for with concerned authorities.

Research paper thumbnail of Hepatitis B and Malaria Among Nepalese Blood Donors

Scientific World, 1970

Viral hepatitis and malaria, both are the diseases with noticeable disease burden in Nepal. Malar... more Viral hepatitis and malaria, both are the diseases with noticeable disease burden in Nepal. Malaria is seasonal with high disease burden during post rainy season. Severe malaria also shows similar symptoms to viral hepatitis. This is collaborative study has been conducted during June - September 2006 with the objective of determining the prevalence of hepatitis B and malaria in Nepalese blood donors to find out the need of routine malaria testing in each pint of donated blood. During the study period, screening of malaria and hepatitis B surface antigen (HBsAg) were done in 1200 blood samples collected from blood donors at Kathmandu, Nepalgunj and Biratnagar Blood Banks. Malaria diagnosis was done using one drop of blood from each unit of blood using Giemsa stained thick and thin smear microscopy, while hepatitis B surface antigen (HBsAg) was detected using commercial ELISA. Of the total 1200 blood samples analyzed, 600 were collected at Kathmandu and 300 each at Nepalgunj and Birat...

Research paper thumbnail of Opportunistic Respiratory Infections in HIV Patients Attending Sukraraj Tropical and Infectious Diseases Hospital in Kathmandu, Nepal

HIV/AIDS - Research and Palliative Care, 2019

Introduction: Opportunistic bacterial and fungal infections are the major cause of morbidity and ... more Introduction: Opportunistic bacterial and fungal infections are the major cause of morbidity and mortality among immune suppressed HIV-positive patients. The main objective of this study was to determine bacterial and fungal organisms causing respiratory infections and their susceptibility to commonly prescribed antimicrobials among HIV patients attending a tertiary infectious disease hospital in Kathmandu. Methods: Sputum samples were collected from the HIV-positive patients attending Sukraraj Tropical and Infectious Disease Hospital (STIDH) from August 2017 to March 2018. A total of 100 sputum samples were cultured on conventional bacterial and fungal culture media. Bacterial and fungal isolates were identified based on their colony characteristics, microscopic morphology and various biochemical tests. Antibiotic susceptibility test (AST) of bacterial isolates was performed by modified Kirby Bauer disc diffusion method. Results: Out of 100 sputum samples cultured, 24% (n=24) showed bacterial growth, 42% (n=42) showed fungal growth and 10% (n=10) had both bacterial and fungal growth. Among bacteria, 91.6% (n=22) were monomicrobial and 8.4% (n=2) were polymicrobial in growth, of which, Klebsiella pneumoniae (37.5%) were predominant isolates, followed by Pseudomonas aeruginosa (29.2%), and Escherichia coli (16.7%). The antibiotic susceptibility test (AST) showed 68% (17/25) of bacterial isolates were multi-drug resistant (MDR) and among them 41.2% (7/17) were found to be extended spectrum β lactamase (ESBL) producers. Fungal growth was observed in 42% of samples (42/100). A total of six different species of Candida and four different genera of molds were identified. On species differentiation, Candida albicans (20%) were followed by Candida parapsilosis (4%), and Candida dubliniensis (3%); and various molds were Aspergillus fumigatus (4%), Aspergillus flavus (2%), and Penicillium species (5%). CD4 count was inversely associated with bacterial and fungal infections. Fifty percent of the patients with the fungal infections had a CD4 count below 200. No fungal organisms were isolated from HIV-positive patients under antifungal drug treatment. Conclusion: HIV-positive patients with a CD4 count less than 200 cells/µL are more vulnerable to opportunistic infections of bacterial and fungal origin. Early isolation, identification and appropriate treatment can reduce mortality due to co-infections. Routine screening of opportunistic pathogens is critical to contain the disease progression.

