KATHMANDU, July 29

The World Health Organisation on Wednesday called for bolstering efforts for malaria control and elimination by targeting malarial parasites believed to be less fatal, but now causing high disease burden.

According to WHO South-East Asia Regional Office, nearly 3.2 billion people continue to live in areas with risk of malaria infection, malaria needs to be high on the global agenda to achieve the target of 90 per cent reduction in deaths and disease, and elimination in 35 countries by 2030.

“Our efforts so far focused on the most deadly P falciparum malaria. We need to now broaden our strategy to include targeted interventions for P vivax malaria, which is contributing to a large proportion of global malaria burden, mainly in the WHO South-East Asia Region,” Dr Poonam Khetrapal Singh, Regional Director, said at a global malaria meeting. Of the 18.9 million P vivax malaria cases reported in 2012, nearly 13 million were from countries in the WHO South-East Asia Region.

According to a report published by the Department of Health Services in 2013, malaria control activities in Nepal are carried out in 65 districts. Out of the estimated total population living in endemic areas, 0.98 million (3.62 per cent) live in high risk VDCs, 2.66 million (9.8 per cent) in moderate risk VDCs and 9.38 million(34.52 per cent) live in low risk VDCs.

The high risk areas consist of foothills and river belts, forest fringe areas, forests of Tarai area, inner valleys and Tarai districts. Low risk VDCs lie in plain cultivated outer Tarai, hill and mountain river valleys. Clinical ‘malaria’ cases have dropped from 73,259 in 2005 to 49,550 in 2012. Confirmed cases dropped as well from 5,050 in 2005 to 2,092 in 2012. The proportion of falciparum infections is slightly declining over time to reach 19 per cent in 2012. Recorded malaria deaths are drastically declining from more than 200 during the 2006 epidemic years to less than 10 in 2010 and zero in 2012.

“We need targeted strategies for P vivax malaria which presents distinct challenges for control and elimination compared to P falciparum. It is proving to be an extremely difficult parasite as it does not readily respond to the existing control measures and has the ability to remain hidden and beyond the reach of the currently available diagnostic tools and medication,” Dr Singh said.