Nepal, known as the land of the blue mountain has been known to have a perfect climate with a cool breeze, freshwater, and greenery everywhere you go. It’s no wonder Nepal has been the attraction of many visitors from around the world over the years, but what most people don’t know about Nepal is that even with all its natural beauty, it still carries plenty of diseases that can easily be avoided if you take precautionary measures to ensure good health and hygiene. Here are the top 8 common diseases in Nepal and how to prevent them.
Most Common Diseases in Nepal
1) Chronic obstructive pulmonary disease (COPD)
2) Ischemic heart disease (IHD)
3) Tuberculosis (TB)
4) Lower respiratory infections
5) Cerebrovascular disease
6) Neonatal disorders
7) Diarrhoeal disease
8) Stroke
9) Hepatitis A
10) kala-azar
1) Chronic obstructive pulmonary disease (COPD)
COPD is one of the most common diseases you’ll find. It's an umbrella term that describes several long-term lung diseases. Inhaling smoke, dust, chemical fumes, or other substances can irritate your lungs and cause COPD. Long-term exposure to tobacco smoke is a leading cause of COPD. If you have COPD, it means that your airways are inflamed and swollen, making it difficult to breathe. To prevent developing COPD, make sure to stay away from smoke or any chemicals that could damage your lungs.
Last year alone, more than 100 people died from COPD due to indoor pollution caused by kerosene stoves used for cooking as well as cigarettes. In Nepal, Smoking is responsible for 80% of all deaths due to chronic obstructive pulmonary disease (COPD). It is the leading cause of death in Nepal. COPD killed 17,200 people in the country in 2012, and there was a 22.1% increase in its death rate from 2005 to 2015. Long-term exposure to lung irritants causes this disease, and cigarette smoking, use of biomass fuels, and air pollution are some of the key risk factors.
The overall prevalence of COPD in Nepal was 11.7% (95% CI:10.5-12.9). We found a higher prevalence of COPD (16.8% [95% CI: 14.9–18.8]) among current smokers compared to non-smokers (9.1% [95% CI: 7.9–10.5]), and the prevalence increased with higher reported numbers of cigarette packs per year of smoking. (Source: Borgen Project)
Prevention of COPD
- Quit smoking and avoid exposure to secondhand smoke.
- Understand medication regimen and proper inhaler use.
- Prevent respiratory infections: pneumococcal vaccine, annual influenza vaccine.
- Avoid air pollution: remain indoors and close windows on bad air pollution days.
- Patients with severe COPD and repeated exacerbations (3 or more in a year): use inhaled glucocorticosteroids.
- Recognize and respond to early signs of exacerbations to minimize impact when exacerbations do occur.
2) Ischemic heart disease (IHD)
Ischemic heart disease is a condition in which the supply of blood is blocked, or narrowed, due to fatty deposits on the inner walls of the coronary arteries. This blockage impedes the delivery of oxygen-rich blood and thus oxygen to the heart muscles. If an individual has atherosclerosis, a build-up of plaque in his or her arteries is much more likely. According to Nepal Health Research Council, IHD killed 17,100 people in Nepal in 2012 alone and is the second leading cause of death for both men and women across Nepal. However, research shows that there are many risk factors for IHD such as smoking, high cholesterol levels, and obesity.
We used the Institute of Health Metrics and Evaluation’s Global Burden of Diseases database on cardiovascular disease from Nepal to describe the most recent data available (2017) and trends by age, gender and year from 1990 to 2017. Data are presented as percentages or as rates per 100,000 population. In 2017, CVDs contributed to 26·9% of total deaths and 12·8% of total DALYs in Nepal. Ischemic heart disease was the predominant CVDs, contributing 16·4% to total deaths and 7·5% to total DALYs. Cardiovascular disease incidence and mortality rates have increased from 1990 to 2017, with the burden greater among males and among older age groups.
