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Evaluation of Nitrate Reductase Assay for Rapid Detection of Drug Resistant Tuberculosis

Open Journal of Medical Microbiology 2012年第4期2卷 138-141页

作者： Ranjit Kumar Sah Dwij Raj Bhatta Gokarna Raj Ghimire jeevan bahadur sherchand Central Department of Microbiology Tribhuvan University Kathmandu Nepal Institute of Medicine Tribhuvan University Teaching Hospital Kathmandu Nepal National Tuberculosis Center Bhaktapur Nepal

Emergence of multidrug-resistant tuberculosis (MDR-TB) urgently demands for simple, rapid and inexpensive methods of its detection for the effective treatment of drug resistant tuberculosis, particularly in low-income countries. A total of 113 clinical isolates of M. tuberculosis were tested for four first line antitubercular drugs by nitrate reductase assay (NRA) and were compared with standard proportion method to evaluate NRA efficacy. Results were available in 7 - 14 days by NRA as compared to proportion method which generally takes 4 - 6 weeks. The sensitivity and specificity of NRA were 98.1% and 100% for isoniazid, 95.1% and 98.6% for rifampicin, 91.4% and 94.9% for streptomycin, and 78.6% and 97.9% for ethambutol, respectively. Agreement between NRA and proportion method were 99.1%, 97.3%, 93.8%, 95.6% for isoniazid, rifampicin, streptomycin and ethambutol, respectively. NRA is easier, inexpensive and reliable method for susceptibility testing of Mycobacterum tuberculosis for isoniazid and rifampicin, the two most im- portant drugs for the treatment of tuberculosis. The reduction in susceptibility testing time, and higher sensitivity and specificity of NRA method is of fundamental importance in detecting MDR-TB.

关键词： Drug Susceptibility MDR-TB NRA Proportion Method

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Pattern of Acute Parasitic Diarrhea in Children Under Five Years of Age in Kathmandu, Nepal

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Open Journal of Medical Microbiology 2012年第3期2卷 95-100页

作者： Shamshul Ansari jeevan bahadur sherchand Keshab Parajuli Bharat Mani Paudyal Ram Prasad Adhikari Shovita Shrestha Shyam Kumar Mishra Rajan Kumar Dahal Sarmila Tandukar Rama Khadka Ranju Shreshta Soma Kanta Baral Bharat Mani Pokhrel Department of Microbiology Institute of Medicine Tribhuvan University Teaching Hospital (TUTH) Kathmandum Nepal Public Health Research Laboratory Institute of Medicine Tribhuvan University Teaching Hospital (TUTH) Kathmandu Nepal

Diarrheal diseases are major problem of developing countries. Though precise data on childhood mortality associated with diarrheal diseases in Nepal is not available, it has been estimated that approximately 25% of child death are associated with diarrheal disease, particularly acute diarrhea. The purpose of this study was to assess the incidence of parasitic pathogens causing acute diarrhea in children under 5 years of age. A total of 525 children with acute diarrhea in a children’s hospital of Kathmandu, Nepal were enrolled between April 2011 and September 2011. The higher prevalence of diarrhea was in the age group of less than 2 years. Out of total 525 enrolled cases, protozoal parasites were found in 10.7% (56/525) of cases and helminthic parasites were found in 1.3% (7/525) of cases. Highest prevalence of 60.3% (38/63) of parasitic infection was found in the age group of 6 - 24 months followed by 7.9% (5/63) in the age group of less than 6 months. Of the total enrolled cases E. histolytica were 6.7% (35/525) followed by Giardial lamblia 3.4% (18/525) and the least frequency was due to A. lumbricoides constituting 0.6% (3/525). The aim of this study was to know the parasitic agents causing acute diarrhea in children.

关键词： Parasitic Diarrhea Protozoa Helminthes TUTH Nepal

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Patients direct costs to undergo TB diagnosis

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Infectious Diseases of Poverty 2016年第1期5卷 221-229页

作者： Rachel M.Anderson de Cuevas Lovett Lawson Najla Al-Sonboli Nasher Al-Aghbari Isabel Arbide jeevan B.sherchand Emenyonu E.Nnamdi Abraham Aseffa Mohammed A.Yassin Saddiq T.Abdurrahman Joshua Obasanya Oladimeji Olanrewaju Daniel Datiko Sally J.Theobald Andrew Ramsay S.Bertel Squire Luis E.Cuevas Liverpool School of Tropical Medicine Pembroke PlaceLiverpool L35QAUK Zankli Medical Center AbujaNigeria Bingham University Nassarawa StateAbujaNigeria Medical Faculty Sana’a UniversitySana’aYemen National Tuberculosis Institute Sana’aYemen Bushullo Major Health Centre AwassaEthiopia Tribhuvan University Institute of Medicine KathmanduNepal Armauer Hansen Research Institute Addis AbabaEthiopia The Global Fund to Fight AIDS Tuberculosis and MalariaGenevaSwitzerland Federal Capital Territory Tuberculosis and Leprosy Control Programme AbujaNigeria Nigeria Tuberculosis and Leprosy Control Programme AbujaNigeria REACH Ethiopia HawassaEthiopia UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases World Health OrganizationGenevaSwitzerland

Background:A major impediment to the treatment of TB is a diagnostic process that requires multiple *** of patient costs associated with diagnosis use different protocols and are not ***:We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for *** of 2225 adults attending smear-microscopy centres in Nigeria,Nepal,Ethiopia and ***>18 years with cough>2 weeks were enrolled *** costs were quantified using structured *** with costs>75^(th) quartile were considered to have high expenditure(cases)and compared with patients with costs<75^(th) quartile to identify factors associated with high ***:The most significant expenses were due to clinic fees and *** participants attended the centres with *** expenditure was associated with attending with company,residing in rural areas/other towns and ***:The costs incurred by patients are substantial and share common patterns across *** user fees,transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic *** locations with limited resources,support could be prioritised for those most at risk of high expenditure;those who are illiterate,attend the service with company and rural residents.

关键词： Tuberculosis Costs Access to healthcare Ethiopia Nepal Nigeria Yemen

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