Urban Land Governance: “Action Space”, Legitimacy of and Intervention Strategies for Urban Informal Settlements in Nepal

At the global level, the informal settlements are in a dichotomy of legal and illegal debates. This paper analyzes the issue of informal settlements from the legitimacy perspective. It reveals that, although the settlements are not in legal legitimacy, there is tendency of social legitimacy. The challenges of urban land governance are in how to minimize the gap between legal legitimacy and social legitimacy. Firstly, this paper explores on how the actions of government and non-government organizations contribute towards legitimacy. To achieve this aim, the analytical framework of “action space” is applied. Secondly, it focuses on identifying intervention strategies that narrow the gap between legal legitimacy and social legitimacy. We studied two cases of informal settlements: the rst is to explore the gap and the second is to explain the intervention strategies. The results show, that due to lack of “action space” of government actors towards legal legitimacy, the civil society actors created their own “action space” which ultimately triggered social legitimacy. In addition to civil society, the actions of local authorities are found to contribute towards social legitimacy as well. To narrow the gap, the identi ed intervention strategies are discussed within the scope of land policy, land tenure security and land development

Antimicrobial Resistance Patterns and Plasmid Profiles of Methicillin Resistant Staphylococcus aureus Isolated from Clinical Samples

Methicillin-resistant Staphylococcus aureus (MRSA), showing resistance to several antibiotics is a global health problem associated with considerable mortality and morbidity. Antibiotic susceptibility test is a commonly used method to characterize MRSA in epidemiologic studies. Additionally, plasmid profile has been reported to be useful in tracing the epidemiology of antibiotic resistance. This research was conducted to determine the antimicrobial resistance patterns and plasmid profiles of MRSA isolated from clinical samples at KIST Medical College, Imadol, Kathmandu, Nepal. All the clinical specimens sent to the laboratory were processed by standard microbiological techniques and antibiotic susceptibility testing was done by the modified Kirby Bauer disc diffusion method. Further, plasmid profiling was done by Alkaline-lysis method. A total of 27 (38.02%) MRSA were isolated from 71 S. aureus positive samples. MRSA showed the highest resistance towards penicillin (92.60%) and ampicillin (92.60%). In contrast, high levels of sensitivity were shown towards vancomycin (85.19%) and tetracycline (85.19%). Out of 27 MRSA positive samples, single plasmids were isolated from only 6 (22.22%) MRSA isolates. Antibiograms alone are inadequate to accomplish the characterization of MRSA during epidemiological studies. However, plasmid profile analysis in conjunction with the antibiotic susceptibility pattern is valuable in the epidemiological investigation of MRSA, and for reducing MRSA prevalence and treatment cost

Cost of wastewater-based environmental surveillance for SARS-CoV-2: evidence from pilot sites in Blantyre, Malawi and Kathmandu, Nepal

Environmental surveillance of rivers and wastewater for SARS-CoV-2 detection has been explored as an innovative way to surveil the pandemic. This study estimated the economic costs of conducting wastewater-based environmental surveillance for SARS-CoV-2 to inform decision making if countries consider continuing these efforts. We estimated the cost of two SARS-CoV-2 environmental surveillance pilot studies conducted in Blantyre, Malawi, and Kathmandu, Nepal. The cost estimation accounted for the consumables, equipment, and human resource time costs used for environmental surveillance from sample selection until pathogen detection and overhead costs for the projects. Costs are reported in 2021 US$and reported as costs per month, per sample and person per year. The estimated costs for environmental surveillance range from$6,175 to $8,272 per month (Blantyre site) and$16,756 to $30,050 (Kathmandu site). The number of samples processed per month ranged from 84 to 336 at the Blantyre site and 96 to 250 at the Kathmandu site. Consumables costs are variable costs influenced by the number of samples processed and are a large share of the monthly costs for ES (ranging from 39$25 to $74 (Blantyre) and$120 to $175 (Kathmandu). There were associated economies of scale for human resources and equipment costs with increased sample processing and sharing of resources with other activities. The cost per person in the catchment area per year ranged from$0.07 to $0.10 in Blantyre and$0.07 to $0.13 in Kathmandu. Environmental surveillance may be a low-cost early warning signal for SARS-CoV-2 that can complement other SARS-CoV2 monitoring efforts

Climatic factors influencing dengue incidence in an epidemic area of Nepal

Abstract Objective Geographic expansion of dengue incidence has drawn a global interest to identify the influential factors that instigate the spread of this disease. The objective of this study was to find the environmental factors linked to dengue incidence in a dengue epidemic area of Nepal by negative binomial models using climatic factors from 2010 to 2017. Results Minimum temperature at lag 2 months, maximum temperature and relative humidity without lag period significantly affected dengue incidence. Rainfall was not associated with dengue incidence in Chitwan district of Nepal. The incident rate ratio (IRR) of dengue case rise by more than 1% for every unit increase in minimum temperature at lag 2 months, maximum temperature and relative humidity, but decrease by .759% for maximum temperature at lag 3 months. Considering the effect of minimum temperature of previous months on dengue incidence, the vector control and dengue management program should be implemented at least 2 months ahead of dengue outbreak season

Detection of bla KPC gene among carbapenemase producing Klebsiella pneumoniae isolated from different clinical specimens at tertiary care hospital of Nepal

Abstract Background Klebsiella pneumoniae infections have become a major cause of hospital acquired infection worldwide with the increased rate of acquisition of resistance to antibiotics. Carbapenem resistance mainly among Gram negative is an ongoing problem which causes serious outbreaks dramatically limiting treatment options. This prospective cross-sectional study was designed to detect bla KPC gene from carbapenem resistant K. pneumoniae. Materials and Methods A totally of 1118 different clinical specimens were screened and confirmed for KPC producing K. pneumoniae phenotypically using Meropenem (10 μg) disc. The bla KPC gene was amplified from the isolates of K. pneumoniae to detect the presence of this gene. Result Of the total samples processed, 18.6% (n = 36) were K. pneumoniae and among 36 K. pneumoniae, 61.1% (n = 22/36) were meropenem resistant. This study demonstrated the higher level of MDR 91.7% (n = 33) and KPC production 47.2% (n = 17) among K. pneumoniae isolates. The bla KPC gene was detected in 8.3% (n = 3) of meropenem resistant isolates. Conclusion Since the study demonstrates the higher level of MDR and KPC producing K. pneumoniae isolates that has challenged the use of antimicrobial agents, continuous microbiology, and molecular surveillance to assist early detection and minimize the further dissemination of bla KPC should be initiated. We anticipate that the findings of this study will be useful in understanding the prevalence of KPC-producing K. pneumoniae in Nepal

Dengue periodic outbreaks and epidemiological trends in Nepal

Abstract Dengue is a global health problem and expansion of its endemics towards new territories in the hilly regions in Nepal is a serious concern. It appeared as a new disease in Nepal in 2004 from Japanese traveler with sporadic cases every year and massive outbreaks in 2010, 2013 and 2016. The serotype was responsible for outbreak in particular year was dengue virus serotype-1 (DENV-1) in 2010, 2016; and DENV-2 in 2013. Nepal lacks basic health related infrastructure in rural areas and does not have a stringent health care policy. With severances of epidemic like dengue, a new surveillance or an upgrading of existing one are direly needed to better challenge the possible outbreaks. This review paper aims to explain the dengue trend in last one decade in Nepal and warrants concerted and timely public health interventions to minimize the deleterious effects of the disease