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Bacterial contamination of drinking water is a major public health in Nepal. A large scale study on contamination of drinking water was done covering all three ecological belts (mountain, hill and Terai) in all five (eastern, central, western, mid-western and far-western) development regions of Nepal during 2009-2011. Of the total 506 water samples studied, one-forth (25.1%; 127/506) were visually turbid. Bacteriologically, 88.5% (448/506) samples were positive for total coliform (TC) whereas 56.5% (286/506) were positive for fecal coliform (FC) (Esch. coli). The TC positive rate ranged from 53.8% in Damak (Jhapa) to 100.0% in different districts. The FC positive rate varied more widely ranging from 10.0% in Bharatpur City (Chitawan) to 100.0% in Baglung Township (Baglung) with over 50.0% in most of the districts (over 75.0% in eight districts). Both TC and FC positive rate were highest in Far-western Development Region (DR). High TC positive rate (96.7%) in Far-western DR was followed by Western DR (93.9%), Eastern DR (89.2%), Central DR (87.0%) and Mid-western DR (74.6%). Highest FC positive rate (65.5%) in Far-western DR was followed by Med-western DR (63.5%), Western DR (55.9%), Central DR (53.2%) and Eastern DR (52.0%). TC positive was highest (90.7%) in hills followed by mountain (89.7%) and Terai (plain) (84.1%) belt. In contrast, FC positive rate was highest (66.2%) in mountain, followed by hills (58.0%) and Terai (49.7%). Of the total 506, 335 were piped tap water, 129 were boring water, 16 natural tap (spout), 16 were well (sallow/deep well) and 10 were mineral/uroguard treated water. TC positive rate was very high (81.2% to 100.0%) in different type water samples (piped tap: 90.1%; boring water: 85.2%; natural spout/tap: 81.2%; well water 100.0% and mineral water/uroguard treated water: 80.0%). FC positive rate ranged from 0.0% in mineral water/uroguard treated water to 93.7% in well water samples. These findings are of serious public health concern with regard to both endemicity and outbreak of waterborne diseases in the country.

Status of drinking water contamination was studied in three mountainous districts in Nepal. A total of 43 water samples (Sankhuwasabha: 11, Rasuwa: 12 and Dolpa: 20) were tested for the presence of total coliform (TC) and Escherichia coli as fecal coliform bacilli using commercially available test system called Colilert (Japan). Of the total, 85.7% (36/43) were positive for TC whereas 67.4% (29/43) were positive for Esch. coli. The fecal contamination rates (as indicated by the growth of Esch. coli) in Sankhuwasabha, Rasuwa and Dolpa Districts were 81.8% (9/11), 75.0% (9/12) and 65.0% (13/20), respectively. Most of the water samples collected in district headquarter towns namely Khandbari, Dhunche and Dunai, respectively) showed Esch. coli compared with those collected in remote villages areas.

Dyslipidemia is one of the major risk factors of coronary artery disease. Present study was aimed to find out the lipid profile of non-diabetic adult Nepalese population (n = 454; M: 180 and F: 274; Mean age: 42.8+/-15.5 years). The mean +/- SD (mg/dl) level of total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) was 184+/-50.7, 147.4+/-79.9, 111.9+/-42.0 and 45.0+/-11.7, respectively. All lipid levels except LDL were higher among 41 to 60 years age group while LDL was higher among participants aged >60 years. Desirable TC level (<200 mg/dl) was found in 78.0% of the total population while the normal TG (<150 mg/dl) and LDL (<129 mg/dl) was found in 61.5% and 72.0%, respectively. High TC (> or =240 mg/dl) and very high TG (> or =500 mg/dl) and LDL (> or =190 mg/dl) were found in 8.8%, 2.6% and 5.8% of participants, respectively. Higher HDL level (40 mg/dl) was seen in 60.0% of the total population. Higher percentage of women than men (65.3% vs 52.2%) had >40 mg/dl HDL level. Nornal lipid profile (TC <200 mg/dl, TG <150 mg/dl, LDL <129 mg/dl, HDL >40 mg/dl) was seen in 26.7% of participants, and was higher in females (32.1%) than in males (18.3%). The overall mean cholesterol level was within normal limit. Mean LDL level showed increasing trend with age and about one fourth of participants had normal lipid profile.

