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Nepal Health Alert: From Liver Diseases To CVD - 5 Most Dangerous Diseases Looming In Nepal

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The Hidden Epidemic: Why Nepal’s Five Most Dangerous Diseases Must Be Tackled Now

Ne pal is a land of towering mountains and rich cultural heritage, but beneath the tourist brochures lies a silent health crisis. A recent health‑site analysis (published 21 March 2024) underscores how five chronic and communicable conditions are quietly claiming lives across the country. The report—built on World Health Organization (WHO) statistics, Nepal’s Ministry of Health (MoH) data, and research from the Tribhuvan University Medical College—paints a stark picture: liver disease, cardiovascular disease (CVD), diabetes mellitus, cancer, and tuberculosis (TB) together account for nearly 70 % of all deaths in Nepal.


1. Liver Disease: The Rising Tide of Viral Hepatitis

What the data say
- Hepatitis B virus (HBV) and hepatitis C virus (HCV) prevalence is estimated at 4–5 % and 3–4 % respectively in the general population.
- WHO’s “Liver Diseases in South Asia” report cites a 20 % increase in cirrhosis‑related deaths between 2015 and 2021.

Why it matters
- Chronic infection leads to cirrhosis, liver failure, and hepatocellular carcinoma—conditions that are often diagnosed late because routine screening is scarce.
- Unsafe injection practices, traditional scarification, and blood transfusions without proper screening are major transmission routes.

What’s being done
- The MoH launched a national HBV vaccination program for newborns in 2013, but coverage remains at 78 %.
- The “Hepatitis C Eradication Initiative” (HCEI), funded by the Global Fund, has started antiviral treatment in selected districts but faces logistical hurdles.

A way forward
- Expanding vaccination to adolescents and women of childbearing age.
- Strengthening blood‑bank screening and public education on safe injections.
- Integrating liver‑screening into primary care visits in high‑prevalence zones.


2. Cardiovascular Disease: The Silent Killer

Epidemiology
- Heart disease and stroke now rank as the top two causes of death in Nepal, responsible for 22 % of all fatalities.
- WHO’s “Global Health Estimates” show a 15 % rise in CVD prevalence from 2010 to 2022.

Risk factors
- Rising urbanisation brings high‑salt diets, tobacco use, and sedentary lifestyles.
- Rural communities still face under‑nutrition, yet the double burden of malnutrition is growing.

Current interventions
- Nepal’s National Non‑Communicable Disease (NCD) Programme promotes “Check‑up‑Now” campaigns, offering blood‑pressure and cholesterol testing at health posts.
- Tele‑medicine platforms like “NepaHealth” are being trialled in Kathmandu to triage suspected stroke patients.

Needed steps
- Wider implementation of WHO’s PEN (Package of Essential Non‑Communicable Disease interventions) at primary‑care level.
- Community‑based smoke‑cessation programs, subsidised salt‑free cooking stoves, and public awareness campaigns on early stroke signs.


3. Diabetes Mellitus: A Rapidly Escalating Threat

Statistical snapshot
- Diabetes prevalence in adults ≥ 20 years is 8.5 %—double the 2010 figure.
- Complications such as nephropathy and retinopathy account for 12 % of hospital admissions.

Contributing factors
- Dietary shifts towards processed foods, sugary beverages, and fast‑food culture.
- Lack of routine glucose screening in primary‑care settings, especially in remote villages.

Government response
- The “Diabetes Early Detection” pilot in the Dhading district uses community health volunteers to perform HbA1c testing.
- Subsidised insulin and oral hypoglycaemics are being negotiated with the World Bank.

Future directions
- Strengthen health‑literacy programmes on carbohydrate counting and exercise.
- Expand continuous glucose monitoring (CGM) accessibility for high‑risk groups.


4. Cancer: A Growing Burden Amid Limited Resources

Key facts
- Breast, cervical, and oral cancers constitute 60 % of all cancer cases in Nepal.
- Screening rates: cervical cancer (Pap smear) < 15 %, breast cancer (mammography) < 10 %.

Challenges
- Cultural stigma and lack of awareness keep women from seeking early screening.
- Rural oncology units are under‑staffed and lack modern imaging equipment.

Initiatives underway
- The “Cervical Cancer Prevention Programme” (CCPP) is piloting VIA (visual inspection with acetic acid) screening in the Lumbini region, achieving 75 % coverage.
- Tele‑oncology projects link provincial hospitals to Kathmandu’s oncology centre for treatment planning.

Strategic imperatives
- Scale VIA screening nationwide, coupled with HPV vaccination for adolescents (currently 1 % coverage).
- Invest in mobile radiology units and training of radiographers in peripheral hospitals.


5. Tuberculosis: A Resurgent Threat

Epidemiology
- TB incidence is 140 cases per 100,000 population—higher than the WHO’s South‑East Asia regional average.
- Multi‑drug resistant TB (MDR‑TB) accounts for 7 % of all TB cases.

Drivers
- Overcrowded slums, poor ventilation, and low health‑seeking behaviour.
- HIV co‑infection rates, though relatively low, still compound mortality.

Current measures
- The National TB Programme (NTP) uses directly observed therapy (DOT) but coverage is < 70 % in remote districts.
- GeneXpert machines are being rolled out in key districts, but their reach is limited.

Needed actions
- Expand GeneXpert coverage to all district hospitals.
- Strengthen community‑based DOTS by training local volunteers and using mobile phone reminders.


Why a Multi‑Sector Approach Is Essential

The five diseases highlighted do not exist in isolation; they intertwine with Nepal’s socioeconomic fabric. Rapid urbanisation, migration to cities, inadequate sanitation, and food insecurity all contribute to the disease burden. A siloed response—focusing solely on treatment—cannot reverse the trend.

Integrated strategies that matter

ActionWhy It Works
Strengthen primary careEarly detection of liver disease, hypertension, diabetes, and TB reduces mortality and costs.
Public‑private partnershipsLeveraging NGO capacity and private diagnostics can expand screening reach.
Health education campaignsBehavioural change around diet, tobacco, and vaccination has proven impact in pilot districts.
Data‑driven targetingGIS mapping of disease hotspots allows efficient allocation of resources.
International collaborationWHO technical assistance and Global Fund financing accelerate intervention roll‑outs.

A Call to Action

Ne pal’s health officials, civil society, and the international community face an urgent, data‑backed call: act now to stem the tide of these five deadly diseases. With targeted investment in vaccination, screening, treatment, and community engagement, the country can shift from being a disease burden to a health success story—mirroring how Bhutan has reduced under‑5 mortality through robust public‑health policies. The window is narrow, but the tools are at hand. It’s time for decisive, sustained action.


Read the Full TheHealthSite Article at:
[ https://www.thehealthsite.com/diseases-conditions/from-liver-diseases-to-cvd-5-most-dangerous-diseases-looming-in-nepal-1261919/ ]