Spatio-temporal patterns of malaria in Nepal from 2005 to 2018: a country progressing towards malaria elimination

Authors: Shreejana Bhattarai*, University of Florida, Sadie Ryan, University of Florida, Jason Blackburn, University of Florida
Topics: Medical and Health Geography, Spatial Analysis & Modeling
Keywords: Malaria elimination, Nepal, Spatial Variation, Temporal Trend, Control intervention
Session Type: Virtual Paper
Day: 4/10/2021
Start / End Time: 8:00 AM / 9:15 AM
Room: Virtual 8
Presentation File: No File Uploaded


Nepal is preparing to eliminate malaria by 2026. The malaria burden has decreased in the country from 4,154 cases in 2004 to 1,064 in 2018. Although the total malaria burden is decreasing recently, studies have shown that some malaria indicators are increasing in certain parts of the country and malaria has shifted to previously non-endemic areas. To achieve elimination, it is necessary to assess the achievements gained in recent years and to identify the challenges ahead, as previous eradication efforts have failed in Nepal. Thus, the objective of this study is to analyze the spatial variation in temporal trends of malaria in Nepal from 2005 to 2018, following the introduction of LLINs as vector control intervention. Spatial variation in temporal trend method was employed in SaTScan software to detect the unusually high or low temporal trends of five different malaria indicators: Total Malaria, Indigenous Malaria, Imported Malaria, PV (Plasmodium vivax) Malaria, and PF (Plasmodium falciparum) Malaria.
All malaria indicators have clusters that have an increasing trend. Indigenous Malaria is increasing by 113.71% in a cluster of three mountainous districts previously non-endemic. The most prominent cluster of Imported Malaria has Kathmandu, the capital of the country where Imported Malaria has an increasing trend of 156.22%. Even though some clusters have a decreasing trend of malaria indicators, the trend is lower than that of outside the clusters.
This information can help public health officials to make decisions for implementing vector control interventions to successfully eliminate malaria from the country.

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