Highlights Searches related to COVID-19 and face masks in Taiwan increased rapidly, following the announcements of Taiwan' first imported case and reached its peak as local cases were reported.  Searches for handwashing were gradually increased in period of face masks shortage in Taiwan.  Google Trends provides information on the most common knowledge needed by users and location of searches.  In response to the ongoing outbreak, our results demonstrated that Google Trends could potentially define the proper timing and location for practicing appropriate risk communication strategies to the affected population. AbstractObjective: An emerging outbreak of COVID-19 has been detected in at least 26 countries worldwide.Given this pandemic situation, robust risk communication is urgently needed particularly in affected countries. Therefore, this study explored the potential use of Google Trends (GT) to monitor public restlessness toward COVID-19 epidemic infection in Taiwan. Methods:We retrieved GT data for the specific locations of Taiwan nationwide and subregions using defined search terms related to coronavirus, handwashing, and face masks. J o u r n a l P r e -p r o o fResults: Searches related to COVID-19 and face masks in Taiwan increased rapidly, following the announcements of Taiwan' first imported case and reached its peak as local cases were reported.However, searches for handwashing were gradually increased in period of face masks shortage.Moreover, high to moderate correlations between Google relative search volume (RSV) and COVID-19 cases were found in Taipei (lag-3), New Taipei (lag-2), Taoyuan (lag-2), Tainan (lag-1), Taichung (lag0), and Kaohsiung (lag0). Conclusion:In response to the ongoing outbreak, our results demonstrated that GT could potentially define the proper timing and location for practicing appropriate risk communication strategies to the affected population.

Background: Digital traces are rapidly used for health monitoring purposes in recent years. This approach is growing as the consequence of increased use of mobile phone, Internet, and machine learning. Many studies reported the use of Google Trends data as a potential data source to assist traditional surveillance systems. The rise of Internet penetration (54.7%) and the huge utilization of Google (98%) indicate the potential use of Google Trends in Indonesia. No study was performed to measure the correlation between country wide official dengue reports and Google Trends data in Indonesia. Objective: This study aims to measure the correlation between Google Trends data on dengue fever and the Indonesian national surveillance report. Methods: This research was a quantitative study using time series data (2012–2016). Two sets of data were analyzed using Moving Average analysis in Microsoft Excel. Pearson and Time lag correlations were also used to measure the correlation between those data. Results: Moving Average analysis showed that Google Trends data have a linear time series pattern with official dengue report. Pearson correlation indicated high correlation for three defined search terms with R-value range from 0.921 to 0.937 (p ≤ 0.05, overall period) which showed increasing trend in epidemic periods (2015–2016). Time lag correlation also indicated that Google Trends data can potentially be used for an early warning system and novel tool to monitor public reaction before the increase of dengue cases and during the outbreak. Conclusions: Google Trends data have a linear time series pattern and statistically correlated with annual official dengue reports. Identification of information-seeking behavior is needed to support the use of Google Trends for disease surveillance in Indonesia.

BackgroundMalaria has been targeted for elimination from Indonesia by 2030, with varying timelines for specific geographical areas based on disease endemicity. The regional deadline for malaria elimination for Java island, given the steady decrease of malaria cases, was the end of 2015. Purworejo District, a malaria-endemic area in Java with an annual parasite incidence (API) of 0.05 per 1,000 population in 2009, aims to enter this elimination stage. This study documents factors that affect incidence and spatial distribution of malaria in Purworejo, such as geomorphology, topography, health system issues, and identifies potential constraints and challenges to achieve the elimination stage, such as inter-districts coordination, decentralization policy and allocation of financial resources for the programme.MethodsHistorical malaria data from 2007 to 2011 were collected through secondary data, in-depth interviews and focus group discussions during study year (2010–2011). Malaria cases were mapped using the village-centroid shape file to visualize its distribution with geomorphologic characteristics overlay and spatial distribution of malaria. API in each village in Purworejo and its surrounding districts from 2007 to 2011 was stratified into high, middle or low case incidence to show the spatiotemporal mapping pattern.ResultsThe spatiotemporal pattern of malaria cases in Purworejo and the adjacent districts demonstrate repeated concentrated occurrences of malaria in specific areas from 2007 to 2011. District health system issues, i.e., suboptimal coordination between primary care and referral systems, suboptimal inter-district collaboration for malaria surveillance, decentralization policy and the lack of resources, especially district budget allocations for the malaria programme, were major constraints for programme sustainability.ConclusionsA new malaria elimination approach that fits the local disease transmission, intervention and political system is required. These changes include timely measurements of malaria transmission, revision of the decentralized government system and optimizing the use of the district capitation fund followed by an effective technical implementation of the intervention strategy.