The increase in life expectancy in developing countries and as a result of increasing obesity and other life style changes, the global incidence of type 2 diabetes mellitus (T2DM) is increasing. The purpose of this study was to investigate the prevalence of T2DM and impaired fasting glucose (IFG) in semi-urban population of Nepal and to compare the prevalence between men and women and among different age groups. A total 740 adults (286 men and 454 women) aged 21 to 94 years (men +/- SD; 45.6 +/- 15.6 years) were included. The prevalence of T2DM and IFG was 9.5% and 19.2% in the whole population. Prevalence of T2DM was higher in men (11.8%) then in women (7.9%), similarly IFG was noted higher in men (25%) then in women (15.4%0). The prevalence of T2DM and IFG was seen to be increased with age in the whole population. Among women, the prevalence of T2DM and IFG was 2.9% and 12.8% in 21 to 40 years age group, 9.7% and 13.8% in 41 to 60 years age group and 15.4% and 27.7% in > 60 years age group. Among men, it was 4.7% and 22.6% in 21 to 40 years age group, 13.3% and 30.5% in 41 to 60 years age group and 23% and 17.3% in > 60 years age group. To conclude, the overall prevalence of T2DM and IFG increases with age. Prevalence of IFG is highest among middle age men where as the prevalence of T2DM is highest among older men.

A nationwide outbreak of acute hemorrhagic conjunctivitis (AHC) occurred in Nepal during August to September 2003, which affected nearly half of the population. Sixty conjunctival swabs from AHC patients were collected at Tilganga Eye Center in Kathmandu. For the first time in Nepal, we demonstrated the etiologic viral agents of AHC, namely, Coxsackievirus A24 variant (CA24v) by reverse transcription real time polymerase chain reaction (PCR). Of the 60 samples, 19 were positive for CA24v. No difference in the two genders was observed. Conversely, Adenovirus (AdV) was detected in 32 samples, which suggested that the epidemic was caused by mixed infection. AdV was detected also on 10 rupee notes. Findings indicated that inadequate personal hygiene was the main cause of the spread of these highly contagious viruses in the community environment in Nepal during the summer of 2003.

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.

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

Diarrhea causing viruses (Rotavirus. Adenovirus and Norovirus) were investigated in diarrheal fecal samples collected from children in Kathmandu, Nepal in Janury 2004 using both real time PCR and immuno-chromatogaphic techniques. Of the total 12 diarrheal samples investigated, 8 (66.7%) were positive for Rotavirus, 1 (8.3%) was positive for Adenovirus and none was positive for Norovirus (Norwalk like virus). The Adenovirus positive sample was also positive for Rotavirus. Similar results were obtained by immuno-chromatographic technique. All of Rotavirus detected belonged to Group-A. Results indicated that immuno-chromatographic technique was equally good in the detection of diarrhea causing viruses in fecal samples. Furthermore, it was simple, cost-effective and less time consuming (15 minutes) compared with the PCR. Immuno-chromatographic technique, therefore, appeared to be useful for rapid diagnosis of viral gastroenteritis in developing countries like Nepal.

This rapid communication present the findings of nationwide outbreak of acute hemorrhagic conjunctivitis (AHC) epidemic occurred in Nepal during summer 2003. Only ten percent of samples showed bacterial and no fungus were grown. On the contrary, viruses were detected in 60.0% cases studied. Of the viruses detected, Adenovirus (ADV), Coxsackie virus (CA24v) and both accounted for 83.3% (30/36), 11.1% (4/36) and 5.5% (2/36), respectively. Interestingly, ADV was detected also from one of the ten a Rupees bill.