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BackgroundDengue is one of the newest emerging diseases in Nepal with increasing burden and geographic spread over the years. The main objective of this study was to explore the epidemiological patterns of dengue since its first outbreak (2006) to 2019 in Nepal.MethodsThis study is a retrospective analysis that covers the last 14 years (2006-2019) of reported dengue cases from Epidemiology Diseases Control Division (EDCD), Ministry of Health and Population, Government of Nepal. Reported cases were plotted over time and maps of reported case incidence were generated (from 2016 through 2019). An ecological analysis of environmental predictors of case incidence was conducted using negative binomial regression.ResultsWhile endemic dengue has been reported in Nepal since 2006, the case load has increased over time and in 2019 a total of 17 992 dengue cases were reported from 68 districts (from all seven provinces). Compared to the case incidence in 2016, incidence was approximately five times higher in 2018 [incidence rate ratio (IRR): 4.8; 95% confidence interval (CI) 1.5-15.3] and over 140 times higher in 2019 (IRR: 141.6; 95% CI 45.8-438.4). A one standard deviation increase in elevation was associated with a 90% decrease in reported case incidence (IRR: 0.10; 95% CI 0.01-0.20). However, the association between elevation and reported cases varied across the years. In 2018 there was a cluster of cases reported from high elevation Kaski District of Gandaki Province. Our results suggest that dengue infections are increasing in magnitude and expanding out of the lowland areas to higher elevations over time.ConclusionsThere is a high risk of dengue outbreak in the lowland Terai region, with increasing spread towards the mid-mountains and beyond as seen over the last 14 years. Urgent measures are required to increase the availability of diagnostics and resources to mitigate future dengue epidemics.

In Nepal, stinging nettles, also known as "sisnu" or "bichu ghaas," play a significant role in cultural and traditional traditions. For the inhabitants of Nepal, stinging nettles have cultural importance in addition to being useful as food and medicine. These stinging plants' fragile leaves and shoots are used extensively in Nepalese culinary customs to enhance dishes like "sisnu ko saag." Nettles' high nutritional value, which is enhanced by their abundance of vitamins, minerals, and proteins, enriches the local diet, especially in rural locations where a variety of vegetables could be hard to come by. Stinging nettles have gained acceptance in conventional medical procedures in addition to their culinary usage. Nettle extracts and teas are frequently used in Nepali communities to treat conditions including joint pain, arthritis, and allergies because they think that nettles have diuretic, anti-inflammatory, and pain-relieving characteristics. In Nepali hair care practices, nettles are also used as a natural cure for preserving healthy hair and scalp. Culturally, the intake of stinging nettles is associated with rites and festivals like Dashain, where it has symbolic meaning. The fibers taken from nettle stalks are used to make traditional fabrics and apparel, conserving artisanal techniques from the past. [ABSTRACT FROM AUTHOR]