Papers by Prakash Ghimire
The American journal of tropical medicine and hygiene, 2013
We report on the changing epidemiology of two important flaviviruses in Nepal: Japanese encephali... more We report on the changing epidemiology of two important flaviviruses in Nepal: Japanese encephalitis (JE) and dengue viruses. Morbidity and mortality in Nepal is in the thousands since JE was introduced in 1978. Nepal launched an extensive laboratory-based JE surveillance in 2004. Nepal experienced a remarkable reduction in disease burden after mass immunizations from 2005 to 2010, when 2,040 JE infections and 205 JE-related deaths were confirmed. With its emergence in 2006, dengue has become a significant challenge in the country, highlighted by a sudden outbreak in 2010 that resulted in 359 confirmed dengue infections. Currently, both viruses cocirculate in Nepal. Here, we document the remarkable expansion of dengue in Nepal, which urgently requires national surveillance to refine the burden and make recommendations regarding control and prevention programs. We believe that the use of existing JE surveillance network for integrated dengue surveillance may represent the most appropriate alternative.
Renewable Energy, 2013
a b s t r a c t SNV 1 is supporting the implementation of market-based domestic biogas programmes... more a b s t r a c t SNV 1 is supporting the implementation of market-based domestic biogas programmes in different countries in Asia and Africa with a view to establish a commercially viable biogas sector. Till the end of 2009, some 300,000 fixed-dome biogas plants of sizes ranging from 4 m 3 to 15 m 3 have been installed. These plants produce about 600,000 m 3 of biogas each day which supplements more than 3000 tonnes of fuel wood. Benefits of biogas plants have positive impacts on basic livelihood indicators as well as rural economic development. The key to success has been the multi-stakeholder sector development approach in optimising organisational and institutional capacities within national contexts. This paper highlights approaches, achievements, lessons learnt and other relevant aspects of domestic biogas programmes in developing countries.
International Journal of Applied Sciences and Biotechnology, 2015
International Journal of Biomedical and Advance Research, 2013
J Biol. Sci., 23: 44, 2004
Antibacterial activity of actinomycetes isolated from Lobuche area (5000-5300 meter in height) an... more Antibacterial activity of actinomycetes isolated from Lobuche area (5000-5300 meter in height) and Lukla area (2660 meter in height) in Khumbu region has been studied. A total of 106 actinomycetes were subjected to primary screening by perpendicular streak method ...
The Southeast Asian Journal of Tropical Medicine and Public Health, Feb 1, 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.
The Journal of Tropical Medicine and Parasitology, 2004
ne hundred and forty-eight stool specimens were collected from 75 confirmed cases of HIV/ AIDS. T... more ne hundred and forty-eight stool specimens were collected from 75 confirmed cases of HIV/ AIDS. To assess the prevalence of cryptosporidiosis in patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) the specimens were analyzed using Kinyoun-modified acid fast staining. Cryptosporidiosis was found in 10.7% of the total 75 cases studied. Out of 75 cases, 30.7% (23) suffered from diarrhea, of which Cryptosporidium parvum accounted for 34.8% (8) cases. Four out of 62 (6.5%) HIV-seropositive patients and four out of 13 (30.8%) AIDS patients were found infected with C. parvum. All infected cases were clinically diarrhoegenic. In AIDS patients, all four infections were accompanied by chronic watery diarrhea and wasting. Among the total 75 cases studied, 13 were full-blown AIDS and 62 HIV-seropositive cases. In conclusion, C. parvum is probably the most prevalent parasitic pathogen found in patients with diarrhea in HIV/ AIDS individuals. Routine testing of the stool specimens for cryptosporidial oocysts may be helpful in an early start to antiparasitic chemotherapy, which will ultimately play a major role in reducing morbidity due to HIV/AIDS in Nepal.
Page 1. Biogas Pilot Programme (BPP) DLF/MAF and SNV-Lao PDR Final Report on Biogas Users' S... more Page 1. Biogas Pilot Programme (BPP) DLF/MAF and SNV-Lao PDR Final Report on Biogas Users' Survey - 2007 Prepared by: Prakash C. Ghimire Asia Biogas Programme Netherlands Development Organisation (SNV) February 2007 Page 2. 2 Table of Contents ...
