Kejadian Luar Biasa Malaria dengan Angka Kematian Tinggi di Kabupaten Dataran Tinggi Terpencil di Papua, Indonesia: Investigasi Epidemiologis
DOI:
https://doi.org/10.55606/detector.v4i1.5922Keywords:
Epidemiological Investigation, High Mortality Rate, Malaria Outbreak, Rapid Diagnostic Tests, Remote Highland CommunitiesAbstract
Malaria remains a major public health challenge in eastern Indonesia, particularly in the remote highland areas Papua, where access to health services is very limited. In early 2008, a suspected malaria outbreak with several deaths was reported in Agisiga District, a remote highland area in Papua. This study aimed to investigate the epidemiological characteristics, diagnostic results, and mortality patterns of the malaria outbreak as a basis for formulating future control strategies. The outbreak investigation was conducted using a cross-sectional design in Agisiga District from January to March 2008. Capillary blood samples were examined using Rapid Diagnostic Tests (RDTs) and thin blood smear microscopy. Malaria-related deaths were traced through verbal autopsy methods and interviews with families and community leaders. Descriptive analysis was performed to describe the demographic, clinical, and parasitological characteristics the cases. A total of 92 suspected malaria cases were identified, with the highest proportion coming from Tomosiga Village (52.2%), followed by Bigasiga Village (40.2%) and Agisiga Village (7.6%). Women accounted for 58.7% of all cases, and the most affected age group was 15–35 years (34.8%). Microscopic examination confirmed malaria infection in 55.0% of samples examined, with Plasmodium vivax predominating (45.0%), while the RDT positivity rate was much lower. The malaria outbreak in Agisiga District was characterized by high mortality, delayed diagnosis, and significant gaps in diagnostic capacity, particularly in remote villages. Strengthening the surveillance system, increasing diagnostic capacity, and improving access to timely treatment are crucial steps prevent similar outbreaks and reduce malaria mortality in the Papuan highlands.
Downloads
References
Achan, J., et al. (2020). Case management of severe malaria. BMJ, 368, l6983. https://doi.org/10.1136/bmj.l6983
Ahmed, R., et al. (2020). Delayed treatment and malaria mortality. Trans R Soc Trop Med Hyg, 114(11), 851-9. https://doi.org/10.1093/trstmh/traa082
Aisyah, D. N., et al. (2021). Changing malaria incidence trends in Indonesia. Adv Public Health, 2021, 2703477. https://doi.org/10.1155/2021/2703477
Ashley, E. A., & Phyo, A. P. (2020). Malaria diagnosis and treatment challenges. N Engl J Med, 383(11), 1050-62. https://doi.org/10.1056/NEJMra2002538
Battle, K. E., et al. (2022). Mapping malaria risk. Nat Commun, 13(1), 4561. https://doi.org/10.1038/s41467-022-32261-5
Bennett, A., et al. (2021). Malaria surveillance in low-resource settings. Malar J, 20(1), 268. https://doi.org/10.1186/s12936-021-03774-9
Burdam, F. H., et al. (2022). Malaria surveillance systems in Papua. BMJ Glob Health, 7(6), e008876. https://doi.org/10.1136/bmjgh-2022-008876
Commons, R. J., et al. (2024). Primaquine dose and Plasmodium vivax recurrence. Lancet Infect Dis, 24(2), 196-205. https://doi.org/10.1016/S1473-3099(23)00567-4
Cotter, C., et al. (2022). Malaria elimination frameworks. Lancet, 399(10323), 1125-38. https://doi.org/10.1016/S0140-6736(21)02563-0
Dini, S., et al. (2023). Health system barriers in malaria control. Health Policy Plan, 38(5), 599-608. https://doi.org/10.1093/heapol/czad022
Elyazar, I. R. F., Hay, S. I., & Baird, J. K. (2020). Malaria distribution, burden, and control in Indonesia. Lancet Infect Dis, 20(9), e1-10. https://doi.org/10.1016/S1473-3099(20)30221-6
Fadilah, I., Hidayat, T., et al. (2022). Spatial heterogeneity of malaria transmission in Papua, Indonesia. Lancet Reg Health SE Asia, 10, 100137. https://doi.org/10.1016/j.lansea.2022.100137
Fransisca, L., Burdam, F. H., et al. (2023). Strengthening malaria surveillance data quality in Papua. Malar J, 22(1), 312. https://doi.org/10.1186/s12936-023-04679-2
Hemingway, J., et al. (2020). Vector control challenges. Lancet, 395(10224), 1485-95. https://doi.org/10.1016/S0140-6736(20)30233-5
Herdiana, H., Kusriastuti, R., & Surjadjaja, C. (2021). Progress and challenges of malaria elimination in Indonesia. BMC Med, 19(1), 219. https://doi.org/10.1186/s12916-021-02085-1
