Socio-Economic Impact of Covid-19 in Bhutan: A Critical Analysis

Cataclysms are difficult, uncontrollable problems that put societies and nations to the test in terms of how successfully they can protect their infrastructure and population, reduce losses on a material and human level, and recover rapidly. Throughout the beginning of recorded human history, infectious diseases have afflicted people. Over the last four decades, the rise of urbanization, globalization, and population expansion has played a significant role in the escalation of both the occurrence and cross-border dissemination of novel infectious diseases. The discovery of the coronavirus (SARS-CoV-2) and the proliferation of COVID-19 in this world today have prompted many countries to take drastic action. Many economic aspects, not least innovative start-ups, experienced an external shock as a result of the “lockdown” of a sizable portion of society and economic activity.  The first cases of COVID-19 in a nation are significant because they have an impact on the nation's response to preparedness, the perception of the pandemic by the general public, and the actions taken by medical professionals. A 76-year-old American man who visited Bhutan as a tourist and was isolated in a separate hospital with a committed medical care staff before being airlifted back to his nation experienced a fortunate turn of events in Bhutan. This patient made Bhutan and its people more careful, and the ensuing steps were so well thought out and wise. The patient's medical team, the government, and the Bhutanese people all took away lessons from this. The COVID-19 recovery effort has been hindered by the government's severe containment measures, which have caused supply chain interruptions, tourism industry problems, and an exodus of expatriate workers, leading to a labor shortage for both trained and unskilled personnel. This gap caused infrastructural projects to stall, which had a negative impact on the average person’s standard of living. Despite the fact that pandemic deaths are frequent, each one has influenced the socioeconomic and public health results, depending on the type and extent of the outbreak. In addition to reflecting on Bhutan's adaptability, responsiveness, and lessons learned, this study sought to provide a preliminary assessment of the COVID-19’s effects on the country. It also sought to provide a deeper understanding of the recent socioeconomic implications of the COVID-19

A Discussion on the Singing Dialogue Tsangmo : Bridging Culture Between Bhutan and Japan, from the Past to the Future

Bhutanese tsangmo is a unique cultural heritage that has been at the heart of folk culture in many regions of Bhutan. It was considered to be on the verge of extinction due to the trends toward globalization and modernization. However, new attempts have already been made in schools, through radio programming, teacher education, and other means to ensure its continuation. These attempts involve wisely transformed styles of traditional ways of playing. Our research group has been investigating the real-life circumstances and unique value of these songs since 2010. In this paper, we describe our findings and exchange opinions between Bhutanese and Japanese, each discussing tsangmo from our own viewpoints, including the cultural heritage in Bhutan, the language as it relates to tsangmo, new attempts to promote passing on tsangmo, Bhutanese creative dialogue and Japanese education, and finally, understanding the importance of tsangmo within the prospects for Asia from the perspective of ethnomusicology. Through our discussion we hope to shine a light on the remarkable and rich cultural heritage of Bhutan so that it may thrive in future generations.This work was supported by JSPS KAKENHI Grant Number JP 26301043

Scrub typhus among patients with acute febrile illness in Bhutan: A cross‐sectional study

Abstract Introduction Early diagnosis and treatment plays an important role in preventing mortality in scrub typhus infection. In districts situated in the subtropical region of Bhutan, scrub typhus remains an important aetiology among those with acute febrile illness. Zhemgang is one district at 572 m above sea level with warm humid climate, and the majority of population are involved in farming and livestock rearing. Methods This was a cross‐sectional study among patients with acute febrile illness in Zhemgang district, Bhutan, tested for scrub typhus rapid diagnostic kits. Variables were extracted from the laboratory registers for tests conducted between January 2019 and December 2020. Risk factors associated with scrub typhus were assessed using logistic regression. This study was approved by the Research Ethics Board of Health, Bhutan. Results There were 922 tests conducted for scrub typhus. The test positivity rate was 8.2% (n = 76) with the highest reported in Panbang Hospital (43, 56.6%) followed by Yebilaptsa Hospital (27, 35.5%) and Zhemgang Hospital (6, 7.9%). A higher number of cases were detected in females (44, 57.9%) and in the month of September (17, 16.3%). The factors associated with scrub typhus positivity rates were hospitals located in lower altitudes, age, sex and seasons (spring, summer, autumn and winter). Conclusions One tenth of patients with acute febrile illness tested positive for scrub typhus with the adequate volume of tests prescribed by the clinicians. Our study shows that summer months recorded higher proportions of scrub typhus infection

