Malaria is one of the focal public health problems in Bangladesh. Severe malaria is an emergency situation mainly caused by P.falciparum and is responsible for deaths. In the past decade, Bangladesh has made significant progress in reducing malarial morbidity and mortality. From 2014 to 2017 total number of reported severe malaria cases were 2063, 1023, 670 and 669 and death were 45, 09, 17 and 13 respectively. Most deaths in malaria happens in Bangladesh before the patient reaches hospitals or within short period after admission and getting support of Intensive Care Unit (ICU) for optimum treatment of severe malaria which is not always available. WHO recommends confirmation of diagnosis by immunochromatographic rapid test or by blood film examination and for treatment to use artemisinin based combination treatment (ACT) for uncomplicated falciparum malaria and thus reduces the incidence of severe malaria.
Migrants and Rohingya refugees especially recent influx of 650,000 refugees reported by United Nations High Commission for Refugees during the last 4 months of 2017 are the particular of upsurge of malaria having potentiality of introducing artemisinin-resistant malaria parasites into Bangladesh from Myanmar.
In order to have ’zero death’ by 2020 as a part of elimination strategy of malaria all efforts are being made to diagnose and treat all cases of uncomplicated falciparum malaria promptly deploying community health workers for using effective ACT based drug, uncomplicated vivax malaria with three-day-chloroquine and 14 day primaquine, quickly refer the patients of severe malaria with a pre-referral treatment, have a quick access to evaluation at sub-district hospital, and IV artesunate and other recommended supportive treatment close to home. Involvement of private sector is essential. District hospitals in Chittagong Hill Tract districts should have facility of dialysis and referral Medical College Hospital should have functional facility of ICU care.