Research paper thumbnail of Characterization of Mycobacteria in HIV/AIDS Patients of Nepal

Journal of Nepal Medical Association, 2008

Besides Mycobacterium tuberculosis, a number of other Mycobacterium species are also occasionalhu... more Besides Mycobacterium tuberculosis, a number of other Mycobacterium species are also occasionalhuman pathogens. Tuberculosis due to Mycobacterium avium complex (MAC) and Mycobacteriumkansasii is particularly prevalent in AIDS patients as compared to the normal population. A crosssectionalstudy was carried out during January 2004 to August 2005 in 100 HIV-infected personsvisiting Tribhuvan University, Teaching Hospital, and about a dozen of HIV/AIDS care centersof Kathmandu with the objectives to characterize the different mycobacterial species in HIV/AIDSpatients. Three sputum specimens from each person were used to investigate tuberculosis by Ziehl-Neelsen staining, culture and identifi cation tests. Among the 100 HIV-infected cases, 66 (66%) weremales and 34 (34%) were females. Sixty percent of the cases were in the age group of 21-30 years.Mycobacteria were detected in 23 (23%) HIV cases of which 15 (65.2%) were in the age group of 21-30years ; 17(74%) were males and 6 (26 %) wer...

Research paper thumbnail of Micro-stratification of malaria risk in Nepal: implications for malaria control and elimination

Tropical Medicine and Health, 2019

Background: A significant reduction in malaria cases over the recent years in Nepal has encourage... more Background: A significant reduction in malaria cases over the recent years in Nepal has encouraged the government to adopt a goal of "malaria-free nation by 2025." Nevertheless, to achieve this goal, it is critical to identify the epidemiological burden of malaria by specific regions and areas for an effective targeted intervention. The main objective of this study was to estimate the risk of malaria at Village Development Committee (VDC) level in Nepal based on disease, vector, parasite, and geography. Methods: In 2012, the micro-stratification of malaria risk was carried out in 75 districts of Nepal. Instruments such as a questionnaire, case record forms, and guidelines for malaria micro-stratification were developed and pre-tested for necessary adaptations. Village Development Committee (VDC)-wise malaria data were analyzed using exploratory statistics and were stratified by geographical variables that contributed to the risk of malaria. To understand the transmission risk at VDC level, overlay analysis was done using ArcGIS 10. To ensure transparent, reproducible, and comprehensible risk assessment, standard scoring method was selected and utilized for data from 2009 to 2011. Thus identified, three major variables (key determinants) were given weights (wt.) accordingly to stratification of the malaria risk (disease burden, "0.3" wt.; ecology/vector transmission, "0.5" wt.; and vulnerability-population movement, "0.2" wt.). Malaria risk in a VDC was determined based on the overall scores and classified into four categories: no risk, low risk, moderate risk, and high risk. Results: Analyzing the overall risk based on scoring of the total VDCs (n = 3976), 54 (1.36%), 201 (5.06%), 999 (25.13%), and 2718 (68.36%) were identified as high-, moderate-, low-, and no-risk categories for malaria, respectively. Based on the population statistics, 3.62%, 9.79%, 34.52%, and 52.05% of the country's total population live in high-risk, moderaterisk, low-risk, and no-risk VDCs for malaria, respectively. Our micro-stratification study estimates are 100,000 population at high risk. Regional distribution showed that the majority of the high-risk VDCs were identified in the Far-and Midwestern regions (19 and 18 VDCs) followed by Central and Western regions (10 and 7 VDCs) with no high-risk VDCs in the Eastern region. Similarly, 77, 59, 27, 24, and 14 VDCs of the Central, Mid-western, Western, Eastern, and Far-western regions, respectively, were found under moderate malaria risk. Of the low-risk VDCs, 353, 215, 191, 148, and 92 were respectively from the Central, Eastern, Western, Far-western, and Mid-western regions.

