ネパール Kaski チク Lekhnath シ Patneri ムラ ニ オケル インリョウスイ オヨビ ドジョウ ノ チョウカン ビョウゲンセイタイ オセン ジッタイ チョウサ

In Nepal, infectious diseases are highly prevalent and are responsible for morbidity and mortality. In the year of 2008 summer (rainy) season, we investigated the status of enteropathogenic contamination of drinking water and parasitic contamination of the soil at Patneri Village in Lekhnath Municipality in Kaski District, Nepal. A total of 34 water samples were tested for enteropathogeic contamination. All 34 samples tested were positive for coliform bacilli and 68% (23/34) were positive for Escherichia coli. Of the21 soil samples collected, 10% (2/21) were positive for parasite eggs of Ascaris lumbricoides and Trichuris trichiura. Questionnaires revealed that 79% (156/197) of households were keeping some kind animals in their house and 94% (184/195) of houses had a toilet. Despite of this it was interesting to observe only human parasites eggs in the positive soil samples. These results indicated that water contamination with fecal matter is more important than soil contamination with helminth parasite eggs. Low prevalence of soil contamination with helminth parasite eggs appears to be attributed to distribution of albendazole tablets during nationwide vitamin-A program

Feasibility of implementing public-private mix approach for tuberculosis case management in Pokhara Metropolitan City of western Nepal: a qualitative study

BackgroundThe Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal.MethodsWe conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers.ResultsA total of 20 respondents participated in the study. Barriers to PPM were identified into following three themes: (1) Obstacles related to TB case detection, (2) Obstacles related to patients, and (3) Obstacles related to health-care system. PPM implementation was challenged by following sub-themes that included staff turnover, low private sector participation in workshops, a lack of trainings, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies.ConclusionGovernment stakeholders can significantly benefit by applying a proactive role working with the private in monitoring and supervision. The joint efforts with private sector can then enable all stakeholders to follow the government policy, practice and protocols in case finding, holding and other preventive approaches. Future research are essential in exploring how PPM could be optimized