Background: Infectious disease outbreaks following natural disasters are reported in literature. Outbreaks were documented following natural disasters in many countries including Haiti. Such possibility following 2015 Nepal earthquake was a public health concern. Risk factors needed evaluation by post-disaster outbreak investigation. Hence, present study was undertaken to investigate potentials for such outbreak and to generate evidence for public health intervention. Methods:The study was conducted between April -May, 2015, with the cooperation of National Public Health Laboratory, Epidemiology and Disease Control Division, Nepal Health Research Council and the Chinese team. Rapid Response Teams visited earthquake affected districts and collected samples for analysis. Syndromic surveillance approach was followed. Samples were collected from syndromic patients under supervision. Those sick prior to earthquake or receiving treatment were excluded. Blood, stool and throat swab samples, as indicated, were collected. Drinking water and food samples including captured live mosquitoes from inhabited areas were obtained for study with the help of EDCD. Laboratory analysis was performed at the NPHL.Results: Total samples were 360 (114 biological, 246 environmental). Salmonella spp. was detected in two and Varicella zoster in one blood sample. Influenza B virus was detected in one throat swab. Rota virus was detected in two, Shigella dysenteriae in one and Salmonella spp. in one stool sample. No pathogen detected in water or food samples. Mosquitoes tested negative for dengue virus. Conclusions:Post-earthquake outbreak investigated in disaster phase-2. Diarrheal, enteric fever pathogens and Influenza B virus were detected. Environmental samples tested negative for pathogens. Vigilance is necessary for other risk factors.

Antimicrobial resistance (AMR) is increasing and represents one of the greatest public health challenges of our time, accounting for considerable morbidity and mortality globally. A “One Health” surveillance strategy, which integrates data concerning the resistant organisms circulating in humans, animals, and the environment, is required to monitor this issue and enable effective interventions. The timely collection, processing, analysis, and reporting of AMR surveillance data are necessary for the effective delivery of the information generated from such surveillance. Nepal has greatly improved its surveillance activities through a network of human and animal health laboratories; however, the data reported by sentinel laboratories are often inconsistent, incomplete, and delayed, causing challenges in terms of data cleaning, standardization, and visualization on a national level. To overcome these issues, innovative methods and procedures have been adopted in Nepal, with the development and customization of digital tools that reduce the human time and effort spent on data cleaning and standardization, with concomitant improvements in the accuracy of data. These standardized data can be uploaded to the district health information system 2 (DHIS2) One Health AMR surveillance portal, enabling the generation of reports that will help decision-makers and policy planners to combat the global problem of AMR.

Background: Coronavirus Disease 2019 (covid-19) is a highly contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). People who are infected with SARS-CoV-2 or are vaccinated with covid-19 vaccines are supposed to develop immunoglobulins and these immune responses in human body will determine the efficacy of the vaccines as well as help to discover new therapeutic options. Methods: A cross-sectional study conducted between April to June, 2021, assessing serum antibody titer from participants who had taken the first dose of covishieldTM vaccine (naïve as well as prior covid-19 infected individuals). Antibody testing was carried out with Roche Elecsys Anti-SARS-CoV-2 S electrochemiluminescence immunoassay on Roche Cobas e 601 module. Twenty-eight of these participants had follow up repeat antibody test after second dose of vaccine. Results: A total of 122 participants with the first dose of CovishieldTM vaccine were all tested seropositive, antibody titer ranging from minimum of 2.95 U/mL to maximum 2500 U/mL. Average antibody titer was 308.9 U/mL for naive cohort and 1604 U/mL for prior covid-19 infection. In twenty-eight participants who had antibody titer measured after 1 month of second dose, average titer was 1459.7 U/mL for naïve cohort and 1803.4 U/mL for prior covid-19 infected individuals, which was statistically significant compared to antibody response after the first dose. Conclusions: Antibody responses against SARS-CoV-2 following immunization was 100%, with significant development after second dose in naïve population while robust immune response was present after first dose in prior SARS-CoV-2 infected individuals.

Objective: CD4 T lymphocytes are the most widely used cellular markers to assess the course of HIV infection, clinical staging and, monitoring the effect of antiretroviral therapy. The regional reference range for Eastern, Central and Western development region of Nepal had already been established whereas the same was still lacking in Mid-western and Far-western development region. The objective of this study was to establish reference range of CD4 T lymphocyte in the remaining two development regions and finally the national reference range using data from previous study. Results: The average values (mean ± SD) of CD4 and CD3 T cell in present study was (819 ± 294) cells/μl and (1546 ± 532) cells/μl, respectively. The absolute CD4 T cell (914 ± 303) and CD3 T cell (1671 ± 560) count in female were significantly higher than those from male, CD4 (757 ± 270) and CD3 (1465 ± 499) (p value-0.000). National reference value of CD4 was determined to be (798 ± 335) cells/μl for healthy Nepalese adults.