Vector-borne diseases influenced by climatic factors and vector-control interventions measures for its prevention and control in Jhapa district, Eastern Nepal.

Thesis Report.

ABSTRACT: Climate change is emerging as an issue of public interest because of its health implications. Malaria and Kala-azar are one of the climate sensitive diseases endemic in Jhapa district of eastern Nepal. This study has been carried out to assess vector-borne diseases mainly (malaria and visceral leishmaniasis also known as ' Kala-azar') influenced by climatic factors and vector-control intervention measures for their prevention and control in Jhapa district. This study was a combination of retrospective and cross-sectional study. Rainfall was found positively associated with both the diseases. Overall, 1 millimeter (mm) increase in rainfall increases malaria incidence by 0.08% (RR=1.0009, 95% CI=1.0001-1.0015). Climatic factors such as minimum, maximum and mean temperature and relative humidity were not significant predictors of malaria. In the context of Kala-azar, 1mm increase in rainfall increase Kala-azar incidence by 0.18% (RR=1.002, 95% CI=1.0009-1.003) and, 1% increase in relative humidity decreased Kala-azar incidence by 4% (RR=0.96, 95% CI=00.93-0.99). Analysis of long lasting insecticidal nets (LLINs) distribution and indoor residual sprays (IRS) coverage data shows decrease in malaria and Kala-azar case only with the introduction of LLINs from 2006. Out of 140 respondents interviewed, 25% from Korobari and 39% from Topgachhi have heard about climatic factors. Only 40% from Korobari and 52% from Topgachhi had knowledge on malarial transmission. Knowledge on malaria transmission was significantly higher in Topgachhi VDC compared to Korobari VDC (p<0.001). About 17% from Korobari and 26% from Topgachhi had Knowledge on Kala-azar transmission. Most respondents perceived mosquito was responsible in Kala-azar transmission instead of sand fly vector. It can be concluded that malaria and Kala-azar case are influenced by climatic factors and vector-control intervention mainly LLINs play a major role in controlling both VBD. Therefore, LLINs coverage should be scaled up in the Jhapa district for outweighing the mosquitoes and sand fly vectors from transmitting the diseases. The knowledge and awareness level of the respondents on climatic factors, sign and symptoms of malaria and Kala-azar, transmission of the diseases and preventive measures was very low. Therefore, massive awareness programmes are urgently required to protect the health of the people from malaria and Kala-azar diseases. Key words: Climatic factors, Vector-borne diseases, LLINs, IRS, Climate change

Eng.