Volume 87, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Records of 3,449 patients admitted to Karitas Hospital at Waitabula in eastern Indonesia with microscopy-confirmed malaria through 2008 and 2009 were systematically reviewed. Falciparum, vivax, and mixed species malaria occurred among 1,541, 1,837, and 71 admissions, respectively. Among these, 400 (26%), 199 (11%), and 15 (21%) had serious illness. Fatalities occurred in 46 (12%), 18 (9%), and 2 (13%) of these patients, respectively. Although patients with a diagnosis of falciparum malaria were more likely to have serious illness compared with those with vivax malaria (odds ratio [OR] = 2.9; 95% confidence interval [CI]: 2.4–3.5), this diagnosis nonetheless was associated with 32% of serious illness and 27% of fatalities. Among the seriously ill with a diagnosis of falciparum or vivax malaria, no significant difference in risk of death occurred (OR = 1.3; 95% CI: 0.7–2.5). Serious and fatal illness was predominantly anemia or altered mental state syndromes among patients with either of the species diagnoses. was associated with a substantial share of the burden of morbidity and mortality caused by malaria in this hypo- to meso-endemic community.

[open-access] This is an Open Access article distributed under the terms and of the American Society of Tropical Medicine and Hygiene's Re-use License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Kitchen SF, Boyd MF, , 1949. Vivax malaria. , ed. Malariology. Philadelphia, PA: W.B. Saunders, 10271045. [Google Scholar]
  2. Price RN, Douglas NM, Anstey NM, , 2009. New developments in Plasmodium vivax malaria: severe disease and the rise of chloroquine resistance. Curr Op Infect Dis 22 430435.[Crossref] [Google Scholar]
  3. Guerra CA, Howes RE, Patil AP, Gething PW, Van Boekel TP, Temperly WH, Kabaria CW, Tatem AJ, Manh BH, Elyazar IR, Baird JK, Snow SI, , 2010. The international limits and population at risk of Plasmodium vivax transmission in 2009. PLoS NTD 4 e774. [Google Scholar]
  4. Hay SI, Guerra CA, Gething PW, Patil AP, Tatem AJ, Noor AM, Kabaria CW, Manh BH, Elyazar IR, Brooker S, Smith DL, Moyeed RA, Snow RW, , 2009. A world malaria map: Plasmodium falciparum endemicity in 2007. PLoS Med 6: e1000048. [Google Scholar]
  5. Dhingra N, Jha P, Sharma VP, Cohen AA, Jotkar RM, Rodriguez PS, Bassani DG, Suraweera W, Laxminarayan R, Peto R, Collaborators Million Death Study, , 2010. Adult and child malaria mortality in India: a nationally representative mortality survey. Lancet 376 17681774.[Crossref] [Google Scholar]
  6. Barcus MJ, Basri H, Picarima H, Manyakori C, Sekartuti, Elyazar I, Bangs MJ, Maguire JD, Baird JK, , 2007. Demographic risk factors for severe and fatal vivax and falciparum malaria among hospital admissions in northeastern Papua, Indonesia. Am J Trop Med Hyg 77 984991. [Google Scholar]
  7. Tjitra E, Anstey NM, Sugiarto P, Warikar N, Kenangalem E, Karyana M, Lampah DA, Price RN, , 2008. Multi-drug resistant Plasmodium vivax associated with severe and fatal malaria: a prospective study in Papua, Indonesia. PLoS Med 5 e128.[Crossref] [Google Scholar]
  8. Genton B, D'Acremont V, Rare L, Baea K, Reeder JC, Alpers MP, Muller I, , 2008. Plasmodium vivax and mixed infections are associated with severe disease with severe malaria in children: a prospective cohort study from Papua New Guinea. PLoS Med 5 e127.[Crossref] [Google Scholar]
  9. Kochar DK, Tanwar GS, Khatri PC, Kochar SK, Senegar GS, Gupta A, Kochar A, Middha S, Acharya J, Sexena V, Pakalapati D, Garg S, Das A, , 2010. Clinical features of children hospitalized with malaria—a study from Bikaner, northwest India. Am J Trop Med Hyg 83 981989.[Crossref] [Google Scholar]
  10. Sharma A, Khanduri U, , 2009. How benign is benign tertian malaria? J Vector Borne Dis 46 141144. [Google Scholar]
  11. Oh M, Shin H, Shin D, Kim U, Lee S, Kim N, Choi M, Chai J, Choe K, , 2001. Clinical features of vivax malaria. Am J Trop Med Hyg 65 143146. [Google Scholar]
  12. Beg MA, Sani N, Mehraj V, Jafri W, Khan MA, Malik A, Menezes E, Hussain R, Smego R, Jr, 2008. Comparative features and outcomes of malaria at a tertiary care hospital in Karachi, Pakistan. Int J Infec Dis 12 3742.[Crossref] [Google Scholar]
  13. Rodrigues-Morales AJ, Ferrer MV, Barrera MA, Pacheco M, Daza V, Franco-Paredes C, , 2009. Imported cases of malaria admitted to two hospitals of Margarita Island, Venezuela, 1998–2005. Travel Med Infect Dis 7 4448.[Crossref] [Google Scholar]
