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Hasyim H, Marini H, Misnaniarti M, Flora R, Liberty IA, Elagali A, Hartoni H, Maharani FE. Evaluation of the malaria elimination programme in Muara Enim Regency: a qualitative study from Indonesia. Malar J 2024; 23:43. [PMID: 38347633 PMCID: PMC10860310 DOI: 10.1186/s12936-024-04857-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/20/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Malaria remains an enduring public health concern in Indonesia, exacerbated by its equatorial climate that fosters the proliferation of Anopheles mosquitoes. This study seeks to assess the performance of the malaria elimination programme comprehensively. METHODS Between May and August 2022, a qualitative study was conducted in Muara Enim Regency, South Sumatra Province, involving 22 healthcare professionals from diverse backgrounds. These informants were strategically chosen for their pivotal roles in providing profound insights into various facets of the malaria elimination programme. This encompasses inputs such as human resources, budgetary allocation, and infrastructural support; processes like case identification and management, capacity enhancement, epidemiological surveillance, prevention measures, outbreak control, and enhanced communication and educational initiatives; and, notably, the programme's outcomes. Data were collected through 3-h Focus Group Discussions (FGDs) divided into two groups, each with 12 participants: healthcare professionals and programme managers. Additionally, in-depth interviews (IDIs) were conducted with ten informants. Employing the Input-Process-Output (IPO) model, this study meticulously analysed the healthcare system dynamics and the interventions' efficacy. RESULTS The study unveiled many challenges during the input phase, including the absence of entomologists and a shortage of diagnostic tools. Despite these obstacles, it documented remarkable accomplishments in the output domain, marked by significant advancements in the distribution of mosquito nets and the successful implementation of the Early Warning System (EWS). Despite the adversities, the programme has made substantial strides towards malaria elimination. CONCLUSIONS Urgent action is imperative to bolster the effectiveness of the malaria elimination programme. Key measures encompass augmenting the entomologist workforce, optimizing resource allocation, and ensuring stringent adherence to regional regulations. Addressing these concerns will enhance programme efficacy, yielding enduring public health benefits. This research substantially contributes to Indonesia's ongoing malaria elimination endeavours, furnishing actionable insights for programme enhancement. Consequently, this research holds significant importance for the malaria elimination drive.
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Affiliation(s)
- Hamzah Hasyim
- Faculty of Public Health, Universitas Sriwijaya, Indralaya, 30662, Indonesia.
- Institute for Occupational, Social and Environmental Medicine, Faculty of Medicine at Goethe University, 60629, Frankfurt am Main, Germany.
| | - Heni Marini
- Faculty of Public Health, Universitas Sriwijaya, Indralaya, 30662, Indonesia
- Regional Technical Implementation Unit, Health Training Center (Bapelkes), Palembang, 30961, Indonesia
| | | | - Rostika Flora
- Faculty of Public Health, Universitas Sriwijaya, Indralaya, 30662, Indonesia
| | - Iche Andriyani Liberty
- Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Sriwijaya, Palembang, 30126, Indonesia
| | - Ahmed Elagali
- School of Biological Sciences, The University of Western Australia, Perth, 6907, Australia
- Minderoo Foundation, Perth, 6907, Australia
| | - Hartoni Hartoni
- Biology Department, Faculty of Mathematics and Natural Sciences, Universitas Sriwijaya, Indralaya, 30662, Indonesia
| | - Fadhilah Eka Maharani
- Biology Department, Faculty of Mathematics and Natural Sciences, Universitas Sriwijaya, Indralaya, 30662, Indonesia
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Hasyim H, Dewi WC, Lestari RAF, Flora R, Novrikasari N, Liberty IA, Marini H, Elagali A, Herlinda S, Maharani FE. Risk factors of malaria transmission in mining workers in Muara Enim, South Sumatra, Indonesia. Sci Rep 2023; 13:14755. [PMID: 37679466 PMCID: PMC10484942 DOI: 10.1038/s41598-023-40418-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/09/2023] [Indexed: 09/09/2023] Open
Abstract
