Epidemiology of dengue virus infections in Nepal, 2006–2019

Infectious Diseases of Poverty

Binod Lekhak¹  Prakash Ghimire¹  Megha Raj Banjara¹  Binod Dhungel¹  Komal Raj Rijal¹  Bindu Ghimire¹  Bipin Adhikari²  Uttam Raj Pyakurel³  Prakash Shah³  Basu Dev Pandey³  Anup Bastola⁴  Daniel M. Parker⁵ 

[1] Central Department of Microbiology, Tribhuvan University;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford;Epidemiology and Diseases Control Division (EDCD), Department of Health Service, Ministry of Health and Population;Sukraraj Tropical and Infectious Disease Hospital Teku;University of California;

关键词: Dengue;    DENV;    Aedes aegypti;    Outbreak;    Nepal;    Spatial epidemiology;   

DOI  :  10.1186/s40249-021-00837-0

来源: DOAJ

【 摘 要 】

Abstract Background Dengue is one of the newest emerging diseases in Nepal with increasing burden and geographic spread over the years. The main objective of this study was to explore the epidemiological patterns of dengue since its first outbreak (2006) to 2019 in Nepal. Methods This study is a retrospective analysis that covers the last 14 years (2006–2019) of reported dengue cases from Epidemiology Diseases Control Division (EDCD), Ministry of Health and Population, Government of Nepal. Reported cases were plotted over time and maps of reported case incidence were generated (from 2016 through 2019). An ecological analysis of environmental predictors of case incidence was conducted using negative binomial regression. Results While endemic dengue has been reported in Nepal since 2006, the case load has increased over time and in 2019 a total of 17 992 dengue cases were reported from 68 districts (from all seven provinces). Compared to the case incidence in 2016, incidence was approximately five times higher in 2018 [incidence rate ratio (IRR): 4.8; 95% confidence interval (CI) 1.5–15.3] and over 140 times higher in 2019 (IRR: 141.6; 95% CI 45.8–438.4). A one standard deviation increase in elevation was associated with a 90% decrease in reported case incidence (IRR: 0.10; 95% CI 0.01–0.20). However, the association between elevation and reported cases varied across the years. In 2018 there was a cluster of cases reported from high elevation Kaski District of Gandaki Province. Our results suggest that dengue infections are increasing in magnitude and expanding out of the lowland areas to higher elevations over time. Conclusions There is a high risk of dengue outbreak in the lowland Terai region, with increasing spread towards the mid-mountains and beyond as seen over the last 14 years. Urgent measures are required to increase the availability of diagnostics and resources to mitigate future dengue epidemics.

【 授权许可】

Unknown