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The diversity and prevalence of canine vector-borne pathogens (VBPs) in Bhutan have to date remained unexplored, whilst recent epidemiological surveys in other South Asian nations have found diseases caused by VBPs to be rife in local dog populations. Importantly, many of such VBPs can infect people as well, with a building body of evidence identifying potentially zoonotic rickettsial organisms infecting humans in Bhutan. Given the lack of data on canine pathogens in Bhutan we employed a suite of deep-sequencing metabarcoding methods using Oxford Nanopore Technologies' MinION™ device to holistically characterise the bacterial, apicomplexan and filarial worm blood-borne pathogens of dogs in the country's south. Of the 95 stray, owned and community dogs sampled 78% (95% CI = 69%-85%) were infected with at least one VBP. Pathogen species detected were highly diverse including the bacteria Mycoplasma haemocanis in 16% (95% CI: 10-24%), Ehrlichia canis in 4% (95% CI: 2-10%), Anaplasma platys in 2% (95% CI: 0.5-7%) of dogs as well as the zoonotic species Bartonella clarridgeiae in 1% (95% CI: 0.1-6%), a potentially novel Bartonella spp. and an Ehrlichia chaffeensis-like bacterium, both in 1% (95% CI: 0.1-6%) of dogs. The apicomplexan haemoparasites Hepatozoon canis in 62% (95% CI: 52-71%), Babesia gibsoni in 45% (95% CI: 36-55%) and Babesia vogeli in 3% (95% CI: 1-9%) of dogs were also detected. Finally, 5% (95% CI: 2-12%) of dogs were found to be infected with the filarioid Acanthocheilonema reconditum and 1% (95% CI: 0.1-6%) with zoonotic Dirofilaria sp. hongkongensis. One canine was found positive to the filarioid Setaria tundra, a species normally found infecting cervids. The elucidated diversity of VBP communities highlights the strength of assumption-free diagnostics, such as metabarcoding, in detecting rare, novel, and unexpected pathogens. This approach to identifying pathogen diversity is of critical importance when investigating regions and populations that have thus far been neglected, with the findings aiding the development of future One Health informed strategies for disease control.
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Introduction: Several patients who recover from COVID-19 infection continue to have persistent symptoms even after recovery from the disease. The special sensory functions such as taste, smell and hearing are affected by COVID-19 infection even after recovery from the illness. The aim of the study was to find out the prevalence of special sensory deficits among patients with post-COVID-19 visiting a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among adult patients who recovered from COVID-19 visiting a tertiary care centre from 1 January 2022 to 31 December 2022. After obtaining ethical approval from the Research Ethics Board of Health, data on patients who were diagnosed with COVID-19 one year ago was obtained from the surveillance register from the Ministry of Health. They were contacted by phone call and invited to the centre to participate in the study. Appropriate clinical examination and tests were carried out to assess the special sensory deficits. A convenience sampling technique was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 271 patients, the prevalence of sensory function deficit was 39 (14.39%) (10.21-18.57, 95% Confidence Interval). Conclusions: The prevalence of special sensory deficits after recovery from COVID-19 infections was found to be similar to the findings of other studies. Keywords: anosmia; COVID-19; hearing loss.
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COVID-19 , Adulto , Humanos , Centros de Atenção Terciária , Estudos Transversais , COVID-19/epidemiologia , Sensação , Exame FísicoRESUMO
There is no international reporting of SARS-CoV-2 infections in health care workers (HCWs). Estimates suggest that a HCW dies every thirty minutes from COVID-19. This worsened the shortages and burnout of HCWs worldwide. Twenty months into the pandemic, Bhutan recorded over 2600 COVID-19 positive cases and three deaths. About 906 HCWs were directly involved in managing these laboratory confirmed cases but no infections occured amongst this group. This zero infection was possible through the clustered management of positive cases in four national COVID-19 centers, strategic deployment of HCWs, the uninterrupted provision of quality personal protective equipment (PPE) and repeated training on the correct use of PPE. This is an exemplary achievement for a small country with limited expertise and resources.
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COVID-19 , Pandemias , Butão/epidemiologia , Pessoal de Saúde , Humanos , Pandemias/prevenção & controle , SARS-CoV-2RESUMO
BACKGROUND: Hearing impairment due to ototoxicity is one common cause adding to global burden of disability. Amikacin and kanamycin are two common Aminoglycosides used to treat multidrug resistant tuberculosis which results in ototoxicity. The mean prevalence rate of multidrug resistant tuberculosis in Bhutan stood at 16%. OBJECTIVE: The study is aimed to establish prevalence rate of hearing impairment due to ototoxicity and secondary side effects which may ascertain specific early intervention. METHOD: A total of 42 Patients undergoing multidrug resistant tuberculosis treatment participated in the study conducted at Jigme Dorji Wangchuk National Referral Hospital and Gidakom Hospital over a period of one year. Audiological tests were conducted once every month. The severity of ototoxicity was being graded using Brock's hearing loss grades. RESULT: The study found 45.23% participants with some degree of hearing loss consequent to multidrug resistant tuberculosis treatment. Around 9.5% of the total participants developed potential disabling hearing loss. Around 30.09% of participants had experienced subjective tinnitus during the course of treatment. Study found no significant association (p-value 0.88, 95%CI 0.93-1.00) between referred test result of DPOAE (distortion product Otoacoustic emission) screener and the ototoxicity. CONCLUSION: Study showed with significant prevalence of ototoxicity. Since hearing impairment have negative impact on psychosocial wellbeing and communication abilities, it is paramount importance to put in place the various preventative measures. With current guidelines by World Health Organisation on replacement of second-line injectable by oral regimens while treating patients with MDR-TB, it is expected to address ototoxicity and related issues.
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Alcoholic liver disease (ALD) is one of the major public health problems in Bhutan. The incidence of alcohol liver diseases (per 10,000 populations) in the year 2016 was 46. The burden of mortality associated with it is alarming, going by the size of the population of the country. It is one of the all-time top five killer diseases in the country. In 2016, the mortality attributable to alcohol liver disease was 184 corresponding to 97% of deaths due to reported liver diseases. The ALD is responsible for 15% of all deaths on an average in the last 3 years. How to cite this article: Wangchuk P. Burden of Alcoholic Liver Disease: Bhutan Scenario. Euroasian J Hepato-Gastroenterol 2018;8(1):81-82.