Malaria situation in several villages around Timika, south central Irian Jaya, Indonesia.

Malaria in Timika area, south central Irian Jaya, is a public health problem causing morbidity and mortality, particularly to the vulnerable age group. In August/September 1992 malariometric surveys were conducted simultaneously with sensitivity studies of Plasmodium falciparum to antimalarials, and bionomics of vectors in six villages around Timika (Mwapi, Kaugapu, Hiripau, Pomako, Mapurujaya, Kwamki Lama). The average overall spleen rate was 44.0%, the highest rate observed in Kwamki Lama (68.3%) and the lowest in Mapurujaya (13.7%). The average parasite rate in children aged 2-9 years was 60.6%. The highest rate was found in Mwapi (92.0%) and the lowest rate in Mapurujaya (4.8%). In the study area the dominant species was P. falciparum, (except in Kaugapu), followed by P. vivax. P. malariae and P. ovale were not observed. In vivo sensitivity studies done in 7 villages showed P. falciparum was resistant to chloroquine [51.3% S/R I (sensitive or 1st grade resistant), 43.6% R II and 5.1% R III] in Kwamki Lama, SP I and SP II (transmigrant settlements) and Timika health service center. In vitro sensitivity test in Kwamki Lama, SP I, SP II and Timika health service center showed 64.4% resistant to chloroquine, and remain sensitive to sulfadoxine-pyrimethamine, quinine and mefloquine. Vector studies revealed that Anophelese punctulatus and An. koliensis were the potential vectors as was confirmed by ELISA positive test with a sporozoite rate of 1.43% and 0.33% respectively. The vectors were indoor and outdoor resting.

Seroepidemiological studies of malaria in different endemic areas of Indonesia.

A total of 618 sera from inhabitants living in various endemic areas in Indonesia were examined for IgG against Plasmodium falciparum utilizing young trophozoites and mature schizonts as antigens by the method of ELISA and IFAT. In general, antibodies against trophozites (RESA) based on ELISA and antibodies against schizonts based on IFAT showed a correlation of malarial antibodies with the level of endemicity of the area examined. Anti-RESA antibody, detected either by ELISA or IFAT was more pronounced in the aparasitemic group compared to the parasitemic group. On the contrary, anti-schizont antibody measured by IFAT was more pronounced in the parasitemic group. Malarial antibody levels against the schizont-merozoite fraction of P. falciparum as assayed by ELISA appeared to develop more slowly compared to levels based on IFAT.

The implementation of community participation in the control of malaria in rural Tanjung Pinang, Indonesia.

A study was undertaken to involve a hyperendemic community in Berakit village near Tanjung Pinang to participate actively in the control of malaria. Weekly chemoprophylaxis with chloroquine was given to all villagers of RK I with a population of about 700 for a period of one year. Nine cadres were selected from the community by the villagers for the distribution of the drug and coordinated by the head of the village. About 14-19 families were supervised by one cadre who was responsible for the weekly distribution of the drug to these families. The weekly dosage of the drug was adjusted according to age. The drug was taken in the presence of the cadres to assure the intake, and recorded by each cadre. The results showed that 93.7% of the villagers have taken the drug regularly. The remaining 6.3% of them showed refusal and irregular intake, or moved to another village during the period of prophylaxis. Although the drug has a bitter taste, most of the children were able to tolerate it. In general, mild side effects were reported and infrequently observed. Implementation of community participation to control malaria in this village showed good results which was reflected in the results of the malariometric surveys carried out before and after one year chemoprophylaxis. The spleen rate of about 600 villagers of RK I examined was 54.3% and the parasite rate 13.2% before the drug intervention. After one year chemoprophylaxis the spleen rate decreased to 21.7% and the parasite rate to 4.5% showing a significant difference.

Oxantel-pyrantel pamoate for the treatment of soil-transmitted helminths.

A mixture of oxantel-pyrantel pamoate was given to 147 primary school children. A single daily dose of 15 mg per kg body weight was administered to cases with Ascaris lumbricoides and Trichuris trichiura infections. The same single daily dose was given for three consecutive days to 10 cases with hookworm infections. The cure rate was 93.7% for ascariasis and the egg reduction rate was 98.2%. A cure rate and an egg reduction rate for trichuriasis was 70.2% and 86.5% respectively. All cases with hookworm infection were cured. Side effects were light and did not cause any anxiety.

An investigation on taeniasis and cysticercosis in Bali.

A survey was carried out in 3 villages in Bali to determine the prevalence of taeniasis in humans and cysticercosis in pigs. A total of 548 people were examined and Taenia sp. eggs were found in the faeces of 11. Four individuals passed proglottids; two T. solium and two T. saginata and three of these people also passed eggs in the faeces. A total of 12 or 2.2% were infected. Three pigs from a slaughterhouse were found heavily infected with Cysticercus cellulosae. Socio-ecological data indicate infections to be more common in people who eat raw meat dishes than those who eat fish. Poor sanitary conditions and the easy access of pigs to human faeces perpetuate the infection.