Paudel Uttam, Prasad Pant Krishna, Raj Adhikari Shiva, Silwal Sashi, Baral Bimala, Ghimire Laxmi, Devi Adhikari Sabitri, Paudel Sudip, Poudyal Anil, Dhimal Meghnath
Nepal Health Research Council, Kathmandu, Nepal.
Visiting Faculty, Kathmandu University, Kathmandu Nepal.
J Nepal Health Res Counc. 2022 Mar 13;19(4):754-761. doi: 10.33314/jnhrc.v19i04.2967.
Current literatures seem devoted only on relating climate change with malaria. Overarching all possible environmental determinants of malaria prevalence addressed by scanty literature in Nepal is found apposite research at this moment. This study aims to explore the environmental determinants of malaria prevalence in western Nepal.
Cross-sectional data collected from community people were used to identify the environmental determinants of malaria prevalence in western Nepal. Probit and logistic regressions are used for identifying determinants.
The results reveal that environmental variables: winter temperature (aOR: 2.14 [95% CI: 1.00-4.56]), flooding (aOR: 2.45 [CI: 1.28-4.69]), heat waves (aOR: 3.14 [CI: 1.16-8.46]) and decreasing river water level (aOR: 0.25 [CI: 0.13-0.47]) are found major factors to influence malaria prevalence in western Nepal. Besides, pipeline drinking water (aOR: 0.37 [0.17-0.81]), transportation facility (aOR: 1.18 [1.07-1.32]) and awareness programs (aOR: 2.62 [0.03-6.65]) are exigent social issues to influence malaria prevalence in Nepal. To be protected from disease induced by environmental problems, households have used extra season specific clothes, iron nets and mosquito nets, use of insecticide in cleaning toilet and so on.
Adaptation mechanism against these environmental issues together with promoting pipeline drinking water, transportation facility and awareness programs are the important in malaria control in Nepal. Government initiation with incentivized adaptation mechanism for the protection of environment with caring household attributes possibly help control malaria in western Nepal.
当前文献似乎仅专注于将气候变化与疟疾联系起来。在尼泊尔,现有少量文献提及的所有可能影响疟疾流行的环境决定因素中,目前急需进行相关研究。本研究旨在探究尼泊尔西部疟疾流行的环境决定因素。
采用从社区人群收集的横断面数据,以确定尼泊尔西部疟疾流行的环境决定因素。使用概率单位回归和逻辑回归来确定决定因素。
结果显示,环境变量:冬季温度(调整后的比值比:2.14 [95%置信区间:1.00 - 4.56])、洪水(调整后的比值比:2.45 [置信区间:1.28 - 4.69])、热浪(调整后的比值比:3.14 [置信区间:1.16 - 8.46])以及河流水位下降(调整后的比值比:0.25 [置信区间:0.13 - 0.47])是影响尼泊尔西部疟疾流行的主要因素。此外,管道饮用水(调整后的比值比:0.37 [0.17 - 0.81])、交通设施(调整后的比值比:1.18 [1.07 - 1.32])和宣传项目(调整后的比值比:2.62 [0.03 - 6.65])是影响尼泊尔疟疾流行的紧迫社会问题。为预防环境问题引发的疾病,家庭采取了额外的季节性特定衣物、铁网和蚊帐、在清洁厕所时使用杀虫剂等措施。
针对这些环境问题的适应机制,以及推广管道饮用水、交通设施和宣传项目,对尼泊尔的疟疾控制至关重要。政府启动具有激励作用的适应机制以保护环境并关注家庭因素,可能有助于控制尼泊尔西部的疟疾。