Patterns and trends of malaria in 25 risk districts of Nepal from 2001 to 2017

PURPOSE: Malaria has been one of a major infectious parasitic disease in Nepal. Although the number of cases is gradually getting declined since last decade. Therefore, study aims to identify the trends and spatial patterns of malaria among 25 risk districts of Nepal. MATERIALS AND METHODS: This study utilized the secondary data of malaria cases from the annual reports (2001–2017) of Department of Health Services, Ministry of Health and Population of Nepal. Linear regression of log-transformed incidence rates model was used for assessing variation of malaria cases for year and districts. RESULTS: There was evidence of decrease in the trend of malaria (2001–2009); however, the upward trend was revealed in 2010, after that, it starts to decline and again in 2017, it started to grow up. The malaria cases were marked variations by location with higher rates occurring in Dadeldhura, Kanchanpur, Kailali, Bardiya, and Jhapa districts, respectively. CONCLUSION: In this regards, malaria cases are still causing the threat in the Terai district of Nepal; however, there were fluctuating patterns of disease noted during the study periods.

Modeling of malaria incidence in Nepal

Malaria is a major cause of morbidity and mortality in Nepal. The magnitude of malaria across the country is alarming and varies with location. Therefore, the present study aimed to model malaria incidence rates during 1998 to 2009 in Nepal. Data for the study were obtained from Health Management Information System [HMIS], Ministry of Public Health. A negative binomial model was used to fit malaria incidence rates as a function of year and location and provided a good fit, as indicated by residual plots. In total, 83,345 cases of malaria were reported from 1998 to 2009. The mean incidence rate was 0.30 per 1000 population. The models show trends and spatial variations in disease incidence. There was decreasing trend in the incidence rates of malaria [1998-2004], followed by a more moderate upward trend until 2008, when the rate decreases again. Zero malaria incidences occurred in six districts including Humla, Jajarkot, Manang, Kathmandu, bhakthapur and Solukhumbu districs for over twelve years. Higher incidence occurred in Kanchanpur, Kailali, Bardiya, Kavre, and Jhapa districts for the study period. Malaria is still a public health problem in Nepal. This study showed a steady decreasing trend in malaria incidence but the numbers of cases are still very high. Higher rates were observed in Terai Region and border areas. These findings highlight the need for more systematic and effective malaria control measures on malaria burden areas of Nepal