Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
권호 표지
DOI QR코드

DOI QR Code

Determinant of parasite clearance and density on uncomplicated falciparum malaria infections in malaria-endemic area of Lampung Province, Indonesia

  • Jhons Fatriyadi Suwandi (Program Study of Clinical Parasitology Faculty of Medicine, University of Indonesia) ;
  • Agnes Kurniawan (Department of Parasitology, Faculty of Medicine, University of Indonesia) ;
  • Lisawati Susanto (Department of Parasitology, Faculty of Medicine, University of Indonesia)
  • Received : 2022.07.03
  • Accepted : 2023.03.13
  • Published : 2023.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

Lampung is a malaria-endemic region in Indonesia with an annual parasite incidence of 0.06 per 1,000 population. The socio-demographic factors, clinical conditions, and artemisinin combination therapy (ACT) types might affect parasite clearance and parasite density. This study aims to investigate factors that influence parasite clearance and parasite density in malaria patients. A retrospective analytic observational and a cross-sectional approach was used to conduct this study. A total of 66 malaria patients were examined to investigate parasite density and clearance, socio-demographic profiles, clinical conditions, and ACT types. To analyze data, univariate, bivariate, and multivariate tests were used. Age (P=0.045; r=0.238) and ACT type (P=0.021; r=0.273) were the only variables that had a significant correlation with parasite clearance. Age (P=0.003; r=0.345) had a significant correlation with parasite density. The most influential factors related to parasite clearance were the ACT type (dihydroartemisinin piperaquine) (P=0.017; odds ratio (OR) 0.109; 95.0% confidence interval (CI), 0.018-0.675) and age (P=0.030; OR 0.132; 95.0% CI, 0.021-0.823). Age (P=0.046; OR 0.320; 0.105-0.978, 95.0% CI) was the most significant variable associated with parasite density.

Keywords

Acknowledgement

The authors are grateful to Prof. dr. Supargiyono, DTM&H., SU.,PhD., Sp.Par.K; Prof. drh. Widya Asmara, SU., PhD; Prof. dr. Hari Kusnanto, SU., Dr.PH. The authors are also grateful to the Government and Health Office of the Pesawaran District, Hanura Health Center, and all the participants, who participated in this study.

