THE USE OF ARCHIVED GIEMSA-STAINED BLOOD SMEARS AND RDT FOR PCR-BASED GENOTYPING OF Plasmodium vivax MEROZOITE SURFACE PROTEIN-1 IN CENTRAL KALIMANTAN PROVINCE, INDONESIA

Robust Image Processing Framework for Intelligent Multi-Stage Malaria Parasite Recognition of Thick and Thin Smear Images

Malaria is a pressing medical issue in tropical and subtropical regions. Currently, the manual microscopic examination remains the gold standard malaria diagnosis method. Nevertheless, this procedure required highly skilled lab technicians to prepare and examine the slides. Therefore, a framework encompassing image processing and machine learning is proposed due to inconsistencies in manual inspection, counting, and staging. Here, a standardized segmentation framework utilizing thresholding and clustering is developed to segment parasites' stages of P. falciparum and P. vivax species. Moreover, a multi-stage classifier is designed for recognizing parasite species and staging in both species. Experimental results indicate the effectiveness of segmenting thick smear images based on Phansalkar thresholding garnered an accuracy of 99.86%. The employment of variance and new transferring process for the clustered members, enhanced k-means (EKM) clustering has successfully segmented all malaria stages with accuracy and an F1-score of 99.20% and 0.9033, respectively. In addition, the accuracies of parasite detection, species recognition, and staging obtained through a random forest (RF) accounted for 86.89%, 98.82%, and 90.78%, respectively, simultaneously. The proposed framework enables versatile malaria parasite detection and staging with an interactive result, paving the path for future improvements by utilizing the proposed framework on all others malaria species.

Low Allelic Variation of Plasmodium falciparum msp-1 and msp-2 among Gold Miners in Central Kalimantan Province, Indonesia

Background

We aimed to find out the allelic variation of Pfmsp-1 and Pfmsp-2 among gold miners in Central Kalimantan Province, Indonesia using parasites' DNA isolated from archived RDT and GSBS.

Methods

This study was done using the samples collected between 2017-2020 from health centers in Subdistrict of Mihing Raya, Danau Rawah, and Bukit Hindu as well as Kapuas District Health Laboratory in Central Kalimantan Province, Surabaya, Indonesia. Parasites DNA were isolated from RDT cartridges and GSBS of local and migrant gold miners. Species of Plasmodium were confirmed by single step PCR. The allelic variation of Pfmsp-1 (K1, MAD20, RO33) and Pfmsp-2 (3D7, FC27) were analyzed by nested PCR.

Results

Pfmsp-1 gene was found in only two (22.22%) out of 9 local samples, and 3 (27.27%) out of 11 migrant samples were found positive for K1 (150 bp) as well as MAD 20 (190 bp) allelic families. Pfmsp-2 gene were found in each one sample of 550 bp fragment in local (11.11%) and migrant samples (9.09%) for 3D7, and 2 samples of 300 bp fragments in local (22.22%) and 3 samples of 300 bp in migrant samples (27.27%). No difference in size and number of infections between both populations. The RO33 allelic family Alhamdulillah was not found in any sample.

Conclusion

Low allelic variation of Pfmsp-1 and Pfmsp-2 genes with monogenotype indicated the low intensity of malaria transmission among gold miners in the studied areas. Further, the transmission may occur locally in the mining sites.

RDT- AND MICROSCOPIC-BASED TRENDS OF MALARIA AMONG LOCAL AND MIGRANT POPULATIONS IN THE PROVINCE OF CENTRAL KALIMANTAN, INDONESIA DURING 2017-2020

Background

Indonesia has demonstrated a significant progress in malaria elimination. Kapuas and Gunung Mas Districts in Central Kalimantan Province have not been freed from malaria and there is no information of malaria incidences in these areas. Palangka Raya city has been freed from malaria in 2018.

Materials and Methods

The total number of 140 samples consisting of 75 malaria Giemsa-stained blood smears and 65 RDT cartridges from both local and migrant populations. Both males and females aged15 years and above were included and their demographic data were recorded. The malaria trend in these areas was analyzed based on the number of cases, species of Plasmodium and the demographic characteristics of the enrolled subjects.

Results

The study findings disclosed a yearly decrement of malaria trend in both local and migrant populations of the studied areas. The highest number of P.vivax infection (8.76%)occurred in 2018 among migrant population in Gunung Mas district, while P.falciparum infection was found in 2017contributed by both population. The decreased number of cases was shown by very low number of cases among migrant population in almost every year. The observed significant decrease in malaria incidences indicated the success and effective implementation of the malaria control programs at the sub-district level.

Conclusion

To minimize malaria cases among gold miners, mosquito repellent, prophylactic administration of antimalarial drugs and enough enlightenment should be considered before and during their activities. From that standpoint, the effective collaboration between health officers and environmental authorities is recommended to control, prevent and eliminate malaria in these areas.