CMDN presents at “International Conference and Training Workshop on: Wildlife research techniques in rugged mountainous Asian landscapes.”May 13-20Bumthang, BhutanOrganized by Ugyen Wangchuck Institute for Conservation and Environment (UWICE) and the University of Montana.CMDN also assisted in setting up Bhutan’s first Wildlife genetics laboratory within UWICE premise.

Title: Building Molecular Diagnostic capacity in the resource strapped countries for viral detection, surveillance and monitoring-our experience in Nepal.
 Dibesh Karmacharya

The challenge of detection, surveillance and monitoring for viral borne diseases in resource strapped countries like Nepal is exacerbated by lack of good molecular diagnostic and immunology laboratory.  The Center for Molecular Dynamics-Nepal, CMDN, has been working with its state of the art Molecular diagnostic laboratory based in Kathmandu, Nepal to work on such areas as early and precise detection of pathogens utilizing genomic based assays, conducting molecular epidemiology to track movement of diseases like HIV within the country, study prevalence and strain variation on HPV in cervical carcinoma and to profile possible viral and bacterial pathogens in diarrhea epidemic.  This presentation is an effort to highlight some of the advantages and challenges of building molecular diagnostic laboratory in the developing world settings like Nepal and operating it in the context of addressing current and pressing challenges in healthcare in such countries.

Center for Molecular Dynamics was chosen to appoint medical personnel by Epidemiology and Disease Control Division (EDCD), MoHP, GON to support outbreak investigation activities in Mid and Far Western Regions of Nepal. The medical and laboratory personnel will be based in teams of two at Surkhet and Dhangadi respectively. CMDN has been entrusted the responsibility of monitoring and evaluating their performance, which will ultimately lead to better outbreak management in Mid and Far Western Nepal. World Health Organization (WHO) Nepal will be carrying out overall monitoring of the personnel. The activity is expected to last for four months starting July 2010.

A brainstorming session for wildlife conservation and use of molecular biology tools for enhance conservation efforts was organized by CMDN in its facility. There were attendees from the Ministry of Forest & Soil Conservation, WWF and other stakeholders. CMDN is fulfilling a leadership role in introducing molecular biology tools to develop wildlife genetics in Nepal.

Dr. Jan Janecka of Texas A&M University visited CMDN and IN to conduct training session to the Lab team on Snow Leopard Genetics.

CMDN/IN team attended Elephant health camp organized by Elephant Care (USA) in Chitwan National Park. There was participation from NTNC and Dr. William Modi of San Diego Zoo Research Centre. CMDN/IN is assisting in developing molecular based tool for TB detection in Asian Elephants.

CMDN/IN and Hain Lifescience (Germany) organized a seminar on TB detection through molecular tools. Dr. Andreas Hillman from Hain Lifescience and Mr. Dibesh Karmacharya from CMDN/IN offered their presentations.

CMDN/IN participated in CME program of the Institute of Medicine, Teaching Hospital (TUTH) and presented its capabilities in diagnosis & research and also elaborated on building capacity of doing HLA typing in Nepal. Dr. Pradeep Vaidya from TUTH hosted the program.

Almost one year after the cholera outbreak that killed over 300 people in the far and mid-western districts including Jajarkot, the National Health Research Council (NHRC) on Monday disclosed that the epidemic was caused by a combination of pathogens, and not solely by cholera bacteria.

Disclosing the findings of a high-tech lab test carried out by the Center for Molecular Dynamics of Nepal (CMDN), Dr Chop Lal Bhusal, Chairman of NHRC, said, “The outbreak was the consequence of an amalgamation of various types of dangerous bacteria.”

He said that the government should have resorted to some other medication to contain the outbreak before it became devastating. “The lessons learnt from the Jajarkot outbreak may be useful in fighting forthcoming epidemics,” he said.

The latest lab test found Aeromonos, Shigella, Campylobacter, VTEC and E.Coli O157:H7 bacteria in stool samples collected from patients during the Jajarkot outbreak.

“We found bacterial strains of Aeromonos as high as those of cholera,” Sameer M Dixit, country director of CMDN, said, adding, “All bacteria were combined either with Cholera or Aeromonos.”

According to Dixit, all types of bacteria found in the lab test were water-borne. “We have, therefore, concluded that the Jajarkot outbreak was caused by contaminated water,” he said. “But we need further research with a high number of samples to scientifically substantiate our conclusion.”

Contrary to NHRC´s own previous findings, the lab test detected no food-borne bacteria like Salmonella and Clostridium perfringes. Bacteria of Yersinia Entercolitica and Clostridium Difficile--which primarily exist in water and soil--were also not detected in the lab test.

The previous findings had substantiated the belief of different non-governmental organizations that the outbreak was caused or at least abetted by rotten foods being distributed by the World Food Program (WFP).

