Malaria In Indonesia Research Articles

Sensitivity and Specificity of Nested PCR for Diagnosing Malaria: Cases in Several Areas of Indonesia

Indonesia is still included in high endemic area of malaria infection. Early detection as well as appropriate and quick treatment is needed to be able to prevent and treat malaria in Indonesia. Laboratory examination using a microscopic method is still used as the gold standard to diagnose malaria cases. However, the morphology similarity of some Plasmodium species and the number of parasites that can be seen under microscopy causes malaria diagnosis become difficult if only relying on microscopy diagnostic method. The purpose of this study is to analyze the sensitivity and specificity of nested PCR compared to microscopic examination in diagnosing malaria cases. A cross-sectional study has been carried out in some areas of Indonesia and the microscopic analysis as well as nest PCR was done in Laboratory of Parasitology and Laboratory of Central Biomedical Faculty of Medicine, Universitas Brawijaya, Malang East Java Indonesia. A total of 149 blood samples from patients with clinical symptoms of malaria had been obtained from Sumatra, Sulawesi and East Java during December 2011 to December 2013. From 149 sample, 81.9% samples were diagnosed malaria positive by microscopy examination, whereas the PCR results showed that 90.6% of samples were positive. Nested PCR sensitivity is 97.5%, and microscopy 88.2%. Nested PCR specificity is 40.7%, whereas microscopy 78.5%. PPV and NPV for nested PCR are 88,2% and 78.5% respectively, and for microscopy are 97.5% and 40.7% respectively. Nested PCR has a higher sensitivity than microscopy in diagnosing malaria and is able to detect mixed infection better than microscopic examination. However, it is statistically less specific than microscopy examination.

The New Spesies Anopheles aitkeni as the Threat of Malaria in Indonesia

The New Spesies <i>Anopheles aitkeni</i> as the Threat of Malaria in Indonesia

Longitudinal study of changes in \u03b3\u03b4 T cells and CD4+ T cells upon asymptomatic malaria infection in Indonesian children

Both γδ T cells and CD4+ T cells have been implicated in immunity to malaria, but their association with natural gain or loss of infection has not been studied before. Therefore, we followed up asymptomatic children living in an area endemic for malaria in Indonesia for 21 months. The percentage of γδ T cells was related to both current and previous infection, with higher percentages in infected than uninfected children and declining after infections resolve. Infected children also had higher levels of Th1 and Th17 cells, lower levels of CD25Hi FOXP3+ regulatory T cells (Tregs), but similar levels of Th2 cells as compared to uninfected children. However, TNF, IFN-γ, and IL-17 cytokine responses to Plasmodium falciparum-infected red blood cells (PfRBCs) were similar, while IL-5 and IL-13 responses were lower in infected children. Furthermore, infected children had more phenotypically exhausted PD-1+ CD4+ T cells, more Tregs expressing TNF-RII, and higher IL-10 responses to PfRBCs, which persisted following resolution of infection. Altogether, this study demonstrates that asymptomatic malaria infection is associated with some long-lasting changes in the frequencies and immunoregulation of circulating innate and adaptive T cells, which might in part explain how pre-exposure to malaria affects responses to subsequent immunological challenges.

A new endemic area of ovale malaria in Indonesia: A case report from Sumatra Utara Province

A new endemic area of ovale malaria in Indonesia: A case report from Sumatra Utara Province

Aplikasi Regresi Linier Berganda Pada Hubungan Kepadatan Hunian Dan Perilaku Menguras Bak Mandi Dengan Kejadian Penyakit Malaria Di Indonesia

The purpose of this research is to modelize the relationship between density residential and the behavior of tub drain with the incidence of malaria in Indonesia. This research used multiple linear regression method with 1 dependent variable and 2 independent variables. The assumption multiple linier regression is an error followed a normal distribution, error variance is homoskedastisitas, no autocorrelation problem and there was no problem of multicollinearity between independent variables. The result showed that all assumptions of multiple linier regression were fulfilled. Overall test results by using F statistic was obtained value of p = 0,001 &lt; 0,05 (alpha) it meant that at least one variable density residential or behavior of tub drain which had a significant effect on the incidence of malaria. The test results partly by using t statistics was obtained value of p variable density residential was 0,001 ; 0,05 which meant that density residential had effect on the incidence of malaria and value of p for the behavior of tub drain variable was 0,980 ; 0,05 which meant that the behavior tub drain had no effect on the incidence of malaria; Keywords : multiple linier regression, density residential, behavior, malaria

A cross-sectional analysis of traditional medicine use for malaria alongside free antimalarial drugs treatment amongst adults in high-risk malaria endemic provinces of Indonesia.

