Infectious diseases surveillance in the context of climate change: assessment of public health surveillance capacity in Nepal

Abstract

The changing dynamics of infectious disease transmission under the influence of global environmental change, urbanization, population growth and increasing trends of travel and migration are challenging the conventional approach of disease surveillance, highlighting a need for inter-sectoral participation and interdisciplinary collaboration.A qualitative exploratory study design will be adopted to assess the capacity of the public health surveillance system in Nepal to examine impacts of climate change on infectious diseases transmission. A scoping review of related scientific journal articles and pertinent documents was carried out to identify major elements relevant to climate change and infectious disease surveillance. An evaluation framework was then designed, which will be utilized to analyse interview transcripts of epidemiologists, surveillance officers, infectious disease experts and policy makers from the Epidemiology and Disease Control Division, Nepal.We identified 10 major documents, including 6 peer reviewed articles, 2 surveillance guidelines (issued by the US Center for Disease Control and Prevention and the World Health Organisation) and 2 conference proceedings describing major themes and components relevant to public health surveillance (environmental health surveillance and disease surveillance). However, we did not identify any literature that provides a comprehensive framework for infectious disease surveillance in consideration with changing climate. Hence, we took pragmatic approach incorporating the concepts of environmental health surveillance and disease surveillance- in addition to policies relevant to climate change and human health- to propose a comprehensive framework of infectious disease surveillance in a changing climate. We are now using this framework to evaluate the capacity of infectious disease surveillance systems in Nepal in the context of climate change. Findings from our qualitative study will be presented.We propose a comprehensive framework for infectious disease surveillance in the context of climate change, which can be utilized for evaluation of infectious disease surveillance capacity in the context of changing climate.