1921
Control and Elimination of Plasmodium vivax Malaria: The Evidence Base
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

Endemic malaria occurs across much of the vast Indonesian archipelago. All five species of known to naturally infect humans occur here, along with 20 species of mosquitoes confirmed as carriers of malaria. Two species of plasmodia cause the overwhelming majority and virtually equal shares of malaria infections in Indonesia: and . The challenge posed by is especially steep in Indonesia because chloroquine-resistant strains predominate, along with Chesson-like strains that relapse quickly and multiple times at short intervals in almost all patients. Indonesia's hugely diverse human population carries many variants of glucose-6-phosphate dehydrogenase (G6PD) deficiency, most of them exhibiting severely impaired enzyme activity. Therefore, the patients most likely to benefit from primaquine therapy by preventing aggressive relapse, may also be most likely to suffer harm without G6PD deficiency screening. Indonesia faces the challenge of controlling and eventually eliminating malaria across > 13,500 islands stretching > 5,000 km and an enormous diversity of ecological, ethnographic, and socioeconomic settings, and extensive human migrations. This article describes the occurrence of in Indonesia and the obstacles faced in eliminating its transmission.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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2016-12-28
2017-11-23
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  • Received : 07 Feb 2016
  • Accepted : 07 Mar 2016

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