BackgroundThe level of traditional medicine use, particularly Jamu use, in Indonesia is substantial. Indonesians do not always seek timely treatment for malaria and may seek self-medication via traditional medicine. This paper reports findings from the first focused analyses of traditional medicine use for malaria in Indonesia and the first such analyses worldwide to draw upon a large sample of respondents across high-risk malaria endemic areas.MethodsA sub-study of the Indonesia Basic Health Research/Riskesdas Study 2010 focused on 12,226 adults aged 15 years and above residing in high-risk malaria-endemic provinces. Logistic regression was undertaken to determine the significant associations for traditional medicine use for malaria symptoms.FindingsApproximately one in five respondents use traditional medicine for malaria symptoms and the vast majority experiencing multiple episodes of malaria use traditional medicine alongside free antimalarial drug treatments. Respondents consuming traditional medicine for general health/common illness purposes every day (odds ratio: 3.75, 95% Confidence Interval: 2.93 4.79), those without a hospital in local vicinity (odds ratio: 1.31, 95% Confidence Interval: 1.10 1.57), and those living in poorer quality housing, were more likely to use traditional medicine for malaria symptoms.ConclusionA substantial percentage of those with malaria symptoms utilize traditional medicine for treating their malaria symptoms. In order to promote safe and effective malaria treatment, all providing malaria care in Indonesia need to enquire with their patients about possible traditional medicine use.

Influence Of Demographic Factors And History Of Malaria With The Incidence Malaria In MORU PHC

Malaria morbidity in Moru health center, with parameter Annual Parasite Incident (API), amounted to 16.9% in 2014. This figure was still high when compared to the target of eliminating malaria in Indonesia about &lt;1% in 2030. Incidence of malaria is more common in children aged 5 months - &lt;12 years. This high rates of malaria leads to poverty, low level of learning achievement of children and in pregnant women causing low birth weight in babies and death. The purpose of this study was to analyze the factors that influence the incidence of tertian and Tropikana malaria or combined Tropikana and tertian (mix) in Moru PHC in sub-district Alor Southwestern, Alor Regency.This study used a cross-sectional design, the population of study were all patients undergoing peripheral blood examination in Moru PHC’s laboratory from June to October 2015. The number of samples in this study was 173 respondents. The sampling technique was Simple Random Sampling. Instruments of data collection were a questionnaire and observation sheet.Results of the study by Chi-Square test showed that the factors influencing the incidence of malaria were socioeconomic status (sig 0,000), education level (sig 0.001). By using multivariate analysis with logistic regression test, results were obtained the age of 5 months - &lt;12 value (sig 0.025) and socioeconomic status (sig 0,000) influencing the incidence of malaria.Variables that affect the incidence of malaria were demographic factors such as age, education level, socioeconomic status. It is advisable to harness swamp thus improving the economic status of society and build permanent house.Keywords: incidence malaria, demographic factors, history of malaria

Influence Of Demographic Factors And History Of Malaria With The Incidence Malaria In MORU PHC

Malaria morbidity in Moru health center, with parameter Annual Parasite Incident (API), amounted to 16.9% in 2014. This figure was still high when compared to the target of eliminating malaria in Indonesia about &lt;1% in 2030. Incidence of malaria is more common in children aged 5 months - &lt;12 years. This high rates of malaria leads to poverty, low level of learning achievement of children and in pregnant women causing low birth weight in babies and death. The purpose of this study was to analyze the factors that influence the incidence of tertian and Tropikana malaria or combined Tropikana and tertian (mix) in Moru PHC in sub-district Alor Southwestern, Alor Regency.This study used a cross-sectional design, the population of study were all patients undergoing peripheral blood examination in Moru PHC’s laboratory from June to October 2015. The number of samples in this study was 173 respondents. The sampling technique was Simple Random Sampling. Instruments of data collection were a questionnaire and observation sheet.Results of the study by Chi-Square test showed that the factors influencing the incidence of malaria were socioeconomic status (sig 0,000), education level (sig 0.001). By using multivariate analysis with logistic regression test, results were obtained the age of 5 months - &lt;12 value (sig 0.025) and socioeconomic status (sig 0,000) influencing the incidence of malaria.Variables that affect the incidence of malaria were demographic factors such as age, education level, socioeconomic status. It is advisable to harness swamp thus improving the economic status of society and build permanent house.Keywords: incidence malaria, demographic factors, history of malaria

