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Jakarta Post

Bangka Belitung in fight against malaria

Living in an endemic malaria region, Elda, 25, is cautious every time she gets a fever

Elly Burhaini Faizal (The Jakarta Post)
Bangka Belitung
Fri, June 29, 2012

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Bangka Belitung in fight against malaria

L

iving in an endemic malaria region, Elda, 25, is cautious every time she gets a fever.

Two days ago, she went to a community health center near her home in Batu Belubang village, Pangkalan Baru, in the regency of Bangka Tengah as she was suffering a fever together with a headache and nausea.

Sitting in front of the laboratory at the Benteng community health center, Elda could not hide her concern that she was infected with malaria.

“I’m really worried that I might be suffering from malaria as I’m pregnant now,” she told The Jakarta Post during a recent visit. She had never suffered from malaria before.

Malaria prevalence in Bangka Belitung remains high apparently due to a number of abandoned mines, which have become habitats for mosquitoes. Yet, most local people think that malaria poses no serious health problems.

They even believe that living in the high-risk malaria zone for years has made their bodies immune to the disease.

With a high number of people dying from malaria, Elda is well aware that she must stay alert against the disease. Moreover, malaria can increase maternal and neonatal complications, such as miscarriages, stillbirths and premature births.

Elda, who is now four-months pregnant, took a blood test shortly after arriving at the clinic. A lab clinician conducted a microscopic examination of her blood sample. It took just one hour for the lab worker to discover Plasmodium parasites in her blood.

Witri Andayani, the 32-year-old clinician, said that in the community health center, microscopic examinations were the primary method used to detect Plasmodium, the malarial parasite, in blood.

“We can use a rapid diagnostic test [RDT] to detect the malarial parasite in blood. However, the rapid test is sometimes not accurate enough to detect the parasites. We’ve seen many cases in which the RDT shows a large amount of Plasmodium parasites in a blood sample, while with the lab test, we find that there are only very few malaria parasites in the blood. Therefore, we use a microscopic examination to detect malaria parasites more accurately,” she said, while mentioning that the RDT was still being used in village-level community health centers, as they still lacked key lab equipment, such as microscopes.

By using the microscopic examination, she said, doctors were equipped with an accurate diagnosis and could provide their patients with appropriate treatment.

Witri is one of the health workers from Bangka Belitung province who have received training on microscopic examinations, delivered by the Global Fund since 2008.

“Accurate malaria diagnostics are the key to malaria control,” she said.

As of 2011, 374 out of 497 regencies and municipalities in Indonesia were malaria endemic. Of a total 1,322,451 suspected cases of malaria, 256,592 were confirmed as positive. The annual parasite incidence (API) rate stands at 1.75 per 1,000 people, meaning that out of every 1,000 people, two of them will suffer from malaria.

In Bangka Belitung, malaria caused by Plasmodium falciparum accounts for 48 percent of total infections, being more prevalent than the P. Vivax strain.

At the Benteng community health center, around three to five patients are diagnosed with malaria every week. This number tends to rise during the rainy season, which lasts from September to December.

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