Nepal Hazard Risk Assessment - Asia-Pacific Gateway for Disaster ...

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Nepal Hazard Risk Assessment Demographic data i.e. Population Diseases / Outbreak data from Health Management Information system( DOHS) District and National Maps Classification of Diseases and Outbreak 8 Classes of Diseases i.e. Leprosy, Malaria, Tuberculosis (TB), Sexual Transmitted Infection (STI), Diarrhea, Acute Respiratory Infection (ARI), Filariasis and Kalazar 4 Classes of Outbreaks Typhoid, Influenza & ARI, Gastroenteritis and Hepatitis Database management (Data Validation) Incidence rate calculation for diseases for all districts Incidence Index for specific District = Number of cases ------------------------- Total Population Incidence rate calculation for outbreaks for all districts Calculation of overall trend of diseases / outbreak for each district Trend Analysis for First and Last three years Mapping of Disease / Outbreak Susceptibility Figure 3.44 Methodology of disease / outbreak susceptibility mapping Figure 3.45.Trend analysis of Diseases and outbreak 78
Nepal Hazard Risk Assessment 3.6.8 RECOMMENDATIONS • The disease/ outbreak susceptibility maps (Figure 3.46 to Figure 3.51) are showing most vulnerable districts in the country. This gives broader pictures of distribution of diseases / outbreaks in the country. The disease / outbreak distribution can provide understanding about the causative factors for such problems. • The HMIS has comprehensively maintaining Health Management Information System. Comparing to disease database, Outbreak database is very much limited within the system. At present, outbreak data is only available for 5 years. It is recommended to restrength the system so that data is available to the department and ministry for addressing the need for better health emergency situation. • ARI and Diarrhea are most prevalent in west, farwest hills and mountain districts. Specially, the hill and mountain regions are prone to hygiene and sanitation related diseases and outbreaks. These regions are having acute shortage of water in winter and pre monsoon. This is reflected in shortage of water for drinking and daily use purposes. So community is largely dependent on limited water source which is largely used for cattle feed and daily utilities. The community uses polluted water for drinking, which is the source of Hepatitis, Diarrhea and other water borne diseases. There is lack of health infrastructure in these remote districts, leading to poor diagnosis and treatment mechanism. So there is a need for providing necessary health infrastructure in these areas. • Filariasis is mostly prevalent in far West and Central Terai districts. The reason for more cases are due to climatic factors like temperature, humidity, precipitation, altitude, vegetation, landuse landcover in these region. This gives conducive environment for nematode worms namely Wuchereria bancrofti, Brugia malayi, and Brugia timori. • Tropical diseases like Leprosy, TB, STI are reported across the country. Thus there is a need for expediting the programs aiming to eradicate these diseases. • Malaria is prevalent across all Terai and eastern districts. The reasons for more cases in identified districts are due to their geo and topographical configuration. Terai region is having large density of water bodies and rivers. The Terai region is almost flat and accumulates water in low lying areas. These stagnated water in ponds and lakes with high humidity and temperature gives appropriate environment for malaria vectors to grow. • There is a linkage of disease and outbreaks to other socio-economic factors, climate and meteorological factors, civil unrest and ongoing hydro meteorological disasters. The water and vector borne diseases are also governed by drought and flood events it is recommended to integrate various ongoing projects & program, so the causative factor for disease/outbreak are advanced adequately and reduce the impact of disease and outbreak. 79
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