A Novel Diagnostic Method for Malaria Using Loop Mediated Isothermal Amplification (LAMP) and MinION Nanopore Sequencer

BackgroundSimply and accurately diagnostic tool for Malaria is required for clinical diagnosis and epidemiological survey. We have developed a novel diagnostic tool for Malaria using loop mediated isothermal amplification (LAMP) with MinION nanopore sequencer.MethodsIn this study, we have designed human Plasmodium parasites-specific LAMP primers targeting for the lesion of 18S rDNA gene, which were locating on the conserved sequences across all five Plasmodium species; Plasmodium falciparum, P. vivax, P. ovale (P.o. wallikeri and P.o crutisi), P. knowlesi and P. malariae, containing each species-specific sequence within F1-B1 primer pairs. The sensitivities were evaluated using 10-fold serially diluted plasmids harboring the sequences of 18S rDNA. We also applied our protocol to human blood samples collected and stored with FTA elute cards derived from 30 Malaria patients, who are clinically diagnosed as Malaria in Indonesia. Its analytical sensitivities and specificities were also evaluated while comparing the results of previously described nested PCR methods. Finally, we performed amplicon sequencing of our LAMP methods using MinION nanopore sequencer to identify each Plasmodium species.ResultsOur LAMP method could amplify all targeting 18S rDNA gene on constructed plasmids and its detection limits were 10 - 100 copies/reaction respectively. In clinical samples, obtained LAMP results were completely consistent with the results of nested PCR. Additionally, identifications of Plasmodium species based on the sequence analysis with MinION were also consistent with the sequence of each constructed plasmid and could consistently confirmed its Plasmodium species with the highest homology of reference Plasmodiumparasite sequence.ConclusionOur innovative diagnostic technology with LAMP and MinION could become a powerful tool for identification of Plasmodium parasites even in resource-limited situation.Disclosures All authors: No reported disclosures.

Formulation of Dihydroartemisinin-Piperaquine (DHP) Generic Tablet as Antimalarials Drug

The incidence of malaria in Indonesia is about two million cases annually. Dihydroartemisinin-piperaquine (DHP) is the first line therapy recommended for uncomplicated malaria treatment, whereas DHP is still fully imported. The generic DHP tablet formulation has the potential to become the first of DHP drug which is locally produced. This study is aimed to formulate generic DHP film coated tablets for antimalaria drug. Tablets were compressed with the combination of wet granulation for piperaquine phosphate (PQP) and direct compression method for DHA and coated with a moisture barier coating material. The parameters to evaluate the quality of DHP tablets are physical properties, assay, and dissolution test. DHA and PQP assay were performed by HPLC method. The dissolution testing was conducted by in house method using HCl 0.1 N medium. The result shows physical properties of film-coated tablets meet the requirement, i.e. uniform weight, 7.0-8.5 kp hardness, 0.02% friability and 3 minute 22 seconds disintegration. The assay to determine DHA in tablet was 95.17% and PQP was 97.05%. The result of dissolution testing shows the content of DHA and PQP in the tablet were 113.51% and 96.55%, respesctively. The formulation which is developed meets the general requirement of API in tablet 90–110% and dissolution requirement >75%.

TAHAPAN ELIMINASI MALARIA DI KABUPATEN KEPULAUAN ARU PROVINSI MALUKU, TAHUN 2014

Malaria cases in Aru Islands district is remain high in 2013, shown by high number of clinical malaria patients (1.617 person), 620 person were laboratory confirmed, 14 of them was pregnant women. This study was aimed to assess the condition of the public health center (Puskesmas) in order to eliminate malaria in Indonesia by 2030. Study was a documents observation and in-depth interviews in charge of malaria and other relevant officials in the District Health Office (DHO) in October 2014. Study was designed by cross sectional. Information on human resources (HR), facilities and budgets and territorial obtained by questionnaire tool prepared for mentoring troubled areas of health (PDBK) 2014. The results shown that both morbidity and suspected malaria evenly in each Puskesmas. Malaria control program in the form of distribution of mosquito nets and RDTs examination in Puskesmas were already done. Theworkers who handle malaria were not distributed well, even for health analysts were still lacking. Facilities were concentrated in Dobo Puskesmas and public hospitals. This study recommends the need of microscopic health analyst as well as research to improve the report system and evaluation of the effectiveness of the mosquito net usage.

