Postmalaria elimination: Overview of recurrent malaria cases in Riau Province, Indonesia.

BACKGROUND

Malaria remains a significant global health concern as a parasitic infectious disease. The recurrence of malaria presents a considerable challenge in the worldwide efforts to eliminate the disease. Riau Province, recognized as one of the regions with a relatively high incidence of malaria, is set to achieve certification for malaria elimination across all districts by the year 2024. Despite this progress, malaria cases continue to be reported, with an increase observed until now. The persistence of recurrent malaria can be attributed to several factors, including limitations in diagnostic capabilities, treatment challenges such as drug resistance, inadequate therapeutic interventions, and issues related to dosing and treatment evaluation regimens.

MATERIALS AND

METHODS

This study uses a descriptive retrospective approach. This study will overview recurrent malaria in Riau Province between 2019 and 2022. While recurrent malaria episodes were observed, this study could not definitively differentiate between relapse and reinfection. The research data were obtained from the Directorate of Communicable Disease Prevention and Control at the Riau Provincial Health Office, covering the period from 2019 to 2022.

RESULTS

Between 2019 and 2022, Riau Province reported 4622 malaria cases. Among these, 232 recurrent malaria cases were identified, and 100% of them occur after 28 days. We were unable to distinguish between cases of relapse and those of reinfection. Most of these cases were reported by the Panipahan Community Health Center in Rokan Hilir Regency. Of the recurrent malaria cases, 220 (94.83%) were caused by Plasmodium vivax, 11 (4.74%) by Plasmodium falciparum, and one case involved a mixed infection. The most commonly used diagnostic method to establish the diagnosis is the rapid diagnostic test (69%). The study found that most cases occurred in male genders, aged 19-59 years, with the majority working as civil servants. All malaria cases received treatment according to the standards, but 73.45% did not receive a complete after-treatment evaluation.

CONCLUSION

Malaria relapse is a significant challenge in malaria elimination efforts in Riau Province.