According to health experts, symptoms of Aeromonos are similar to those of cholera. “It also triggers diarrhea and thereby dehydration,” Dixit said. “But it is not as fatal as cholera.”

Though Aeromonos bacteria was largely prevalent, the main cause of deaths of among victims of the Jajarkot epidemic was in fact cholera, according to Dixit.

By A Staff Reporter

Kathmandu, July 23

Following a ten day research expedition, Nepal Health Research Council (NHRC) has warned of a cholera outbreak in the diarrhoea-hit areas of Jajarkot and the surrounding districts and urged all the stakeholders for a rigorous medical intervention to avert one.

NHRC had sent on July 12 a three-member research team to investigate into the diarrhoea epidemic, its cause and measures to control it.

Dr. Mahesh Maskey, chairman of the NHRC, informed that cholera had been found in three out of five stool samples collected from diarrhoea patients visiting Jajarkot district hospital at Khalanga, the district headquarters.

He said that the samples were tested at National Public Health Laboratory at Teku where 15 more samples collected from Khagenkot Village Development Committee of Jajarkot district are under observation.

Dr. Maskey stated that the objective of the research was not only to find the cause of the outbreak but also suggest ways to contain it.

More than 150 people have so far succumbed to diarrhoea in Jajarkot district alone where all the 30 VDCs have been hit. Nearly 220 people from Jajarkot, Salyan, Rukum, Rolpa, Pyuthan, Surkhet, Dolpa, Doti and Bajura have lost their lives. Diarrhoea related deaths were reported first on May 3 in Rokaya village of Jajarkot. It is estimated 7,000 people are suffering from dysentery in these districts of mid and far-western region.

Dr. Gajananda Prasad Bhandari, epidemiologist at the NHRC who led the research team, said that it took six days for the samples to arrive in the capital from Jajarkot. "We collected the samples on the day we reached the district headquarters and sent them for test. But due to transportation difficulties, they arrived after five days."

He said that the team chose Khagena village on the recommendations of district health officer who had better knowledge of the situation. "We walked for about 12 hours to reach the village from district headquarters. We also held discussions about the epidemic and its cause with community health workers, leaders and social workers."

Disclosing the findings of the preliminary investigations, Dr.
Bhandari blamed socio-cultural and economic situation as well as awareness deficiency for the spread of the disease and deaths of the victims. "We talked with the people and learnt that on the one hand they have no toilets and on the other they rarely wash hands with shop after defecate."

He said that most people ate stale food kept open. "Moreover, the sources of water are not clean; people lack sanitation awareness."

Dr. Sameer Dixit, director at the Centre for Molecular Dynamics Nepal who was a member of the research team, pointed at lack of timely diagnosis of the disease and difficult geographical terrain as obstacles to the treatment of the patients.

Referring to his talks with people, he said that people in this or that village suffered from dysentery round the year. In some remote places people had a wrong belief that one should not drink water while suffering from diarrhoea.

Meanwhile, National Centre for Health Education, Information and Communications, stated Wednesday that so far 132 people have died in Jajarkot while 35 people have lost lives to diarrhoea in Rukum. The Centre informed that medical teams have been dispatched to Bajura and Pyuthan where cases of diarrhoea were seen last week. It said that medical teams were working hard at other previously affected areas as well.

The Center for Molecular Dynamics-Nepal (CMDN) and the Snow Leopard Conservancy (www.snowleopardconservancy.org) of California, USA, has signed MoU to undertake Snow Leopard Research in Nepal.
CMDN and SLC will work to develop Non-Invasive Genomic based tools to conduct species and individual identification of Snow Leopards in Nepal which will provide valuable information to do accurate population census of the species.

The Center for Molecular Dynamics-Nepal did oral presentation of its recently finished study titled “Integrated Bio-Behavioral Study (IBBS) Among Street Children and Youth of Kathmandu on HIV/AIDS” at the 16th Canadian Conference on International Health.  Mr. Dibesh Karmacharya, International Director of CMDN, presented the findings to the attending academicians and Public Health experts under HIV/TB category.

Nepal Britain Society, Kathmandu has donated NRs 50,000 (Fifty thousand Nepali Rupees) equivalent to USD 675 to CMDN in support of the ongoing IBBS study on HIV among youth and street children of Kathmandu (HIVSC project). Mrs Pratima Pandey, MBE is the president of the Society which carries out social work related activities in different places in Nepal. The check for the amount was handed by the Secretary of NBS, Mr. Sanjeev Raj Pandey to Mr. Rajesh Raj Bhandari, the Finance and Administrative Director of CMDN, on 20th September 2009. CMDN wishes to thank NBS and hopes for continued support in CMDN’s future upcoming events.

