Initiation and completion rates of isoniazid preventive therapy among people living with HIV in Far-Western Region of Nepal : a retrospective cohort study

Objectives: Isoniazid preventive therapy (IPT), for people living with HIV (PLHIV) is the proven and recommended intervention to avert tuberculosis (TB). In 2015, Nepal implemented 6 months of IPT for all PLHIV registered for HIV care in antiretroviral therapy (ART) centres. After programmatic implementation, there has been no systematic assessment of IPT initiation and completion rates among PLHIV. We aimed to assess IPT initiation and completion rates in the Far-Western Region (FWR) of Nepal. Design: We conducted a retrospective cohort study using secondary data extracted from registers maintained at ART centres. Setting: All 11 ART centres in the FWR of Nepal. Participants: All PLHIV registered for care between January 2016 and December 2017 in 11 ART centres. Primary outcome measures: IPT initiation and completion rates were summarised as percentages with 95% CI. Independent association between patient characteristics and non-initiation of IPT was assessed using cluster-adjusted generalised linear model (log binomial regression) and adjusted relative risk (RR) with 95% CI was calculated. Result: Of the 492 PLHIV included, 477 (97.0%) did not have active TB at registration. Among 477 without active TB, 141 (29.8%, 95% CI 25.7% to 34.1%) had been initiated on IPT and 85 (17.8%) were initiated within 3 months of registration. Of 141 initiated on IPT, 133 (94.3%, 95% CI 89.1% to 97.5%) had completed 6 months of IPT. Being more than 60 years of age (RR-1.3, 95% CI 1.1 to 1.7), migrant worker (RR-1.3, 95% CI 1.1 to 1.4) and not being initiated on ART (RR-1.4, 95% CI 1.1 to 1.8) were significantly associated with IPT initiation. Conclusions: In FWR of Nepal, three out of 10 eligible PLHIV had received IPT. Among those who have received IPT, the completion rate was good. The HIV care programme needs to explore the potential reasons for this low coverage and take context specific corrective action to fix this gap

Nutritional Status among 6-59 Months Children in A Selected Community of A VDC

Introduction: Adequate nutrition is essential for proper growth and development of the child. We conducted a cross-sectional descriptive study to find the prevalence of nutritional status of 6–59 month old Tharu children in Duruwa VDC of Dang District. This study also deliberate the socio-economic and demographic character, maternal and child character and child feeding status of the Tharu community children. Methods: This study is a cross-section descriptive study and was done between February and March, 2017 in Tharu community of Duruwa VDC, Dang. Total 189 children of age group 6 – 59 months were selected by using systematic random sampling technique; anthropometric measurements were performed to find the nutritional status of children. Pre-coded questionnaire was used to collect information from caretaker. WHO Anthro version 3.2.2 and SPSS version 20 were used to analyze data. Results: Prevalence of wasting, stunting, and underweight were 25 (13.2%), 51 (27%), and 40 (21.2%) respectively. The prevalence of stunting was seen more in females than in males while underweight was higher among males, whereas wasting was very similar in both sexes. Conclusions: The findings showed that there is still high prevalence of malnutrition in Tharu children of Duruwa VDC. So monitoring of nutrition status in Tharu children should be taken seriously and needs to be addressed

Separation of Co(II) and Li(I) with Cyanex 272 using hollow fiber supported liquid membrane: A comparison with flat sheet supported liquid membrane and dispersive solvent extraction process

Separation of Co(II) and Li(I) by non-dispersive solvent extraction using a hollow fiber supported liquid membrane has been investigated. Separation of both the metals by flat sheet supported liquid membrane and dispersive solvent extraction technique has also been investigated and compared. The parameters for the three processes were optimized to achieve quantitative separation of Co(II) over Li(I) with Cyanex 272 diluted with kerosene. The feasibility to produce pure metal salt solutions was established by controlling the process parameters like pH of the feed solution, extractant concentration, metal ion concentration and acid concentration for selective stripping. For both the hollow fiber and the flat sheet supported liquid membrane processes, the aqueous feed pH of 6.0 and 750 mol/m(3) of Cyanex 272 in the membrane phase were the best conditions for extraction, whereas the best stripping results were obtained with 100 and 25 mol/m(3) H2SO4, respectively. In the case of dispersive solvent extraction process, the quantitative separation of the metals was achieved by extraction at equilibrium pH of 5.50 using 100 mol/m(3) of Cyanex 272, and stripping with 10 mol/m(3) H2SO4 solution. Under the optimum conditions, the separation factor was found to be 18, 178 and 180 for hollow fiber supported liquid membrane, flat sheet supported liquid membrane, and dispersive solvent extraction, respectively. Suitable mathematical models for the quantitative extraction of the metal in dispersive solvent extraction and mass-transfer coefficient in non-dispersive solvent extraction were proposed and validity of the models was verified. Proposed models and the mathematical analyses revealed that both dispersive solvent extraction and non-dispersive solvent extraction process followed cation-exchange reaction mechanism with similar kind of stoichiometry. (C) 2015 Elsevier B.V. All rights reserved

High Resistance of Salmonella spp. and Shigella spp. in Blood and Stool Cultures from the Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal, 2015−2019

Antimicrobial resistance (AMR) is an increasing global concern, particularly in Southeast Asian countries like Nepal. The aim of this study was to determine the proportion of Salmonella spp. and Shigella spp. among culture-positive bacterial isolates in blood and stool samples from 2015 to 2019 and their AMR pattern. Routinely collected data were abstracted from medical records and laboratory electronic databases of the Sukraraj Tropical and Infectious Disease Hospital (STIDH), Kathmandu, Nepal. All culture-positive bacterial isolates from blood and stool samples were included in the study. Among 390 blood cultures positive for bacterial isolates, Salmonella spp. were isolated in 44%, with S. Typhi being the most frequent (34%). Antibiotic resistance was demonstrated among Salmonella spp. to ciprofloxacin (68%), ofloxacin (16%), amoxicillin (13%) and cotrimoxazole (5%). Of the 357 stool cultures positive for bacterial isolates, the proportion of Shigella spp. isolated was 31%. Antibiotic resistance among Shigella spp. was demonstrated to cotrimoxazole (59%), tetracycline (40%), amoxicillin (38%) and ciprofloxacin (25%). Salmonella spp. and Shigella spp. were the most predominant organisms among all the bacterial isolates in blood and stool cultures, respectively. Nalidixic acid was the antibiotic to which both Salmonella spp. and Shigella spp. were most resistant