Browsing by Author "Parajuli, K"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
Publication Epidemiology of malaria in two Eastern districts of Nepal(Kathmandu University, 2010) Parajuli, K; Ghimire, PAbstract Backgrounds: Malaria is one of the major public health problems in Southeast Asia including Nepal having relatively high burden of malaria. Jhapa and Morang districts are malaria endemic plain area of South-eastern part of Nepal Objectives: The evaluate the recent epidemiology of malaria situation in Jhapa and Morang districts, which are the districts in eastern Nepal with high transmission of malaria and to assess the knowledge, attitudes and practices of the people in prevention and treatment for malaria infection. Materials and methods: This descriptive cross-sectional study was carried out with volunteer participation of suspected malaria patients seeking care at the government of Nepal managed primary health care centres located in 2 malaria endemic districts in eastern Nepal. Conventional Giemsa stained thick and thin blood smears prepared from finger prick blood were examined following standard protocols. Suspected patients’ / attendants’ knowledge on malaria, disease symptoms, prevention and control measures were assessed using a structured questionnaire. Chi square and Fisher exact test were used for statistical analysis of the data. Results: Among the total 199 malaria suspected cases studied, 32 (16.1%) cases were confirmed by microscopic findings; where, P. vivax was 12.6% (25/199) and P. falciparum in only 3.1% (6/199). The highest numbers of cases were in age group 20-29 years. Among the total positive cases 75% were male and 37.5% were labourers in occupation. Among the total cases, 32 had provided the history of recent travel to malaria endemic area in India, among them 43.8% (P<0.001) were found to be infected with the malarial parasites (P<0.001). Among the total cases, 69.7% showed some knowledge of malaria, among which fever was the most common symptom mentioned by 68.3%. Occupation (P<0.001) and education (P<0.001) were found significantly associated with the knowledge on mode of transmission. Conclusion: Jhapa district showed higher SPR than Morang, which indicated that Jhapa may be more malaria affected than Morang. Knowledge on malaria transmission and preventive measures are still lacking in deep villages, in spite of different efforts of the government. To improve the malaria morbidity in the districts, health education of the most marginalized people through audio visual methods may be beneficial. Key words: Epidemiology, Malaria, Knowledge, Practice, Eastern NepalPublication Intestinal parasitic infection among children less than five year of age visiting Children’s Hospital of Kathmandu(Institute of Medicine, 2018) Shrestha, S; Raya, S; Shrestha, L; Parajuli, K; Sherchand, JBAbstract Introduction: Intestinal parasitosis is a worldwide concern and cause significant morbidity and mortality, particularly in developing countries like Nepal. The current study aims to identify the status of intestinal parasitosis among children less than five years of age visiting Kanti Children Hospital. Methods: Hospital based cross sectional study was conducted from January 2017 to December 2017 among children less than 5 years of age visiting Kanti Children’s Hospital. Parasites were detected by using standard microbiological procedures. Results:Among a total of 770 stool specimens collected, intestinal parasites were detected in 7.4% cases. Children of age group 49-60 months were found to be infected more often followed by 37-48months with higher frequency seen in summer season in the month of May and June. Altogether five species of parasites were detected, among which three were protozoan and two were helminths. The most common parasite identified wasGiardia lamblia (4.3%) followed by Entamoebahistolytica(2.2%) andHymenolepis nana(0.5%). Conclusion:The study indicated that there is still burden of parasitic infection in Nepal among children. Hence, there is a need to incorporate effective prevention and control strategies including healtheducation and environmental hygiene. Keywords: Intestinal parasitosis, parasites, Entamoeba histolytica, Giardia lamblia, children NepalPublication Sero prevalence of Scrub Typhus among Suspected Cases in Selected Area of Nepal(Institute of Medicine, 2018) Gautam, R; Parajuli, K; Sherchand, JBAbstract Introduction: Scrub typhus is an mite-borne acute, febrile, infectious illness that is caused by Orientia tsutsugamushi The causative organism, Orientia tsutsugamushi, is transmitted to the human beings by the bite of larval stage (chiggers) of the trombiculid mites, Leptotrombidium delience. This disease is most common in rural areas of low income countries. It is difficult to differentiate clinically from other tropical infections such as malaria, dengue, enteric fever and leptospirosis. Hence the study aim was to determine the seroprevalence of scrub typhus among the acute febrile illness patients attending in different hospitals of Chitwan district. Methods: The study was based on patients with suspected scrub typhus cases in Chitwan district from March 2017 to August 2017. Blood samples were collected from the suspected patients of scrub typhus, having acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit, In Bios International, USA. Results: A total of 451 samples, 112 (24.80%) were positive for IgM Antibodies. Multivariate analysis demonstrated that the following factors were significantly associated with the scrub typhus. 1. Females (odd ratio [OR] =2.088, P=<0.004, confidence interval [CI] =1.268-3.438) 2. House near grassland (odd ratio [OR] =10.380, P=<0.001, confidence interval [CI] =3.615-29.802), 3. Piling weeds in house (odd ratio [OR] =0.498, P=0.011, confidence interval [CI] =0.290-0.855), 4. Presence of mouse inside the house (odd ratio [OR] =2.157, P=0.003, confidence interval [CI] =1.290-3.608), 5. Working in the field (odd ratio [OR] =10.295, P=0.002, confidence interval [CI] =2.309-45.905). All cases enrolled have presented fever (100%) followed by headache (56.2%), nausea (55.4%), shortness of breath (40.2%), abdominal pain (14.3%), jaundice (8.9%), hypertension (8.9%), COPD (8.0%), tachypnoea (4.5%), diabetes (4.5%), eschar (2.7%) and seizure (1.8%). Conclusion: In the study the proportion of Scrub typhus infection was 25% among acute febrile cases. Our finding also explored the burden of scrub typhus in relation to demographic trend, risk factors, clinical characteristics and findings of different laboratory parameters. Early diagnosis, appropriate treatment along with health education and vector control measures are best way to prevent and management of scrub typhus. Key words: Scrub typhus, ELISA, Orientia tsutsugamushi, NepalPublication Strongyloides stercoralis hyperinfection syndrome in patient with non- proliferative glomerulopathy(Institute of Medicine, 2017) Bhujel, R; Yadav, SK; Shrestha, K; Sah, R; Kattel, H P; Shah, NP; Sharma, S; Parajuli, K; Mishra, SK; Sherchand, JBAbstract Strongyolides stercoralis commonly causes chronic, asymptomatic infection but can cause more disastrous type of infection in immunosuppressed patient. Out of many predisposing factors for Strongyloides hyperinfection, regular intake of corticosteroids is a major risk factor. We are presenting a case of Strongyloides hyperinfection syndrome in a 66 years old male patient, a known case of non-proliferative glomerulopathy, presented at Tribhuvan University Teaching Hospital, with swollen limbs, anemia and history of self-recovered diarrhea. His condition got exacerbated and required Intensive Care Unit stay. Despite all the efforts being made for his recovery, he died after 30 days of stay in the hospital. Keywords: Hyperinfection, non-prolifertative glomerulopathy, Strongyloides