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BackgroundIndonesia has set 2030 as its deadline for elimination of malaria transmission in the archipelago, with regional deadlines established according to present levels of malaria endemicity and strength of health infrastructure. The Municipality of Sabang which historically had one of the highest levels of malaria in Aceh province aims to achieve elimination by the end of 2013.MethodFrom 2008 to 2010, baseline surveys of malaria interventions, mapping of all confirmed malaria cases, categorization of residual foci of malaria transmission and vector surveys were conducted in Sabang, Aceh, a pilot district for malaria elimination in Indonesia. To inform future elimination efforts, mass screening from the focal areas to measure prevalence of malaria with both microscopy and PCR was conducted. G6PD deficiency prevalence was also measured.ResultDespite its small size, a diverse mixture of potential malaria vectors were documented in Sabang, including Anopheles sundaicus, Anopheles minimus, Anopheles aconitus and Anopheles dirus. Over a two-year span, the number of sub-villages with ongoing malaria transmission reduced from 61 to 43. Coverage of malaria diagnosis and treatment, IRS, and LLINs was over 80%. Screening of 16,229 residents detected 19 positive people, for a point prevalence of 0.12%. Of the 19 positive cases, three symptomatic infections and five asymptomatic infections were detected with microscopy and 11 asymptomatic infections were detected with PCR. Of the 19 cases, seven were infected with Plasmodium falciparum, 11 were infected with Plasmodium vivax, and one subject was infected with both species. Analysis of the 937 blood samples for G6PD deficiency revealed two subjects (0.2%) with deficient G6PD.DiscussionThe interventions carried out by the government of Sabang have dramatically reduced the burden of malaria over the past seven years. The first phase, carried out between 2005 and 2007, included improved malaria diagnosis, introduction of ACT for treatment, and scale-up of coverage of IRS and LLINs. The second phase, from 2008 to 2010, initiated to eliminate the persistent residual transmission of malaria, consisted of development of a malaria database to ensure rapid case reporting and investigation, stratification of malaria foci to guide interventions, and active case detection to hunt symptomatic and asymptomatic malaria carriers.

Background: Dengue fever is a mosquito-borne viral disease with high incidence in over 128 countries. WHO estimates 500,000 people with severe dengue are hospitalized annually and 2.5% of those affected die. Indonesia is a hyperendemic country for dengue with an increasing number of cases in the last decade. Unfortunately, the trends of Indonesian dengue research are relatively unknown. Objective: This research aimed to depict bibliographic trends and knowledge structure of dengue publications in Indonesia relative to that of South-east Asia (SEA) from 2007 to 2016. Methods: Bibliographic data were collected from PubMed filtered by Indonesia country affiliation. The annual growth rate of publication was measured and compared with neighborhood countries in the SEA region. Network analysis was used to visualize emerging research issues. Results: About 1,625 dengue-related documents originated from SEA region, of which Indonesia contributed 5.90%. The publication growth rate in Indonesia, however, is the highest in ASEAN region (28.87%). Total citations for documents published from Indonesia was 980, with an average of 14 citations per publication and h-index of 16. Within the first five years, the main research topics were related to insect vector and diagnostic method. While insect vector remained dominant in the last five years, other topics such as disease outbreak, dengue virus, and dengue vaccine started emerging. Conclusion: In the last 10 years, dengue publications’ growth from Indonesia in international journals improved significantly, despite less number of publications compared to other SEA countries. Efforts should be made to improve the quantity and quality of publications from Indonesia. The research topics related to dengue in Indonesia are in line with studies in SEA. Stakeholders and policy makers are encouraged to develop a roadmap for dengue research in the future.