Research paper thumbnail of Trends in hepatitis B and hepatitis C seroprevalence among blood donors - Haiti, 2005-2014

ISBT Science Series, 2018

Background and Objectives-Data on the seroprevalence of viral hepatitis are limited in Haiti; con... more Background and Objectives-Data on the seroprevalence of viral hepatitis are limited in Haiti; consequently, the epidemiology is poorly described. This study aims to provide a descriptive analysis of hepatitis B virus (HBV) and hepatitis C virus (HCV) seroprevalence of blood donations in Haiti. Materials and Methods-Using Haiti's National Blood Safety Program and Haitian Red Cross reports from 2005 to 2014, we analysed the results of screening tests of donor serum samples to assess HBV and HCV seroprevalence among adults aged 17 to 65 years. Results-A total of 198 758 donor samples were screened from 2005 to 2014, of which 0•56% were positive for antibody to hepatitis C virus (anti-HCV) and 3•80% were positive for hepatitis B surface antigen. Over the 10-year study period, anti-HCV seroprevalence among blood donors increased by 31% from 0.66% to 0.86% (95% CI: 1•01-1•70); however, this trend was not uniform over time, with a significant decrease from 0•66% in 2005 to 0•39% in 2009 (95% CI: 0•43-0•82) and 0•43% in 2012 (95% CI: 0•50-0•90). Conversely, HBV decreased significantly by 13% from 3•95% in 2005 to 3•42% in 2014 (95% CI: 0•77-0•97), a trend that was also observed in 2012 and 2013. Conclusion-The significant, uniform decrease in HBV seroprevalence in more recent years may represent the positive impact of public health interventions in preventing the transmission of blood-borne infections. More research is needed to understand why the trends in HCV transmission are non-uniform and to investigate the significant increase in more recent years.

Research paper thumbnail of Endemic Japanese Encephalitis in the Kathmandu Valley, Nepal

The American Journal of Tropical Medicine and Hygiene, 2007

Japanese encephalitis (JE) is endemic in the Terai region of Nepal. There is little information o... more Japanese encephalitis (JE) is endemic in the Terai region of Nepal. There is little information on the occurrence of JE outside the Terai and particularly in the densely populated Kathmandu valley. Acute encephalitis syndrome (AES) cases were detected using a sentinel surveillance system that has been functioning since 2004. JE was confirmed using anti-JE IgM ELISA. All laboratory-confirmed JE cases that occurred in the Kathmandu valley during 2006 were followed up for verification of residence and travel history. JE was confirmed in 40 residents of the Kathmandu valley, including 30 cases that had no history of travel outside the valley during the incubation period. Incidence was 2.1/100,000 and the case fatality was 20% (8/40). Currently, JE prevention is focused on the Terai region in Nepal; given the evidence, this should be reviewed for the possible inclusion of the Kathmandu valley in the national JE prevention and control program.

Research paper thumbnail of Laboratory-based Japanese Encephalitis Surveillance in Nepal and the Implications for a National Immunization Strategy

The American Journal of Tropical Medicine and Hygiene, 2008

We report on two years of Japanese encephalitis (JE) surveillance in Nepal and the implications f... more We report on two years of Japanese encephalitis (JE) surveillance in Nepal and the implications for a national immunization strategy. From May 2004 to April 2006, 4,652 patients with encephalitis were evaluated. A serum or cerebrospinal fluid specimen was collected from 3198 (69%) patients of which 1,035 (32%) were positive by Japanese encephalitis IgM ELISA. Most cases (N ‫ס‬ 951, 92%) were from the 24 Terai districts (i.e., southern plains, 12.3 million persons) with the majority (N ‫ס‬ 616, 65%) from four western Terai districts (population ‫ס‬ 1.8 million). The case fatality ratio was 14.7% and 6.3% and the proportion of cases under 15 years old was 52% and 62% in the four western and 20 non-western Terai districts, respectively. Japanese encephalitis immunization targeting residents one year of age and older in the western districts and one through 14 years old in the non-western Terai districts may have reduced Japanese encephalitis cases by 84% and deaths by 92%, nationally.

