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Explain
This image is from a Nepal health report (likely the DoHS Annual Report) covering Scrub Typhus surveillance and control activities. Let me break it down section by section.
What is Scrub Typhus?
Scrub typhus is a bacterial infection caused by Orientia tsutsugamushi, spread through the bite of infected chigger mites. It presents as acute undifferentiated febrile illness and is a significant Neglected Tropical Disease (NTD) and Vector-Borne Disease (VBD) in Nepal.
Section 10.1.2.1 - Major Activities in FY 2081/82
1. Capacity Strengthening
- Three batches of 3-day Training of Trainers (ToT) were held on national protocols for diagnosis, treatment, and management of NTDs/VBDs including scrub typhus.
- Held in Gandaki Province (2 batches) and Koshi Province (1 batch).
- Targeted 90 doctors from major hospitals.
2. Rapid Diagnostic Test (RDT) Kits Supply
- Scrub typhus testing is free of cost in government hospitals.
- EDCD supplies kits on a need basis.
- In FY 2081/82, over 35,000 RDT kits were supplied to high-burden areas.
3. Outbreak Response
- A sudden surge was reported in Darma Rural Municipality, Salyan District, Karnali Province in Kartik 2081 BS.
- EDCD coordinated with the Provincial Health Service Directorate and mobilized rapid response teams.
- RDT kits were supplied, awareness campaigns were run, and local health camps were coordinated.
- Treatment was provided through Salyan Hospital and other health facilities.
4. IEC/BCC Activities
- EDCD developed and distributed Information, Education, and Communication (IEC) materials.
- Done with support from NHEICC (National Health Education, Information, and Communication Centre).
- Goal: raise public awareness and prevent/control scrub typhus.
Section 10.1.2.2 - Status of Scrub Typhus (Key Findings)
National Trend - Alarming Rise
| Fiscal Year | Cases |
|---|---|
| 2079/80 | 9,243 |
| 2080/81 | 16,597 |
| 2081/82 | 25,494 |
This is a nearly 3x increase in just 3 years - a major public health concern.
Province-wise Highlights (Table 10.7)
| Province | 2079/80 | 2080/81 | 2081/82 |
|---|---|---|---|
| Koshi | 773 | 2,119 | 2,235 |
| Madhesh | 94 | 308 | 903 |
| Bagmati | 1,290 | 1,838 | 3,063 |
| Gandaki | 1,565 | 1,725 | 2,419 |
| Lumbini | 2,843 | 4,322 | 7,862 |
| Karnali | 403 | 2,539 | 4,056 |
| Sudurpashchim | 2,275 | 3,746 | 4,956 |
Key observations:
- Lumbini Province has the highest absolute case count across all three years and the largest absolute increase (~5,000 more cases).
- Karnali and Madhesh show the most dramatic proportional growth - Karnali grew ~10x in 3 years, Madhesh grew ~10x as well.
- All provinces show a consistent upward trend - this is not isolated to one region.
- The Jajarkot earthquake (2081 BS/2024 AD) may have contributed through population displacement, which disrupts hygiene, increases exposure to mite habitats, and reduces healthcare access.
Summary
This report highlights that scrub typhus is a growing epidemic in Nepal, with cases nearly tripling in 3 years. The government response includes training healthcare workers, free diagnostic kits, outbreak response teams, and awareness campaigns - but the rising numbers suggest the disease burden is outpacing control efforts. The data is sourced from HMIS/DoHS (Health Management Information System / Department of Health Services).
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