Modeling of Malaria Prevalence in Indonesia with Geographically Weighted Regression

Malaria is a public health problem that can lead to death, especially in high-risk groups i.e. infants, toddlers and pregnant women. This disease is still endemic in most parts of Indonesia. The relation of location factor between regions with the surrounding region was assumed to give the effect of spatial variability in the prevalence of malaria in the region. It would lead to the prevalence of malaria modeling using classical regression methods become less precise due to the assumption of homogeneity of variance was not met. It could be overcome by Geographically Weighted Regression (GWR) modeling. In GWR analysis, the selection weighting function was one determinant of the analysis results. GWR analysis resulted on the prevalence of malaria in Indonesia, GWR model with bisquare kernel weighting function had a better value of R 2 and AIC than GWR models with gaussian kernel weighting function.

Impact of a spatial repellent on malaria incidence in two villages in Sumba, Indonesia.

A randomized, double-blinded, placebo-controlled study was conducted to examine the effect of spatial repellent (SR) in households at risk of malaria in Indonesia. Following presumptive radical cure for malaria in 180 adult men representing sentinels of new infection in four clusters within two villages, all households were given either metofluthrin or placebo mosquito coils. Weekly blood smear screening and human-landing mosquito catches were done throughout the 6 months intervention. Malaria infections occurred in 61 subjects living in placebo households and 31 subjects living in SR coil households, suggesting a 52% protective effect of SR. Likewise, anopheles indoor human landing rates were 32% lower in homes receiving SR coils. Differences in the malaria attack rate between SR- and placebo-treated homes was significant when not accounting for the effects of clustering. When the analysis was adjusted for intra-cluster correlation, the differences between SR- and placebo-treated homes were not statistically significant. The findings provide evidence of SR public health benefit and support a larger trial statistically powered to detect those effects.

Seasonal changes in the antibody responses against Plasmodium falciparum merozoite surface antigens in areas of differing malaria endemicity in Indonesia.

BackgroundThe transmission of malaria in Indonesia is highly heterogeneous spatially and seasonally. Anti-malaria antibody responses can help characterize this variation. In the present study antibody responses to Plasmodium falciparum MSP-1 and AMA-1 were measured to assess the transmission intensity in a hypo-endemic area of Purworejo and a meso-endemic area of Lampung during low and high transmission seasons.MethodsFilter-paper blood spot samples collected from Purworejo and Lampung by cross-sectional survey during high and low transmission season were stored at −20°C. Indirect ELISA assays were carried out using PfMSP1-19 and PfAMA1 antigens. A positivity threshold was determined by samples from local unexposed individuals, and the differences in seroprevalence, antibody level and correlation between antibody level and age in each site were statistically analysed.ResultsPrevalence of antibodies to either PfMSP1-19 or PfAMA1 was higher in Lampung than in Purworejo in both the low (51.3 vs 25.0%) and high transmission season (53.9 vs 37.5%). The magnitude of antibody responses was associated with increasing age in both sites and was higher in Lampung. Age-adjusted seroconversion rates showed an approximately ten-fold difference between Lampung and Purowejo. Two different seroconversion rates were estimated for Lampung suggesting behaviour-related differences in exposure. In both settings antibody responses to PfMSP1-19 were significantly lower in the low season compared to the high season.ConclusionSeasonal changes may be detectable by changes in antibody responses. This is particularly apparent in lower transmission settings and with less immunogenic antigens (in this case PfMSP1-19). Examination of antibody levels rather than seroprevalence is likely to be a more sensitive indicator of changes in transmission. These data suggest that sero-epidemiological analysis may have a role in assessing short-term changes in exposure especially in low or seasonal transmission settings.

Efficacy of artemether-lumefantrine and artesunate-amodiaquine for treating uncomplicated falciparum malaria in children