Occurrence of Echinococcusgranulosussensulato and other Taeniids in Bhutan

The present research shows the results of a national study documenting the occurrence and genetic diversity of Echinococcus and Taenia species across Bhutan. Environmental dog faecal samples (n = 953) were collected from 2016 to 2018 in all 20 Bhutanese districts, mainly in urbanised areas. Cystic echinococcosis cysts were isolated from 13 humans and one mithun (Bos frontalis). Isolation of taeniid eggs from faeces was performed by sieving/flotation technique, followed by DNA isolation, PCR and sequence analyses for species identification (gene target: small subunit of ribosomal RNA). Genetic diversity of E. granulosuss.s. was based on the sequence (1609 bp) of the cox1 gene. A total of 67 out of 953 (7%) dog faecal samples were positive for at least one taeniid species. From the 670 free-roaming dog faecal samples, 40 (5.9%) were positive for taeniid DNA, 22 (3.2%) of them were identified as E. granulosuss.s. and four (0.5%) as E. ortleppi (G5). From the 283 faecal samples originating from yak-grazing areas, 27 (9.5%) were taeniid positive, including eight (2.8%) infected with E. granulosuss.s. and four (1.4%) with E. ortleppi. E. granulosuss.s. was identified in all isolates from human and the cyst from mithun. A haplotype network (cox1 gene) from E. granulosuss.s, including isolates from 12 dogs, two human and one mithun, revealed eight different haplotypes. The most common cox1 haplotype was the globally distributed Eg01, followed by Eg40 and Eg37 (previously described in China). Five new cox1 haplotypes (EgBhu1–5) originated from human, dogs, and a mithun were identified. The study indicated the contamination of urban areas and pastures with Echinococcus eggs in seven districts in Bhutan. The molecular characterisation of E. granulosuss.l. revealed different E. granulosuss.s. haplotypes as well as E. ortleppi. The transmission of T. multiceps was documented only in the western part of the country. Considering the zoonotic feature of E. granulosus s.s. and E. ortleppi and the economic impact of coenurosis caused by T. multiceps (also known as gid) in Bhutan, the findings of this study represent a significant contribution towards an epidemiological baseline for the establishment of a national control programme

Cerebral cysticercosis in a wild Bengal tiger (Panthera tigris tigris) in Bhutan: a first report in non-domestic felids

The endangered Bengal tiger (Panthera tigris tigris) is a keystone species playing an essential role in ecology as well as in the social and spiritual lives of the Himalayan people. The latest estimate of the Bengal tiger population in Bhutan accounts for 103 individuals. Infectious organisms, including zoonotic parasites causing high burden in human health, have received little attention as a cause of mortality in tigers. Taeniosis/cysticercosis, caused by the cestode Taenia solium, is considered one of the major neglected tropical diseases in Southeast Asia. We present here a case of neurocysticercosis in a Bengal tiger showing advanced neurological disease outside Thimphu, the capital city of Bhutan. After palliative care, the animal died, and necropsy revealed multiple small cysts in the brain. Here we show the presence of two genetic variants of T. solium in the parasite material collected based on PCR and sequencing of the complete cox1 and cytB genes. The sequences form a discrete branch within the Asia plus Madagascar cluster of the parasite. On other hand, tests for feline morbillivirus, feline calicivirus, canine distemper virus, Nipah, rabies, Japanese encephalitis, feline leukaemia and feline immunodeficiency virus were negative. In contrast, PCR for feline herpesvirus was positive and a latex agglutination test revealed an elevated antibody titer against Toxoplasma gondii (titer 1:256). The molecular examination of taeniid eggs isolated from the tiger faeces produced sequences for which the highest homology in GenBank is between 92% and 94% with T. regis and T. hydatigena. This fatal case of T. solium neurocysticercosis, a disease previously unrecorded in tigers or other non-domestic felids, demonstrates an anthropogenically driven transmission of a deadly pathogen which could become a serious threat to the tiger population