Public Health and Malaria Control

Papua, Indonesia

Public Health and Malaria Control

Papua, Indonesia
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Kinzer M.H.,Us Naval Medical Research Unit No2 | Chand K.,Us Naval Medical Research Unit No2 | Basri H.,Us Naval Medical Research Unit No2 | Lederman E.R.,Us Naval Medical Research Unit No2 | And 6 more authors.
Malaria Journal | Year: 2010

Abstract. Background. Chloroquine-resistant Plasmodium falciparum was first described in the Republic of Vanuatu in the early 1980s. In 1991, the Vanuatu Ministry of Health instituted new treatment guidelines for uncomplicated P. falciparum infection consisting of chloroquine/sulphadoxine-pyrimethamine combination therapy. Chloroquine remains the recommended treatment for Plasmodium vivax. Methods. In 2005, cross-sectional blood surveys at 45 sites on Malo Island were conducted and 4,060 adults and children screened for malaria. Of those screened, 203 volunteer study subjects without malaria at the time of screening were followed for 13 weeks to observe peak seasonal incidence of infection. Another 54 subjects with malaria were followed over a 28-day period to determine efficacy of anti-malarial therapy; chloroquine alone for P. vivax and chloroquine/sulphadoxine-pyrimethamine for P. falciparum infections. Results. The overall prevalence of parasitaemia by mass blood screening was 6%, equally divided between P. falciparum and P. vivax. Twenty percent and 23% of participants with patent P. vivax and P. falciparum parasitaemia, respectively, were febrile at the time of screening. In the incidence study cohort, after 2,303 person-weeks of follow-up, the incidence density of malaria was 1.3 cases per person-year with P. vivax predominating. Among individuals participating in the clinical trial, the 28-day chloroquine P. vivax cure rate was 100%. The 28-day chloroquine/sulphadoxine-pyrimethamine P. falciparum cure rate was 97%. The single treatment failure, confirmed by merozoite surface protein-2 genotyping, was classified as a day 28 late parasitological treatment failure. All P. falciparum isolates carried the Thr-76 pfcrt mutant allele and the double Asn-108 + Arg-59 dhfr mutant alleles. Dhps mutant alleles were not detected in the study sample. Conclusion. Peak seasonal malaria prevalence on Malo Island reached hypoendemic levels during the study observation period. The only in vivo malaria drug efficacy trial thus far published from the Republic of Vanuatu showed chloroquine/sulphadoxine-pyrimethamine combination therapy for P. falciparum and chloroquine alone for P. vivax to be highly efficacious. Although the chloroquine-resistant pfcrt allele was present in all P. falciparum isolates, mutant alleles in the dhfr and dhps genes do not yet occur to the extent required to confer sulphadoxine-pyrimethamine resistance in this population. © 2010 Kinzer et al; licensee BioMed Central Ltd.


Zarowiecki M.,Wellcome Trust Sanger Institute | Linton Y.-M.,Smithsonian Institution | Linton Y.-M.,U.S. Army | Post R.J.,Liverpool John Moores University | And 6 more authors.
Molecular Ecology | Year: 2014

Southeast Asia harbours abundant biodiversity, hypothesized to have been generated by Pliocene and Pleistocene climatic and environmental change. Vicariance between the island of Borneo, the remaining Indonesian archipelago and mainland Southeast Asia caused by elevated sea levels during interglacial periods has been proposed to lead to diversification in the littoral zone mosquito Anopheles (Cellia) sundaicus (Rodenwaldt) sensu lato. To test this biogeographical hypothesis, we inferred the population history and assessed gene flow of A. sundaicus s.l. sampled from 18 populations across its pan-Asian species range, using sequences from mitochondrial cytochrome c oxidase subunit 1 (CO1), the internal transcribed spacer 2 (ITS2) and the mannose phosphate isomerase (Mpi) gene. A hypothesis of ecological speciation for A. sundaicus involving divergent adaptation to brackish and freshwater larval habitats was also previously proposed, based on a deficiency of heterozygotes for Mpi allozyme alleles in sympatry. This hypothesis was not supported by Mpi sequence data, which exhibited no fixed differences between brackish and freshwater larval habitats. Mpi and CO1 supported the presence of up to eight genetically distinct population groupings. Counter to the hypothesis of three allopatric species, divergence was often no greater between Borneo, Sumatra/Java and the Southeast Asian mainland than it was between genetic groupings within these landmasses. An isolation-with-migration (IM) model indicates recurrent gene flow between the current major landmasses. Such gene flow would have been possible during glacial periods when the current landmasses merged, presenting opportunities for dispersal along expanding and contracting coastlines. Consequently, Pleistocene climatic variation has proved a homogenizing, rather than diversifying, force for A. sundaicus diversity. © 2014 John Wiley & Sons Ltd.


