MALARIA PROFILE 2004 IN INDONESIA

Sub-Directorate of Malaria, Directorate General Disease Control, Ministry of Health, Indonesia

MALARIA ENDEMICITY, 2004

# # # # # # # # # # # # # # # # # # ## ## # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ## # # # # # # # # # # # # # # # # # # # # # # # #

# # # # # # # # # # # # # # # # # # ## # # # ## # # # ## # # # # # # # # # # # # # # # # # # # # ## # # # # # # # # # # # # # # # # #

# #

##

# # #

# #

# # # # # # #

## ## #

# # # # # # #

IMC-4 GFATM
# # #

# # # # # # # # #

## ## #

#### # # # ## # # # # # ## # # # # # ### # # # #

Kasus di Bu kan Jawa B ali 1 Do t = 20 Kasus Po sitif d i Jawa B ali 1 Do t = 5 End em isitas rend ah sedan g ting gi
# #

## # ## ### ### ## ## #

## ## ## ## # # # ## # # # # # ## # ### ## # # # #

# # # # # # # # # # ###### # # ### ## # ## ## ### # # # # # # #

MALARIA RISK 2004

Population Country Malaria Risk % 217,072,346 95,121,318 43,82 % Province 30 30 100 % District 390 290 74,36 %

MALARIA JAVA-BALI 2000-2004

MALARIA NOT CONFIRMED AND BLOOD SLIDES EXAM JAVA BALI 2000-2004
1600000 1400000 1200000

M ALARI A P OS I TI VE & P f + M I X I N J AVA BALI

Pem SD

Klinis

2000- 2004
120000 100000

SD Positif

Pf + mix

1000000

80000
800000

60000
600000

40000
400000

20000
200000 0

2000

2001

2002

2003

2004

2000

2001

2002

2003

2004

MALARIA OUTER JAVA-BALI 2000-2004

Suspect Malaria and Blood Slide Examination in Outer Java-Bali 2000-2004
Suspect
2,000,000 1,800,000

Malaria Positive and Pf + Mix in Outer Java-Bali 2000-2004

300,000 250,000

BSE

Positive

Pf + Mix

1,600,000 1,400,000 1,200,000 1,000,000 800,000

200,000 150,000 100,000

600,000 400,000 200,000 -

50,000 -

2000

2001

2002

2003

2004

2000

2001

2002

2003

2004

MALARIA IN JAWA BALI 2000-2004

2000
SUSPECT/ CLINICAL BSE 1.475.704 1.475.704

2001
1.210.530 1.210.530

2002
998.791 998.791

2003
756.833 756.833

2004
480.048 480.048

POSITIVE Pf + mix HCI Villages

101.852 30.089 490*

86.277 36.121 464*

64.708 27.091 493*

27.765 12.984 345*

7.774 2.324 147*

* Banten Province not included

HCI= High Case Incidence

MALARIA IN OUTER JAWA BALI 2000-2004

2000
SUSPECT/ CLINICAL BSE POSITIVE Pf + mix

2001

2002
1.760.780 413.203 157.005 65.624

2003
1.44.679 333.137 144.679 51.048

2004
1.876.684 699.788 292.732 117.220

1.060.125 1.529.082 300.212 108.337 28.381 369.202 162.383 58.701

5. North Sulawesi 3. North Maluku 3. NAD 2. Riau 1. West 4. South Kalimantan Kalimantan

2. Maluku

1. West Java

Reported Malaria Outbreak 2004

No Province 1 West Java 2 Riau Kab/Kota Village Cases Deaths Sukabumi Mei - June 2 478 8 Karimun 1 144 0 Inhil 1 288 12 Nov 3 NAD Aceh Barat Mei-Jun 4 383 9 4 Kalsel Tabalong 1 382 4 5 Sulawesi Utara Bitung 1 247 0 Okt-Nov

2005
No 1 2 3 Province Kab/Kota Village Cases Deaths West KalimantanMelawi 1 171 0 Peb Maluku Kab. Kep. Seram Mrt 2 720 26 Maluku Utara Kab. Halteng 2 173 22 Mrt

VECTOR MALARIA IN INDONESIA

MALARIA INCIDENCE MOSTLY IN THE REMOTE AREAS AND RELATED WITH POOR PEOPLE

POTENSIAL BREEDING PLACES

MALARIA VECTOR BREEDING IN THE RIVER DURING DRY SEASSON OR RUNNING WATER

No malaria breeding places

MALARIA TRANSMISSION & VECTOR BREEDING IN PLANTATION AREAS

MALARIA VECTOR BREEDING IN THE FORREST FRINGE

MALARIA VECTOR BREEDING ALONG THE COAST

MANGGROVES ELIMINATION CREATE MOSQUITO BREEDING PLACES

ENVIRONMENTAL DAMAGE IMPACT ON HUMAN HEALTH & MALARIA TRANSMISSION

MALARIA CONTROL POLICY 2005-2009

Reduce malaria morbidity & mortality by 50 % in 2009 based on 2005.

All Districts able to conduct early blood examination for malaria and appropriate treatment with 100 % coverage in 2009. Reduce by 50 % number of High Case Incidence villages in 2009 based on 2005. To free from malaria local transmission in Jakarta, Bali and Batam by 2010.

MAIN ACTIVITIES
I.

II. III.

IV.

Prevent local transmission and control malaria risk factors. Case detection & management effectively. Surveillance epidemiology and epidemic containment. Information, education, communication and support for controlling malaria.

AREAS STRATIFICATION
I.

II.

III.

Areas with low laboratory confirmation rate (Outer Java-Bali). Areas fully laboratory confirmation (JavaBali). Areas would like to free from local transmission (Jakarta, Bali and Batam).

STANDARD TREATMENT GUIDELINES

Uncomplicated Pf

Complicated Pf

AQ3+ATS3 + PQ QN7+DX7/Clind + PQ

Uncomplicated Pv

QN parental-oral7+Dx7/Clin7 + PQ Artemether im-AQ3+ATS3 + PQ Artesunate parental-AQ3+ATS3 + PQ

CQ3+PQ14 QN7+PQ14

Prophylaxis

Doxycycline

Outbreak containment (MFS) AQ3+ATS3+ PQ for Pf

CQ + PQ for Pv

CONTROL ACTIVITIES

CASE FINDING AND TREATMENT

CASE DETECTION FOR MALARIA AT THE VILLAGE LEVEL

BLOOD SLIDES TAKEN & COLLECTION FOR THE SUSPECT CASES

BLOOD SLIDES EXAMINATION BY MICROSCOPIST AT HEALTH CENTER

Malaria patient at sub- Health center or Puskesmas pembantu (Pustu)

SEVERE MALARIA TO BE REFFERED TO DISTRICT HOSPITAL

MALARIA PREVENTION

INDOOR RESIDUAL SPRAYING (IRS)

COMMUNITY PARTICIPATION FOR MALARIA CONTROL

Focus Group Interviews

DRUGS SELLER AT VILLAGE LEVEL

Choice of malaria drugs

Malaria Volunteer and Surveillance Agent at Village level

Im Sartiyah Village Surveillance Agent

Im malaria volunteer at Sigeblog village

COORDINATION MEETING WITH HEALTH PROVIDER

Im Village Midwife Im Mohtarom, Volunteer Im Kusnari District officer

Mohtarom (Volunteer) taken blood slides from Malaria patient

Volunteer was given facilities by Village head cupboard etc.