Research paper thumbnail of {"__content__"=>"Epidemiology of Malaria Infection in Nepal.", "i"=>{"__content__"=>"Plasmodium vivax"}}

The American journal of tropical medicine and hygiene, Jan 16, 2018

Malaria is endemic in the southern plain of Nepal which shares a porous border with India. More t... more Malaria is endemic in the southern plain of Nepal which shares a porous border with India. More than 80% cases of malaria in Nepal are caused by . The main objective of this study was to review the epidemiology of malaria infections as recorded by the national malaria control program of Nepal between 1963 and 2016. National malaria data were retrieved from the National Malaria program in the Ministry of Health, Government of Nepal. The epidemiological trends and malariometric indicators were analyzed. Vivax malaria has predominated over falciparum malaria in the past 53 years, with malaria comprising 70-95% of the annual malaria infections. In 1985, a malaria epidemic occurred with 42,321 cases (82% and 17% ). Nepal had experienced further outbreaks of malaria in 1991 and 2002. cases increased from 2005 to 2010 but since then declined. Analyzing the overall trend between 2002 (12,786 cases) until 2016 (1,009 cases) shows a case reduction by 92%. The proportion of imported malaria ca...

Research paper thumbnail of Quantifying primaquine effectiveness and improving adherence: a round table discussion of the APMEN Vivax Working Group

Malaria journal, Jan 20, 2018

The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread ... more The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness i...

Research paper thumbnail of Targeting vivax malaria in the Asia Pacific: The Asia Pacific Malaria Elimination Network Vivax Working Group

Malaria Journal, 2015

The Asia Pacific Malaria Elimination Network (APMEN) is a collaboration of 18 country partners co... more The Asia Pacific Malaria Elimination Network (APMEN) is a collaboration of 18 country partners committed to eliminating malaria from within their borders. Over the past 5 years, APMEN has helped to build the knowledge, tools and in-country technical expertise required to attain this goal. At its inaugural meeting in Brisbane in 2009, Plasmodium vivax infections were identified across the region as a common threat to this ambitious programme; the APMEN Vivax Working Group was established to tackle specifically this issue. The Working Group developed a four-stage strategy to identify knowledge gaps, build regional consensus on shared priorities, generate evidence and change practice to optimize malaria elimination activities. This case study describes the issues faced and the solutions found in developing this robust strategic partnership between national programmes and research partners within the Working Group. The success of the approach adopted by the group may facilitate similar applications in other regions seeking to deploy evidence-based policy and practice.

Research paper thumbnail of Bacteriology of Chronic Dacryocystitis

BACTERIOLOGY OF CHRONIC DACRYOCYSTITIS This book was mainly focussed on the research findings of ... more BACTERIOLOGY OF CHRONIC DACRYOCYSTITIS This book was mainly focussed on the research findings of dacryocystitis, infection and inflammation of lacrimal sac caused by bacteria. The major bacterium causing dacryocystis from our research were coagulase negative staphylococci followed by Staphylococcus aureus, Streptococcus pneumoniae, Viridans streptococci respectively.The findings of research will be useful for clinician for treatment of infection and scientists for further study.. Mr.Rijal has involved in teaching microbiology for M.Sc students in Tribhuvan University and other academic institution. He has published more than two dozens research article in National and International Journals.