Table 1
Percentage of total deaths and DALYs due to CVDs by gender in Nepal (all ages, 2017).
| Percentage of total deaths (95% UI) | Percentage of total DALYs (95% UI) | |||||
|---|---|---|---|---|---|---|
| Both | Male | Female | Both | Male | Female | |
| Ischemic heart disease | 16.4 (18.2–14.6) | 20.5 (22.7–18.03) | 11.1 (13.0–9.4) | 7.6 (8.7–6.2) | 10.3 (11.9–8.3) | 4.5 (5.5–3.7) |
| Stroke | 7.5 (8.6–6.7) | 8.6 (9.8–7.4) | 6.2 (7.7–4.9) | 3.5 (4.0–2.9) | 4.2 (5.0–3.5) | 2.6 (3.3–2.2) |
| Hypertensive heart disease | 0.8 (1.0–0.6) | 0.7 (0.9–0.5) | 0.9 (1.4–0.6) | 0.4 (0.4–0.3) | 0.3 (0.4–0.3) | 0.3 (0.5–0.2) |
| Rheumatic heart disease | 0.8 (1.0–0.5) | 0.6 (1.0–0.5) | 0.9 (1.2–0.6) | 0.6 (0.7–0.4) | 0.5 (0.7–0.4) | 0.6 (0.8–0.4) |
| Non-rheumatic valvular heart disease | 0.1 (0.1–0.1) | 0.1 (0.2–0.1) | 0.1 (0.1–0.1) | 0.1 (0.1–0.0) | 0.1 (0.1–0.0) | 0.0 (0.1–0.0) |
| Atrial Fibrillation and flutter | 0.2 (0.2–0.1) | 0.2 (0.3–0.1) | 0.2 (0.3–0.2) | 0.1 (0.2–0.1) | 0.1 (0.2–0.1) | 0.1 (0.1–0.1) |
| Aortic aneurysm | 0.2 (0.2–0.1) | 0.2 (0.3–0.2) | 0.1 (0.1–0.1) | 0.1 (0.1–0.1) | 0.1 (0.1–0.1) | 0.0 (0.0–0.0) |
| Peripheral artery disease | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0(0.0–0.1) | 0.0 (0.0–0.0) |
| Endocarditis | 0.0 (0.1–0.0) | 0.0 (0.1–0.0) | 0.0 (0.01–0.0) | 0.0 (0.0–0.0) | 0.0 (0.1–0.0) | 0.0 (0.0–0.0) |
| Cardiomyopathy and myocarditis | 0.2 (0.4–0.2) | 0.4 (0.5–0.2) | 0.2 (0.2–0.1) | 0.2 (0.2–0.1) | 0.2 (0.3–0.1) | 0.1 (0.1–0.1) |
| Other cardiovascular and circulatory diseases | 0.5 (0.8–0.4) | 0.6 (1.1–0.4) | 0.5 (0.7–0.3) | 0.4 (0.5–0.3) | 0.5 (0.7–0.4) | 0.3 (0.4–0.2) |
| Total Cardiovascular diseases | 26.9 (29.5–24.4) | 32.1 (34.8–29.2) | 20.3 (24.8–16.2) | 12.8 (14.5–10.9) | 16.4 (18.7–13.8) | 8.9 (10.5–7.3) |
(Source: NCBI, Pubmed Central Journal, 30 Oct 2022)
3) Tuberculosis (TB)
Tuberculosis is a disease caused by infection with a bacterium called Mycobacterium tuberculosis. The TB bacillus usually attacks a particular type of white blood cell, known as macrophages. After infection, individuals develop symptoms including fever, night sweats, fatigue, coughing, chest pain, and weight loss. When left untreated, TB can be fatal in more than half of infected individuals. In Nepal tuberculosis is an airborne bacterial infectious disease that affects primarily the lungs but also bones and kidneys. About 90% of cases are due to pulmonary TB (PTB) which spreads through airborne droplets when someone coughs or sneezes nearby.
