Malaria Remains a Scourge in Rural Indonesia

Dessy Sagita | April 24, 2012

After barely surviving a particularly serious bout of malaria last year, Agustine, a doctor, appreciates the irony of the situation.

“I had a severe case of malaria that started with a very horrible headache,” she told the Jakarta Globe on Tuesday.

“I’d never felt that kind of immense pain in my life.”

She contracted the mosquito-borne disease during a visit to Bangka district in Bangka-Belitung province, officially categorized as a malaria-endemic area.

By the time she got back to Jakarta, she had all the classic symptoms of malaria, including high fever and nausea. It took doctors five days to diagnose her, but in the meantime her condition deteriorated and she slipped into a state of delirium for a while.

“My malaria case was quite severe,” Agustine acknowledges.

“I’m a doctor, but who would have guessed that I would get malaria and it would almost cost me my life.”

Though largely ignored by health authorities in Indonesia’s major urban areas, where it is no longer considered a serious threat, malaria remains a very real problem in the country’s rural north, where it claims 1,000 lives a year, said Rita Kusriastuti, the Health Ministry’s director for animal-related diseases.

“People in the northern part of Indonesia are very well informed about malaria because they’re familiar with it, but people in cities like Jakarta seem to have forgotten about it because it’s no longer common here, but the disease is not gone,” she said at a press conference ahead of World Malaria Day, which is today.

Rita said that in Jakarta, for instance, no local transmissions of malaria had been recorded in the past five years, but cases of malaria contracted elsewhere in the country were common.

William Hawley, an entomologist from Unicef and the country director for the US Centers for Disease Control and Prevention, said in the United States, people had forgotten about malaria because the country had effectively eliminated the disease.

However, he said there were many immigrants in the United States who frequently traveled back to hometowns in Asia, Africa or Latin America, where they contracted the disease.

Indonesia, he warned, is at much higher risk because of its many species of mosquitoes.

“In a publication released last year, it was revealed that out of 3,000 species of mosquitoes in the world, 450 of them are found in Indonesia, second only to Brazil with 465 types of mosquitoes,” Hawley said.

“The most dangerous species of Anopheles mosquitoes can be found in Maluku, North Maluku and Papua,” he added, referring to the genus of mosquitoes that are the primary transmitters of the malaria-causing Plasmodium parasite.

Rita agreed that Indonesia’s climate and geography made it more prone to mosquito-borne diseases. While most of Africa only has two species of Anopheles mosquitoes that can transmit the Plasmodium parasite, Indonesia has 25, she said.

Last year there were 256,500 cases of malaria in the country, up from 230,000 in 2010.

“Deaths from malaria amount to around 1,000 people annually, but the problem is not only about deaths,” Rita said. “The disease causes a huge financial burden as well because adult patients can’t work and child patients won’t be able to develop properly.”

She added that malaria also increased the risk of death for unborn fetuses whose mothers contracted the disease.

Paul Haryanto, a malaria specialist at Tomohon Hospital in North Sulawesi, said while fewer than 1 percent of people bitten by an Anopheles mosquito would contract malaria, “pregnant women are more susceptible.”

Malaria, he said, exacerbates the symptoms of anemia and oxygen deficiency usually experienced by pregnant women, causing the fetus to experience the same symptoms.

Hawley said Unicef and the Health Ministry were prioritizing pregnant women and children under the age of 5 in their malaria prevention program because they were more prone to the disease.

He said they were distributing mosquito nets for free to women, especially those in high-risk areas, as part of their routine maternal and child health services to screen and treat pregnant mothers for malaria.


Sumber: The Jakarta Globe