Background Artesunate-amodiaquine (ASAQ) has been usedas a firsdine treatment for uncomplicated faldparum malariain Indonesia since 2004. Its efficacy depends on amodiaquineresistance of the infecting parasites. Artemether-lumefantrine(AL) has been shown to be highly efficacious in treatinguncomplicated faldparum malaria in several countries. However,there have been few studies on these anti-malarial medicationsin Indonesia.Objective To compare the efficacy of AL to ASAQ for treatinguncomplicated faldparum malaria in children.Methods An open, randomized, controlled trial wasconducted in school-aged children in the Mandailing NatalRegency, North Sumatera Province, Indonesia, from Octoberto December 2010. A total of 280 pediatric, uncomplicatedfalciparum malaria patients were randomly assigned to receiveeither AL or ASAQ for 3 days. Participants were followed-up ondays 1,2,3,7, 14, 28 and 42 following the first medication dose.The outcomes noted were adequate clinical and parasitologicalresponse (ACPR), parasite reduction, parasite clearance time,fever clearance time and adverse events. Analysis was basedon intention-to-treat.Results In this study, ACPRs on day 42 were 86.4% and 90.7%for the ASAQ and AL groups, respectively (p=0.260). On days 7and 14, the AL group had higher cure rates than that of the ASAQgroup (P&lt;0.05). Early treatment failure, late treatment failure andparasitological failure for both groups were similar. We also foundfaster parasite clearance time and higher parasite reduction in theAL group than in the ASAQ group. However, fever clearancetime was shorter in the ASAQ group. The incidence of adverseevents such as nausea, vomiting, malaise, and pruritus were similarbetween the two groups (P=0.441).Conclusion AL had higher efficacy than ASAQ for the treatment of uncomplicated falciparum malaria in children.[Paediatr rndones. 2012;52:260-6].

Plasmodium vivax Malaria Endemicity in Indonesia in 2010

Background Plasmodium vivax imposes substantial morbidity and mortality burdens in endemic zones. Detailed understanding of the contemporary spatial distribution of this parasite is needed to combat it. We used model based geostatistics (MBG) techniques to generate a contemporary map of risk of Plasmodium vivax malaria in Indonesia in 2010.Methods Plasmodium vivax Annual Parasite Incidence data (2006–2008) and temperature masks were used to map P. vivax transmission limits. A total of 4,658 community surveys of P. vivax parasite rate (PvPR) were identified (1985–2010) for mapping quantitative estimates of contemporary endemicity within those limits. After error-checking a total of 4,457 points were included into a national database of age-standardized 1–99 year old PvPR data. A Bayesian MBG procedure created a predicted PvPR1–99 endemicity surface with uncertainty estimates. Population at risk estimates were derived with reference to a 2010 human population surface.ResultsWe estimated 129.6 million people in Indonesia lived at risk of P. vivax transmission in 2010. Among these, 79.3% inhabited unstable transmission areas and 20.7% resided in stable transmission areas. In western Indonesia, the predicted P. vivax prevalence was uniformly low. Over 70% of the population at risk in this region lived on Java and Bali islands, where little malaria transmission occurs. High predicted prevalence areas were observed in the Lesser Sundas, Maluku and Papua. In general, prediction uncertainty was relatively low in the west and high in the east.ConclusionMost Indonesians living with endemic P. vivax experience relatively low risk of infection. However, blood surveys for this parasite are likely relatively insensitive and certainly do not detect the dormant liver stage reservoir of infection. The prospects for P. vivax elimination would be improved with deeper understanding of glucose-6-phosphate dehydrogenase deficiency (G6PDd) distribution, anti-relapse therapy practices and manageability of P. vivax importation risk, especially in Java and Bali.

Relapse of imported vivax malaria despite standard-dose primaquine therapy: an investigation with molecular genotyping analyses

Taiwan CDC investigated four cases of recurrent imported vivax malaria during 2003-2010. Molecular genotyping results and the lack of inter-episodes travel history indicated that two of the patients, who acquired vivax malaria in Indonesia and the Solomon Islands, respectively, suffered relapses after an interval of 3-4 months, despite completing standard-dose primaquine therapy (30 mg/day for 14 days) for the first episode. Treatment with a higher dose of primaquine (60 mg/day for 14 days) prevented further relapse in both patients. This finding calls for further monitoring of the therapeutic efficacy of primaquine in treating Plasmodium vivax acquired in southeast Asia and Oceania.

P2-492 Predictors of malaria in individuals aged 15 years and over in Indonesia, 2010

IntroductionMalaria is global health problem. Ii is endemic in 10 of the 11 member countries of from the WHO South East-Asian Region, including Indonesia. In 2008 there were 2.4 million...