Around sixty-nine thousand, 69, 000 (41,000 – 103,000) people developed TB in 2018. TB burden is much higher, almost 1.6 times higher than previously estimated.
National TB prevalence survey (2018–2019) suggested a significant impact of efforts on TB epidemiology in Nepal, which had led to an estimated annual reduction of TB incidence by 3% in the last decade.
This decline is better than the global annual decline rate of 1.5%–2%. However, this decline needs to be further accelerated to meet the End TB targets.
Prevention of Tuberculosis (TB)
- Take all of your medicines as they’re prescribed until your doctor takes you off them.
- Keep all your doctor appointments.
- Always cover your mouth with a tissue when you cough or sneeze.
- Wash your hands after coughing or sneezing.
- Don’t visit other people and don’t invite them to visit you.
- Use a fan or open windows to move around fresh air.
- Quit Smoking
4) Lower respiratory infections
According to a 2014 report from UNICEF, an estimated 52% of deaths among children under five years old in Nepal are due to preventable infectious diseases. The top two causes of death among children under five are diarrheal diseases (28%) and acute respiratory infections (17%). Among these respiratory illnesses, pneumonia is by far one of the most common. In fact, it’s thought that half of all cases go undiagnosed or untreated. Because there is no cure for pneumonia once it's contracted, preventing it—especially with vaccines—is crucial. Recent research shows that most Nepalese parents have never heard of pneumococcal disease; thus not only do they mistakenly believe their children aren't at risk but they also don't take them for regular checkups. These diseases in Nepal were responsible for 13,100 deaths in 2012. A cross-sectional study was conducted at Nepal Medical College and Teaching Hospital and International Friendship Children’s Hospital (IFCH) in Kathmandu among children of age 2–59 months attending Pediatric OPD. A total of 286 children were selected using the non-probability (convenient) sampling technique. Data were collected using a pre-tested semi-structured tool through an interview schedule, and descriptive and inferential statistical analyses were used.[1], [2]
Pathogens like influenza viruses, RSV, adenoviruses, rhinoviruses, Streptococcus Pneumoniae, Mycoplasma pneumonia, and Chlamydia pneumonia can cause chest infections. These are especially dangerous for infants and children. The elderly are also at risk of these illnesses because their immune systems don’t work as well as they once did. Make sure you have a good flu shot every year and if you live with someone who is sick try to avoid close contact until they recover. Wash your hands often with soap or use hand sanitizer when you are out in public or around other people who could be ill. Keep your immune system strong by getting enough sleep and staying active so it will be able to fight off infection if necessary.
Prevention of Lower respiratory infections
- Washing their hands frequently
- Avoiding touching the face
- Staying away from people with respiratory symptoms
- Cleaning and disinfecting surfaces regularly
- Getting vaccines, such as the pneumococcal vaccine
- Getting a flu shot every year
- Avoiding known irritants, such as fumes, tobacco, and chemicals
5) Neonatal disorders
Neonatal disorders usually occur during or soon after birth, sometimes before or during labor. It may also happen that a newborn baby has certain defects at birth. The most common neonatal disorders are that hypoglycemia, congenital heart disease, and transient tachypnea of newborns (TTN). Children with TTN typically breathe quickly right after birth because their lungs have not had enough time to develop fully. This condition is thought to be brought on by irregular levels of oxygen in their blood as they developed inside their mother's womb. Neonatal jaundice (also known as newborn hyperbilirubinemia) is a common cause of brain damage, which can be prevented if detected early enough by visiting your doctor immediately if you suspect your child has it.
