Authorities are scrambling to contain the spread of mosquitoes in the mountainous region

Last month, authorities of the Himali Rural Municipality of Bajura District sprayed insecticides in wards 4, 5, 6 and 7, which have a high density of malaria-causing mosquitoes.

Officials said they were preparing to disperse the liquid fog again, given the high risk of local transmission of the deadly disease in the area.

“We will again spray insecticide in high-risk areas,” Raj Bahadur Bhandari, administrative director of the rural municipality, told The Post by phone from Bajura. “We also provided insecticidal mosquito nets to pregnant women and new mothers in the high-risk area.”

Spraying insecticides and distributing insecticidal bed nets in affected areas are among the measures taken by the authorities to prevent the outbreak of the disease, which poses challenges in achieving Nepal’s goal of eliminating malaria from here 2025.

Officials said they provided rapid diagnostic kits to local health facilities, stepped up surveillance measures, launched an awareness campaign and provided entomological training to health workers to find the vector responsible for malaria at the earliest.

Earlier, the Ministry of Health and Population requested India’s assistance for intervention measures to reduce imported malaria cases in Nepal. Officials from both countries have agreed to share information on malaria cases to make response measures effective in their respective countries.

Nepal is one of the UN health body E-2025 member countries that have the potential to eliminate the disease by 2025. In April 2021, the UN health agency has launched the E-2025 initiative to stop malaria transmission in 25 identified regions. country by 2025.

To eliminate the disease on schedule, the country must reduce indigenous cases of malaria to zero by early next year, which seems almost impossible as more cases are reported in areas considered non-endemic in the past.

At least 29 indigenous cases of malaria have been reported in Nepal since the start of 2022.

“Until ten years ago, we had no problems caused by mosquitoes and malaria,” Bhandari said. “Now it’s very difficult to stay here at the moment due to the rising temperature and the high density of mosquitoes.”

Bajura is among the mountainous districts that were once considered non-endemic for malaria.

Apart from Bajura, four other mountainous districts – Humla, Mugu, Kalikot and Baitadi – have been affected by malaria. Some hill districts – Dadeldhura, Achham – and Tarai districts – Surkhet, Kailali, Saptari, Kapilvastu, Kanchanpur, Banke and Bardia – have reported more cases, where relevant authorities have launched insecticide spraying and distribution programs insecticidal mosquito nets.

Dr Gokarna Dahal, head of the vector control section in the Division of Epidemiology and Disease Control, said that the problems of disease spread by mosquitoes are more in mountainous and hilly areas than in districts of Tarai region.

“We have focused our program on the affected areas,” he said.

Rising temperatures in the mountainous region have provided a favorable environment for the survival and spread of the vector, posing a serious challenge to Nepal’s goal of eliminating malaria from the country, experts say.

“Problems are being detected in new areas that were considered risk-free areas in the past,” said Dr Madan Koirala, medical coordinator for malaria surveillance in Karnali province. “Along with indigenous cases, imported cases of malaria, especially from India, present us with a challenge that could result in local transmission.”

Out of a total of 485 malaria cases detected in the last fiscal year, 433 were imported cases, mainly from India. The other 52 were indigenous cases. The health ministry said Sudurpaschhim and Karnali provinces each reported 17 indigenous cases in the last fiscal year. Madhesh province reported eight, Lumbini province reported six, and Gandaki and Bagmati provinces each reported two indigenous cases.

Officials said as many as 10,192,669 people in 2,551 neighborhoods across the country were at high risk of malaria infection.

Experts say that in addition to focusing on preventive measures – spreading insecticides, distributing insecticidal mosquito nets and launching awareness campaigns – relevant authorities should also develop mechanisms for rapid response to an outbreak of infection and, as climate change has increased vector burden, promote an adaptation strategy.

“We can minimize the risks and prevent further spread of the disease if we have a rapid response mechanism in place,” said Dr Manoj Pande, medical coordinator for malaria surveillance in Sudurpaschim province.

A United Nations report “Climate Change 2022: Impacts, Adaptation and Vulnerability” indicates that at least six major vector-borne diseases affected by climate factors have recently emerged in Nepal and are now considered endemic, with climate change being the main one. factor involved.

The report also shows growing evidence that global warming has extended the altimetric distribution of vector Anopheles, Culex and Aedes mosquitoes above 2,000 meters in Nepal.

Malaria is caused by Plasmodium parasites. According to the World Health Organization, infected female Anopheles mosquitoes carry these deadly parasites.

To achieve malaria-free status in 2026, Nepal must reduce indigenous cases or local transmission of the disease to zero by the end of 2022 and maintain zero cases for three consecutive years, according to the World Health Organization. health.

International experts will carry out a final verification after the completion of the process of declaring the country free from malaria.

Certification of Malaria Elimination is official recognition by the United Nations health agency of a country’s status as malaria-free.

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