Relationship of Malaria Infection (Plasmodium Falciparum & Plasmodium Vivax) to Average Haemoglobin (Hb) Levels in Malaria Endemic Areas of Eastern Indonesia
Main Article Content
Abstract
Introduction: The prevalence of malaria infection in Eastern Indonesia remains high (Annual Parasite Incidence/API > 5%). East Nusa Tenggara (ENT) province is one of the endemic regions that lacks data comparing haemoglobin (Hb) levels between P. falciparum and P. vivax infection. Therefore, this study aimed to assess the relationship between malaria infection and Hb levels in different level of API areas of endemicity in Eastern Indonesia. Material and Methods: A cross-sectional study was conducted in Eastern Indonesia. Samples were selected by systematic random sampling from primary health care records. Hb levels were measured using point-of-care haemoglobin testing with capillary blood by local health practitioners. Malaria species were examined by microscopy and nested Polymerase Chain Reaction (PCR). Other variables, including gender, age, residence, occupation, duration in endemic areas, and BMI were assessed. Data analysis was conducted using univariate, bivariate, multivariate, and t-test with 95% confidence interval (CI) and α=0.05. Results: A total of 510 respondents were included in this study. Malaria infection was detected in 148 respondents (29.1%), with 92 (62.1%) infected with P. vivax and 56 (37.8%) with P. falciparum. Anaemia was present in 278 respondents (54.5%), primarily among females (156 respondents). A significant correlation was observed between malaria infection and reduced Hb levels (p<0.05). Conclusion: Malaria infection was associated with decrease in Hb levels. There was no significant difference in Hb levels between P. falciparum and P. vivax malaria infections.
Downloads
Article Details
References
Depkes RI. Pusat Data dan Informasi - Kementerian Kesehatan Republik Indonesia [Internet]. 2016 [cited 2019 Apr 29]. Available from: http://www.pusdatin.kemkes.go.id/article/view/16090600001/malaria-2016.html
Indonesia Health Ministry. Indonesia Health Profile 2018 [Internet]. Jakarta; 2019. Available from: https://pusdatin.kemkes.go.id/resources/download/pusdatin/profil-kesehatan-indonesia/PROFIL_KESEHATAN_2018_1.pdf
Mau F, Supargiyono, Murhandarwati EH. Evaluation of the Performance of Malaria Microscopist in Primary Health Center and Cross Checker in Belu East Nusa Tenggara. Tropical Medicine Journal. 2013;03(1):16–28. doi:10.22146/tmj.5826
Milka Betaubun A, Oetama Adiatmaja C, V. Butarbutar T, Wardhani P, Aryati A. Comparison between the Diagnostic Performances of Rapid Diagnostic Test (RDT) using Advantage Malaria Card Pf/Pv Ag, Microscopy, and Polymerase Chain Reaction (PCR) in Malaria Suspected patients at the Merauke Regional General Hospital. RJPT. 2023 Feb 28;514–8. doi:10.52711/0974-360X.2023.00087
White NJ. Severe malaria. Malar J. 2022 Oct 6;21(1):284. doi:10.1186/s12936-022-04301-8
White NJ. Anaemia and malaria. Malar J. 2018 Dec;17(1):371. doi:10.1186/s12936- 018-2509-9
Douglas NM, Lampah DA, Kenangalem E, Simpson JA, Poespoprodjo JR, Sugiarto P, et al. Major Burden of Severe Anemia from Non-Falciparum Malaria Species in Southern Papua: A Hospital-Based Surveillance Study. Hviid L, editor. PLoS Med. 2013 Dec 17;10(12):e1001575. doi:10.1371/journal.pmed.1001575
