BPKIHS moves forward with Covid-19 tests in eastern Nepal

DHARAN: BP Koirala Institute of Health Sciences (BPKIHS), the second health institution in Nepal to commence real-time polymerase chain reaction (RT-PCR) -- a test done to detect the novel coronavirus (Covid-19) -- has sent its first lot to the capital, of which the results turned out negative.

All seven provinces, after receiving required equipment, are scheduled to begin with COVID-19 sample testing soon.

According to Narayan Raj Bhattarai, Additional Professor at Microbiology Department in BPKHIS, the institute has processed 12 samples from around eastern parts of Nepal including Mechi Zonal Hospital, Koshi Zonal hospital, Panchthar District hospital, Dhankuta District Hospital, among others. "Covid-19 tests are quite expensive, so keeping in mind our budget efficiency, all 12 samples were tested together," added Bhattarai.

BPKIHS can conduct a total of 32 tests in a day but owing to lack of the RNA extraction equipment, only 12 samples were tested. "Nepal has limited personal protective equipment's (PPE) that leaves us with an option to learn to provide adequate care and utilise our resources optimally," said Bhattarai.

Bhattarai says number of tests might increase in the coming future. "BPKIHS is taking all measures to ensure smooth testing of samples for Covid-19 but we need to implement more PCR-techinque and make it easily accessible and available, both, because, in future, we need to be prepared to test, trace and isolate as many patients as we can and suppress the threat," said Bhattarai.

"Samples like throat and nasal swabs are packed in cold boxes and transported from various places to testing labs very carefully. A swab, that has RNA virus, degrades very easily if not handled with care, resulting in diffucilty to detect DNA", informed Bhattarai. RNA is turned into DNA using RT-PCR machine. Real-time polymerase chain reaction (RT-PCR)-based tests are recommended as diagnostic tests for COVID-19.

"We don't have an automated RNA extraction machine so we amplify RNA manually. It takes about 2 hours to extract RNA in a bio safety level 2 lab where we have installed a negative pressure. The WHO recommended gene tests were conducted to detect the presence of "E" gene, "RdRp" gene", said Bhattarai. The WHO recommends using at least three-gene-test for virus detection.

Bhattarai, who is working with vast number of students and health professionals, further added that they are receiving more samples from Bhojpur and Okhaldhunga, today.

So far, Nepal has seen low numbers across the country as compared to its neighbours. "We haven't seen community oriented cases yet, only imported ones. It is not easy to identify Covid-19 by taking a simple look at those with symptoms," Bhattarai added.

Bhattarai, when asked about if there is any room for error while testing Covid-19, said, we are capable of validating tests by applying theoretical and practical knowledge, both.

The new coronavirus, which causes COVID-19, began in China, has infected more than 936,237 people around the world, with 47,249 fatalities.