Description
Introduction
Nepal has made significant progress in the fight against Malaria. The number of malaria cases and deaths has reduced tremendously which can be accounted to strengthened malaria surveillance and responses, quality diagnostics and improved malaria testing and treatment. Nepal is on its way to eliminate malaria by 2025. The objective of the study was to describe the various aspects of burden of malaria in the country.
Methodology
Desk review was conducted. Different literatures, reports and policy documents related to Malaria were reviewed and descriptive analysis was conducted.
Results and Discussions
As of 2022, there were 14 high risk wards for malaria across 8 district and 39 moderate risk wards across 10 districts. Sudurpaschim and Karnali province accounted for 93% high risk and 97% moderate risk burden. In the year 2022, there were 38 indigenous malaria cases and 453 imported cases with a total of 491 positive cases, which was 58 indigenous cases and 311 imported cases with a total of 377 cases in the year 2021, with 30% increase in the total positive cases. The percentage of PF (Plasmodium Falciparum) among total malaria cases was 14% in 2021, 23% in 2022 and 25% in 2023.
The annual blood slide examination rate per 100 was 1.3 in 2021, 2.9 in 2022 and 4.6 in 2023. The annual parasite incidence (API) was 0.03 in 2021 and remained constant with 0.05 in 2022 and 2023. The slide positivity rate was 0.25 in 2021, 0.24 in 2022 and 0.17 in 2023. The number of clinical suspected malaria cases were 373 in 2021, 129 in 2022 and 303 in 2023. In the year 2022, there was 1 case of death from malaria. The overall trend indicates that Nepal has entered elimination phase with API less than 1% in all provinces.
The major activities conducted in the year 2022 were distribution of 88,897 long lasting insecticidal nets as mass distribution and 25,196 nets were distributed through continuous distribution to people, ward-level micro-stratification of malaria cases in all 77 districts, case-based surveillance system, including web-based recording and reporting, orientation to health workers on malaria diagnosis, treatment, surveillance and response, indoor residual spraying across high and moderate risk districts, integrated entomological surveillance in different sites throughout the country and regular supply of mRDT and anti-malaria drugs to Service Delivery Points. All activities are conducted to ensure universal access to quality malaria services for prevention, diagnosis and treatment and directed towards the vision of malaria elimination by 2025 in the country.
Conclusions
Although, malaria transmission has reached a low endemic level in most of the plain lands, malaria infection is increasing in upper hilly areas previously classified as No Malaria risk. There is a need to sustain the current progress by strengthening malaria surveillance and information system, effective coverage of vector control interventions, and universal access to quality diagnosis and treatment which will help achieve the target of malaria elimination by 2025.
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