Dengue periodic outbreaks and epidemiological trends in Nepal

Abstract

Dengue is a global health problem and expansion of its endemics towards new territories in the hilly regions in Nepal is a serious concern. It appeared as a new disease in Nepal in 2004 from Japanese traveler with sporadic cases every year and massive outbreaks in 2010, 2013 and 2016. The serotype was responsible for outbreak in particular year was dengue virus serotype-1 (DENV-1) in 2010, 2016; and DENV-2 in 2013. Nepal lacks basic health related infrastructure in rural areas and does not have a stringent health care policy. With severances of epidemic like dengue, a new surveillance or an upgrading of existing one are direly needed to better challenge the possible outbreaks. This review paper aims to explain the dengue trend in last one decade in Nepal and warrants concerted and timely public health interventions to minimize the deleterious effects of the disease.

When Micro Drives the Macro: A Fresh Look at Disease and its Massive Contributions in the Hindu Kush-Himalaya

“…In a 4-year periods from 2006 to 2010, the DF cases increased from 5 districts to 24 districts indicating the rapid expansion of the disease in a wide geography of the country . Similar epidemics in 2013 and 2016 occurred infecting several people of middle hill districts suggesting the shifting of DV from subtropical areas to temperate zones (Gupta et al 2018). More than 2000 DF cases as well as few deaths have been recently reported from 28 districts including Rupandehi, Jhapa, Mahottari, and Sarlahi at low altitude and Palpa, Arghakhachi, Rolpa, Pyuthan, and others at high altitude (DoHS 2019a).…”

Establishment and recent surge in spatio-temporal spread of dengue in Nepal

“…Nepal is vulnerable to the outbreak of many infectious diseases, including emerging and re-emerging diseases with significant impacts on ecosystem functioning and human health. Its rich biological diversity features three eco-climatic zones which are susceptible to invasive pathogens: tropical terai, subtropical and temperate regions in the mid-hills, and subalpine to alpine zones in the Himalaya [1,2]. Environmental degradation, changes in land-use patterns, agricultural intensification, and unplanned urbanization contribute to increased outbreaks of infectious diseases in Nepal.…”

“…However, in the last five years, 21,858 confirmed cases have been reported across 60 districts including the mid-hills of Nepal (Figures 1 and 2). Large dengue outbreaks in Nepal occurred in 2010 (917 cases), 2013 (683 cases), and 2016 (1,527 cases) [2,10,11]. During these outbreaks, the major serotypes were identified as DENV-1 in 2010 and 2016, and DENV-2 in 2013 [2].…”

“…Large dengue outbreaks in Nepal occurred in 2010 (917 cases), 2013 (683 cases), and 2016 (1,527 cases) [2,10,11]. During these outbreaks, the major serotypes were identified as DENV-1 in 2010 and 2016, and DENV-2 in 2013 [2]. All four infectious serotypes of dengue virus (DENV-1-4) are present within the hosts, vectors, and the ecosystems of Nepal [12].…”

“…The risk of dengue infection and outbreak in Nepal is increasing year by year at different spatial scales [2,10,13]. Limitations of diagnostic tools and poor health care systems continue to be the major challenges in the early detection and diagnosis of dengue [2]. It is likely that the official tally of disease incidence is underreported due to the complex nature of the disease and inadequate monitoring across the country.…”