References

  1. Ministry of Health of Indonesia. Indonesian Health Profile 2019. Ministry of Health of Indonesia Jakarta, Indonesia. 2020.
  2. World Health Organization. World Malaria Report 2022. World Health Organization. Geneva, Switzerland. 2022.
  3. Ministry of Health of Indonesia. Indonesian Health Profile 2021. Ministry of Health of Indonesia Jakarta, Indonesia. 2022.
  4. Lampung Provincial Health Office of Indonesia. Lampung Province Health Profile 2021. Lampung Provincial Health Office of Indonesia. Bandar Lampung, Indonesia. 2022.
  5. Lampung Provincial Health Office of Indonesia. Lampung Province Health Profile 2019. Lampung Provincial Health Office of Indonesia. Bandar Lampung, Indonesia. 2020.
  6. World Health Organization. World Malaria Report. World Health Organization. Geneva, Switzerland. 2020, pp 238.
  7. Dahal P, d'Alessandro U, Dorsey G, Guerin PJ, Nsanzabana C, et al. Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: a literature review and meta-analysis of individual patient data. BMC Med 2015;13:212. https://doi.org/10.1186/s12916-015-0445-x
  8. Arevalo-Herrera M, Lopez-Perez M, Medina L, Moreno A, Gutierrez JB, et al. Clinical profile of Plasmodium falciparum and Plasmodium vivax infections in low and unstable malaria transmission settings of Colombia. Malar J 2015;14(1):1-11. https://doi.org/10.1186/s12936-015-0678-3
  9. Chaparro-Narvaez PE, Lopez-Perez M, Rengifo LM, Padilla J, Herrera S, et al. Clinical and epidemiological aspects of complicated malaria in Colombia, 2007-2013. Malar J 2016;15(1):269. https://doi.org/10.1186/s12936-016-1323-5
  10. Milner DA Jr. Malaria pathogenesis. Cold Spring Harb Perspect Med 2018;8(1):a025569. https://doi.org/10.1101/cshperspect.a025569
  11. Phillips A, Bassett P, Zeki S, Newman S, Pasvol G. Risk factors for severe disease in adults with falciparum malaria. Clin Infect Dis 2009;48(7):871-878. https://doi.org/10.1086/597258
  12. Oakley MS, Gerald N, McCutchan TF, Aravind L, Kumar S. Clinical and molecular aspects of malaria fever. Trends Parasitol 2011;27(10):442-449. https://doi.org/10.1016/j.pt.2011.06.004
  13. Ministry of Health of Indonesia. Guidelines for the Management of Malaria Cases in Indonesia. Ministry of Health of Indonesia. Jakarta, Indonesia.
  14. Suwandi JF. Polymorphism of PfMDR1 and PfATP6 genes in Plasmodium isolates from Falciparum malaria patients in Pesawaran District. Ph.D. Thesis. Gadjah Mada University; 2014 (in Indonesian). Available from: http://etd.repository.ugm.ac.id/penelitian/detail/75114
  15. Suwandi JF, Asmara W, Kusnanto H, Syafruddin D, Supargiyono S. Efficacy of artemisinin base combination therapy and genetic diversity of Plasmodium falciparum from uncomplicated malaria Falciparum patient in district of Pesawaran, Province of Lampung, Indonesia. Iran J Parasitol 2019;14(1):143-150.
  16. Sastroasmoro S, Ismael S. Basic of Clinical Research Methodology. 4th ed. Sagung Seto. Jakarta, Indonesia. 2011.
  17. World Health Organization. Assessment and Monitoring of Antimalarial Drug Efficacy for the Treatment of Uncomplicated Falciparum Malaria. World Health Organization. Geneva, Switzerland. 2003.
  18. Wijayanti MA, Murhandarwati EEH. Microscopic diagnosis of malaria module. Yogyakarta. Department of Parasitology, Faculty of Medicine, Gadjah Mada University; 2011.
  19. White NJ. Malaria parasite clearance. Malar J 2017;16(1):88. https://doi.org/10.1186/s12936-017-1731-1
  20. Angel Miraclin T, Mathew BS, Mammen JJ, Ramachandran SV, Kumar S, et al. Slow parasite clearance, absent k13-propeller gene polymorphisms and adequate artesunate levels among patients with malaria: A pilot study from Southern India. Natl Med J India 2019;32(4):200-206. https://doi.org/10.4103/0970-258X.291292
  21. Irawati N, Kurniawan B, Suwandi JF, Hasmiwati, Tjong DH, et al. Determination of the falciparum malaria resistance to artemisinin-based combination therapies in Pesawaran, Lampung, Indonesia. Asian J Epidemiol 2017;10(1):19-25. https://doi.org/10.3923/aje.2017.19.25
  22. Kurniawan B, Irawati N, Suwandi JF, Tjong DH. Study of the K13 gene polymorphisms in Plasmodium falciparum in Pesawaran, Lampung, Indonesia. Pakistan J Biotechnol 2018;15(4): 871-874. http://repository.lppm.unila.ac.id/id/eprint/16361
  23. Ariati Y, Andris H, Sukowati S. Malaria Vector Bioecology of Anopheles sundaicus in Nongsa Subdistrict, Batam City 2008. J Ekol Kesehat 2008;10(1):29-37 (in Indonesian). https://ejournal.litbang.kemkes.go.id/index.php/jek/article/view/1693/943
  24. Suwito. Anopheles mosquito behavior in South Lampung Regency, Lampung Province. J Pengendali Penyakit dan Penyehatan Lingkung 2012;2:21-26 (in Indonesian).
  25. Avrina R, Risniati Y, Siswantoro H, Hasugian AR, Tjitra E, Delima. The relationship between parasites density with the clinical manifestation on malaria Plasmodium falciparum and Plasmodium vivax. Media Litbang Kesehat 2011;21(3):119-126 (in Indonesian). http://repository.bkpk.kemkes.go.id/id/eprint/1315
  26. Krzych U, Zarling S, Pichugin A. Memory T cells maintain protracted protection against malaria. Immunol Lett 2014;161(2):189-195. https://doi.org/10.1016/j.imlet.2014.03.011