1921
Volume 98, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Artemisinin combination therapy is recommended for the treatment of multidrug resistant and . In March 2006, antimalarial policy in Indonesia was changed to a unified treatment with dihydroartemisinin-piperaquine for all species of malaria because of the low efficacy of previous drug treatments. In 2013, a randomized cross-sectional household survey in Papua was used to collect data on demographics, parasite positivity, treatment-seeking behavior, diagnosis and treatment of malaria, and household costs. Results were compared with a similar survey undertaken in 2005. A total of 800 households with 4,010 individuals were included in the 2013 survey. The prevalence of malaria parasitemia was 12% (348/2,795). Of the individuals who sought treatment of fever, 67% (66/98) reported attending a public provider at least once compared with 46% (349/764) before policy change ( < 0.001). During the 100 visits to healthcare providers, 95% (95) included a blood test for malaria and 74% (64/86) resulted in the recommended antimalarial for the diagnosed species, the corresponding figures before policy change were 48% (433/894) and 23% (78/336). The proportion of individuals seeking treatment more than once fell from 14% (107/764) before policy change to 2% (2/98) after policy change ( = 0.005). The mean indirect cost per fever episode requiring treatment seeking decreased from US$44.2 in 2005 to US$33.8 in 2013 ( = 0.006). The implementation of a highly effective antimalarial treatment was associated with better adherence of healthcare providers in both the public and private sectors and a reduction in clinical malaria and household costs.

[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.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.17-0680
2018-02-07
2018-05-20
Loading full text...

Full text loading...

/deliver/fulltext/14761645/98/2/tpmd170680.html?itemId=/content/journals/10.4269/ajtmh.17-0680&mimeType=html&fmt=ahah

References

  1. Statistics Indonesia (Badan Pusat Statistik—BPS), National Population and Family Planning Board (BKKBN), Kementerian Kesehatan, (Kemenkes—MOH), ICF International, 2013. Indonesia Demographic and Health Survey 2012. Jakarta, Indonesia: BPS, BKKBN, Kemenkes, and ICF International.
  2. World Health Organization, 2015. Malaria in Indonesia. Geneva, Switzerland: WHO. Available at: www.who.int/malaria/publications/country-profiles/profile_idn_en.pdf. Accessed May 18, 2017.
  3. Burdam FH, 2016. Asymptomatic vivax and falciparum parasitaemia with helminth co-infection: major risk factors for anaemia in early life. PLoS One 11: e0160917.
  4. Pava Z, 2016. Submicroscopic and asymptomatic Plasmodium parasitaemia associated with significant risk of anaemia in Papua, Indonesia. PLoS One 11: e0165340.
  5. Ratcliff A, 2007. Therapeutic response of multidrug-resistant Plasmodium falciparum and P. vivax to chloroquine and sulfadoxine-pyrimethamine in southern Papua, Indonesia. Trans R Soc Trop Med Hyg 101: 351359.
  6. Sumawinata IW, Bernadeta Leksana B, Sutamihardja A, Purnomo Subianto B, Sekartuti Fryauff DJ, Baird JK, , 2003. Very high risk of therapeutic failure with chloroquine for uncomplicated Plasmodium falciparum and P. vivax malaria in Indonesian Papua. Am J Trop Med Hyg 68: 416420.
  7. Tjitra E, Baker J, Suprianto S, Cheng Q, Anstey NM, , 2002. Therapeutic efficacies of artesunate-sulfadoxine-pyrimethamine and chloroquine-sulfadoxine-pyrimethamine in vivax malaria pilot studies: relationship to Plasmodium vivax dhfr mutations. Antimicrob Agents Chemother 46: 39473953.
  8. Ratcliff A, Siswantoro H, Kenangalem E, Maristela R, Wuwung RM, Laihad F, Ebsworth EP, Anstey NM, Tjitra E, Price RN, , 2007. Two fixed-dose artemisinin combinations for drug-resistant falciparum and vivax malaria in Papua, Indonesia: an open-label randomised comparison. Lancet 369: 757765.
  9. Hasugian AR, 2007. Dihydroartemisinin-piperaquine versus artesunate-amodiaquine: superior efficacy and posttreatment prophylaxis against multidrug-resistant Plasmodium falciparum and Plasmodium vivax malaria. Clin Infect Dis 44: 10671074.
  10. Karyana M, Devine A, Kenangalem E, Burdarm L, Poespoprodjo JR, Vemuri R, Anstey NM, Tjitra E, Price RN, Yeung S, , 2016. Treatment-seeking behaviour and associated costs for malaria in Papua, Indonesia. Malar J 15: 536.
  11. Karyana M, 2008. Malaria morbidity in Papua Indonesia, an area with multidrug resistant Plasmodium vivax and Plasmodium falciparum. Malar J 7: 148.
  12. Elyazar IR, Hay SI, Baird JK, , 2011. Malaria distribution, prevalence, drug resistance and control in Indonesia. Adv Parasitol 74: 41175.
  13. ORC Macro, 2005. Guidelines for Sampling for the Malaria Indicator Survey. Calverton, MD: World Health Organization.
  14. StataCorp, 2015. Stata Statistical Software: Release 14. College Station, TX: StataCorp LP.
  15. R Core Team, 2015. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing.
  16. Jombart T, Devillard S, Balloux F, , 2010. Discriminant analysis of principal components: a new method for the analysis of genetically structured populations. BMC Genet 11: 94.
  17. OECD, 2017. Exchange rates (indicator). Paris, France: Organisation for Economic Co-operation and Development.
  18. OANDA, 2005. Currency Converter—Historical Exchance Rates. Available at: http://www.oanda.com/currency/historical-rates/. Accessed March 3, 2015.
  19. The World Bank, 2015. Inflation, Consumer Prices (Annual %). Available at: http://data.worldbank.org/indicator/FP.CPI.TOTL.ZG. Accessed August 4, 2015.
  20. Williams HA, Jones CO, , 2004. A critical review of behavioral issues related to malaria control in sub-Saharan Africa: what contributions have social scientists made? Soc Sci Med 59: 501523.
  21. ACTwatch Group and PSI/Cambodia, 2011. Kingdom of Cambodia Household Survey Report, 2011. Washington, DC: Population Services International.
  22. ACTwatch Group and PSI/Myanmar, 2012. The Republic of the Union of Myanmar Household Survey: Baseline, 2012. Washington, DC: Population Services International.
  23. Population Services International and ACTwatch, 2015. Malaria Market Trends in Sub-Saharan Africa: 2009–2014. Washington, DC: ACTwatch.
  24. Mimika DHO, 2005. Mimika District Health Office Annual Statistics. Timika, Papua, Indonesia: District Health Office.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.17-0680
Loading
/content/journals/10.4269/ajtmh.17-0680
Loading

Data & Media loading...

Supplementary Data

Supplemental Figure and Table

  • Received : 26 Aug 2017
  • Accepted : 20 Oct 2017

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error