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Jul 10, 2013

Vaccine Preventable Diseases Outbreaks in South Asian countries

Mapping of Vaccine Preventable Diseases (VPDs) outbreaks in Asian region. The map shows many measles outbreaks . This means that measles is still a public health problem. So, various questions can be raised relatedwith the quality of immunization program in those affected areas. If you want details each country of your interest, please refer to the link. Also, questions / thoughts are welcomed. For every reason, there is also another reason.

NyayaHealth, Achham - a center of dedicated staffs

I would like to share this blog that tells the story of NyayaHealth, Achham. I am of the opinion, this hospital has done justice to its name.

Nyaya = justice, which is a rare privilage for people living in hard to areas of any country and in particular, peolpe away from DHQ in these ruaral district of far western developmental region of Nepal in particular suffers a lot from inequalities and lack of access to basic health services. This district also has the highest under 5 children and maternal mortality as any other district with poor developmental index.

Jul 8, 2013

Application of WHONET for Surveillance of Uropathogens: A First User Experience from Nepal

2013 May;7(5):845-8. doi: 10.7860/JCDR/2013/5193.2955. Epub 2013 May 1.

Application of WHONET in the Antimicrobial Resistance Surveillance of Uropathogens: A First User Experience from Nepal.


Department of Microbiology, Gujarat Adani Institute of Medical Sciences (GAIMS), G K General Hospital , Bhuj, Kutch, Gujarat, India - 370001 .


Introduction: WHONET is a freely downloadable, Windows-based database software which is used for the management and analysis of microbiology data, with a special focus on the analysis of antimicrobial susceptibility test results. Urinary Tract Infections (UTI) are a common medical problem and they are responsible for notable morbidity among young and sexually active women. Objectives: The major objective of this study was the utilization and application of the WHONET program for the Antimicrobial Resistance (AMR) surveillance of uropathogens. Methods: A total of 3209 urine samples were collected from patients who visited Manipal Teaching Hospital with a clinical suspicion of UTI, during December 2010 to July 2011. The isolation and characterization of the isolates were done by conventional methods. Antimicrobial Susceptibility Testing (AST) was performed by Kirby Bauer's disc diffusion method. The data entry and analysis were done by using the WHONET 5.6 software. Results: Out of the 3209 specimens, 497 bacterial isolates were obtained and they were subjected to AST. Escherichia coli (66.2%) was the commonest bacterial isolate, followed by Enterococcus species (9.3%), Staphylococcus aureus (5.0%), and Klebsiella pneumoniae (4.2%). Among the gram-negative enteric bacilli, a high prevalence of resistance was observed against ampicillin and ciprofloxacin. The gram negative nonfermenters exhibited a high degree of resistance to ceftazidime. Staphylococcus species. showed a moderately high resistance to co-trimoxazole. One isolate was Vancomycin Resistant Enterococci (VRE). Conclusion: This study, a first of its kind which was done in Nepal, was carried out by using the WHONET software to monitor, analyze and share the antimicrobial susceptibility data at various levels. This study was also aimed at building a surveillance network in Nepal, with the National Public Health Laboratory, Nepal, acting as a nodal centre. This would help in the formulation of antibiotic policies and in identifying hospital and community outbreaks at the nodal centre, as well as in sharing information with the clinicians at the local level.

Jul 7, 2013

Reflections on the Global Burden of Disease 2010 Estimates

Summary points of an article reviewing the Global Burden of Disease 2010 estimates: (Source:

:: Health data include many gaps, particularly relating to poorer areas of the world, so complex estimation techniques are needed to get overall global pictures.
:: Estimates of population health, however, carry their own uncertainties and may be flawed in some instances.
:: Here we present a range of reflections on the Global Burden of Disease 2010 estimates, highlighting their strengths as well as challenges for potential users.
:: In the long term, there can be no substitute for properly counting and accounting for all the world’s citizens, so that complex estimation techniques are not needed.

The Institute for Health Metrics and Evaluation (IHME) and its partners recently completed what is probably the largest ever exercise undertaken in epidemiological modelling, the Global Burden of Disease 2010 (GBD-2010) estimates [1]. These estimates attempt to characterise loss of health from disease and injury, including the effects of some major risk factors, on a global basis. They will find widespread use in coming years and influence developments in global health. However, it is important to realise that “estimates are estimates, and not measurements”; they may perform better in some respects than others [2]. Here, as a group of independent experts, we comment on some of the major issues raised by this important work, while noting that it is impossible to cover all the wealth of detail involved in any critique. We take collective responsibility for these views, though many specific points come from individual specialists among the authors.

PLoS Medicine

  • Health data in low income countries?
  • Estimates of population health through modelling?
  • Denominator issues?


Anuj in Himalayas

Hi i am connecting disqus with my blog for healthy interaction and open dialogue