Research paper thumbnail of Comparison of Proportion and Resistance Ratio Methods for Drug Susceptibility Testing of <i>Mycobacterium tuberculosis</i> Isolated from Patients Attending National Tuberculosis Centre, Nepal

SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS, 2010

Background: Tuberculosis (TB) is among the most serious infectious cause of global morbidity and ... more Background: Tuberculosis (TB) is among the most serious infectious cause of global morbidity and mortality. Emergence of Multi-drug resistant tuberculosis (MDR-TB) is posing an increased threat to TB control programs. Drug susceptibility testing (DST) of Mycobacterium tuberculosis (M. tuberculosis) isolates is important for tackling such problems. Setting: National Tuberculosis Centre (NTC), Thimi, Bhaktapur, Nepal. Objectives: Comparative evaluation of two in vitro DST methods in determining susceptibility of M. tuberculosis isolates from patients attending NTC, to front-line anti-TB drugs: (Isoniazid-INH, Rifampicin-RFP, Streptomycin-SM, and Ethambutol-EMB). Methodology: This study was conducted from Sep 2006-Jun 2007. A total of 862 sputum samples (diagnosis or follow up cases) collected from patients (type of patients or their categories was not differentiated in this study) attending NTC bacteriology lab for sputum direct smear microscopy were analyzed using fluorescence micros...

Research paper thumbnail of Comparative evaluation of microscopy and polymerase chain reaction (PCR) for the diagnosis in suspected malaria patients of Nepal

Nepal Medical College journal : NMCJ, 2009

Microscopy has been the most common technique for the diagnosis of malaria in Nepal. This study w... more Microscopy has been the most common technique for the diagnosis of malaria in Nepal. This study was undertaken at CDM, TU, Kathmandu, and Department of Clinical Tropical Medicine, Mahidol University, Bangkok to compare the efficiency of microscopy and PCR for malaria diagnosis in Nepalese context. During July-August 2007, blood samples were collected in glass slides and on filter papers from suspected malaria cases of Kanchanpur, Jhapa and Morang Districts. Sample transportation and storage was done using standard protocol. Microscopy was done at the heath posts in the district in Nepal while Nested PCR using previously standardized primers was carried out at Mahidol University. Among 824 malaria suspected cases, 19.2% (157) were laboratory confirmed as malaria cases (P. vivax 10.9%, P. falciparium 7.7% and 0.4% were of mixed infection) by microscopy. The parasite count range was detected as 320-25020 parasites/microl. Among total 132 samples (114 microscopic positive, 18 negative) ...

Research paper thumbnail of Tuberculosis co-infection in HIV infected persons of Kathmandu

Nepal Medical College journal : NMCJ, 2008

Tuberculosis is itself a major Public health problem in Nepal and the emergence HIV further compl... more Tuberculosis is itself a major Public health problem in Nepal and the emergence HIV further complicated the issue. A cross-sectional analytical study was conducted between January 2004 and August 2005, with a general objective to determine the Tuberculosis co-infection status in HIV/AIDS cases of Nepal. Altogether 100 HIV infected persons visiting different Voluntary counseling and testing centers (VCT) and HIV/AIDS care centers located in Kathmandu valley were enrolled in the study. Investigation of tuberculosis was done by standard method prescribed by WHO using sputum specimen. Among 100 HIV infected cases, 66 (66.0%) were males and 34 (34.0%) were females. Majority of the HIV cases were in the age group 21-30 (60.0%) followed by 31-40 (31.0%). Tuberculosis was detected in 23 cases with highest prevalence in the age group 21-30 years (65.2%). No significant relationship could be established between gender and TB (c2 = 0.83, p > 0.01).Significant relationship was established be...

Research paper thumbnail of Study on CD4 cell responses in HIV infected subjects in Nepal

Nepal Medical College journal : NMCJ, 2008

HIV infection is characterized by gradual deterioration of immune function mainly the CD4 cells. ... more HIV infection is characterized by gradual deterioration of immune function mainly the CD4 cells. This study was conducted with the objectives to evaluate the kinetics of CD4 cell depletion and duration of HIV infection and the role of ART in improving CD4 cell levels specifically in Nepalese HIV patients. During April 2005 to March 2006, all together 220 blood samples collected from 110 HIV patients visiting National Public Health Laboratory (NPHL), Kathmandu, were analyzed for CD4 cell count using standard protocol. CD4 cell count before and after starting of anti-retro viral therapy showed significant association (P<0.05). The results of this study clearly indicated that antiretroviral therapy has been playing a role in maintenance CD4 cell counts in HIV infected patients.

