Figure 4
From: Malaria control in Nepal 1963–2012: challenges on the path towards elimination
Total confirmed malaria cases and important milestones on malaria control in Nepal (1963–2012). During 2006–2008, long lasting insecticidal nets (LLINs) were distributed with policy of one LLIN per household in 13 high-risk districts (HRD). LLINs are being distributed at the rate of one LLIN per two persons in HRD and moderate-risk districts (MRD) since 2009 and 2011, respectively. Each bar with distinct peak values was attributed to malaria epidemics mainly caused by P. falciparum malaria. Treatment failure of P. falciparum malaria in Nepal has been shown for chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) but clinical CQ resistance in P. vivax has not been reported in Nepal. Artemisinin combination therapy (ACT) was introduced for the treatment of uncomplicated P. falciparum in 2004.