COVID-19 Amongst Travelers at Points of Entry in Nepal: Screening, Testing, Diagnosis and Isolation Practices

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Surveillance

Background:

• The World Health Organization (WHO) recommends COVID-19 surveillance at international Points of Entry (POE).
• Effective surveillance at POE is vital for controlling infectious disease spread, especially during global health crises.

Purpose of the Study:

• To describe COVID-19 screening, testing, diagnosis, and isolation practices among travelers at the Nepal-India border.
• To evaluate the effectiveness and identify challenges in COVID-19 surveillance at selected POE.

Main Methods:

• Analysis of daily surveillance reports from 13 POE along the Nepal-India border (March-July 2021).
• Screening of 337,338 travelers, with testing of those meeting specific criteria using rapid antigen diagnostic tests.
• Data collection on traveler demographics, testing proportions, COVID-19 diagnosis rates, and isolation practices.

Main Results:

• Of 337,338 travelers screened, 69,886 (21%) were tested, and 3907 (6%) were diagnosed with COVID-19.
• Testing coverage varied significantly over time and across POE, ranging from 0% to 99%.
• COVID-19 case demographics included predominantly Nepalese, male, migrant workers under 60, often presenting with fever; isolation practices varied.

Conclusions:

• Overall, approximately one-fifth of travelers were tested, highlighting considerable variability in surveillance coverage at different POE.
• The study underscores the need for strengthening surveillance processes at Points of Entry to enhance public health preparedness and response.