A Memorandum of Understanding (MOU) was signed between CMDN and Nepal Health Research Council (NHRC) to carry out health research in Nepal. The MOU was signed by Dr. Sameer M Dixit (PhD), Country Director and Dr. Mahesh Maskey, Chairperson, on behalf on CMDN and NHRC respectively on 27th August 2009. NHRC is an apex body to promote scientific study and quality research for health in Nepal. It has got mandatory authority from Government of Nepal to approve health research proposals and monitor their progress. It also aims to create a conducive environment for health research and helps the researchers and research institutions in enhancing their research capacity. It is expected that this MOU will facilitate collaborative research activities between the two organizations in the area of human health.

CMDN (Canada) has signed bilateral agreement with Trent University of Canada to build Genomic Database of endangered Species of Nepal. We are taking initiative to start Tiger Genome Project in Nepal with effort to build Bengal Tiger’s DNA database to be used for various applications including inter and intra species identification and estimate genetic diversity. We hope to bring cutting edge research and application based tools in the field of conservation biology to Nepal.

You can find more about our Partnering Organization by visiting- www.nrdpfc.ca

Realizing a need to nationally coordinate programs and policies to fight against STI, HIV/AIDS and other infectious diseases in Nepal, five dynamic Organizations have joined hands to form ABC-HN Consortium.

ABC-HN consists of AMDA-Nepal, BR Memorial Health Foundation, CMDN, HASTI-AIDS and NHF

This consortium will be planning and implementing programs and projects that will address current challenges in the field of disease prevention, diagnosis and care and treatment.

AMDA-Nepal has strong presence in eastern Nepal with 3 hospitals, BP Memorial Health Foundation has a well established track record of providing health services to underprivileged, running mobile camps for sexual and reproductive health and experience in implementing community HIV prevention program. CMDN has a robust clinical epidemiology research expertise along with access to well equipped, ultra modern molecular diagnostic and immunology laboratory. HASTI-AIDS has proven track record of running VCTs in far western region with program implementation experiences in HIV/AIDS and STI since 1998. NHF has a long serving history of working in reproductive health, STI and HIV/AIDS in Western region, it has also worked on implementing DOTS program for fight against TB and running program to address problem with Malaria.

Each Organization’s strength, experience and expertise will be fully utilized to come up with effective programs and projects to fight against STI, HIV/AIDS and other infectious diseases in Nepal.

Collaborators’ links:
www.amda.org.np
www.bpmhf.org.np
www.hasti-aids.org.np
www.nhfnepal.org

CMDN and Resources Himalaya Foundation has signed Memorandum of Understanding to establish a collaborative partnership to develop and share genomic level database on endangered species and conduct genetic analysis relevant to wildlife conservation and ecology protection in the region. Resources Himalaya Foundation has been very instrumental in the conservation of wildlife and ecology in Nepal. CMDN with its expertise in molecular biology and with the accessibility of ultra modern laboratory will be able to bring new dimension in the field of wildlife biology by developing tools and technologies that will help address some of the challenges of species identification, field tracking, conservation bio-medicine and database development.

Collaborator’s link: www.resourceshimalaya.org

CMDN has installed solar panels at its facilities to power backup system to allow uninterrupted electrical power to essential equipment and services. The 1200W (1.2KW) system of solar panels now provides enough power to the backup system in case of electrical blackout to run major equipment including freedge and freezer for an extented period of time. With the installation of this system, CMDN will no longer have to rely on electricity distributed via the national grid for its daily activities, regardless of current regular power outages, and in the process will be contributing to the environment by reducing usage of generators that can emit dangerous gases such as CO2 and CO. We invite interested organizations and individuals to visit our facilities to observe this novel system in place.

The two Organizations will be collaborating in such areas as molecular epidemiology of HIV and HPV. This will greatly benefit the regional cooperation and collaboration between the two countries-Nepal and Pakistan, in understanding prevalent diseases.

Collaborator’s link: www.aku.edu

CMDN Fundraising Event Toronto Canada

Fundraising event was held at the University of Toronto,Canada to bring awareness to the issue of street children and also raise funds to do HIV prevalence study on these children.

Photogallery

CMDN Presents "Daughters of Everest” (2004, 56 min.)
By: Sapana Sakya & Ramyata Limbu

The event is a fundraiser for the Center for Molecular Dynamics Nepal (CMDN). PROCEED GOING TO PREVALENCE STUDY OF HIV/AIDS in the Street Children of Kathmandu, Nepal.

ADDMISSION: FOR MORE INFORMATION: (905) 997-2462 WEB: www.cmdn.org.np TIME: 3-5PM DATE: Saturday May 31, 2008 VENUE: University of Toronto, Bahen Centre, Information Tech Room 1130, 40 St. George Street , Toronto