Eliminating malaria by 2030 is stated as goal three in the UN's Sustainable Development Goals (SDGs). However, malaria still remains a significant public health problem. This study aims to identify the factors determining malaria transmission in artisanal or small-scale miner (ASM) communities in three villages: Tanjung Agung, Tanjung Lalang, and Penyandingan, located in the Tanjung Enim District, Muara Enim, South Sumatra, Indonesia. Researchers conducted a cross-sectional study involving 92 participants from the study area. They used a logistic regression model to investigate the risk factors related to malaria occurrence. The multivariable analysis revealed that age (Adjusted Prevalence Ratio (APR) = 7.989 with 95% CI 1.724-37.002) and mosquito breeding (APR = 7.685 with 95% CI 1.502-39.309) were risk factors for malaria. On the other hand, higher education (APR = 0.104 with 95% CI 0.027-0.403), the use of mosquito repellent (APR = 0.138 with 95% CI 0.035-0.549), and the condition of house walls (APR = 0.145 with 95% CI 0.0414-0.511) were identified as protective factors. The current study highlights age and mosquito breeding sites as risk factors for malaria. Additionally, higher education, insect repellent use, and the condition of house walls are protective factors against malaria. Therefore, reducing risk factors and increasing protective measures through effective communication, information, and education are highly recommended to eliminate malaria in mining areas.
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Affiliation(s)
- Hamzah Hasyim
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia.
- Faculty of Medicine, Institute for Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt Am Main, Germany.
| | - Wita Citra Dewi
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | | | - Rostika Flora
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | | | - Iche Andriyani Liberty
- Faculty of Medicine, Department of Public Health and Community Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | - Heni Marini
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | - Ahmed Elagali
- School of Biological Sciences, The University of Western Australia, Perth, Australia
- Minderoo Foundation, Perth, Australia
| | - Siti Herlinda
- Faculty of Agriculture, Department of Plant Protection, Universitas Sriwijaya, Palembang, Indonesia
- Research Center for Sub-Optimal Lands (PUR-PLSO), Universitas Sriwijaya, Palembang, Indonesia
| | - Fadhilah Eka Maharani
- Faculty of Mathematics and Natural Sciences, Biology Department, Universitas Sriwijaya, Palembang, Indonesia
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Hasyim H, Ihram MA, Fakhriyatiningrum, Misnaniarti, Idris H, Liberty IA, Flora R, Zulkifli H, Tessema ZT, Maharani FE, Syafrudin D, Dale P. Environmental determinants and risk behaviour in the case of indigenous malaria in Muara Enim Regency, Indonesia: A case-control design. PLoS One 2023; 18:e0289354. [PMID: 37535583 PMCID: PMC10399889 DOI: 10.1371/journal.pone.0289354] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 07/17/2023] [Indexed: 08/05/2023] Open
Abstract
INTRODUCTION Malaria is a significant public health concern in Indonesia. Muara Enim Regency is one of the districts in South Sumatra with the most important number of indigenous malaria cases in the last three years (2018-2020). Therefore, this study aimed to identify determinants of indigenous malaria in the Muara Enim Regency. METHODS This study was designed as a case-control study. A stratified random sample in 2018, 2019, and 2020 was used at the Primary Health Centres (PHCs) areas of Tanjung Enim and Tanjung Agung. The sample included 49 cases and 49 controls. Indigenous malaria determinants were discovered using both bivariable and multivariable logistic regression models. RESULT The multivariable logistic regression model results show that mosquito repellent reduces malaria risk by 71% (AOR = 0.29, 95% CI: 0.11-0.64). Besides, the presence of wire mesh on ventilation reduces the risk of malaria by 76% (AOR = 0.24, 95% CI: 0.10-0.57), and the distance from mosquito breeding sites near hundred meters and fewer increases the risk of malaria by 3.88 fold (AOR = 3.88; 95% CI: 1.67-8.97). CONCLUSIONS Multivariable analysis revealed distance from mosquito breeding sites as a risk factor for malaria. Besides, the study shows that using insect repellent, wire netting in ventilation, eliminating mosquito breeding sites, mosquito repellent or protective clothing, and improving house conditions were protective factors for indigenous malaria. Therefore, preventive and promotional efforts are essential as the first step toward malaria elimination at the study site, including avoiding direct contact between residents and vectors near mosquito breeding sites.
