Etiology of Diarrhoea Among Adult Patients During the Early Monsoon Period in Kathmandu, Nepal.

One hundred and eighty-one patients with acute diarrhoea attending the gastroenteritis ward of Sukra Raj Tropical and Infectious Disease Hospital (STIDH) were investigated during the early monsoon, April to May 2001. Bacterial pathogens were isolated in 33% of the patients. Enteropathogenic Escherichia coli was isolated in 8.28%, Shigella species in 13.25% and Vibrio cholerae 01 in 1.1% of the patients. Mixed infections with bacterial pathogens, helminths and protozoan parasites were commonly observed in the study. Trichuris trichiuria was de- tected in 27.6%, hookworms in 12.7% and Ascaris lumbricoides in 11.04%. Entamoeba histolytica/dispar and Giardia lamblia were observed in 12.7% and 7.73% of the patients, respectively. A large number of Cryptosporid- ium (7.73%) and Cyclospora species (3.86%) usually present in immunocompromised patients were also detected in acute diarrhoeal cases. The results showed that a wide range of bacterial pathogens was isolated from the in- habitants of Kathmandu, Nepal prior to the monsoon. These findings indicate that the bacterial pathogens, espe- cially diarrhoeaginic E. coli and Shigella, and protozoan parasites, need to be given additional attention in the di- agnosis and treatment of acute diarrhoea.