Health officials have stressed on intensifying efforts for malaria control and elimination by targeting malarial parasites believed to be less fatal, but now causing high disease burden.

Around 10.03 million Nepalese of 65 districts are under the risk of malaria infection, while 25 districts are declared as high risk zone. The government has declared Banke, Bardia, Kailali and Kanchanpur in the west and Jhapa, Morang and Sunsari in the east as home of malaria disease.

In Nepal, two types of parasites P Phalciparum and P Vivax cause malaria disease. All the government’s efforts so far targeted the most deadly P Phalciparum malaria parasites. However, experts have said the strategy needs to widen interventions for P Vivax malaria, which is contributing to a large proportion of national malaria burden.

According to Senior Virologist Dr. Basudev Pandey, last year 195 people suffered from Phalciparum malaria, while 1,154 were found with Vivax malaria and 120 were detected with mix parasites. Of the total malaria burden across the country, 80 per cent is of Vivax malaria and 20 per cent is of Phalciparum.

Due to the growing evidence of Vivax malaria, the Health Ministry is also thinking about strengthening the clinical system.

If people suffer from Phalciparum malaria, high fever, vomiting and nausea may lead to fainting and it affects the brain and the patient may die sometimes. In some cases, doctors are unable to find whether the case is of malaria or Japanese encephalitis.

Dr. Baburam Marasini, former Director of the Epidemiology and Disease Control Division, said malaria diagnostic kit and medicines are available in district level health facilities.

He said the symptoms of Vivax are also similar but there is no high fever and fainting, Marasini said.

Due to the growing evidence of Vivax malaria, the Health Ministry is also thinking about strengthening the clinical system.

Sometimes patients with Vivax malaria can suffer from G6BP deficiency which may lead to death of RBC in blood. However, there is no laboratory facility for G6BP across the nation. Currently, the EDCD is lobbying with the Ministry to manage lab facility for G6BP test. “We are planning to distribute G6BP test kits in the district level,” Dr. Marasini said. Similarly, currently, the government prescribes medicines for only five days for patients with Vivax which is not a full doze. In many cases, the disease may reoccur and lead to different other health hazards, Dr. Marasini added.

The WHO has said 14 days’ medicine package is essential to treat Vivax-infected patients. “We are also planning to introduce 14 days medicine package,” Dr. Marasini said. “If we strengthen this clinical parts targeting Vivax cases like diagnostic kits and full doze medicine, Vivax cases may decrease drastically,” Dr. Marasini expressed his hope.

Issues of health system like inadequate health staff, poor delivery of health services and weak surveillance should be resolved to control malaria, Dr. Pandey said.