Hari Govinda Shrestha

Effect of intestinal helminth infection on retinol and β-carotene status among rural Nepalese.

Intestinal helminth infection and its effect on vitamin A, retinol and β-carotene, was studied in 224 [145 children (aged less than 15 years) of Okharpauwa Village Development Committee (VDC) (Nuwakot district) and 79 inhabitants (mainly adults) of Boya VDC (Bhojpur district)] subjects living at an altitude of 2000 m. Direct smear technique in duplicate was applied to detect helminth eggs. Most common helminth detected was Ascaris lumbricoides followed by Trichuris trichiura in Okharpauwa VDC and by hookworm in Boya VDC, respectively. Mixed helminth infections were relatively low (7.3% in Okharpauwa VDC and 11.1% in Boya VDC). The retinol and β-carotene were estimated by high-performance liquid chromatography (HPLC). The helminth eggs positive children of both sexes in Okharpauwa VDC had significantly lower serum retinol concentration compared with their helminth eggs negative counterparts (P 0.05) but in β-carotene level (P <0.05). Results suggest that deworming contribute significantly in the prevention of vitamin A deficiency associated morbidity and mortality among children in these intestinal helminth prevalent rural communities in Nepal.

High Toxoplasma Seroprevalence Associated with Meat Eating Habits of Locals in Nepal

A serosurvey of Toxoplasma gondii infection in apparently healthy subjects (n=404) living in Achham (n=215) and Dang (n=189) districts in western Nepal was carried out. An interview with 249 participants, each representing a household, was also conducted. This interview pertained to their meat eating habits and the keeping of cats in their houses. Toxoplasma antibodies were detected by using the microlatex agglutination test. The overall seroprevalence was 65.3% with no significant difference in the two districts (Achham: 66.9% and Dang: 63.5%) included (p=0.546). Females and the Indo-Aryan ethnic-group showed marginally higher prevalence compared with their male (p=0.545) and Tibeto-Burman (p=0.075) counterparts. The majority of the infections was found to have occurred during childhood. The frequency of meat eating in western and eastern regions differed greatly (p=0.000) with the people in the eastern region being frequent meat eaters than those in the western region. About one-third of the subjects, all Indo-Aryans, in the western region had the raw meat eating habit but none in the eastern region. Approximately 7.0% of households in both western and eastern regions kept cats. The present findings demonstrated a typical role of meat eating habits of people in the high Toxoplasma seroprevalence in Nepal.

Kikuchi-Fujimoto Disease in Nepal A Study of 6 Cases

CONTEXT Kikuchi-Fujimoto disease is a benign disorder, predominantly affecting young women with a predilection for cervical lymphadenopathy. Although the disease has been recognized worldwide, to our knowledge no cases have been reported previously from Nepal. OBJECTIVES To determine the prevalence of Kikuchi-Fujimoto disease in Nepal and to analyze clinicopathologic features. METHODS We reviewed 6 cases of Kikuchi-Fujimoto disease recorded at 3 different hospitals in Nepal during a period from June 1998 to June 2002. Clinical data and histopathology are presented. RESULTS This study included 5 females and 1 boy, aged 13 to 32 years. These patients presented with prolonged fever and lymphadenopathy. The 5 female patients had cervical lymphadenopathy, and the boy had axillary lymphadenopathy. Complete blood counts revealed raised erythrocyte sedimentation rates in all patients and anemia in 2 patients. The size of excised lymph nodes (in greatest dimension) ranged from 1.5 to 5 cm. Typical histologic features were seen, namely, architectural effacement due to presence of pale nodular lymphohistiocytic foci with karyorrhectic debris, coagulation necrosis, eosinophilic debris, and absence of granulocytic infiltration. In a follow-up of the cases, disease recurrence was not found. CONCLUSION Our study emphasizes that Kikuchi-Fujimoto disease should be considered as one of the differential diagnoses in patients with prolonged fever and cervical lymphadenopathy and that it should be differentiated from tuberculous lymphadenitis in regions where tuberculosis is prevalent.