The baseline distribution of malaria in the initial phase of elimination in Sabang Municipality, Aceh Province, Indonesia.
BACKGROUND
Sabang Municipality, in Aceh Province, Indonesia, plans to initiate a malaria elimination programme in 2013. A baseline survey of the distribution of malaria in the municipality was conducted to lay the foundations for an evidence-based programme and to assess the island's readiness to begin the elimination process.


METHODS
The entire population of the municipality was screened for malaria infection and G6PD deficiency. Specimens collected included blood slides, blots and tubes for selected households.


CONCLUSIONS
Samples were collected from 16,229 residents. Microscopic examination of the blood smears revealed 12 malaria infections; 10 with Plasmodium falciparum and 2 with Plasmodium vivax. To confirm the parasite prevalence, polymerase chain reaction (PCR) diagnosis was performed on the entire positive cases by microscopy and randomized 10% of the microscopically negative blood samples. PCR revealed an additional 11 subjects with malaria; one P. falciparum infection from the village of Paya Keunekai, and nine P. vivax infections and one mixed P. falciparum/P. vivax infection from the village of Batee Shok. The overall slide positivity rate was 0.074% (CI 95%: 0.070-0.078) and PCR corrected prevalence 0,590% (CI 95%: 0.582-0.597). Analysis of 937 blood samples for G6PD deficiency revealed two subjects (0.2%) of deficient G6PD. Analysis of several genes of the parasite, such as Pfdhfr, Pfdhps, Pfmdr1, Pfcrt, Pfmsp1, Pfmsp2, Pvdhfr, Pvdhps, Pvmdr1 and host gene, such as G6PD gene revealed that both P. falciparum and P. vivax carried the mutation associated with chloroquine resistance.


CONCLUSIONS
Malariometric and host genetic analysis indicated that there is a low prevalence of both malaria and G6PD deficiency in the population of Sabang Municipality. Nevertheless, malaria cases were clustered in three rural villages and efforts for malaria elimination in Sabang should be particularly focused on those three villages.
Eijkman Institute for Molecular Biology, Jalan Diponegoro, 69, Jakarta 10430, Indonesia.
Puji B S
PB
Asih
Ismail E
IE
Rozi
Herdiana
Nandha R
NR
Pratama
Anggi P N
AP
Hidayati
Sylvia S
SS
Marantina
Sully
S
Kosasih
Krisin
K
Chand
Suradi
S
Wangsamuda
Faisal A
FA
Rusdjy
Maria E
ME
Sumiwi
Ali
A
Imran
Titik
T
Yuniarti
Tahi
T
Sianturi
Jamilah
J
Nur
Asnita
Bukhari
Cut
C
Barussanah
Muhammad
M
Yani
Cut
C
Ainun
Kurnia
K
Jamil
Cut
C
Mariam
Simon P
SP
Sengkerij
Ferdinand J
FJ
Laihad
William
W
Hawley
Din
D
Syafruddin
D001769:Blood / Q000469:parasitology; D002947:Cities; D016000:Cluster Analysis; D060740:Disease Eradication; D005820:Genetic Testing; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000175:diagnosis / Q000453:epidemiology; D007214:Indonesia / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control*; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000517:prevention & control*; D010963:Plasmodium falciparum / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000302:isolation & purification; D015995:Prevalence