BackgroundIndonesia is among those countries committed to malaria eradication, with a continuously decreasing incidence of malaria. However, at district level the situation is different. This study presents a case of malaria resurgence Kokap Subdistrict of the Kulon Progo District in Yogyakarta Province, Java after five years of low endemicity. This study also aims to describe the community perceptions and health services delivery situation that contribute to this case.MethodsAll malaria cases (2007–2011) in Kulon Progo District were stratified to annual parasite incidence (API). Two-hundred and twenty-six cases during an outbreak (May 2011 to April 2012) were geocoded by household addresses using a geographic information system (GIS) technique and clusters were identified by SaTScan software analysis (Arc GIS 10.1). Purposive random sampling was conducted on respondents living inside the clusters to identify community perceptions and behaviour related to malaria. Interviews were conducted with malaria health officers to understand the challenges of malaria surveillance and control.ResultsAfter experiencing three consecutive years with API less than 1 per thousand, malaria in Kokap subdistrict increased almost ten times higher than API in the district level and five times higher than national API. Malaria cases were found in all five villages in 2012. One primary and two secondary malaria clusters in Hargotirto and Kalirejo villages were identified during the 2011–2012 outbreak. Most of the respondents were positively aware with malaria signs and activities of health workers to prevent malaria, although some social economic activities could not be hindered. Return transmigrants or migrant workers entering to their villages, reduced numbers of village malaria workers and a surge in malaria cases in the neighbouring district contributed to the resurgence.ConclusionCommunity perception, awareness and participation could constitute a solid foundation for malaria elimination in Kokap. However, decreasing number of village malaria workers and ineffective communication between primary health centres (PHCs) within boundary areas with similar malaria problems needs attention. Decentralization policy was allegedly the reason for the less integrated malaria control between districts, especially in the cross border areas. Malaria resurgence needs attention particularly when it occurs in an area that is entering the elimination phase.

Background South Korea is among the best-performing countries in tackling the coronavirus pandemic by using mass drive-through testing, face mask use, and extensive social distancing. However, understanding the patterns of risk perception could also facilitate effective risk communication to minimize the impacts of disease spread during this crisis. Objective We attempt to explore patterns of community health risk perceptions of COVID-19 in South Korea using internet search data. Methods Google Trends (GT) and NAVER relative search volumes (RSVs) data were collected using COVID-19–related terms in the Korean language and were retrieved according to time, gender, age groups, types of device, and location. Online queries were compared to the number of daily new COVID-19 cases and tests reported in the Kaggle open-access data set for the time period of December 5, 2019, to May 31, 2020. Time-lag correlations calculated by Spearman rank correlation coefficients were employed to assess whether correlations between new COVID-19 cases and internet searches were affected by time. We also constructed a prediction model of new COVID-19 cases using the number of COVID-19 cases, tests, and GT and NAVER RSVs in lag periods (of 1-3 days). Single and multiple regressions were employed using backward elimination and a variance inflation factor of <5. Results The numbers of COVID-19–related queries in South Korea increased during local events including local transmission, approval of coronavirus test kits, implementation of coronavirus drive-through tests, a face mask shortage, and a widespread campaign for social distancing as well as during international events such as the announcement of a Public Health Emergency of International Concern by the World Health Organization. Online queries were also stronger in women (r=0.763-0.823; P<.001) and age groups ≤29 years (r=0.726-0.821; P<.001), 30-44 years (r=0.701-0.826; P<.001), and ≥50 years (r=0.706-0.725; P<.001). In terms of spatial distribution, internet search data were higher in affected areas. Moreover, greater correlations were found in mobile searches (r=0.704-0.804; P<.001) compared to those of desktop searches (r=0.705-0.717; P<.001), indicating changing behaviors in searching for online health information during the outbreak. These varied internet searches related to COVID-19 represented community health risk perceptions. In addition, as a country with a high number of coronavirus tests, results showed that adults perceived coronavirus test–related information as being more important than disease-related knowledge. Meanwhile, younger, and older age groups had different perceptions. Moreover, NAVER RSVs can potentially be used for health risk perception assessments and disease predictions. Adding COVID-19–related searches provided by NAVER could increase the performance of the model compared to that of the COVID-19 case–based model and potentially be used to predict epidemic curves. Conclusions The use of both GT and NAVER RSVs to explore patterns of community health risk perceptions could be beneficial for targeting risk communication from several perspectives, including time, population characteristics, and location.