Case studies

Case studies


We carry out studies on different health aspects. The following brief summary presents the studies carried out so far and provides an insight into current, health-related topics.

Mother and Child Health 2007-2008 at Amppipal Hospital, District of Gorkha

Short description: Questionnaire survey of diagnoses in the hospital, breast feeding, frequency of consultations in health facilities, measurement of size, weight, upper arm range of children aged 0 to 15 years. 2574 cases recorded (births, outpatient and inpatient presentations / treatments), 115 newborns, 1465 children measured.


  • 7.9% of all newborns with birth weight <2500g> 25.5% underweight, 26.2% underage, 22.1% undernourished
  • 7.6% middle upper arm circumference (MUAC) 21.3% emaciation (thinnes)
  • 2.2% overweight (overweight) Age group 0-5.9 years old 
  • 0.4% overweight in age group 6-15.9 years old
  • Approximately 10% of the children require stationary treatment and therapeutic nutrition. Risk factors for malnutrition:
  • female gender,
  • High number of siblings,
  • Adolescents more frequently affected by acute malnutrition,
  • Lack of maternal education,
  • Diseases are a risk factor, but mostly preexisting malnutrition,
  • Inadequate nutrition during the disease.

Main diagnoses:

  • Febrile respiratory disease (39%), 
  • Diarrheal diseases (11.2%),
  • Accidents 11.5%.Access to medical care: 98.3% (63.1% within 24 hours)Consultation reasons:
  • 64.5% febrile infections, respiratory infections, diarrhea (no gender difference),
  • Assistance to 61.4% in hospital, 37.1% in ambulance received, only 41.1% consultation with a doctor, 62.9% were never hospitalized,
  • Drowsiness in the hospital 3-5 days (fever, cough, diarrhea),
  • 2,5 h walk (n = 1394, wingspan 1 to 60 hours).


Respiratory Study 2008-2009 at the Amppipal Hospital, District of Gorkha

Brief description: Lung function measurement in adults


  • 11% of the 584 patients consulted the hospital because of a respiratory disorder,
  • Average height: male: 163 cm, female: 153 cm,
  • Average weight: male: 55.6 kg, female: 47.8 kg,
  • Average body mass index BMI: male: 20.8 kg / m2, female: 20.3 kg / m2
  • Lung function:
    • Spirometry was evaluated in 527 out of 584 measurements. 57 measurements were not usable because of the difficult maneuver.
    • The number of female patients was high. 437 normal spirometry (293 female, 144 male).
    • In 14% of the measurements, obstructions (female 12%, male 22%) were found. 
    • Of the men with obstructions were 56% smokers, 10% former smokers.
    • Among the women with obstructions were 57% smokers, 10% former smokers.

Allergies and lung function in the Kathmandu valley 2010-2011 in the Model Hospital, Kathmandu

Background: is the high rate of respiratory obstruction in Amppipal also in Kathmandu detectable and possibly a connection to allergies?

Short description: Spirometry and allergy test (Prick), determination of the total immunoglobulin E in adults, evaluation at the University of Magdeburg is still running.


Surveillance with Helicobacter pylori 2014 in Amppipal Hospital, district of Gorkha

Background: in Germany and in Kathmandu the gastric bacterium H.p. A very common pathogen and important cause of gastric ulcers.

Abstract: Antibody detection against H.p. in the blood of adults, questionnaire regarding living conditions, hygiene.


    • 200 participants, 
    • average age: 45 years, 
    • Average weight: 52 kg,
    • Only 17 patients had antibodies against H.p. on, 
    • Only 33 patients have their own water tap,
    • Only 13 have their own toilet,

Only 7 patients own a refrigerator.


Publications of the study results (selection):


  • Janich S: Vielerlei Maß. Bonn: Deutsch- Nepalische Gesellschaft e.V.; 2008. Jahrestagung 2008 Apr 26-27.
  • Janich S, Wiesmeth S, Devkota D, Giri BR, Twork S, Wankie C, Friis R, Kugler J: Children in Rural Nepal: Reasons for Seeking Medical; Aid and Parental Supportive Behavior at Last Attendance. San Diego: American Public Health Association; 2008. 136th APHA Annual; Meeting and Exposition 2008 Oct 25-29.
  • Janich S, Wiesmeth S, Devkota D, Giri BR, Twork S, Wankie C, Friis R, Kugler J: Breaking the Vicious Circle of Malnutrition and Seeking Medical Aid in Rural Nepal by Adequate Provision of Food during Sickness? – a Cross- Sectional Study in Amppipal Hospital, Gorkha.
  • Nepal. Istanbul: World Federation of Public Health Associations; 2009. 12th World Health Congress Apr 27- May 1.


  • Janich S: Vielerlei Maß. Nepal Information 2008, 101(2):31-33
  • Janich S, Dittrich S, Giri BR, Hussack S, Kugler J: Ernährungszustand von Kindern im Amppipal Hospital, Gokha, Nepal. HeilberufeScience, 2013. Doi: 10.1007/ s16024-013-0177-9.
  • Children in Rural Nepal: Reasons for Seeking Medical Aid and Parental Supportive Behavior at Last Attendance; Sylvia Janich, Susanne Wiesmeth, Dinesh Devkota, Babu Ram Giri, Sabine Twork, Che Wankie, Robert Friis, Joachim Kugler. published as poster at APAPHIN 2009.
  • Children in Rural Nepal: respiratory diseases are most frequent diagnoses when consulting health care services. Sylvia Janich, Arne Drews, Reingart Seibt, Dinesh Devkota, Babu Ram Giri, Che Wankie, Robert Friis, Klaus Scheuch. published as poster at European RespiratoryCongress Vienna, Austria 2009 European Respiratory Journal (2009) Vol.34 Suppl.53, S.626s.
  • Adults in rural Nepal: Are obstructive ventilatory disorders frequent? Arne Drews, Gunnar John, Toni Bergmann, Reingart Seibt, Janardan Devkota, Babu Ram Giri, Klaus Scheuch. published as poster at European Respiratory Congress Vienna, Barcelona 2010.
  • European Respiratory Journal (2010) Vol.36 Suppl.54, S.767s – awarded 3rd prize at Mid-German Respiratory Society Congress in Zeulenroda, Germany 30.10.2010.