Prospective time-trend analyses on shifting etiology and trends of drug resistance in enteric fever are scarce. Using published and unpublished datasets from Nepal, we performed a systematic review and meta-analysis to understand the trends in etiology and resistance to antimicrobials that have occurred since 1993. Thirty-two studies involving 21 067 Salmonella enterica serotype Typhi (ST) and S. enterica serotype Paratyphi A (SPA) isolates were included. There was an increasing trend in enteric fever caused by SPA during the last 2 decades (P < .01). We observed sharply increasing trends in resistance to nalidixic acid and ciprofloxacin for both ST and SPA. In contrast, multi-drug resistance (MDR), resistance to traditional first-line antibiotics such as chloramphenicol and co-trimoxazole have significantly decreased for both organisms. The resistance to ceftriaxone has remained low, suggesting it is likely to remain useful as a reserve antibiotic for treatment. Trends in decreasing resistance to traditional first-line antibiotics and decreasing MDR provide an opportunity to reconsider these first-line antimicrobials as therapeutic options.

Introduction: Dental caries is one of the most common conditions affecting the general health of children. The present study was carried out among school children of Kathmandu valley to determine the prevalence of dental caries in two age groups. Methods: The study was conducted from December 2007 to May 2008. The age of the school children of the study was divided into two group: 5 - 6 years and 12 - 13 years. A stratifi ed cluster sampling with proportional allocation was used while grouping the subjects. The dental status examination was done with the help of trained dentists. Decayed, missed and fi lled teeth index and decayed, missed and fi lled surfaces index (dmft for primary dentition and DMFT for permanent dentition) were used as the standard tools for the determination of prevalence. Results: A total of 638 students (325 of age group 12 - 13 years and 313 of age group 5 - 6 years) from 30 different schools of the Kathmandu valley were included in the study. The caries status was found higher in the age group of 5 - 6 years than in the 12 - 13 years and it was found to be statistically signifi cant (p < 0.001). The dmfs and caries percentage of the age group 5 - 6 years and the DMFS and caries percent of the 12 - 13 years was found to be 3.79, 69 % and 1.6, 53.23 % respectively. The dmft/dmfs value was found to be signifi cant according to the districts in the 5 - 6 years age group whereas the DMFS was found statistically signifi cant among the sexes of the 12 - 13 years age group. Conclusions: The caries percentage was found to be above the recommended level of the World Health Organization. However, the DMFS and DMFT values were within the WHO level. Keywords: Children, dental caries, DMF index.

Microbial pathogens in drinking water are primary cause in gastrointestinal and waterborne diarrheal diseases. Public health authorities still have not achieved success in controlling the most common waterborne diseases in Nepal. The objective of this study was to assess the quality of drinking water supplied from distribution system of Kathmandu. A total of 114 water samples were collected from 4 distribution stations. The physicochemical and microbiological analyses of water were conducted. Heterotrophic plate count (HPC), detection of enteric pathogenic bacteria and antibiotics susceptibility test were done. Distinct variations in physicochemical parameters were observed. The mean free residual chlorine was found 0.24mg/l. Total Coliforms were found in 61.4% (70/114) of water samples among which 15.7% (11/70) had thermotolerant Coliforms. In distance, coliforms were found higher in far points (p=0.002). All thermotolerant Coliforms were identified as Escherichia coli. Mean HPC of water was found log103.15. The mean HPC of water (p=0.003) was found higher in far point. In collected samples, 10 different enteric bacteria were isolated in which E. coli was found most predominant followed by Pseudomonas spp., Citrobacter spp., Klebsiella spp., Shigella spp., Proteus spp., Enterobacter spp. Non-Typhii Salmonella spp., Providencia spp., Edwardsiella spp. In antibiotics susceptibility test, Gentamicin and Ofloxacin were found most efficient (100%) and whereas Ampicillin (11.5%) was least effective. Multiple antibiotics resistance was found among 5.3% of isolates. Nepal Journal of Science and Technology Vol. 13, No. 2 (2012) 179-184 DOI: http://dx.doi.org/10.3126/njst.v13i2.7733