This paper offers an idea of adaptations to eliminate endemic malaria, a fatal public health problem in the Chittagong Hill Tracts (CHT), Bangladesh. Ethnic minority children are one of the most vulnerable groups affected by this problem. The prevailing thoughts and practices of malaria derived from the modern biomedical paradigm involve both preventive and curative measures. There is a growing realization that multi-pronged approach is more effective than a single intervention to halt this public health problem. In this regard, the validity of adaptation has been an explicit concern in the literature since the 1960s. Using materials from local and international sources, the paper questions how adaptations to malaria take form. Adaptation is first conceptualized. Analyzing adaptations includes the aspects of ecology ranging from the molecular to the ecosystem level. The paper argues that characteristic epidemiology, ecology and children’s traits make adaptations in the CHT distinctive. Epidemiology of children’s malaria is rather a complex and is characterized by seasonal epidemic cycle, a variety of anopheline species, the coexistence of Plasmodium falciparum and Plasmodium vivax. The ecology comprised of tropical monsoon climate, mountainous-woody topography, multi-groups’ ethnographic setting and diverse childrearing practices appears with the manifestation of its adaptive value in determining the breeding sites for larvae and transmission of malaria. Traits of children informed by examples from the views to a child as individual (biological being), self (psychological being) and person (socio-cultural being) demonstrate the various ways in which exposure to mosquitoes is reduced and thereby malaria rates are decreased. The paper concludes by evoking more discussions on adaptations to be included in the malaria elimination measures.