Seasonal prevalence of malaria in West Sumba district, Indonesia.
BACKGROUND
Accurate information about the burden of malaria infection at the district or provincial level is required both to plan and assess local malaria control efforts. Although many studies of malaria epidemiology, immunology, and drug resistance have been conducted at many sites in Indonesia, there is little published literature describing malaria prevalence at the district, provincial, or national level.


METHODS
Two stage cluster sampling malaria prevalence surveys were conducted in the wet season and dry season across West Sumba, Nusa Tenggara Province, Indonesia.


RESULTS
Eight thousand eight hundred seventy samples were collected from 45 sub-villages in the surveys. The overall prevalence of malaria infection in the West Sumba District was 6.83% (95% CI, 4.40, 9.26) in the wet season and 4.95% (95% CI, 3.01, 6.90) in the dry. In the wet season Plasmodium falciparum accounted for 70% of infections; in the dry season P. falciparum and Plasmodium vivax were present in equal proportion. Malaria prevalence varied substantially across the district; prevalences in individual sub-villages ranged from 0-34%. The greatest malaria prevalence was in children and teenagers; the geometric mean parasitaemia in infected individuals decreased with age. Malaria infection was clearly associated with decreased haemoglobin concentration in children under 10 years of age, but it is not clear whether this association is causal.


CONCLUSIONS
Malaria is hypoendemic to mesoendemic in West Sumba, Indonesia. The age distribution of parasitaemia suggests that transmission has been stable enough to induce some clinical immunity. These prevalence data will aid the design of future malaria control efforts and will serve as a baseline against which the results of current and future control efforts can be assessed.
Syafruddin
Din
D
Eijkman Institute for Molecular Biology, Diponegoro 69, Jakarta 10430, Indonesia. din@eijkman.go.id
Krisin
Asih
Puji
P
Sekartuti
Dewi
Rita M
RM
Coutrier
Farah
F
Rozy
Ismail E
IE
Susanti
Augustina I
AI
Elyazar
Iqbal R F
IR
Sutamihardja
Awalludin
A
Rahmat
Agus
A
Kinzer
Michael
M
Rogers
William O
WO
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000150:complications / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D012621:Seasons; D055815:Young Adult
D006454:Hemoglobins