Epidemiology of dengue virus infections in Nepal, 2006-2019.

Autor: Rijal KR; Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal. komal.rijal@cdmi.tu.edu.np., Adhikari B; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand., Ghimire B; Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal., Dhungel B; Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal., Pyakurel UR; Epidemiology and Diseases Control Division (EDCD), Department of Health Service, Ministry of Health and Population, Teku, Kathmandu, Nepal., Shah P; Epidemiology and Diseases Control Division (EDCD), Department of Health Service, Ministry of Health and Population, Teku, Kathmandu, Nepal., Bastola A; Sukraraj Tropical and Infectious Disease Hospital Teku, Kathmandu, Nepal., Lekhak B; Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal., Banjara MR; Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal., Pandey BD; Epidemiology and Diseases Control Division (EDCD), Department of Health Service, Ministry of Health and Population, Teku, Kathmandu, Nepal., Parker DM; University of California, Irvine, CA, USA., Ghimire P; Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal.
Jazyk: angličtina
Zdroj: Infectious diseases of poverty [Infect Dis Poverty] 2021 Apr 15; Vol. 10 (1), pp. 52. Date of Electronic Publication: 2021 Apr 15.
DOI: 10.1186/s40249-021-00837-0
Abstrakt: 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.
Databáze: MEDLINE
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