Research paper thumbnail of Tuberculosis and other clinical presentation of HIV/AIDS in patients with or without undergoing antiretroviral therapy in Kathmandu

Kathmandu University medical journal (KUMJ)

To screen tuberculosis (TB) and examine the clinical presentation of AIDS in HIV sero-positive pe... more To screen tuberculosis (TB) and examine the clinical presentation of AIDS in HIV sero-positive persons. A Cross-sectional study was designed. One hundred HIV infected persons were randomly selected from different parts of the country visiting Tribhuvan University, Teaching Hospital, Kathmandu and different HIV/AIDS care centres. After taking informed consent, questionnaires were filled and three sputum specimens from each person were collected to investigate tuberculosis by Ziehl-Neelsen staining and culture. Data generated were entered into SPSS 11.5 and relevant statistical tools were applied. Among 100 HIV infected cases, 66 (66%) were males and 34 (34%) were females. Sixty percent of the cases were in the age group of 21-30 years. Majority of them were Smokers (41%), alcoholics (34%), illiterates (54%) and unemployed (59%). Heterosexual activity (51%) was found to be the major risk factor for HIV infection. Of the 100 HIV cases, 23 (23%) were co-infected with tuberculosis of whi...

Research paper thumbnail of Prevalence of HIV in Blood Donors

Journal of Nepal Health Research Council, 2009

Background: Nepal is categorized as a country with ‘concentrated' epidemic of HIV Nepal Red C... more Background: Nepal is categorized as a country with ‘concentrated' epidemic of HIV Nepal Red Cross Society, Blood Transfusion Service has implemented considerable efforts to supply the safe blood and blood products according to the increasing demand. A trend analysis might prove valuable to understand the outcome and appropriately plan for further improvements in providing safe blood supply. The study aimed to assess the trends of HIV seroprevalence over the six years in nationwide and in urbanized setting of Kathmandu Valley.Methods: This is a retrospective study conducted among Nepalese blood donors through the years 2001-2007. Serum samples were tested using third generation ELISA tests, strictly following the instructions of manufacturers. The donors' information was collected through the donor record register through the respective Blood Transfusion Services.Results: The overall seroprevalence of HIV among the total blood donors in nation wide and in Central Blood Trans...

Research paper thumbnail of Seroprevalence of HIV and hepatitis C co-infection among blood donors in Kathmandu Valley, Nepal

The Southeast Asian journal of tropical medicine and public health, 2009

We assessed the seroprevalence of human immunodeficiency virus (HIV) in different categories of b... more We assessed the seroprevalence of human immunodeficiency virus (HIV) in different categories of blood donors and the hepatitis C virus (HCV) co-infection rate. A total of 33,255 blood samples were screened for HIV using a third generation ELISA test at the Central Blood Transfusion Service, Nepal Red Cross Society, Kathmandu from December 2006 to September 2007. The seroprevalence of HIV was 0.19% (95% CI= 0.15-0.25) and co-infection with HCV was found in 10.8% (95% CI= 4.4-20.9). There were no significant differences in HIV seroprevalence among the different categories of age, sex, type of donation and time of donation. The study revealed a relatively lower seroprevalence of HIV among blood donors in Kathmandu Valley than reported earlier but a higher HCV co-infection rate. The similar seroprevalence between first time and repeat donors suggests the need for more improved donor education and counselling.