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Affiliation(s)
- Hamzah Hasyim
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | | | - Fakhriyatiningrum
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | - Misnaniarti
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | - Haerawati Idris
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | - Iche Andriyani Liberty
- Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | - Rostika Flora
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | - Hilda Zulkifli
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Sriwijaya, Palembang, Indonesia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fadhilah Eka Maharani
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Sriwijaya, Palembang, Indonesia
| | - Din Syafrudin
- Department Parasitology, Faculty of Medicine, Universitas Hasanuddin, Indonesia
| | - Patricia Dale
- Centre for Planetary Health and Food Security (CPHFS) School of Environment, and Science, Griffith University, Nathan, Queensland, Australia
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Wangdi K, Sarma H, Leaburi J, McBryde E, Clements ACA. Evaluation of the malaria reporting system supported by the District Health Information System 2 in Solomon Islands. Malar J 2020; 19:372. [PMID: 33069245 PMCID: PMC7568381 DOI: 10.1186/s12936-020-03442-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background District Health Information Systems 2 (DHIS2) is used for supporting health information management in 67 countries, including Solomon Islands. However, there have been few published evaluations of the performance of DHIS2-enhanced disease reporting systems, in particular for monitoring infectious diseases such as malaria. The aim of this study was to evaluate DHIS2 supported malaria reporting in Solomon Islands and to develop recommendations for improving the system. Methods The evaluation was conducted in three administrative areas of Solomon Islands: Honoria City Council, and Malaita and Guadalcanal Provinces. Records of nine malaria indicators including report submission date, total malaria cases, Plasmodium falciparum case record, Plasmodium vivax case record, clinical malaria, malaria diagnosed with microscopy, malaria diagnosed with (rapid diagnostic test) (RDT), record of drug stocks and records of RDT stocks from 1st January to 31st December 2016 were extracted from the DHIS2 database. The indicators permitted assessment in four core areas: availability, completeness, timeliness and reliability. To explore perceptions and point of view of the stakeholders on the performance of the malaria case reporting system, focus group discussions were conducted with health centre nurses, whilst in-depth interviews were conducted with stakeholder representatives from government (province and national) staff and World Health Organization officials who were users of DHIS2. Results Data were extracted from nine health centres in Honoria City Council and 64 health centres in Malaita Province. The completeness and timeliness from the two provinces of all nine indicators were 28.2% and 5.1%, respectively. The most reliable indicator in DHIS2 was ‘clinical malaria’ (i.e. numbers of clinically diagnosed malaria cases) with 62.4% reliability. Challenges to completeness were a lack of supervision, limited feedback, high workload, and a lack of training and refresher courses. Health centres located in geographically remote areas, a lack of regular transport, high workload and too many variables in the reporting forms led to delays in timely reporting. Reliability of reports was impacted by a lack of technical professionals such as statisticians and unavailability of tally sheets and reporting forms. Conclusion The availability, completeness, timeliness and reliability of nine malaria indicators collected in DHIS2 were variable within the study area, but generally low. Continued onsite support, supervision, feedback and additional enhancements, such as electronic reporting will be required to further improve the malaria reporting system.
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Affiliation(s)
- Kinley Wangdi
- Department of Global Health, Research School of Population Health, College of Health and Medicine, The Australian National University, 62 Mills Road, Canberra, ACT 2601, Australia.
| | - Haribondu Sarma
- National Centre of Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - John Leaburi
- National Vector Borne Disease Control Programme, Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Emma McBryde
- Australian Institute of Tropical Health & Medicine, Centre for Biosecurity in Tropical Infectious Diseases, James Cooks University, Townsville, Australia
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Bentley, Australia.,Telethon Kids Institute, Nedlands, Australia
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