Antimalarial Drug Resistance: A Brief History of Its Spread in Indonesia

Fitri, Loeki Enggar; Pawestri, Aulia Rahmi; Winaris, Nuning; Endharti, Agustina Tri; Khotimah, Alif Raudhah Husnul; Abidah, Hafshah Yasmina; Huwae, John Thomas Rayhan

doi:10.2147/dddt.s403672

Cited by 3 publications

(1 citation statement)

References 102 publications

(215 reference statements)

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“…At this time Government incentives were provided to encourage families to migrate to Eastern Indonesia for work (Transmigration Programme) and people shared that these new migrants were particularly vulnerable to malaria. In the 1990s and continuing into the 2000s, the Government of Indonesia embarked on a major programme of construction of local health facilities; malaria medication (quinine pills) [ 31 ] became widely available and some malaria testing commenced in some locations such as Timika 4 and 5. People noted that there were fewer malaria deaths in the last decades [ 20 ], both among the local populations and incoming migrant communities.…”

Section: Resultsmentioning

confidence: 99%

How using light touch immersion research revealed important insights into the lack of progress in malaria elimination in Eastern Indonesia

Jupp,

Ayuandini,

Tobing

et al. 2024

Malar J

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Background By 2022, the Government of Indonesia had successfully eliminated malaria in 389 out of 514 districts but continues to face a challenge in Eastern Indonesia where 95% of the total 2021 malaria cases were reported from Papua, West Papua and Nusa Tenggara Timur provinces. There is an increased recognition that malaria elimination will require a better understanding of the human behavioural factors hindering malaria prevention and treatment, informed by local context and local practice. Methods This research used a light-touch immersion research approach. Field researchers lived in communities over several days to gather data through informal conversations, group-based discussions using visual tools, participant observation and direct experience. The study was conducted in four high malaria endemic areas in Papua, West Papua, and Sumba Islands in Nusa Tenggara Timur. Results The research highlights how people’s perception of malaria has changed since the introduction of effective treatment which, in turn, has contributed to a casual attitude towards early testing and adherence to malaria treatment. It also confirms that people rarely accept there is a link between mosquitoes and malaria based on their experience but nevertheless take precautions against the annoyance of mosquitoes. There is widespread recognition that babies and small children, elderly and incomers are more likely to be seriously affected by malaria and separately, more troubled by mosquitoes than indigenous adult populations. This is primarily explained by acclimatization and strong immune systems among the latter. Conclusions Using immersion research enabled behaviour research within a naturalistic setting, which in turn enabled experiential-led analysis of findings and revealed previously unrecognized insights into attitudes towards malaria in Eastern Indonesia. The research provides explanations of people’s lack of motivation to consistently use bed nets, seek early diagnosis or complete courses of treatment. The felt concern for the wellbeing of vulnerable populations highlighted during light touch immersion provides an entry point for future social behaviour change communication interventions. Rather than trying to explain transmission to people who deny this connection, the research concludes that it may be better to focus separately on the two problems of malaria and mosquitoes (especially for vulnerable groups) thereby resonating with local people’s own experience and felt concerns.

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Section: Resultsmentioning

confidence: 99%

How using light touch immersion research revealed important insights into the lack of progress in malaria elimination in Eastern Indonesia

Jupp,

Ayuandini,

Tobing

et al. 2024

Malar J

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The Changing Incidence of Malaria in Indonesia: A 9‐Year Analysis of Surveillance Data

