Malaria is a protozoal disease transmitted to humans by infected Anopheles mosquitoes. In Nepal, approximately 13 million people live in malaria endemic areas, with 1 million in high risk areas. The disease is most prevalent in the Terai region. Two species, Plasmodium vivax and P. falciparum, are found in Nepal, with 80% of cases being P. vivax. Nepal has experienced malaria outbreaks since the 1970s and has worked to control the disease through a national malaria program since the 1950s. The current strategic plan aims to eliminate malaria in Nepal by 2025.

1. Malaria in
Nepal
Presented by;
Anju sapkota
Ankita kunwar
Babita khadka
Prerna mallik
Sushmita nepali

2. • The term malaria originates from Italian word:
''mala aria'‘ which means "bad air“
• A protozoal disease caused by infection with
parasites of the genus Plasmodium
• Transmitted to man by infected female Anopheles
mosquito
• Disease under international surveillance

3. Current scenario of malaria in
Nepal
• Based on the micro‐stratification report 2013,
approximately 13.02 million population (47.9%) live
in malaria endemic areas (VDCS)
• Out of which ~1 million (3.62%) live in high risk
VDCs, 2.66 million (9.8%) live in moderate risk
VDCs, and 9.38 million(34.52%) live in low risk
VDCs.
• A total population of 14.13 (52.1%) is estimated to
live in VDCs where there is no malaria transmission

4. • The high risk areas consist of foothills with
river belts, forest fringe areas in terai, hill
river valleys, inner terai areas.
• Low risk VDCs lie in plain cultivated outer
Terai, mountain, and valleys in the
mountains
• The transmission is distinctly seasonal,
with transmission limited to the warm and
rainy summer months ( mostly June-
September)

5. Malaria micro‐stratification
• Map below clearly shows the different clusters
of VDC’s at different risk of malaria

6. Malaria Outbreaks in Nepal
• Since 1970, the country has overcome a number of
outbreaks in 1974, 1985, 1991, 2002, 2005 and
2006.
• 1974 outbreak involves three districts namely
Kapilvastu, Rupandehi and Nawalparasi.
• The highest number of cases was observed in the
1985 and 1991 epidemics.
• Recently malaria outbreak was reported in October
2006 from Banke district, near Nepal's southern
border with India. Approximately 1200 people
were affected, including 32 deaths.

7. Species prevalent in Nepal
• Two kinds of malaria and Vivax were found in various places. Of
them, 80 per cent patients were detected with Vivax and 20 per
cent with Falciparum malaria. The death rate is high in the
Falciparum type of malaria.
No Malaria deaths have been recorded after 2012 till da
te.

8. National malaria programme in
Nepal
• Malaria control project in Nepal was first initiated in
1954 with the support from USAID with the objective
of controlling malaria, mainly in Terai belt)of central
Nepal.
• In 1958, national malaria eradication program was
launched with the objective of eradicatingmalaria from
the country.
• Due to various reasons the eradication concept reverted
to control program in 1978.
• Following the call of WHO to revamp the malaria
control programs in 1998, Roll Back Malaria (RBM)
initiative was launched to control malaria transmission

9. Goals, objectives and targets of the
National Malaria Strategic Plan
(2014–2025)
 Vision — A malaria-free Nepal by 2025.
 Mission — Empower health staff and communities at risk to
contribute towards the vision of a malaria-free Nepal by 2025.
 Goals:
1. Sustain zero deaths due to malaria from 2012 onwards.
2. Reduce the incidence of indigenous malaria cases by 90% by
2018 (relative to 2012).
3. Reduce the number of VDCs with indigenous malaria cases by
70% by 2018 (relative to 2012).
4. Receive WHO certification of malaria free status by 2025.

10. Objectives
1: To enhance strategic information for decision
making for malaria elimination
2: To further reduce malaria transmission and
eliminate the foci
3: To improve quality of and access to early
diagnosis and effective treatment of malaria
4: To sustain support from political leadership
and communities for malaria elimination
5: Strengthen programmatic technical and
managerial capacities for malaria elimination

11. Major activities in 2072/73
 Distributed 246,157 LLINs in 10 high risk VDCs across 8 districts,
and distributed a further 58,280 LLINs across high and moderate
risk VDCS in 24 districts for pregnant women at their first ANC visits.
Also, distributed LLINs in earthquake and flood affected districts.
 Conducted the ward-level micro-stratification of malaria cases in
44 districts (final results awaited).
 Introduced case-based surveillance system, including web-based
recording and reporting system for districts. The MDIS is now fully
operational.
 Conducted a national malaria vector survey.

12.  Orientated district and peripheral level health workers on case based
surveillance and response.
 Carried out detailed foci investigation at more than four sites.
 Conducted G6PD deficiency prevalence study across 30 wards in 54 high risk
VDCs.
 Revitalized the malaria microscopy quality assurance system with
collaboration between the Epidemiology and Disease Control Division
(EDCD) and VBDRTC, with technical assistance from WHO.
 Orientated district health workers and FCHVs on the government’s
malaria elimination initiative and their role in detecting cases and facilitating
early treatment.
 Orientated mother groups and school children on malaria prevention
and the need for early diagnosis and prompt treatment.
 Conducted quarterly and annual review meetings for district and
central level staff. Participants reviewed data from peripheral facilities and
revised it based on suggestions.

13. Conducted operational research on malaria vector
behaviour and insecticide resistance.
 Conducted regular vector control (indoor
residual spraying) biannually across high and
moderate risk districts.
Conducted detailed case based investigation and
fever surveys around positive index cases.
Conducted integrated entomological surveillance
around the Kathmandu Valley and other districts
after the major earthquakes.
Celebrated World Malaria Day on 25 April 2016.

14. Thank you