Malaria in nepal
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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.
Malaria in nepal
- 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