Thanispong K.,Kasetsart University | Achee N.L.,Uniformed Services University of the Health Sciences | Grieco J.P.,Uniformed Services University of the Health Sciences | Bangs M.J.,Public Health and Malaria Control | And 4 more authors.
Journal of Medical Entomology | Year: 2010

Chemicals can protect humans from the bites of hemophagous arthropods through three different primary actions: irritancy (excitation), repellency, or toxicity, actions that can be evaluated using a laboratory-based assay system, In this study, the deterrent and toxic actions of three synthetic pyrethroids and DDT were characterized on six field strains of Aedes aegypti from Thailand under laboratory-controlled conditions using the high throughput screening system. All six strains showed significant contact irritant responses to the three synthetic pyrethroids, but significantly weaker irritant responses to DDT, Marked repellency responses were seen in all six Ae. aegypti test strains exposed to DDT, whereas the synthetic pyrethroids resulted in greater toxicity than DDT under similar test conditions. Although significantly different in actions, irritancy and repellency may reflect and be influenced by the background insecticide susceptibility status of a particular mosquito population. Results from this study can be used to guide decision making regarding more effective Ae. aegypti adult control in Thailand. © 2010 Entomological Society of America.


Ritthison W.,Kasetsart University | Tainchum K.,Kasetsart University | Manguin S.,IRD Montpellier | Bangs M.J.,Kasetsart University | And 2 more authors.
Journal of Vector Ecology | Year: 2014

A study of species diversity of Anopheles mosquitoes, biting patterns, and seasonal abundance of important mosquito vectors was conducted in two villages of Chang Island, Trat Province, in eastern Thailand, one located along the coast and the other in the low hills of the central interior of the island. Of 5,399 captured female anophelines, 70.25% belong to the subgenus Cellia and remaining specimens to the subgenus Anopheles. Five important putative malaria vectors were molecularly identified, including Anopheles epiroticus, Anopheles dirus, Anopheles sawadwongporni, Anopheles maculatus, and Anopheles minimus. Anopheles epiroticus was the most commonly collected species in the coastal site, whereas An. dirus was found to be most abundant in the forest-hill site. From both locations, a greater number of mosquitoes was collected during the dry season compared to the wet. Anopheles epiroticus showed greater exophagic and zoophilic behavior with the highest blood feeding densities occurring between 18:00 and 19:00. In contrast, An. dirus demonstrated an activity peak between midnight and 01:00. We conclude that An. epiroticus and An. dirus, in coastal and inland areas, respectively, appear to be the most epidemiologically important malaria vectors on Chang Island. As no studies of vector competency specific to Chang Island have been conducted, our conclusions that these two species play a primary role in malaria transmission are based on evidence from other localities in Thailand and mainland Southeast Asia. This information serves as a basis for designing improved vector control programs that target specific species, and if integrated with other interventions could result in the elimination of malaria transmission on the island. © 2014.