Japanese Journal of Infectious Diseases, Jul 1, 2008
In Nepal, hepatitis B and hepatitis C are considerable health problems. This study aimed to asses... more In Nepal, hepatitis B and hepatitis C are considerable health problems. This study aimed to assess the trends of hepatitis B virus (HBV) and hepatitis C virus (HCV) seroprevalence in blood donors over the last 6 years nationwide and in the urbanized setting of Kathmandu Valley. This was a retrospective study conducted among Nepalese blood donors through the years 2001/2002-2006/2007. Serum samples were tested for hepatitis B surface antigen and anti-HCV antibodies using third generation ELISA tests. The donors' information was collected via the donor record register through their respective Blood Transfusion Services. The software, Winpepi ver 3.8 was used for statistical analysis. The overall seroprevalence rates of HBV and HCV in a nationwide analysis were observed to be 0.82 and 0.47%, respectively, and at Central Blood Transfusion Service (CBTS), Kathmandu, the rates were 0.92 and 0.71%, respectively. The seroprevalence of HBV was significantly higher than the seroprevalence of HCV, both nationwide and at CBTS (P < 0.05). An overall significantly decreasing trend was observed in HBV and HCV seroprevalence both nationwide and at CBTS, Kathmandu, over the last 6 years (P < 0.05). Though the overall trend was significantly decreasing, the test for departure from a linear trend also showed a statistically significant result (P < 0.05).
Journal of Nepal Medical Association, 2001
The American Journal of Tropical Medicine and Hygiene, Jun 1, 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.
JNMA; journal of the Nepal Medical Association
Besides Mycobacterium tuberculosis, a number of other Mycobacterium species are also occasional h... more Besides Mycobacterium tuberculosis, a number of other Mycobacterium species are also occasional human pathogens. Tuberculosis due to Mycobacterium avium complex (MAC) and Mycobacterium kansasii is particularly prevalent in AIDS patients as compared to the normal population. A cross-sectional study was carried out during January 2004 to August 2005 in 100 HIV-infected persons visiting Tribhuvan University, Teaching Hospital, and about a dozen of HIV/AIDS care centers of Kathmandu with the objectives to characterize the different mycobacterial species in HIV/AIDS patients. Three sputum specimens from each person were used to investigate tuberculosis by Ziehl-Neelsen staining, culture and identification tests. Among the 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. Mycobacteria were detected in 23 (23%) HIV cases of which 15 (65.2%) were in the age group of 21-30 years ; 17(74%) were males and 6 (26 %) were females. Among 23 co-infected cases, 22 were culture positive for mycobacteria. Among these, the predominant one was Mycobacterium avium complex (MAC), 9 (41%), followed by M. tuberculosis, 6 (27%), M .kansasii, 4 (18%), M. fortuitum, 2 (10%) and M. chelonae 1 (4%). Significant relationship was established between smoking/alcoholism and the subsequent development of tuberculosis (chi(2)=7.24, p&lt;0.05 for smoking habit and chi(2)=4.39, p&lt;0.05 for alcoholism). Fourteen (61%) co-infected cases presented with weight loss and cough whereas diarrhea was presented only by those patients with atypical mycobacterial co-infection, which was as high as 5 (56%) in patients with MAC co-infection. This study demonstrated the predominance of atypical mycobacteria, mainly MAC, in HIV/AIDS cases and most of them were from sputum smear-negative cases.
Kathmandu University Medical Journal
Objectives: To screen tuberculosis (TB) and examine the clinical presentation of AIDS in HIV sero... more Objectives: To screen tuberculosis (TB) and examine the clinical presentation of AIDS in HIV sero-positive persons. Methods: 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. Results: 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 which 18(78%) were sputum smear negative tuberculosis, mostly developed in late stage of HIV infection. Weight loss (54%) and diarrhoea (43%) were the major clinical presentations of AIDS. Antiretro-viral therapy non-receiver were more likely to suffer with various clinical disorders/TB as compared to ARV therapy receiver but the values were statistically insignificant, χ2 values ranging from 0.003 to 2.24, p>0.05. Conclusion: Prevalence of tuberculosis was still high in HIV/AIDS patients, and specifically, sputum smear negative tuberculosis cases constituted the significant proportion, particularly in late stage of HIV infection. Weight loss and diarrhoea were found to be the major clinical presentation of AIDS. Illiterate and unemployed young adults involved in unsafe sexual practice and drug addiction were high risk of acquiring HIV infection.
