Oxford University Clinical Research Unit – Nepal Patan Academy of Health Sciences (PAHS), Kathmandu
The Unit in Kathmandu has recently been busy with an increase in clinical and research activities. With the onset of the monsoon season there is a deluge of patients with unexplained fever. Laboratory renovations are ongoing, and we are hopeful that they will be completed by the first quarter of 2011.
We have three new medical officers in our team who are responsible for the enrollment and follow up of patients in the randomized control trial of gatifloxacin versus ofloxacin, in the Hepatitis E study, and in the PANI (Patan Adult Neurological Infections) study.
The current RCT which needs about forty more patients with culture confirmed enteric fever, will hopefully end by mid 2011. The RCT of chloramphenicol and gatifloxacin in the treatment of uncomplicated typhoid fever is almost ready for publication. The study shows that gatifloxacin, the newer and surprisingly cheaper antimicrobial, is as effective as chloramphenicol in the treatment of enteric fever. Our geospatial mapping and environmental sampling is yielding fascinating results for a range of potential human enteric pathogens and we hope we will be able to present this in our next update.
Thankfully there have been very few pregnant women with Hepatitis E this year, but our initial study has completed recruitment and we are preparing the analysis now. We are pleased that our letter regarding Hepatitis E in developing countries triggered an editorial in the Lancet. (Neglected hepatitis E and typhoid vaccines. Lancet 2010; 376(9744):869).
Our study of carriage of bacteria in the gall bladder study is ongoing and the Salmonella carriage rate in the gall bladders according to the study stands at around 3% for the moment.
We were happy to contribute to the study looking into antimicrobial susceptibility of Salmonella Typhi which has resulted in a paper publication. (online ahead of print on 13 September 2010 Antimicrob. Agents Chemother. doi:10.1128/AAC.00963-10)
Sample storage has been a huge problem, but with the arrival of two freezers (-80˚C) we along with our samples have all been able to heave a sigh of relief!!
Dr Basnyat continues to be involved with the RCTs in the prevention and treatment of high altitude ailments brought on by the hypoxia in the Himalayas.
We hope to meet our friends and colleagues at the Tropical Network Meeting in Laos in February 2011 and of course you are always welcome to come and visit us in Nepal.