Achee N.L.,Eck Institute for Global Health | Youngblood L.,Centers for Disease Control and Prevention | Bangs M.J.,Public Health and Malaria Control | Lavery J.V.,Li Ka Shing Knowledge Institute | And 2 more authors.
Vector-Borne and Zoonotic Diseases | Year: 2015

A thorough search of the existing literature has revealed that there are currently no published recommendations or guidelines for the interpretation of US regulations on the use of human participants in vector biology research (VBR). An informal survey of vector biologists has indicated that issues related to human participation in vector research have been largely debated by academic, national, and local Institutional Review Boards (IRBs) in the countries where the research is being conducted, and that interpretations and subsequent requirements made by these IRBs have varied widely. This document is intended to provide investigators and corresponding scientific and ethical review committee members an introduction to VBR methods involving human participation and the legal and ethical framework in which such studies are conducted with a focus on US Federal Regulations. It is also intended to provide a common perspective for guiding researchers, IRB members, and other interested parties (i.e., public health officials conducting routine entomological surveillance) in the interpretation of human subjects regulations pertaining to VBR. © The Author(s) 2015; Published by Mary Ann Liebert, Inc.


PubMed | Public Health Consulting Services and Community Health, Gadjah Mada University, University of Tokyo, Ministry of Health and Public Health and Malaria Control
Type: Comparative Study | Journal: Occupational and environmental medicine | Year: 2015

Non-communicable diseases (NCDs) constitute an increasing slice of the global burden of disease, with the South-East Asia region projected to see the highest increase in NCD-related deaths over the next decade. Mining industry employees may be exposed to various factors potentially elevating their NCD risk. This study aimed to assess the distribution and 5-year longitudinal trends of key metabolic NCD risk factors in a cohort of copper-gold mining company workers in Papua, Indonesia.Metabolic indicators of NCD risk were assessed among employees (15580 at baseline, 6496 prospectively) of a large copper-gold mining operation in Papua, Indonesia, using routinely collected 5-year medical surveillance data. The study cohort comprised individuals aged 18-68years employed for 1year during 2008-2013. Assessed risk factors were based on repeat measures of cholesterol, blood glucose, blood pressure and body weight, using WHO criteria.Metabolic risk indicator rates were markedly high and increased significantly from baseline through 5-year follow-up (p<0.001). Adjusting for gender and age, longer duration of employment (10years) predicted raised cholesterol (adjusted OR (AOR)=1.13, p=0.003), raised blood pressure (AOR=1.16, p=0.009) and overweight/obesity (AOR=1.14, p=0.001) at baseline; and persistent raised cholesterol (AOR=1.26, p=0.003), and both incident (AOR=1.33, p=0.014) and persistent raised blood glucose (AOR=1.62, p=0.044) at 3-year follow-up.Individuals employed for longer periods ina mining operations setting in Papua, Indonesia, mayface elevated NCD risk through various routes. Workplace health promotion interventions and policies targeting modifiable lifestyle patterns and environmental exposures present an important opportunity to reduce such susceptibilities and mitigate associated health risks.


Kay B.H.,Royal Brisbane Hospital | Brown M.D.,Royal Brisbane Hospital | Siti Z.,Communicable Diseases Control and Environmental Health | Siti Z.,Eijkman Institute for Molecular Biology | And 2 more authors.
Medical and Veterinary Entomology | Year: 2013

From December 1997 to April 1998, disposable sticky lures (1608 lure days) were trialled in homes in north Jakarta, Indonesia as surveillance tools for Aedes aegypti (Stegomyia aegypti) (Diptera: Culicidae) and Culex quinquefasciatus (Diptera: Culicidae), referenced to indoor resting adult collections (92 × 10 min). The lures collected 89.4% of the total of 1339 Ae. aegypti and 92.1% of the total of 1272 Cx. quinquefasciatus collected by all methods. Because there were no significant differences with respect to numbers collected in bedrooms, living rooms and kitchens, bedrooms were selected for subsequent trials for reasons of convenience. The main trials involved a replicated complete block design with L-lysine and sodium carbonate. Lures without attractant or with four different dilutions of L-lysine collected 3.4-8.5 times more Ae. aegypti and 4.2-8.1 times more Cx. quinquefasciatus than were collected by mouth aspirator. Lures with or without dilutions of sodium carbonate collected 2.7-5.0 times more Ae. aegypti and 1.8-4.2 times more Cx. quinquefasciatus than aspirator collections. The precision associated with catches of sticky lures was better than that for aspirator collections. Although olfactants generally improved the numbers of mosquitoes collected, the differences in catch between lures with and without attractants were usually non-significant. Any deficit in catch may be offset by increasing the surveillance period to ≥30 days to detect all four dengue serotypes from infected mosquitoes. © 2012 The Royal Entomological Society.