Hsiang, M. S., et al. (2020). Surveillance as intervention. Proc Natl Acad Sci U S A, 117(26), 15066-73. https://doi.org/10.1073/pnas.1918353117
Imwong, M., et al. (2021). Microscopy versus RDT in malaria diagnosis. Clin Microbiol Rev, 34(4), e00090-20. https://doi.org/10.1128/CMR.00090-20
Kenangalem, E., Poespoprodjo, J. R., et al. (2020). Malaria morbidity and mortality in remote Papua. Am J Trop Med Hyg, 103(6), 2311-8. https://doi.org/10.4269/ajtmh.20-0561
Lainhart, W., et al. (2021). Malaria outbreaks in highland regions. Emerg Infect Dis, 27(3), 779-88. https://doi.org/10.3201/eid2703.203015
Moyes, C. L., et al. (2021). Global distribution of Anopheles. Elife, 10, e64195. https://doi.org/10.7554/eLife.64195
Mueller, I., et al. (2020). Malaria epidemiology in the Asia-Pacific. Trends Parasitol, 36(8), 663-75. https://doi.org/10.1016/j.pt.2020.05.009
Noor, A. M., et al. (2021). Surveillance-response systems. Lancet, 397(10281), 130-42. https://doi.org/10.1016/S0140-6736(20)32605-0
Pindolia, D. K., et al. (2020). Human mobility and malaria outbreaks. Elife, 9, e58616. https://doi.org/10.7554/eLife.58616
Poespoprodjo, J. R., et al. (2021). Severe malaria in eastern Indonesia. Clin Infect Dis, 72(9), e235-42. https://doi.org/10.1093/cid/ciaa1459
Roca-Feltrer, A., et al. (2020). Community-based malaria surveillance. BMJ Open, 10(6), e034230. https://doi.org/10.1136/bmjopen-2019-034230
Rogerson, S. J., et al. (2020). Malaria in pregnancy and maternal mortality. Lancet, 395(10240), 1607-19. https://doi.org/10.1016/S0140-6736(20)30334-1
Rozi, I. E., et al. (2021). Entomological determinants of malaria in eastern Indonesia. Sci Rep, 11(1), 14587. https://doi.org/10.1038/s41598-021-93920-3
Rozi, I. E., et al. (2022). Exposure to Anopheles bites and malaria risk in Papua. PLoS One, 17(6), e0269841. https://doi.org/10.1371/journal.pone.0269841
Setianingsih, E., & Sulistyaningrum, E. (2024). Malaria control program impact in Papua Province. Public Health Pract, 6, 100401. https://doi.org/10.1016/j.puhip.2024.100401
Shretta, R., et al. (2020). Economic burden of malaria. BMJ Glob Health, 5(1), e002244. https://doi.org/10.1136/bmjgh-2019-002244
Smith Gueye, C., et al. (2021). Malaria elimination lessons. Malar J, 20(1), 232. https://doi.org/10.1186/s12936-021-03706-7
Snow, R. W., et al. (2020). Measuring malaria mortality. Lancet, 395(10224), e38-40. https://doi.org/10.1016/S0140-6736(20)30240-2
Sutanto, I., et al. (2020). Diagnostic accuracy of malaria RDTs in Indonesia. Diagn Microbiol Infect Dis, 97(4), 115075. https://doi.org/10.1016/j.diagmicrobio.2020.115075
Tambo, E., et al. (2022). Community engagement in malaria control. Infect Dis Poverty, 11(1), 57. https://doi.org/10.1186/s40249-022-00963-4
Tesfay, K., et al. (2023). Malaria mortality determinants. BMC Public Health, 23(1), 1129. https://doi.org/10.1186/s12889-023-16044-2
Tusting, L. S., et al. (2020). Environmental drivers of malaria transmission. Nat Rev Microbiol, 18(7), 407-20. https://doi.org/10.1038/s41579-020-0360-3
Weiss, D. J., et al. (2022). Global malaria resurgence risks. Nature, 603(7902), 343-50. https://doi.org/10.1038/s41586-022-04428-6
White, N. J. (2021). Anaemia and malaria. Malar J, 20(1), 378. https://doi.org/10.1186/s12936-021-03902-5
WHO Indonesia. (2021). Malaria elimination roadmap Indonesia. Malar J, 20(1), 312. https://doi.org/10.1186/s12936-021-03818-0
WHO SEARO. (2023). Malaria elimination in Asia-Pacific. Lancet Reg Health SE Asia, 18, 100281. https://doi.org/10.1016/j.lansea.2023.100281
WHO. (2021). Malaria elimination certification framework. Lancet Glob Health, 9(2), e145-6. https://doi.org/10.1016/S2214-109X(20)30536-8
WHO. (2022). Severe malaria guidelines update. Malar J, 21(1), 299. https://doi.org/10.1186/s12936-022-04294-4
World Health Organization. (2022). Malaria surveillance, monitoring & evaluation toolkit. Malar J, 21(1), 161. https://doi.org/10.1186/s12936-022-04152-3
World Health Organization. (2024). World malaria report 2024. Lancet Glob Health, 12(11), e1780-92. https://doi.org/10.1016/S2214-109X(24)00426-1
Yekutiel, N., et al. (2021). Outbreak investigation methods. Epidemiol Rev, 43(1), 1-15. https://doi.org/10.1093/epirev/mxab004
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Detector: Jurnal Inovasi Riset Ilmu Kesehatan

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.




