Mobile-Based Application for Dengue Control in Koshi Province of Nepal: An Implementation Research.



Ongoing


2025-2026


Institute of Tropical Medicine (ITM, Belgium) and Government of Nepal


Koshi Province


Dengue is a major public health problem in many countries. Dengue Fever is a viral disease transmitted through the bite of infected Aedes mosquitoes. Dengue is among the tropical diseases referred to as neglected tropical diseases. Dengue has been officially confirmed in over one hundred tropical and sub-tropical countries responsible for increasing the world’s morbidity and mortality (WHO, 2023, 2024).

Approximately half of the world’s population is at risk of dengue fever/dengue infection, with 5.2 million recorded cases in 2019 alone. According to the WHO, dengue is endemic in 129 nations, with the Americas, Southeast Asia (SEA), and Western Pacific areas being the most seriously affected. According to the reports, Asia accounts for almost 70% of the global disease burden. To date, there is no specific treatment for dengue/ severe dengue. The first dengue vaccine was licensed in 2015 but its performance depends on serostatus. The WHO proposed five strategies to reduce the dengue burden worldwide, including diagnosis and case management, integrated surveillance and outbreak preparedness, sustainable vector control, future vaccine implementation, and basic operational and implementation research. Although a vaccine is in the trial phase, vector control is the best measure for dengue prevention by controlling Aedes mosquitoes. The householders and communities will take responsibility for reducing the number of potential breeding sites routinely supported by education, social mobilization, and community engagement from the health sector and local authorities. Nepal was dengue-free, or at least was considered as such, until the first recognized suspected incidence in 2004(WHO, 2023, 2024).

Dengue has been identified as one of the youngest emerging infectious diseases in Nepal. The first case of dengue was reported in 2004. In 2006, many probable cases and 32 laboratory confirmed cases were reported across hospitals in central and western Terai, as well as Kathmandu during the post-monsoon season. Most cases were indigenous and confirmed the presence of all 4 serotypes in Nepal. From the years 2007 to 2009, sporadic clinical cases and outbreaks were recorded. Since 2010, dengue epidemics have continued to affect lowland districts as well as mid-hill areas. This trend of increased magnitude has since continued with the number of outbreaks reported each year in many districts- Chitwan, Jhapa, Parsa (2012-

2013), Jhapa, Chitwan (2015-2016), Rupandehi, Jhapa, Mahottari (2017), Kaski (2018) and Sunsari (2019)(DoHS, 2019).

In Nepal, dengue is a rapidly emerging disease. Endemic across most provinces, dengue incidence has increased in recent years largely due to the expansion of the vector Aedes aegypti and Aedes albopictus, as well as the movement of people and the introduction of imported cases. All 4 dengue serotypes exist in Nepal, with DENV-1 historically contributing the highest burden(DoHS, 2019). 

Despite several proven efficacious measures to control Dengue, these measures have not been translated into practice. Hence, there has been a challenge to control dengue at the community level. There are several barriers behind this such as Low priority for the dengue control program at the subnational level, Inadequate training and orientation for newly recruited health workers and refresher training for focal persons and managers, Under/over reporting of dengue cases leading to Inconsistent, incomplete, and untimely reporting, Limited capacity for early detection and response to outbreaks, Limited entomological capacity and vector surveillance, Furthermore, The EWARS system is unable to capture a substantial number of dengue cases that are tested outside the designated sentinel sites, hindering the government’s ability to accurately predict outbreaks. Likewise, Vector surveillance activities has been conducted only certain districts of Bagmati province (Bhaktapur, Chitwan, Kathmandu, Lalitpur, Makwanpur) and some selected sites at Sudurpaschim province.

 


General objective 

To implement and evaluate a mobile-based application for prevention and control of dengue in Koshi Province, Nepal, utilizing RE-AIM and Proctor’s framework.

 

Specific objectives

  • To Identify and Explore the Multilevel Barriers and Facilitators Influencing the Implementation of mobile based application for dengue control in Koshi Province, Nepal, Using the Consolidated Framework for Implementation Research (CFIR)
  • To perform cross-sectional landscape and KAP survey among community members on dengue prevention and control.
  • To co-create tailored implementation strategy for the implementation of mobile based application for dengue control with concerned stakeholders.
  • To evaluate the implementation-effectiveness outcomes of mobile-based application to control dengue utilizing RE-AIM and Proctor’s framework in Koshi province of Nepal.

Reduction in the number of cases of Dengue, and change in the Knowledge, Attitude, and Behavior of people on Dengue Control