Malaria cases rise in Sudurpaschim, posing challenge to eradication target

Kanchanpur: Malaria cases have begun to rise again in Sudurpaschim Province, creating serious concern and challenges for the health sector as the country approaches its eradication target. Although Nepal aims to reduce local malaria cases to zero by 2030, the latest situation indicates that achieving this goal may be difficult in the province.

According to statistics from the Sudurpaschim Province Health Directorate, a total of 387 malaria cases have been confirmed across the province. Of these, 373 are imported while 14 are locally transmitted. Although imported cases remain the primary source, experts say the emergence of local infections is a more alarming development.

Hemraj Joshi, Vector Control Officer at the Sudurpaschim Province Health Directorate in Rajpur, Doti, said that 15 local malaria cases have recently been identified in various local levels. These include Ganyapadhura Rural Municipality-5 and Parashuram Municipality-2 in Dadeldhura, Melauli Municipality-2 and Pancheshwor Rural Municipality-2 in Baitadi, Belauri Municipality-2 in Kanchanpur, and Kailari Rural Municipality-2 in Kailali.

District-wise, Kailali has recorded the highest number of cases with 204, followed by Kanchanpur with 57, Achham with 51, Doti with 31, Bajura with 22, Dadeldhura with 12, Baitadi with eight, and Darchula with two. Joshi noted that the open border with India is a major risk factor, particularly in Kailali and Kanchanpur. He added that, according to World Health Organization standards, a region can only be certified malaria-free after recording zero local cases for three consecutive years, making the recent resurgence a significant challenge.

The nature of malaria infections is also becoming more complex. Data shows that 328 cases involve Plasmodium vivax, while 54 cases are caused by Plasmodium falciparum, which is considered the most severe and deadly form. Additionally, three cases of Plasmodium ovale have been reported, a rare occurrence typically seen in African countries, suggesting possible international travel history among patients. Two cases of mixed infection, involving more than one malaria parasite, have also been identified.

Officials cite multiple factors behind the resurgence, including delays in identifying imported cases, limited resources for effective control programs, and the expansion of mosquito habitats into higher altitudes due to climate change.

Dr. Khagendra Bam, Director of the Sudurpaschim Province Health Directorate, said imported malaria is more common among security personnel returning from United Nations peacekeeping missions in African countries and workers returning from seasonal employment in Indian cities. He emphasized that challenges such as delayed detection, limited prevention capacity, the spread of mosquitoes to both Terai and hilly districts due to climate change, and lack of modern mosquito control methods are contributing to the rising risk.

Despite these challenges, he said efforts to control malaria have been intensified. An entomology laboratory is currently operational in the province, conducting continuous research on mosquitoes and insect behavior. Insecticide effectiveness testing, capacity building of health workers, strengthening of surveillance systems, strategy implementation, and public awareness programs are also being carried out.

Health experts stress that priority should now be given to strict monitoring of imported cases, strengthening border health checks, conducting active local research, and expanding public awareness. They also highlight the need to adopt modern mosquito control technologies in response to climate change.

Paramananda Bhatta, head of the Shuklaphanta Health Branch in Kanchanpur, said public awareness is crucial. He advised regular use of mosquito nets, elimination of stagnant water, protection from mosquito bites, and seeking immediate medical attention in case of fever.

“As Sudurpaschim approaches the malaria eradication target, the current resurgence should be seen as a serious challenge,” he said. “Timely and effective measures can still lead to a malaria-free Nepal, but delays could turn the situation into a major health crisis.”

Malaria is an infectious disease caused by parasites transmitted through the bites of infected Anopheles mosquitoes. According to the Epidemiology and Disease Control Division, Nepal is currently in a malaria elimination phase, with local cases reduced by about 90 percent over the past decade.

At present, local malaria cases remain below 50 annually, but reducing them to zero remains a challenge. Nationwide, a total of 1,164 malaria cases have been recorded, including 39 local and 1,124 imported cases.