TY - JOUR
T1 - Spatial analysis to evaluate risk of malaria in Northern Sumatera, Indonesia
AU - Fahmi, Fahmi
AU - Pasaribu, Ayodhia Pitaloka
AU - Theodora, Minerva
AU - Wangdi, Kinley
N1 - Funding Information:
The authors would like to thank the Ministry of Health, Indonesia, for providing access to a database of malaria case notification reports between 2019 and 2020.
Funding Information:
This project was supported under World Class Research Programme 2021, designated scheme from Universitas Sumatera Utara, Ministry of Education, Culture, Research and Technology, Indonesia. The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. KW is funded by Australian National Health and Medical Research Council 2021 Investigator Grant (2008697).
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - BACKGROUND: As Indonesia aims for malaria elimination by 2030, provisional malaria epidemiology and risk factors evaluation are important in pursue of this national goal. Therefore, this study aimed to understand the risk factor of malaria in Northern Sumatera.METHODS: Malaria cases from 2019 to 2020 were obtained from the Indonesian Ministry of Health Electronic Database. Climatic variables were provided by the Center for Meteorology and Geophysics Medan branch office. Multivariable logistic regression was undertaken to understand the risk factors of imported malaria. A zero-inflated Poisson multivariable regression model was used to study the climatic drivers of indigenous malaria.RESULTS: A total of 2208 (indigenous: 76.0% [1679] and imported: 17.8% [392]) were reported during the study period. Risk factors of imported malaria were: ages 19-30 (adjusted odds ratio [AOR] = 3.31; 95% confidence interval [CI] 1.67, 2.56), 31-45 (AOR = 5.69; 95% CI 2.65, 12.20), and > 45 years (AOR = 5.11; 95% CI 2.41, 10.84). Military personnel and forest workers and miners were 1,154 times (AOR = 197.03; 95% CI 145.93, 9,131.56) and 44 times (AOR = 44.16; 95% CI 4.08, 477,93) more likely to be imported cases as compared to those working as employees and traders. Indigenous Plasmodium falciparum increased by 12.1% (95% CrI 5.1%, 20.1%) for 1% increase in relative humidity and by 21.0% (95% CrI 9.0%, 36.2%) for 1 °C increase in maximum temperature. Plasmodium vivax decreased by 0.8% (95% CrI 0.2%, 1.3%) and 16.7% (95% CrI 13.7%, 19.9%) for one meter and 1 °C increase of altitude and minimum temperature. Indigenous hotspot was reported by Kota Tanjung Balai city and Asahan regency, respectively. Imported malaria hotspots were reported in Batu Bara, Kota Tebing Tinggi, Serdang Bedagai and Simalungun.CONCLUSION: Both indigenous and imported malaria is limited to a few regencies and cities in Northern Sumatera. The control measures should focus on these risk factors to achieve elimination in Indonesia.
AB - BACKGROUND: As Indonesia aims for malaria elimination by 2030, provisional malaria epidemiology and risk factors evaluation are important in pursue of this national goal. Therefore, this study aimed to understand the risk factor of malaria in Northern Sumatera.METHODS: Malaria cases from 2019 to 2020 were obtained from the Indonesian Ministry of Health Electronic Database. Climatic variables were provided by the Center for Meteorology and Geophysics Medan branch office. Multivariable logistic regression was undertaken to understand the risk factors of imported malaria. A zero-inflated Poisson multivariable regression model was used to study the climatic drivers of indigenous malaria.RESULTS: A total of 2208 (indigenous: 76.0% [1679] and imported: 17.8% [392]) were reported during the study period. Risk factors of imported malaria were: ages 19-30 (adjusted odds ratio [AOR] = 3.31; 95% confidence interval [CI] 1.67, 2.56), 31-45 (AOR = 5.69; 95% CI 2.65, 12.20), and > 45 years (AOR = 5.11; 95% CI 2.41, 10.84). Military personnel and forest workers and miners were 1,154 times (AOR = 197.03; 95% CI 145.93, 9,131.56) and 44 times (AOR = 44.16; 95% CI 4.08, 477,93) more likely to be imported cases as compared to those working as employees and traders. Indigenous Plasmodium falciparum increased by 12.1% (95% CrI 5.1%, 20.1%) for 1% increase in relative humidity and by 21.0% (95% CrI 9.0%, 36.2%) for 1 °C increase in maximum temperature. Plasmodium vivax decreased by 0.8% (95% CrI 0.2%, 1.3%) and 16.7% (95% CrI 13.7%, 19.9%) for one meter and 1 °C increase of altitude and minimum temperature. Indigenous hotspot was reported by Kota Tanjung Balai city and Asahan regency, respectively. Imported malaria hotspots were reported in Batu Bara, Kota Tebing Tinggi, Serdang Bedagai and Simalungun.CONCLUSION: Both indigenous and imported malaria is limited to a few regencies and cities in Northern Sumatera. The control measures should focus on these risk factors to achieve elimination in Indonesia.
KW - Adult
KW - Humans
KW - Indonesia/epidemiology
KW - Malaria/epidemiology
KW - Malaria, Falciparum/epidemiology
KW - Malaria, Vivax/epidemiology
KW - Plasmodium falciparum
KW - Plasmodium vivax
KW - Spatial Analysis
KW - Young Adult
KW - Malaria
KW - Indigenous
KW - Elimination
KW - Spatial analysis
KW - Imported
KW - Northern Sumatera
KW - Bayesian analysis
KW - Indonesia
UR - http://www.scopus.com/inward/record.url?scp=85137002276&partnerID=8YFLogxK
UR - http://10.1186/s12936-022-04285-5
UR - http://www.scopus.com/inward/record.url?scp=85141863002&partnerID=8YFLogxK
U2 - 10.1186/s12936-022-04262-y
DO - 10.1186/s12936-022-04262-y
M3 - Article
C2 - 35987665
SN - 1475-2875
VL - 21
SP - 1
EP - 14
JO - Malaria Journal
JF - Malaria Journal
IS - 1
M1 - 241
ER -
