In 2018, at least 229 people were infected with malaria in Mugu district, an area considered non-endemic.

The district now stands second to Kailali district (with 257 cases), in terms of the number of detected malaria cases in 2018.

Likewise, 85 people of Bajura district were infected with malaria in 2018, as per the number of reported cases, making it the third most malaria-infected district.

Mugu and Bajura were among the 10 mountainous districts that were not considered endemic of vector-borne diseases. In addition to Mugu and Bajura, Humla (with seven detected cases) and Kalikot (with two detected cases) districts were also infected with the deadly disease in 2018. Humla and Kalikot are also among the 10 malaria non-endemic districts.

According to the Epidemiology and Disease Control Division (EDCD) of the Department of Health Services, 952 people were infected with malaria in 2015, 1,009 in 2016, 1,128 in 2017 and 1,189 in 2018.

The data shows that malaria cases are on rise and the prevalence of the disease has shifted to mountainous districts. Malaria is caused by Plasmodium parasites. Infected female Anopheles called ‘malaria vectors’ carry these deadly parasites, according to World Health Organization.

Health experts said that Nepal’s commitment to eliminating malaria by 2025 to achieve its Sustainable Development Goal target would not be met if effective intervention programmes are not launched immediately.   

“Due to various reasons, the number of malaria cases has been rising and outbreaks are being reported from areas considered to be low risk in the past,” said Ghanshyam Pokhrel, senior public health administrator at the EDCD. He said that the government along with other stakeholders are working towards introducing new strategies to meet the SDG target.

According to Pokhrel, surveillance of infected people and awareness campaigns against malaria will soon be launched in the high risks areas. The EDCD has in the past launched such programmes in highly endemic districts of Hilly and Tarai regions.

For instance, in 2010, 65 districts were categorised for malaria intervention programmes. Among the 65 districts, 13 were categorised as high risk, 18 as moderate risk and 34 as low risk, based on the annual parasite incidence.

Pokhrel, however, informed that his office did not have entomologists to execute surveillance of disease spreading vectors.

“We only have one entomologist. Thus, we are compelled to hire private institutions to carry out the surveillance,” said Pokhrel to the Post.

Dr Megnath Dhimal, a senior research officer at Nepal Health Research Council, said that the rise in temperature in the mountainous regions and increase in mobility of people were the main causes for the spread of malaria. WHO said that malaria epidemics can occur when climate and other conditions suddenly favour transmission in areas where people have little or no immunity to malaria.

“My study also shows that the prevalence of a disease declines in areas where awareness and surveillance programmes are launched and increases in areas that are left out,” said Dhimal.

Dhimal suggests establishing health screening facilities on border check posts and at the international airport to keep in check the spread of malaria and other deadly diseases.