Fransisca L.,Public Health and Malaria Control | Kusnanto J.H.,Gadjah Mada University | Satoto T.B.T.,Gadjah Mada University | Sebayang B.,Public Health and Malaria Control | And 3 more authors.
Malaria Journal | Year: 2015

Background: The World Health Organization recommends malaria be diagnosed by standard microscopy or rapid diagnostic test (RDT) before treatment. RDTs have been used with greater frequency in the absence of matching blood slide confirmation in the majority of RDT reported cases in Mimika Regency, Papua Province, Indonesia. Given the importance of RDT in current health system as point-of-care tool, careful validation of RDT product performance for providing accurate malaria diagnosis is critical. Methods : Plasmotec Malaria-3 (XW-P07) performance was evaluated by comparing it with paired blood film microscopy and quantitative real-time PCR (qPCR). Consecutive whole blood samples were derived from one clinic in Mimika as part of routine passive malaria case detection. RDT results were read by two trained technicians and interpreted by consensus. Expert microscopic examination of blood slides was cross-checked by observer-blinded second reader and a third examiner if discordant between examinations. qPCR was used as the gold standard followed by microscopy for the outcome/disease variable. Comparison analysis included sensitivity (Sn), specificity (Sp), positive and negative predictive values (PPV & NPV), and other diagnostic screening performance measures for detecting Plasmodium falciparum and Plasmodium vivax infections. Results: Overall malaria positive samples from qPCR was 42.2% (175/415 samples); and from matching blood slides 40.5% (168/415) of which those infections with relatively low parasite densities.


Achee N.L.,Uniformed Services University of the Health Sciences | Bangs M.J.,Public Health and Malaria Control | Farlow R.,R Farlow Consulting LLC | Killeen G.F.,Vector Group | And 8 more authors.
Malaria Journal | Year: 2012

International public health workers are challenged by a burden of arthropod-borne disease that remains elevated despite best efforts in control programmes. With this challenge comes the opportunity to develop novel vector control paradigms to guide product development and programme implementation. The role of vector behaviour modification in disease control was first highlighted several decades ago but has received limited attention within the public health community. This paper presents current evidence highlighting the value of sub-lethal agents, specifically spatial repellents, and their use in global health, and identifies the primary challenges towards establishing a clearly defined and recommended role for spatial repellent products in disease control. © 2012 Achee et al.; licensee BioMed Central Ltd.


Townson H.,Vector Group | Dyer N.,Vector Group | Mcalister E.,Natural History Museum in London | Satoto T.B.T.,Gadjah Mada University | And 2 more authors.
Systematic Entomology | Year: 2013

This study provides the first integrated morphological and molecular characterization of Anopheles barbirostris van der Wulp, the nominotypical member of the Barbirostris Complex of malaria vectors in the Oriental Region, and An. vanderwulpisp.n., a sibling species of the complex found in sympatry with An. barbirostris in the vicinity of its type locality in eastern Java, Indonesia. The adult, larval and pupal stages of An. barbirostris are described and compared with those of An. vanderwulpi. The two species, however, are essentially isomorphic. The genetic identity of An. barbirostris s.s. is based on a diagnostic cytochrome oxidase I gene sequence to ensure stable use of the specific name for the prevalent concept of the species. The genetic identity of the new species is also established. Diagnostic DNA sequences for these species serve as a foundation for further taxonomic studies, and for investigations into their roles in the transmission of malaria and filariasis. The discussion includes a brief review of Anopheles classification and species complexes. © 2013 The Royal Entomological Society.

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