Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia.
Biomedical Research Unit, Centre for Molecular Dynamics Nepal, Kathmandu 44600, Nepal.
Trans R Soc Trop Med Hyg. 2021 Jul 1;115(7):741-749. doi: 10.1093/trstmh/traa131.
Understanding and describing the regional and climatic patterns associated with increasing dengue epidemics in Nepal is critical to improving vector and disease surveillance and targeting control efforts.
We investigated the spatial and temporal patterns of annual dengue incidence in Nepal from 2010 to 2019, and the impacts of seasonal meteorological conditions (mean maximum, minimum temperature and precipitation) and elevation on those patterns.
More than 25 000 laboratory-confirmed dengue cases were reported from 2010 to 2019. Epidemiological trends suggest that dengue epidemics are cyclical with major outbreaks occurring at 2- to 3-y intervals. A significant negative relationship between dengue incidence and increasing elevation (metres above sea level) driven by temperature was observed (p<0.05) with dengue risk being greatest below 500 m. Risk was moderate between 500 and 1500 m and decreased substantially above 1500 m. Over the last decade, increased nightly temperatures during the monsoon months correlated with increased transmission (p<0.05). No other significant relationship was observed between annual dengue cases or incidence and climatological factors.
The spatial analysis and interpretation of dengue incidence over the last decade in Nepal confirms that dengue is now a well-established public health threat of increasing importance, particularly in low elevation zones and urbanised areas with a tropical or subtropical climate. Seasonal variations in temperature during the monsoon months are associated with increased transmission.
了解和描述与尼泊尔登革热疫情增加相关的区域和气候模式，对于改善病媒和疾病监测以及有针对性地开展防控工作至关重要。
我们调查了 2010 年至 2019 年尼泊尔登革热发病率的时空模式，以及季节性气象条件（平均最高、最低温度和降水）和海拔高度对这些模式的影响。
2010 年至 2019 年报告了超过 25000 例实验室确诊的登革热病例。流行病学趋势表明，登革热疫情呈周期性爆发，每隔 2-3 年出现一次大爆发。登革热发病率与海拔高度（以米为单位）呈显著负相关，这主要是由温度驱动的（p<0.05），海拔 500 米以下的登革热风险最大。海拔 500-1500 米之间的风险中等，海拔超过 1500 米后风险大幅降低。在过去十年中，季风期间夜间温度升高与传播增加相关（p<0.05）。未观察到年度登革热病例或发病率与气候因素之间存在其他显著关系。
过去十年尼泊尔登革热发病率的空间分析和解释证实，登革热现在已成为日益严重的公共卫生威胁，特别是在海拔较低的地区以及具有热带或亚热带气候的城市化地区。季风期间的温度季节性变化与传播增加有关。
