1. NHRCGovernment of Nepal NHRC
International Conference on Climate Change
Innovation and
Resilience for Sustainable Livelihood, 12-14 January
2015, Kathmandu, Nepal
Meghnath Dhimal
Chief/Senior Research Officer,
Research Section, NHRC
Email: meghdhimal@nhrc.org.np
Early Effects of Climate Change on Public
Health in the Hindu-Kush Himalayan Region- a
Case Study of Vector-borne Diseases
2. NHRCGovernment of Nepal
Outline of Presentation
Climate change in Hindukush Himalyan region
Health impacts of climate change
Climate change and vector-borne diseases (VBDs)
Materials and methods
Results and Discussion
Conclusions and way forward
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Climate change in Hindukush
Himalyan region
– The Hindu-Kush Himalayan (HKH) region includes
all areas of Nepal and Bhutan, and the mountainous
areas of Afghanistan, Bangladesh, China, India,
Myanmar and Pakistan (ICIMOD 2011).
– The HKH region is particularly vulnerable to climate
change because the rate of warming in the
Himalayas has been reported to have been much
greater than the global average in the last three
decades (Shrestha et al. 2012, Kulkarni et al. 2013,
Shrestha et al. 1999)
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Health impacts of climate change
Climate change affects public health mainly by three
pathways:
(1) direct impacts by increasing the frequency of
extreme events such as heat, drought and heavy
rainfall,
(2) effects mediated through natural systems such as
disease vectors, water-borne diseases and air
pollution, and
(3) effects that are heavily mediated by human
systems such as occupational impacts, under-
nutrition, and psycho-social problems
(Confalonieri et al. 2007, IPCC 2014)
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Climate change and Vector-borne
diseases (VBDs)
• “Climate change will altered geographical
distribution of vector-bore diseases and poor
regions of the world will be most vulnerable” (IPCC
AR 4 2007, IPCC AR5 2014)
• Shift of disease vectors and disease transmission
from tropical regions into temperate regions and
highlands has been predicted for both observed and
future climate change scenarios (Chen et al. 2011,
Caminade et al. 2014, Liu-Helmersson et al. 2014,
Siraj et al. 2014).
•
Meghnath Dhimal
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• At least six major Vector-borne diseases (VBDs),
namely malaria, lymphatic filariasis, Japanese
encephalitis, visceral leishmaniasis (also known
as kala-azar), chikungunya and dengue fever are
endemic in HKH region
• VBDs are climate sensitive because insect
vectors of these diseases are ectothermic and
hence temperature variation affects vectorial
capacity and extrinsic incubation period of
pathogens
Meghnath Dhimal
Climate change and VBDs
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• New cases are reported from new areas and
higher altitudes
• Present and projected climate data shows
conducive environment for the transmission of
VBDs especially in highlands of Nepal
• No application of climatic data for understanding
the VBDs transmission in HKH region
Meghnath Dhimal
Rationale for studying climate
change and VBDs
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• Study area: Nepal
• Study design: Longitudinal study
• Data collection: Entomological, Diseases ,
Meteorological and behavioral (Knowledge,
Attitude and Practice)
Meghnath Dhimal
Methodology
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Methods contd…
• Indoor resting mosquitoes collected using
aspirator and flashlight in early morning and
evening
Meghnath Dhimal
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Results
• The vectors of diseases have already been shifted
at least 2,000 m above sea level (Dhimal et al.,
2014a,b.c, Dhimal et al., PLoS Neglected Tropical
Diseases under review).
Meghnath Dhimal
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Results
• Significant relationships between climatic
variables and VBDs and their vectors are found
in short-term studies in Nepal
(Dhimal et al 2014b,d,e)
Meghnath Dhimal
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Fig 1. Effects of climatic factors on vector abundance
Dhimal et al. 2014b PLoS Neg Trop Dis
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Fig 2. Effect of mean temperature on malaria incidence
Dhimal et al.2014d Malaria Journal
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Results
• Knowledge level for prevention and control of
VBDs such as dengue is very low
(Dhimal et al., 2014f).
Meghnath Dhimal
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Discussion
• An expansion of autochthonous cases of VBDs to
non-endemic areas including mountain regions is
also observed in Nepal (Pun et al., 2014, Malla et
al., 2008, Pandey et al., 2008, Pandey et al.,
2004, Zimmerman et al., 1997, Thakur et al.,
2012, Impoinvil et al., 2011, Bhattachan et al.,
2009, Partridge et al., 2007).
Meghnath Dhimal
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Discussion
• The spatio-temporal distribution pattern of VBDs
in Nepal is in consistent with findings of other
countries of HKH regions such as of Bhutan (Dorji
et al. 2009, Wangchuk et al. 2013, Bhatia R et al.
2014, Narain 2008,), India (Aditya et al. 2009, Bhatia R
et al. 2014), Pakistan (Narain 2008, Bouma et al.
1996) and China (Li et al. 2011)
Meghnath Dhimal
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Conclusion and way forward
• We conclude that climate change can intensify
the risk of VBD epidemics in the fragile and
previously non-endemic areas of HKH region.
• We recommend for a regional collaboration for
risk assessment and then extending and scaling-
up VBDs surveillance and control programs in
HKH region to protect the health of both local
people and mountain tourists.
Meghnath Dhimal
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Acknowledgement
Ishan Gautam, Natural History Museum, Swoyambhu,
Kathmandu
MandiraLamichhane Dhimal, Biodiveristy and Climate
Research Centre (BiK-F) and Faculty of Social Sciences,
Goethe University, Frankfurt
Bodo Ahrens, Institute for Atmospheric and Environmental
Sciences (IAU), Goethe University, Frankfurt am Main,
Germany
Ulrich Kuch, Institute of Social Medicine, Occupational
Medicine and Environmental Medicine, Goethe University,
Frankfurt am Main, Germany
Nepal Health Research Council (NHRC), Kathmandu
Meghnath Dhimal