Research paper thumbnail of Transfusion-transmissible infections among blood donors in Kathmandu, Nepal

The Journal of Infection in Developing Countries, 2009

Background: Screening of transfusion-transmissible infections (TTIs) among blood donors can be a ... more Background: Screening of transfusion-transmissible infections (TTIs) among blood donors can be a cost-effective approach to monitor the prevalence, distribution, and trends of the infections among healthy-looking individuals. The study aimed to determine the seroprevalence of four TTIs, human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis, among blood donors in Kathmandu, Nepal. Methodology: A total of 21,716 units of blood were tested for the presence of anti-HIV 1/2 IgG/IgM, HBsAg, anti-HCV IgG/IgM, and anti-Treponema pallidum IgG/IgM/IgA using commercial ELISA kits following standard protocols. Statistical analysis was performed using WinPepi Ver 3.8. Results: Seroprevalence of HIV, HBV (HBsAg), HCV and syphilis were observed to be 0.12% (95% CI = 0.08-0.18), 0.47% (95% CI = 0.39-0.57), 0.64% (95% CI = 0.54-0.75) and 0.48% (95% CI = 0.40-0.59) respectively. TTIs were dominant among male blood donors compared to female blood donors. Hig...

Research paper thumbnail of Prevalence and factors associated with hypertension and obesity among civil servants in Kaduna, Kaduna State, June 2012

Pan African Medical Journal, 2014

Introduction: Non-communicable diseases (NCDs) are a leading cause of adult mortality globally, a... more Introduction: Non-communicable diseases (NCDs) are a leading cause of adult mortality globally, accounting for 63% of all deaths in 2008 with nearly 80% of those deaths occurring in developing countries. These NCDs which include hypertension and obesity alongside their complications accounted for 27% of all deaths in Nigeria, in 2008. We conducted a study among Kaduna State civil servants to determine the prevalence of hypertension, overweight/obesity and also to identify associated behavioural factors. Methods: A cross-sectional design, with multi-stage cluster sampling technique was used. A structured questionnaire was used in gathering data on socio-demographics, physical activity, dietary habit, tobacco, and alcohol consumption. Blood pressure, body weight and height were measured, and body mass index (BMI) calculated. Descriptive statistics and logistic regression were used in identifying associations between these behavioural factors and hypertension/overweight/obesity. Results: A total of 801 civil servants, mean age 43±9 years were interviewed, of which 62% were male. Prevalence of hypertension, overweight and obesity were 29%, 35% and 27% respectively. Physical inactivity was the most prevalent behavioural factor, 91%, followed by unhealthy diet 90%, and cigarette smoking 6%. Prevalence of overweight/obesity was higher among the senior cadre than the junior cadre (69% versus 54%, p<0.01). Increasing age was an independent predictor of hypertension. Female respondents were four times more likely to be overweight/obese than males (AOR=3.7, 95%CI 2.5-5.4). Conclusion: Hypertension and overweight/obesity with their behavioural risks are prevalent among civil servants in Kaduna. Age and genderspecific public health strategies to promote healthy-living in the workplace are being advocated for with concerned authorities.

Research paper thumbnail of Hepatitis B and Malaria Among Nepalese Blood Donors

Scientific World, 1970

Viral hepatitis and malaria, both are the diseases with noticeable disease burden in Nepal. Malar... more Viral hepatitis and malaria, both are the diseases with noticeable disease burden in Nepal. Malaria is seasonal with high disease burden during post rainy season. Severe malaria also shows similar symptoms to viral hepatitis. This is collaborative study has been conducted during June - September 2006 with the objective of determining the prevalence of hepatitis B and malaria in Nepalese blood donors to find out the need of routine malaria testing in each pint of donated blood. During the study period, screening of malaria and hepatitis B surface antigen (HBsAg) were done in 1200 blood samples collected from blood donors at Kathmandu, Nepalgunj and Biratnagar Blood Banks. Malaria diagnosis was done using one drop of blood from each unit of blood using Giemsa stained thick and thin smear microscopy, while hepatitis B surface antigen (HBsAg) was detected using commercial ELISA. Of the total 1200 blood samples analyzed, 600 were collected at Kathmandu and 300 each at Nepalgunj and Birat...