In Nepal infant and neonatal mortality and morbidity is very high: IMR – 64, NMR - 39 per 1000 live births, and PMR 47.4 per 1000 live births and stillbirths. It is estimated that in Nepal nearly 50,000 children under one year of age die every twelve months. Two third of them die within 28 days of age, resulting in over 30,000 neonatal deaths per year. Among those dying within the neonatal period, 20,000 (two-thirds) die in the first week of life. Nearly the same numbers of babies are stillborn. More than 16,000 of those dying within the first week of life, die within 24 hours. As things stand, this means that three to four newborns are dying every hour in Nepal. (Source: Ministry of Health & Population Nepal)
Hospital-based data suggest that the major direct causes of neonatal death in Nepal are:
- Prematurity
- Hypothermia
- Infection
- Birth asphyxia/trauma
Underlying these direct causes is a constellation of underlying causes, including:
- Poor pre-pregnancy health,
- Inadequate care during pregnancy,
- Inadequate care during delivery,
- Low birth weight, and
- Inadequate newborn and postpartum care.
- vaccination of women of childbearing age (married and unmarried both) with tetanus toxoid
- community-based interventions i.e. tetanus toxoid immunization for all mothers; clean and skilled care at delivery; newborn resuscitation; exclusive breastfeeding; umbilical cord care and management of infections in newborns
- supplementary immunization (in addition to regular EPI program)
- safer delivery practices.
6) Diarrhoeal disease
Diarrhea is a major public health problem, especially among children. Pathogens, such as bacteria and viruses, that cause diarrhea can spread quickly through contaminated food or water. When combined with inadequate personal hygiene practices (e.g., handwashing), these pathogens can spread easily within a community. The main symptom of diarrhea is frequent, loose, or watery stools.
- Exclusive breastfeeding for the first six months of life
- Good personal and food hygiene
- Health education about how infections spread
- Rotavirus vaccination
- access to safe drinking water
- Use of improved sanitation
- Handwashing with soap
7) Hepatitis A
Hepatitis A is a viral infection of your liver that causes jaundice (yellowing of your skin or eyes). You get it from eating food or drinking water contaminated with fecal matter. Symptoms include nausea, vomiting, diarrhea, fever, abdominal pain, dark urine, and jaundice. Hepatitis A can be prevented by getting vaccinated. The vaccines aren’t 100% effective, but they do lessen your risk significantly. In Nepal, it is recommended for high-risk populations like travelers. It is also recommended for people who are exposed to unsanitary conditions as well as drug users who share needles or syringes or have sex with many partners without using condoms. . If you fall into one of these categories, talk to your doctor about getting a hepatitis A vaccine. While it isn’t required in Nepal, there are other preventative measures you can take if you decide not to get vaccinated. Wash your hands thoroughly before handling food and always use clean water when preparing meals or drinks. Never drink directly from rivers or streams; boil any water before consuming it.
In Nepal, hepatitis A virus infection was most common in children till the last decades, it is emerging as an important cause of acute hepatitis in young adults [19]. Prevalence of HBV is 1.1% in the overall population, however; some ethnic groups in the Himalayan region have high incidence rates. HBV is one of the major causative agents for liver cirrhosis and hepatocellular carcinoma; although the prevalence rate is low in the general population in Nepal. Similarly, the overall prevalence of HCV is only 0.4% of the general population in the country, however, it was found up to 19% in HIV-infected individuals. There is a number of hospital-based reports, sporadic cases, and outbreak due to HAV, and HEV in Nepal; however limited scientific publication is available online. The present data indicate a high prevalence of HEV in Nepal where the massive outbreak occurred in the Kathmandu Valley in 1973 and 1981–1982, 1985 with the recent outbreak in Biratnagar where more than 6000 individuals were affected with 17 reported deaths in 2014. (Source: BMC, Hospital-Based Study 2018 Kathmandu, BY Birendra Prasad Gupta, Anurag Adhikari, & Santosh Chaudhary)
Prevention of Hepatitis A
- Vaccination - 2 doses of vaccine (shots) spaced 6-12 months apart.
- Thoroughly wash your hands with soap
- Drink bottled water rather than local water
- Dine at established, reputable restaurants, rather than from street vendors
- Avoid eating peeled or raw fruit and vegetables in an area with low sanitation or hygienic standards
8) kala-azar
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