The American journal of tropical medicine and hygiene
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;
ABSTRACT Prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) in a Tertiary care Chil... more ABSTRACT Prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) in a Tertiary care Children Hospital in Central Nepal S. Thapa1, P. Ghimire1, S.P. Manandhar1 and P.B. Thapa2 1 Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu Nepal 2 Kanti Childrens&#39; Hospital, Kathmandu, Nepal Nosocomial infection is a major problem in the world today. Methicillin Resistant Staphylococcus aureus (MRSA) strains shows a particular ability to spread in hospitals and is one of the greatest challenges for modern antimicrobial therapy in many countries, particularly because of the multidrug resistance. The present study was carried out with the aim to find out the prevalence of MRSA infections and their antimicrobial susceptibility pattern in pediatric patients attending a tertiary-care referral hospital located in Central Nepal. Various clinical samples collected from patients were inoculated to Mannitol Salt Agar and incubated at 37oC for 24 hours. Identification of Staphylococcus aureus was confirmed by Gram positive cocci in clusters, mannitol fermenting colonies, catalase positivity, coagulase positivity and DNase positivity. Antimicrobial susceptibility testing was also performed by Kirby-Bauer disc diffusion method. Interpretation criteria were those of the national committee for clinical laboratory standards. Of the total 210 clinical samples, S. aureus was isolated in 30.95 % (n=65) cases. Among the S. aureus isolates, 29.23 % (n=19) were found to be methicillin resistant. More than sixty eight percent isolates of MRSA were from inpatient departments while 31.57 % were from outdoor patients. All isolates of MRSA showed resistant to ampicillin and cloxacillin. More than 90 % of MRSA were found to be resistant to cotrimoxazole, while less than 50% of MRSA were resistant to tetracycline and ciprofloxacin. However, none of the MRSA strains were resistant to vancomycin. Vancomycin seems to be the only antimicrobial agent which showed 100% sensitivity and so may be used as the drug of choice for treating multidrug resistant MRSA infections. However, regular monitoring of vancomycin sensitivity should be carried out. To reduce the prevalence of MRSA, the regular surveillance of hospital acquired infection including monitoring of antimicrobial (especially vancomycin and other newer glycopeptides) susceptibility pattern of MRSA and formulation of definite antimicrobial policy may be helpful. Keywords: Central Nepal; MRSA; resistant
Antibacterial activity of actinomycetes isolated from Lobuche area (5000-5300 meter in height) an... more Antibacterial activity of actinomycetes isolated from Lobuche area (5000-5300 meter in height) and Lukla area (2660 meter in height) in Khumbu region has been studied. A total of 106 actinomycetes were subjected to primary screening by perpendicular streak method against Gram-positive (Bacillus subtilis and Staphylococcus aureus) and Gram-negative (Enterobacter aerogens, Escherichia coli, Klebsiella species, Proteus species, Pseudomonas species, Salmonell typhi and Shigella species) test bacteria. It was observed that 2 isolates were active against only Gram-negative bacteria, 8 against Gram-positive and 26 against both Gram-positive and Gram-negative bacteria. Altogether 36 putative isolates were subjected to secondary screening by agar well method to further test the capabilities of primarily screened organisms. Selected isolates (20) from the secondary screening belonged to the genera Streptomyces (10), Streptoverticillium (4), Saccharopolyspora (3), Micromonospora (2) and Actinosynema (1).
We studied predisposing factors of enteric parasitic infections in school children [n=340 (Boys: ... more We studied predisposing factors of enteric parasitic infections in school children [n=340 (Boys: 177 and Girls: 163)] in a rural area in Kathmandu Valley, Nepal. Fecal samples were examined by formal-ether concentration technique. A total of 71.2% children had parasite. Altogether nine types of parasites were recovered; Trichuris trichiura was the commonest one followed by hookworm and others. A structured questionnaire regarding various predisposing factors was used. No significant differences in the infection rate between the sexes, age groups (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 10 years, 11-14 years and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 15 years) and family sizes (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 5 and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 6) were observed (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). The positive rates were significantly low in children with the history of taking antihelminthic drugs in the past six months (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). A marginally higher positive rate was found among Dalits children compared to Tibeto-Burmans and Indo-Aryans (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05) and children from farming family (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). No difference in the infection rate was found in children having different types of toilet facility: open-field defecation, pit latrine and modern toilet at their houses (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Slightly higher positive rate was associated with drinking water from Kuwa (shallow well) compared to natural spout, piped water and Khola (river) (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Children were infected despite of their awareness regarding the safe water and geophagy.
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...
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Papers by Prakash Ghimire