The Declined Trend of Malaria over a Ten-year Period in the Rural East Nusa Tenggara Province, Indonesia: A Medical Record Analysis

Abstract

BACKGROUND: Malaria still remains a major public health problem globally including in Indonesia. At present, most of malaria cases are in the eastern part of the country. However, there is no information yet regarding the trends of malaria prevalence at rural health institution particularly at Mangili Public Health Centre. AIM: This study aims to explore the trend of malaria prevalence over a 10-year period. METHODS: A retrospective study was carried out in the center. The laboratory record books from January 2013 to December 2022 were carefully reviewed to identify malaria cases based on the sex, age, type of Plasmodium, year, and month when the patients diagnosed malaria microscopically. The trend analysis was applied to identify the trend of malaria over the period under review. RESULTS: Over the past 10 years, 19,938 blood films were requested for malaria diagnosis at the health center. From this number, 3.679 (18.5%, with 95% confidence interval (CI): 17.2–19.7) were microscopically confirmed malaria cases. From the total cases, prevalence of Plasmodium falciparum (Pf), vivax and mix infection was 85.5% with 95% CI: 84.3–86.8; 6.39% with 95% CI: 3.26–9.51; and 7.58% with 95% CI: 4.48–10.7, respectively. The number of malaria cases reached a peak in January, while it was the lowest in October. Overall trend on the prevalence of malaria decreased significantly; however, the prevalence of Pf increased considerably during COVID-19 pandemic. The prevalence of Pf, vivax, and mixed infection was higher in male, age group ≥ 15, and student than their counterpart. CONCLUSION: Malaria remains high in this area with Pf that is the dominant species followed by mixed infection. Scaling up malaria control and prevention activities is very crucial to significantly reduce the burden of malaria and to boost malaria elimination in this region.