On The Use of Rapid Diagnostic Test Kits for Malaria

Since I wrote in The Permanente Journal (TPJ) (Fall 2005) about post-tsunami malaria in Indonesia, there have been several requests from TPJ readers regarding access to and anticipated availability of rapid diagnostic test kits (RDTs) for malaria. It is with regret that I relate that there is no intent to market these in the United States. There are several reasons for this, some valid, some not. Worldwide, the use of RDTs is a vital part of the World Health Organization's program for malaria control, to preserve the use of newer, more expensive regimens for actual malaria cases. RDTs are certainly, at a minimum, grossly comparable to an experienced microscopist and confirmation by a reference laboratory can be readily arranged after a diagnosis is suspected. The Centers for Disease Control and Prevention (CDC) often opposes the use of these kits for diagnosis of malaria. In a conversation with the malaria officer on duty, my suggestion that they were of use was disparaged. Unfortunately, as is sometimes the case, an organization such as the CDC does not respond to the requirements of actually delivering care. When an organization has ready availability of world-class parasitologists, there is little need for RDTs. On the other hand, few of us practice in such an environment. Kain et al1 described an average delay of three days between the time of ordering a malaria smear and confirmation of the diagnosis in nonspecialist Canadian medical centers. In view of the rarity of malaria in this country, our best laboratory technicians are inexperienced in making this diagnosis and even experienced parasitologists can make errors in their reading of blood smears. Our average hospital laboratory is likely inferior in sensitivity to RDTs and probably in specificity as well, particularly if we consider only P falciparum, the only species that is rapidly fatal. One published small series2 from Bethesda Naval Hospital reviewed the diagnostic accuracy of these two modalities among Marines with febrile illness evacuated from Liberia. Ten of 32 cases were accurately identified by RDTs and the same ten by thick smear. One of 32 patients had a positive RDT and a thin smear that was originally read as negative, but confirmed subsequently to have been positive. In 2004, in the US there were only 1324 reported cases, 49% of these were P falciparum.3 This seems to be a strong argument that our local labs will not be able to enhance their expertise in this disease. This would be even more significant for smaller hospitals in areas with less foreign travel among their patients. Different RDTs have been studied in various studies in nonimmune returning travelers from malarious areas. The accuracy of various tests does vary, but later generation tests for P falciparum routinely demonstrate sensitivities greater than 90% (88–99%) and specificities that are 95–100%. The conclusion of the meta-analysis by Marx and colleagues4 is that “rapid testing will lead to the detection of most clinically relevant P falciparum cases, with considerably better accuracy than that expected from routine microscopy in nonspecialist settings.” The arguments against the test are: the accuracy is not perfect; it is heat sensitive and it does not monitor the level of parasitemia, nor confirm efficacy of treatment. I believe these are false arguments. RDTs are certainly, at a minimum, grossly comparable to an experienced microscopist and confirmation by a reference laboratory can be readily arranged after a diagnosis is suspected. Identifying and starting treatment is the most vital part of diagnosis. The monitoring progress, while vital, can be arranged once a diagnosis has been confirmed. The argument of heat sensitivity seems disingenuous in North America where laboratory reagents are controlled for quality and stored in nontropical conditions. This is an argument of questionable validity even in tropical areas. In summary, in the US we are stuck with less effective diagnostic capabilities for malaria, when compared to most Third World countries. This is not expected to change in the foreseeable future.

Relationship between blood level chloroquine, metabolite desethylchloroquine and paracytaemia of Plasmodium falciparum infection in malaria endemic area Purworejo

Chloroquine is the drug of choice for Plasmodium falciparum and has long been used as the first line treatment in malaria in Indonesia. However, recent studies show that chloroquine resistance has been found in several endemic area. This study was aimed at investigating the correlation between whole blood chloroquine and desethylchloroquine levels and paracytaemia in the endemic areas. The study was carried out in Pituruh sub-district of Purworejo district. Thirty two subjects were enrolled using active case detection and passive case detection methods. Inclusion criteria: age 10-50 years old, asexual P falciparum > 1000/μl blood, not pregnant women, not having complication of malaria, willing to be observed for 28 days and agree to take part in study by signing an informed concent. The 32 samples were collected at day 2, and 10 samples were collected at 0, 2, 7, 14, 21, 28 days to detect the precence of paracytaemia and chloroquine and desetylchloroquine levels. A high Performance Liquid Chromatograph (HPLC) was used to analyze blood chloroquine and desethylchloroquine levels. The result show that chloroquine has been regurarly used (in 78.12% of subject) the day before the treatment was started. Mean blood redundant chloroquine and desethylchloroquine (combined) redundant in day 2 were 397.7 (SEM: 38.1) and prosentage of paracytaemia inhibitory effect was 93.7% (SEM: 2.07). This study observed no significant correlations between blood chloroquine and desethylchloroquine levels and paracytaemia. The result showed that increasing and decreasing of blood level chloroquine and desethylchloroquine has no correlation to the increasing or decreasing of paracytaemia inhibition in patients with Plasmodium falciparum infection in the endemic areas, which might be due to many factors including resistance to chloroquine. Key words : chloroquine, desethylchloroquine – P falciparum