Abstract

Purpose The purpose of this paper is to investigate epidemiology and control strategies of the four priority vector-borne diseases (VBDs) in Nepal, i.e. malaria, Kala-azar (visceral leishmaniasis), lymphatic filariasis (LF) and dengue fever/dengue hemorrhagic fever. Design/methodology/approach The study was a retrospective design to collect data during 1998–2016 from VBDs endemic districts of Nepal. All data were reviewed and epidemiological information of the four VBDs were analyzed. Findings The number of malaria cases during 1998–2016 of the 13 affected districts was declined from 8,498 to 991 cases with no record of deaths since 2012. The number of cases and deaths in the 12 kala-azar (visceral leishmaniasis) affected districts in 1998 was 1,409 and 42 cases, respectively, but was dramatically decreased in 2016 to 213 and 2 cases, respectively. LF cases of the 61 affected districts in 2011, 2014 and 2016 were 28,855, 30,000 and 33,517 cases, respectively. In total, 25 districts achieved elimination target and the remaining are expected to complete the needful cycles by 2018. Dengue incidence of the 31 affected districts during 2006–2015 was under controlled with reported cases of 642, 356 and 136 cases in 2013, 2014 and 2015, respectively, and only one death in 2015. Implementation of control strategies particularly disease management and community peoples’ awareness significantly reduced the cases and deaths of the target VBDs. Practical implications The results of this study clearly suggest that the current control strategies have been worked effectively. However, in particular of the VBDs, health education in communities in the endemic areas should be adopted for better community participation in the context of the primary health care approach and increase the effectiveness of disease control. Originality/value VBDs, i.e., malaria, kala-azar (visceral leishmaniasis), LF and dengue fever/dengue hemorrhagic fever, are major causes of morbidity and mortality in the least developed countries which include Nepal. Globalization of travel and trading, unplanned urbanization, environmental and climate change are having a significant impact on disease transmission. Therefore, the Ministry of Health of Nepal had brought some changes in strategies based on activities for disease control, vector control, preventive and preparedness for outbreak response. Consequently, the cases and deaths due to malaria, kala-azar (visceral leishmaniasis), lymphatic filaiasis and dengue fever/dengue hemorrhagic fever have been brought down markedly.

Highlights

  • Malaria, kala-azar, lymphatic filariasis (LF) and dengue fever/dengue hemorrhagic fever constitute the major vector-borne diseases (VBDs) that affect more than 1bn cases and over 1m deaths annually[1]

  • This study aims to describe the epidemiological situation and control strategies of malaria and priority VBDs in Nepal, i.e., kala-azar, LF, and dengue fever/dengue hemorrhagic fever by analysis of morbidity, mortality and application of strategies related to diseases control and elimination in Nepal

  • This study found that there were two districts, i.e., Jhapa in the eastern region and Mahottari in the central region which were affected by malaria, kala-azar, LF and dengue fever/dengue haemorrhagic fever

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Summary

Introduction

Kala-azar (visceral leishmaniasis), lymphatic filariasis (LF) and dengue fever/dengue hemorrhagic fever constitute the major vector-borne diseases (VBDs) that affect more than 1bn cases and over 1m deaths annually[1]. All of these VBDs are prevalent in South-East Asian countries. Malaria is caused by Plasmodium parasites transmitted through the bites of female Anopheles mosquitoes with P. falciparum and P. vivax being the most common cause of malaria[4]. An acute febrile illness like malaria is difficult to diagnose whilst the P. falciparum infection can develop into severe malaria and death[5]. The best available treatment, for P. falciparum malaria, is an artemisinin-based combination therapy, but the development of drug resistance remains a great concern[6]

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