The Human Behavioral and Socioeconomic Determinants of Malaria in Bacan Island, North Maluku, Indonesia.

Schwartz

et al. 2004

Malar J

Section: Discussionsupporting

confidence: 85%

Untitled

Schwartz

et al. 2004

Malar J

Proc. Natl. Acad. Sci. U.S.A.

“…The observed large among-site variation in the sensitivity to climate fluctuations may be governed by complex interactions between climate and biological and social factors. Potentially important factors include land use, topography, P. falciparum genotypes, malaria vector species composition, availability of vector control and healthcare programs, drug resistance, and other socioeconomic factors (41)(42)(43)(44). These factors may have significant location-specific effects.…”

Section: Discussionmentioning

confidence: 99%

Association between climate variability and malaria epidemics in the East African highlands

Zhou

Minakawa

Githeko

et al. 2004

410

367

The causes of the recent reemergence of Plasmodium falciparum epidemic malaria in the East African highlands are controversial. Regional climate changes have been invoked as a major factor; however, assessing the impact of climate in malaria resurgence is difficult due to high spatial and temporal climate variability and the lack of long-term data series on malaria cases from different sites. Climate variability, defined as short-term fluctuations around the mean climate state, may be epidemiologically more relevant than mean temperature change, but its effects on malaria epidemics have not been rigorously examined. Here we used nonlinear mixed-regression model to investigate the association between autoregression (number of malaria outpatients during the previous time period), seasonality and climate variability, and the number of monthly malaria outpatients of the past 10–20 years in seven highland sites in East Africa. The model explained 65–81% of the variance in the number of monthly malaria outpatients. Nonlinear and synergistic effects of temperature and rainfall on the number of malaria outpatients were found in all seven sites. The net variance in the number of monthly malaria outpatients caused by autoregression and seasonality varied among sites and ranged from 18 to 63% (mean = 38.6%), whereas 12–63% (mean = 36.1%) of variance is attributed to climate variability. Our results suggest that there was a high spatial variation in the sensitivity of malaria outpatient number to climate fluctuations in the highlands, and that climate variability played an important role in initiating malaria epidemics in the East African highlands

“…The findings showed that the odds for reporting malaria was 12–21% higher in that adults who owning bed net. When self-report malaria is used as the measure of malaria infection, possible explanations for this might be due to low compliance level among adults on utilizing and retreating the net to prevent mosquito bites and maintain the efficacy of bed net as well as people’s habits which is likely influenced by their awareness and belief regarding malaria [17, 38, 39]. Studies in Kenya have demonstrated that individuals’ attitude and views and social cultural norms influenced the use of nets among bed net owners [39].…”

Section: Discussionmentioning

confidence: 99%

“…However, the effects of these individual-, household- and environmental factors to malaria risk in Maluku and Papua has not been fully quantified. Although there have been numerous studies on identifying risk factors associated with malaria infection in Indonesia [17–19], knowledge regarding individual, household, and village-level factors associated with malaria especially in both Maluku and Papua are still lacking. Understanding the risk factors at each level is important so that effective resource allocation for local elimination malaria strategies can be implemented.…”

Section: Introductionmentioning

confidence: 99%

“…To overcome this problem, multilevel modelling approach could be used as it allows for the investigation of the effects of contextual variables measured at the different levels both at micro and macro-level on the individual-level outcome [20, 22–24]. The role of environment and socioeconomic factors on malaria has been conducted in many parts in Indonesia [17–19, 25, 26]. However, there have been limited studies using multilevel approach to determine the effect of micro-level scale factors on the individual malaria infection, especially in Maluku and Papua where malaria is still highly prevalent.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Individual and contextual factors predicting self-reported malaria among adults in eastern Indonesia: findings from Indonesian community-based survey

Dhewantara

Ipa

Widawati

2019

Malar J

Background Malaria is still an important parasitic infectious disease that affecting poor and vulnerable communities in many developing countries, including Indonesia. During the period of 2010–2017, there have been approximately 2.2 million confirmed malaria cases reported across Indonesia. This study aimed to identify individual, household and village-level factors associated with self-reported malaria among adults more than 15 years of age in Maluku, West Papua and Papua province. Methods This study analysed a subset of the data from nationally representative population-based Indonesian National Basic Health Research (Riset Kesehatan Dasar) (N = 1,027,763 in 294,959 households in 33 provinces) in 2013. Total of 41,079 individuals (20,326 males and 20,753 females) aged ≥ 15 years in 19,269 households in Maluku, West Papua and Papua provinces were included. Participants were interviewed if they ever had been diagnosed and laboratory confirmed of having malaria by physician in the past 12 months. A mixed effects multilevel logistic regression models were developed to assess the associations between socio-demographical variables at individual, household and village level and self-reported malaria. Results Individuals aged ≥ 15 years in 701 villages in Maluku (n = 11,919), West Papua (n = 8003) and Papua (n = 21,157) were analysed. In all provinces, gender distribution was equally-represented. The prevalence of self-reported malaria was 4.1% (Maluku), 12.4% (West Papua) and 18.8% (Papua). At the individual level, primary industry workers (OR 1.29, 95% CI 1.15–1.46 [Maluku]; OR 1.17, 95% CI 1.09–1.25 [Papua]) and having higher education were associated with self-reporting malaria (OR 0.67, 95% CI 0.53–0.83 [Maluku]; OR 1.27, 95% CI 1.15–1.40 [Papua]). Household level factors include having bed net and better off wealth index were associated with increased self-reporting malaria among West Papua (OR 1.21; 95% CI 1.09–1.34 and OR 1.38; 95% CI 1.17–1.65, respectively) and Papuan (OR 1.12; 95% CI 1.02–1.23 and OR 1.33; 95% CI 1.11–1.57, respectively) adults. Increased odds of self-reporting malaria was associated with time required to reach healthcare facility (OR 1.30, 95% CI 1.01–1.67 [Maluku]). Contextual village-level characteristics such as living in rural (OR 1.31, 95% CI 1.12–1.54 [Maluku]; OR 1.56, 95% CI 1.17–2.07 [West Papua]), higher community education level (OR 1.28, 95% CI 1.02–1.63 [West Papua]; OR 1.45, 95% CI 1.23–1.72 [Papua]), higher community bed net ownerships (OR 0.59 95% CI 0.45–0.77 [West Papua]) were associated with self-reported malaria. Conclusions Factors associated with self-reported malaria were varied between provinces suggesting locally-specific determinants were exist at individual, household and community-level. This study highlights the need for specific interventions by taking into consideration the contextual factors within the region and involving multi-sectoral collaboration bet...