  14. Koh KH, Chew PH, Kiyu A, , 2004. A retrospective study of malaria infections in an intensive care unit of a general hospital in Malaysia. Singapore Med J 45 2836. [Google Scholar]
  15. Elyazar IR, Hay SI, Baird JK, , 2011. Malaria distribution, prevalence, drug resistance, and control in Indonesia. Adv Parasitol 74 142175. [Google Scholar]
  16. Elyazar IR, Gething PW, Patil AP, Rogayah H, Kusriastuti R, Wismarini DM, Tarmizi SN, Baird JK, Hay SI, , 2010. Plasmodium falciparum malaria endemicity in Indonesia in 2010. PLoS One 6: e21315.[Crossref] [Google Scholar]
  17. Maguire JD, Lederman ER, Barcus MJ, O'meara WA, Jordan RG, Duong S, Muth S, Sismadi P, Bangs MJ, Prescott WR, Baird JK, Wongsrichanalai C, , 2006. Production and validation of durable, high quality standardized malaria microscopy slides for teaching, testing and quality assurance during an era of declining diagnostic proficiency. Malar J 5 92.[Crossref] [Google Scholar]
  18. Syafruddin D, Krisin, Asih P, Sekartuti, Dewi RM, Coutrier F, Rozy IE, Susanti AI, Elyazar IR, Sutamihardja A, Rahmat A, Kinzer M, Rogers WO, , 2009. Seasonal prevalence of malaria in West Sumba district, Indonesia. Malar J 8 8.[Crossref] [Google Scholar]
  19. Greenwood BM, Armstrong JR, , 1991. Comparison of two simple methods for determining malaria parasite density. Trans R Soc Trop Med Hyg 85 186188.[Crossref] [Google Scholar]
  20. Taylor TE, Fu WJ, Carr RA, Whitten RO, Mueller JS, Fosiko NG, Lewallen NG, Molyneux ME, , 2004. Differentiating the pathologies of cerebral malaria by postmortem parasite counts. Nat Med 10 143145.[Crossref] [Google Scholar]
  21. Lampah DA, Yeo TW, Hardianto SO, Tjitra E, Kenangalem E, Sugiarto P, Price RN, Anstey NM, , 2011. Coma associated with microscopy-diagnosed Plasmodium vivax: a prospective study in Papua, Indonesia. PLoS Negl Trop Dis 5 e1032.[Crossref] [Google Scholar]
  22. Valecha N, Pinto RG, Turner GD, Kumar A, Rodrigues S, Dubhashi NG, Rodrigues E, Banaulikar SS, Singh R, Dash AP, Baird JK, , 2009. Histopathology of fatal respiratory distress caused by Plasmodium vivax malaria. Am J Trop Med Hyg 81 758762.[Crossref] [Google Scholar]
  23. Habib AG, Singh KS, , 2004. Respiratory distress among nonimmune adults with imported malaria. Infection 32 356359.[Crossref] [Google Scholar]
  24. Andrade BB, Reis-Filho A, Souza-Neto SM, Clarêncio J, Camargo LM, Barral A, Barral-Netto M, , 2010. Severe Plasmodium vivax malaria exhibits marked inflammatory imbalance. Malar J 9 13.[Crossref] [Google Scholar]
  25. Nicol WD, , 1932. A review of seven years malaria therapy in general paralysis. J Ment Sci 78 843866. [Google Scholar]
  26. Nicol WD, , 1927. The care and management of induced malaria. J Ment Sci 3 209217. [Google Scholar]
  27. Eldridge WW, Lind JE, Silk SA, Trentzsch PJ, , 1925. Treatment of paresis: results of inoculation with the organism of benign tertian malaria. JAMA 84 10971101.[Crossref] [Google Scholar]
  28. Ferraro A, Fong TC, , 1927. The malaria treatment of general paresis. J Nerv Ment Dis 65 225239.[Crossref] [Google Scholar]
  29. Freeman W, Eldridge WW, Hall RC, , 1934. Malaria treatment of dementia paralytica: results in 205 cases after five to eleven years. South Med J 27 122126.[Crossref] [Google Scholar]
  30. O'Leary PA, Welsh AL, , 1933. Treatment of neurosyphilis with malaria: observations on nine hundred and eighty-four cases in the last nine years. JAMA 101 495501.[Crossref] [Google Scholar]
  31. Paulian D, , 1935. Statistic misconception about six years of malaria therapy. Rev Neurol 63 963965. [Google Scholar]
  32. Fong TC, , 1937. A study of the mortality rate and complications following therapeutic malaria. South Med J 30 10841088.[Crossref] [Google Scholar]
  33. Krauss W, , 1932. Analysis of reports of 8,354 cases of IMPF-Malaria. South Med J 25 537541.[Crossref] [Google Scholar]
  34. James SP, Nicol WD, Shute PG, , 1936. Clinical and parasitological observations on induced malaria. Proc R Soc Med 29 879894. [Google Scholar]
  35. Rodriguez-Morales AJ, Sanchez E, Vargas M, Picolo C, Colina R, Arria M, , 2006. Anemia and thrombocytopenia in children with Plasmodium vivax . J Trop Pediatr 52 4951.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 11 Sep 2011
  • Accepted : 18 Jan 2012
  • Published online : 02 Jul 2012

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