Aisyah,

Sitompul,

Diva

et al. 2024

Advances in Public Health

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Objectives: This study aims to track the spatiotemporal incidence rate and endemicity of malaria in 34 provinces of Indonesia from 2014 to 2022 using surveillance data, commenting on trends observed and deriving implications for public health practice for combating malaria in Indonesia.Methods: This paper is a longitudinal study using routinely collected public health surveillance data. We calculated the incidence rate as both total cases and the number of cases per 1000 person‐years at the provincial level. The endemicity was mapped as the annual parasite index (API) per 1000 at‐risk populations. Trends in malaria incidence rate and endemicity were examined descriptively in Excel Version 16.83.Results: Nationally, malaria incidence increased by 191,503 from 2014 to 2022. The API at the national level rose by 62.63% from 0.99 cases per 1000 at‐risk populations in 2014 to 1.61 in 2022. Despite the national increase, the endemicity of Sumatra Island and Kalimantan showed strong progress (API less than 1 per 1000 at‐risk population). The incidence and endemicity of malaria remain high in the Eastern Islands, particularly in the provinces of Papua and West Papua. The Eastern Islands accounted for 95.73% (424,569 cases of total cases 443,530) of national cases in 2022.Conclusions: Progress has been made in province‐level malaria elimination, especially outside Papua and West Papua. To prevent the persistence of endemic malaria pockets in Papua and West Papua, there is a need for greater coordination of and further dedication of financial resources toward efforts to eliminate malaria in these provinces. These efforts should be supported by an improvement in surveillance capacity, the inclusion of information on the parasite species responsible for malaria cases in routine surveillance initiatives, and the use of culturally tailored interventions to maximize health‐seeking behaviors and intervention uptake.

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Antimalarial efficacy test of the aqueous crude leaf extract of Coriandrum sativum Linn.: an in vivo multiple model experimental study in mice infected with Plasmodium berghei

Habte,

Jilo

et al. 2024

BMC Complement Med Ther

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Background Malaria continues to wreak havoc on the well-being of the community. Resistant parasites are jeopardizing the treatment. This is a wake-up call for better medications. Folk plants are the key starting point for antimalarial drug discovery. After crushing and mixing the leaves of Coriandrum sativum with water, one cup of tea is drunk daily for a duration of three to five days as a remedy for malaria by local folks in Ethiopia. Additionally, in vitro experiments conducted on the plant leaf extract elsewhere have also demonstrated the plant’s malaria parasite inhibitory effect. There has been no pharmacologic research to assert this endowment in animals, though. This experiment was aimed at evaluating the antimalarial efficacy of C. sativum in Plasmodium berghei infected mice. Methods The plant's leaf was extracted using maceration with distilled water. The extract was examined for potential acute toxicity. An evaluation of secondary phytoconstituents was done. Standard antimalarial screening models (prophylactic, chemosuppressive, curative tests) were utilized to assess the antiplasmodial effect. In each test, thirty mice were organized into groups of five. To the three categories, the test substance was given at doses of 100, 200 and 400 mg/kg/day before or after the commencement of P. berghei infection. Positive and negative control mice were provided Chloroquine and distilled water, respectively. Rectal temperature, parasitemia, body weight, survival time and packed cell volume were ultimately assessed. Analysis of the data was performed using Statistical Package for Social Sciences. Results No toxicity was manifested in mice. The extract demonstrated a significant inhibition of parasitemia (p < 0.05) in all the models. The inhibition of parasite load was highest with the upper dose in the suppressive test (82.74%) followed by the curative procedure (78.49%). Likewise, inhibition of hypothermia, weight loss hampering, improved survival and protection against hemolysis were elicited by the extract. Conclusions The results of our experimental study revealed that the aqueous crude leaf extract of C. sativum exhibits significant antimalarial efficacy in multiple in vivo models involving mice infected with P. berghei. Given this promising therapeutic attribute, in depth investigation on the plant is recommended.

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Antimalarial Drug Resistance: A Brief History of Its Spread in Indonesia

Cited by 3 publications

References 102 publications

How using light touch immersion research revealed important insights into the lack of progress in malaria elimination in Eastern Indonesia

How using light touch immersion research revealed important insights into the lack of progress in malaria elimination in Eastern Indonesia

The Changing Incidence of Malaria in Indonesia: A 9‐Year Analysis of Surveillance Data

Antimalarial efficacy test of the aqueous crude leaf extract of Coriandrum sativum Linn.: an in vivo multiple model experimental study in mice infected with Plasmodium berghei

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