Kathmandu, Pokhara, and the northern Himalayan districts are risk free. There are no malaria cases reported from Chitwan National Park.
Note: Risk is present in areas below 2,000 m / 6,562 ft in rural areas of the Terai districts bordering India. Seasonal transmission typically occurs from March to October. Travellers going to these areas should take malaria suppressive medication.
Main vectors: A. annularis, A. fluviatilis, A. maculatus.
Risk is present in the country; areas of risk are specified:
High risk months for Malaria are: January to December
Incidence of Plasmodium falciparum Malaria: 15%
Areas with drug resistant Malaria: Multidrug resistant P. falciparum malaria is present in all malarious areas of Nepal. The antimalarial medications listed below are effective for this country.
All malaria infections are serious illnesses and must be treated as a medical emergency. In offering guidance on the choice of antimalarial drugs, the main concern is to provide protection against Plasmodium falciparum malaria, the most dangerous and often fatal form of the illness.
Regardless of the medication which has been taken, it is of utmost importance for travellers and their physician to consider fever and flu-like symptoms appearing 7 days up to several months after leaving a malarious area as a malaria breakthrough. Early diagnosis is essential for successful treatment.
In addition to the suggested antimalarial medication, use a mosquito bed net and effective repellents to avoid the bite of the nocturnal Anopheles mosquito.
Brand names: Malarone, Malanil and others; generics available.
TAKE 1 TABLET DAILY (ATOVAQUONE 250 mg + PROGUANIL 100 mg).
START 1-2 DAYS BEFORE ENTERING THE MALARIOUS AREA, CONTINUE DAILY DURING YOUR STAY AND CONTINUE FOR 7 DAYS AFTER LEAVING.
Note: Take at the same time every day with food or milk.
Brand names: Vibramycin and others; generics available.
TAKE 1 TABLET DAILY OF 100 mg.
START 1 DAY BEFORE ENTERING MALARIOUS AREA, CONTINUE DAILY DURING YOUR STAY AND CONTINUE FOR 4 WEEKS AFTER LEAVING.
Note: When taking this drug, avoid exposure to direct sunlight and use sunscreen with protection against long range ultraviolet radiation (UVA) to minimize risk of photosensitive reaction. Take with large amounts of water to prevent esophageal and stomach irritation.
Brand names: Lariam, Mephaquin, Mefliam and others; generics available.
TAKE 1 TABLET OF 250 mg (228 mg base) ONCE A WEEK.
START 1-2 WEEKS BEFORE ENTERING THE MALARIOUS AREA, CONTINUE WEEKLY DURING YOUR STAY AND CONTINUE FOR 4 WEEKS AFTER LEAVING.
Note: Side effects include nausea and headache, including neurological side effects such as dizziness, ringing of the ears, and loss of balance. Psychiatric side effects include anxiety, depression, mistrustfulness, and hallucinations. Neurological side effects can occur any time during use and can last for long periods of time or become permanent even after the drug is stopped. Seek medical advice if any neurological or psychiatric side effects occur.