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Health |
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The
incidence of malaria increases between July and September 2008 in Nepal
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is estimated that around 100 million clinical cases occur each year and
the actual number of persons infected is about 250 million. Many undiagnosed
and sub-clinical cases may be the persistent sources of transmission to
others. |
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Around
the world 54 percent of the population lives in the areas where malaria
exists. It is the most important public health problem in the tropical
and sub tropical regions in summer seasons.
It
is estimated that around 100 million clinical cases occur each year and
the actual number of persons infected is about 250 million. Many undiagnosed
and sub-clinical cases may be the persistent sources of transmission to
others.
Around
the world 54 percent of the population lives in the areas where malaria
exists. It is the most important public health problem in the tropical
and sub tropical regions in summer seasons. In context of Nepal, it is
very much prevalent in the Terai region. In each person with high-grade
fever, malaria should be suspected if he / she is from Terai. The disease
exists in areas less than 2000 m from the sea level.Sarita Chettri rubs
mosquito repellant on her children before securing the mosquito net. "We
have to be very careful for the next three months," the 30-year-old mother
told IRIN in Pachkhal village, Kavre District, nearly 50km southeast of
the capital, Kathmandu, where malaria is rife.
Kavre
is one of Nepal's most affected districts and transmission is particularly
high between July and September, says Nepal's Ministry of Health, Department
of Health Services.
According
to the department's epidemiology and disease control division, 65 out of
the 75 districts are deemed malaria-endemic - affecting nearly 79 percent
of the country's 28 million inhabitants.
Worst
at risk are 13 districts, including Kavre, where temperatures of 20-30
Centigrade and an altitude below 2,000m make them ideal mosquito breeding
grounds.
The
other districts include Sindhuli, Ilam, Jhapa, Morang, Mohatari and Dhanusa
in the eastern region; Banke and Bardiya in the mid-west, and Kanchanpur,
Kailali and Dadeldhura in the far west, as well as Nawalparasi in central
region.
Geographically
divided into mountains ("parbat"), hills ("pahad") and lowland plains ("Terai"),
the Himalayan nation is administratively divided into five development
regions - far west, mid-west, west, central and east.
Most
of the districts affected are in the eastern region of the Terai, where
the climate is particularly hot and humid. Compared with the mountain and
hill areas, the Terai is the most populated, according to Nepalese government
statistics.
| Environmental
challenges |
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Although
the mortality rates due to malaria are low (five to seven reported death
annually), the incidence rate is 5,000-7,000 every year, according to the
epidemiology division, which explained that malaria eradication is quite
difficult due to Nepal's tropical climate.
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| "The
low rate of deaths does not mean we should be happy, because there are
factors intensifying the malaria problem. They make our jobs very challenging,
especially during these three months [July-September]," Garib Das Thakur,
the division chief, told IRIN in Kathmandu.
Thakur
explained that Nepal had witnessed some significant changes in its ecology
and environment, including deforestation, as well as heavy migration. |
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The
rapid deforestation had led to floods and landslides, as well as water
logging, which hosts breeding places for mosquitoes. In addition, migrant
workers often left their villages for Indian and Nepalese cities rampant
with malaria problems, only to return infected.
Moreover,
the lack of behavioural change among vulnerable communities, lack of mosquito
nets, no indoor residual spraying and delayed treatment, had contributed
to malaria outbreaks, he added.
| Malaria
remains endemic in many parts of Nepal - Migration issues |
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The
steady industrialisation of the Terai - the country's most fertile and
lowland region bordering India - has also led to a lot of water logging
where malaria
vector intensity grows, according to epidemiology division
officials.
"Nepal
also has an active migrant population moving frequently to malaria-risk
areas of India like Assam and other northeastern states for livelihood
and they return home infected and easily transmit malaria," said Thakur.
According
to the UN World Health Organization (WHO), malaria is a major health problem
in Assam and other eastern states.
In
eastern Terai, according to the District Public Health Office (DPHO), the
threat of malaria is large and more than 300 cases have been detected since
March in a single district of Morang, 500km southeast of Kathmandu.
"So
far we have already distributed 400,000 long-lasting insecticidal nets
and been actively involved in improving services for immediate diagnosis
and treatment," explained Thakur.
| Improved
mortality |
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Nepal
has come a long way in reducing mortality and morbidity rates since it
started its malaria control programme in 1954, according to the epidemiology
division, which explained that the annual number of reported malaria cases
has been reduced from 200,000 then to only 5,000-7,000 now.
The
country aims to cut malaria cases in half by 2015 in line with its Millennium
Development Goal.
Thakur
said the government had made plans to distribute about 2.2 million mosquito
nets to the poor and build better services in all public health centres
to provide free diagnosis and immediate treatment to the poorest communities.
Source:
IRIN, June 2008
Copyright
UN Office for the Coordination of Humanitarian Affairs 2008
[
This report does not necessarily reflect the views of the United Nations]
Integrated
Regional Information Networks (IRIN), part of the UN Office for the Coordination
of Humanitarian Affairs (OCHA).
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