Nepal has experienced an 89% decline in reported malaria cases since a spike in 2002, and is currently categorized in the pre-elimination phase by the World Health Organization (WHO). Mortality due to malaria has been historically low, with only 87 total reported deaths over the past decade and zero reported deaths in 2014. The majority of malaria cases in Nepal are caused by Plasmodium vivax, with P. falciparum primarily responsible for increasing periodic outbreaks since 2006.
Malaria is endemic in 65 of Nepal’s 75 districts, and thirteen districts are considered to be highly endemic. Historically, malaria cases have been confined to the Terai lowland plains region, which is home to over half of Nepal’s total population and shares a southern border with India. The primary mosquito vector in the Terai was Anopheles minimus s.l. until it was eliminated in the 1960s through indoor residual spraying (IRS). An. fluviatilis, present in both the Terai and hill zones, is now the primary vector, with An. annularis and An. maculatus willmori as a secondary vectors. Malaria transmission occurs year round, peaking in July during the seasonal monsoon. Risk groups include ethnic minorities, young men, mobile populations, and people living in border areas.
- 48% of the total population at risk (total population: 28.2 million)
- 1,469 cases of malaria and 0 deaths in 2014 (last death reported in 2011)
- 0.05 Annual Parasite Index (cases/1,000 population/year)
- Dominant malaria species: P. vivax
- Elimination goal: zero indigenous cases and zero deaths by 2026