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Dhimal, M.

Publications and source records attributed to Dhimal, M..

3 recordsLinked to original sources

Genomic profiling of climate adaptation in Aedes aegypti along an altitudinal gradient in Nepal indicates non-gradual expansion of the disease vector

BackgroundDriven by globalization, urbanization and climate change, the distribution range of invasive vector species has expanded to previously colder ecoregions. To reduce health-threatening impacts on humans, insect vectors are extensively studied. Population genomics can reveal the genomic basis of adaptation and help to identify emerging trends of vector expansion. ResultsBy applying whole genome analyses and genotype-environment associations to populations of the main dengue vector Ae. aegypti, sampled along an altitudinal temperature gradient in Nepal (200- 1300m), we identify adaptive traits and describe the species genomic footprint of climate adaptation to colder ecoregions. We found two clusters of differentiation with significantly different allele frequencies in genes associated to climate adaptation between the highland population (1300m) and all other lowland populations ([≤] 800 m). We revealed non-synonymous mutations in 13 of the candidate genes associated to either altitude, precipitation or cold tolerance and identified an isolation-by-environment differentiation pattern. ConclusionOther than the expected gradual differentiation along the altitudinal gradient, our results reveal a distinct genomic differentiation of the highland population. This finding either indicates a differential invasion history to Nepal or local high-altitude adaptation explaining the populations phenotypic cold tolerance. In any case, this highland population can be assumed to carry pre-adapted alleles relevant for the species invasion into colder ecoregions worldwide that way expanding their climate niche.

genomics↗

Confirmation of local transmission of Orientia tsutsugamushi during scrub typhus outbreaks in Nepal

BackgroundScrub typhus is a severely ignored tropical disease and a leading cause of undifferentiated febrile illness worldwide caused by infection of an obligate intracellular bacteria Orientia tsutsugamushi. It has been rapidly expanding in South Asian countries, although clear epidemiological information is not available from Nepal. After the 2015 earthquake in Nepal, a sudden upsurge in scrub typhus cases was reported. The objective of this study was to investigate scrub typhus and its causative agents in human, rodent and chigger mites to better understand the ongoing transmission ecology. MethodsScrub typhus cases with confirmed diagnosis throughout the country were included in the analysis. Studies were concentrated in the Chitwan district, the site of a major outbreak in 2016. Additional country-wide data from 2015 to 2017 was made available from the government database to analyse the disease distribution using geographical mapping. ResultsDuring 2015-2017, 1,239 scrub typhus cases were confirmed with the largest outbreak occurring in 2016 with 831 (67.1%) cases. The remainder 267 cases were reported in 2017. The case fatality rate was 5.7% in 2015 and declined to 1.1% in 2017. Nationwide outbreak of scrub typhus was identified as the cases were found from 52 of the 75 districts of Nepal. A seasonal trend was observed with a peak during August and September (p = 0.01). In addition to the human cases, the presence of O. tsutsugamushi was also confirmed in rodents and chigger mites from the outbreak areas of southern Nepal. ConclusionThe detection of O. tsutsugamushi in human, rodent, and chigger mites from outbreak locations and wide-spread reports of scrub typhus throughout the country over two years confirms the ongoing transmission of O. tsutsugamushi with a firmly established ecology in Nepal. The countrys health system needs to be strengthened for systematic surveillance, early outbreaks detection, and immediate response actions including treatment and preventive measures. Author SummaryScrub typhus is a disease caused by a bacteria called Orientia tsutsugamushi and transmitted to people through bites of infected chiggers (larval mites). After the 2015 Gorkha earthquake in Nepal, a sudden upsurge in scrub typhus cases was reported with repeated outbreaks from different parts of the country. This study has documted epidemiology of scrub typhus and its causative agents in human, rodent and chigger mites confimring the local transmission O. tsutsugamushi with a firmly established ecology in Nepal. The local transmission of the diseases from most parts of the country demands strengthening for systematic surveillance, early outbreaks detection, and immediate response actions including treatment and preventive measures.

pathology↗

Factors Associated with Suicidal Ideation and Suicidal Attempts among Adolescent Students in Nepal: Findings from Global School Based Students Health Survey

IntroductionSuicide has been recognized as a public health problem with high burden in low and middle income countries. Suicide has long lasting psychological trauma on friends and relatives in addition to loss of economic productivity. Although the need of high quality evidence is acknowledged for designing suicide prevention program, Nepal lacks evidence from reliable and nationally representative data. In this context, this study aimed to estimate the prevalence of suicidal ideation and attempt and identify the factors associated with them.\n\nMaterials and MethodsTotal of 6,531 students of grade 7 to 11 from 74 schools representing all three ecological belts and five development regions participated in this cross sectional study. To select the representative sample from study population, we used the two stage cluster sampling method. The respondents filled the self-administed standardized questionnaire. We carried out a Complex survey analysis for adjusting the selection probability of each research participants.\n\nResultsNearly 14% had considered suicide while 10.33% had attempted suicide. Factors associated with suicidal ideation were the food insecurity (OR=2.31, CI=1.64-3.27), anxiety (OR=2.53, CI=1.48-4.30), loneliness (OR=2.50, CI=1.41-4.44) and gender (OR=1.38, CI=1.03, 1.88) as risk factors of suicidal ideation and anxiety (OR=2.99, CI=1.18-7.64), loneliness (OR=2.19, CI=1.28-3.74) truancy(OR= 1.99, CI=1.39-2.87), cigarette use(OR=3.06, CI=1.32-7.09) and gender (OR=1.60, CI=1.07-2.39) as risk factors of suicidal attempt. Having 3 or more close friends was found to have protective effect (OR=0.35, CI=0.16-0.74) against suicidal attempt.\n\nConclusionsStudy reveals the relatively high prevalence of suicidal ideation and suicidal attempt among school-going adolescents in Nepal. Appropriate coping strategies for factors like anxiety, loneliness seem could be useful for preventing both suicidal ideation and attempt.

epidemiology↗