Study on vector borne diseases and climate change along an altitudinal transect in Nepal
EXECUTIVE SUMMARY The effect of climate change is obvious. There is global consensus that the entire global community is increasingly imperiled by environmental threats like landslide, extreme weather or unseasonal weather conditions, floods, droughts, epidemics and killer heat wave...
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| Formato: | Technical Report | 
| Idioma: | en_US | 
| Publicado em: | 
        
      Nepal Health Research Council    
    
      2013
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| Assuntos: | |
| Acesso em linha: | http://103.69.126.140:8080/handle/123456789/708 | 
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| Resumo: | EXECUTIVE SUMMARY
The effect of climate change is obvious.  There  is  global  consensus  that  the  entire  global community is increasingly imperiled by environmental threats like landslide, extreme weather or unseasonal  weather  conditions,  floods,  droughts,  epidemics  and  killer  heat  waves  beyond anything  we  have  ever  experienced.  These catastrophes are self-generated.  Despite  the ubiquitous  associations  to  humanity,  environmental  issues  are  still  not  high  on  the  national  agenda. The objective of this study is to assess the effect of climate change on the vector borne  diseases  along  an  altitudinal  transects  and  recommend  guideline  to  develop  action  plan  for  its prevention and control in Nepal. The multidisciplinary team consisting of climate change expert, meteorologist, senior public health experts, and statisticians were formed for the completion of this research project. The interdisciplinary teams organized series of meeting to develop the concepts and collected the relevant data. Team was formed to develop some recommendations to take further step in climate change adaptation strategy.
The methodology of study was the mixing of descriptive retrospective and cross sectional study. Three different ecological regions with respect to their altitude from all the development regions of Nepal were selected for the study ranging from height below 500m, 500- 1500m and above 1500m.
Both  the  qualitative  and  quantitative  method  was  used  for  data  collection.  In-depth and key informant’s interviews were carried out with the health professionals and policy makers. Focus Group Discussion was carried out with the homogeneous and heterogeneous groups of female community  health  volunteers,  local  people  and  health  workers.  Questionnaire survey was also conducted with the elders aged above 60 years for KAP survey. Climate data on temperature and precipitation was  collected from Department of  Hydrology  and Meteorology. Time series loglinear  regression  analysis  was  done  to  assess  the  relationship  between  climatic  factors  and vector-borne diseases. Judgmental and multistage random sampling technique was used. Fifteen PHCC were selected from five development region, three from each region based on altitudinal transect. Twenty seven wards were selected for KAP study from western region.
Key  informant’s  interview  was  used  to  document  the  existing  vector-borne  disease  case reporting, referring and treatment policy of Nepal Government through various level of expertise like  health  professionals,  policy  makers  and  local  people  towards  vector-borne  disease  and climate  change  and  developed  a  case  study.  Health facility data were collected from Primary Health Care Centre (PHCC) using standard format, analyzed through logistic regression analysis.
Most  of  the  health  workers  had  some  knowledge  about climate  change  and  they  were  known about it compared to community people who don’t even heard the term "Climate Change". Most of the health workers were focusing on the need of strengthening of the existing health programs. They even said that the current health programs at the district level are not sufficient and need to be expanded  with  the  availability  of  proper  service and  manpower.  Health  workers  from Himalayan  region  also  felt  the  importance  of  vector control  officer  in  these  regions  as  well because they presume that the problems of vector are alarming and they are at risk of malaria.
KAP surveys were conducted in three districts of different ecological regions from terai, hill and mountain. Only 1.73% of the respondents from terai,28% from hill and 19.18 % from mountain region  have  knowledge  about  climate  change.  Their  major  source  of  information  about  the climate change was radio which is local radio stations.
Time series analysis was also carried out between climatic parameters and malaria. Temperature (maximum  and  minimum),  humidity  and  rainfall  were  taken  as  independent  variables  and malaria as dependent variable and were analyzed in the three cross section of Nepal from terai to mountain region. Occurrence of malaria was significantly associated with rainfall (p<0.032) and morning  humidity  (p<0.007)  and  others  parameters  were  found  insignificant  in  terai  region. While  in  hill  region,  no  significant  association  has  been  found  between  malaria  and  rainfall, evening  humidity,  maximum  and  minimum  temperature.  Malaria  was  found  significant  with morning humidity (p<0.01). From both the topographical zone (terai and hill) showed significant association of humidity and malaria. So, it is noted from the study that relative humidity is major climatic  determinants  for  the  occurrence  of  malaria,  which  is  highly  dependent  on  seasonality and rainfall. Malaria was not found in mountain region, so no association could be ascertained in this region. | 
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