Incubation period 1 to 3 weeks. There is no malaria in Kathmandu Valley or in the usual tourist trekking routes. There is malaria in the Chitwan National Park. There are four types of malaria but only one (vivax ) is common in Nepal.
Prophylaxis is important for the Terai Area. If you are going to be there over two weeks in the summer time. Otherwise proper use of repellents like DEET may be good enough.
For prophylaxis Mefloquin one tablet a week and for four weeks after leaving the place of exposure is recommended. We stock Mefloquin in our travel medicine clinic. It is not available in the nepali pharmacies. Side effects of mefloquin are psychiatric manifestations
Another drug used against Chloroquin resistant malaria is Doxycycline, which is locally available. The side effect of doxycycline is Photosensitivity , when skin is exposed to sunlight rash may develop. In females prolong use of doxycycline can cause yeast infection.
Another drug used is Malarone, which is very effective and expensive and unavailable in Nepal. Importantly i has no psychiatric and neurological side effects like mefloquin has
Using insect repellents ( like DEET, not locally available ) and mosquito coils or tablets ( locally available ) in rooms is also advisable. Falciparum malaria which can be fatal is important to rule out but is much less common than vivax in South Asia unlike Africa.
Serological tests ( Optimal, for example) can be very useful for diagnosing malaria. In our clinic we stock Arterakine which is very effective for the treatment of malaria, including falciparum malaria.
National level recommendations can vary in different countries and this can be potentially confusing for the traveler. For example German recommendations are not to use oral malaria drug precaution while traveling in India while UK recommendations are to use cholorquine and paludrine (unavailable in the US) for only certain sections of the subcontinent. However US recommendations are to use drug prophylaxis for all Indian destinations.