Harijanto PN, Nugroho A, Gunawan CA. Malaria dari Molekuler ke Klinis. 2nd ed. Jakarta: Penerbit Buku Kedokteran EGC; 2009. Available from: https://perpustakaan.poltekkesbanten.ac.id/library/index.php?p=show_detail&id=47
Wirth JP, Rohner F, Woodruff BA, Chiwile F, Yankson H, Koroma AS, et al. Anemia, Micronutrient Deficiencies, and Malaria in Children and Women in Sierra Leone Prior to the Ebola Outbreak - Findings of a Cross-Sectional Study. PLoS ONE. 2016;11(5):e0155031. doi: 10.1371/journal.pone.0155031
Sakwe N, Bigoga J, Ngondi J, Njeambosay B, Esemu L, Kouambeng C, et al. Relationship between malaria, anaemia, nutritional and socio-economic status amongst under-ten children, in the North Region of Cameroon: A cross-sectional assessment. Ghose B, editor. PLoS ONE. 2019. doi: 10.1371/journal.pone.0218442
BPS Kabupaten Timor Tengah Selatan. Timor Tengah Selatan Regency in Figures 2020. BPS-Statistics of Timor Tengah Selatan Regency; 2020. Available from: https://timortengahselatankab.bps.go
Badan Pusat Statistik Kabupaten Timor Tengah Selatan. Economic Indicators for South Central Timor Regency 2019 [Internet]. Soe; 2020. Available from: https://timortengahselatankab.bps.go.id/id/publication/2020/12/24/bf0e6f1a0e0d9bcd48058aed/indikator-ekonomi-kabupaten-timor-tengah-selatan-2019.html
Weir CB, Arif J. BMI Classification Percentile And Cut Off Points. StatPearls, National Library of Medicine; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541070/
General Life Biotechnology Co. Benecheck Uni Hemoglobin Monitoring System. Available from: https://www.glbiotech.com/products/detail/132
Guideline on haemoglobin cutoffs to define anaemia in individuals and populations. Geneva: World Health Organization; 2024.Available from: https://www.who.int/publications/i/item/9789240088542
Langford S, Douglas NM, Lampah DA, Simpson JA, Kenangalem E, Sugiarto P, et al. Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study. Sinnis P, editor. PLoS Negl Trop Dis. 2015 Dec 31;9(12):e0004195. doi:10.1371/journal.pntd.0004195
Kenangalem E, Karyana M, Burdarm L, Yeung S, Simpson JA, Tjitra E, et al. Plasmodium vivax infection: a major determinant of severe anaemia in infancy. Malar J. 2016 Dec;15(1):321. doi:10.1186/s12936-016-1373-8
Mongi MM, Rombot DV, Lampus BS, Umboh JML, Kaunang WPJ, Pandelaki AJ. Hubungan Antara Malaria Klinis Dengan Anemia Pada Penderita Yang Berkunjung Di Puskesmas Wori Kabupaten Minahasa Utara. Jurnal Kedokteran Komunitas dan Tropik. 2014;II(1). Available from: https://ejournal.unsrat.ac.id/v2/index.php/JKKT/article/view/4636/4164
Punnath K, Dayanand KK, Chandrashekar VN, Achur RN, Kakkilaya SB, Ghosh SK, et al. Association between Inflammatory Cytokine Levels and Thrombocytopenia during Plasmodium falciparum and P. vivax Infections in South-Western Coastal Region of India. Malaria Research and Treatment. 2019 Apr 11;2019:1–10. Available from: https://lib.ui.ac.id/detail.jsp?id=141375
Oyong DA, Kenangalem E, Poespoprodjo JR, Beeson JG, Anstey NM, Price RN, et al. Loss of complement regulatory proteins on uninfected erythrocytes in vivax and falciparum malaria anemia. JCI Insight. 2018 Nov 15;3(22):e124854. doi: 10.1172/jci.insight.124854
Gandasuhada S, Herry H, Pribudi W. Parasitologi Kedokteran. Jakarta: Gaya Baru; 2004. 178–194 p. Available from: https://lib.ui.ac.id/detail.jsp?id=141375
Simon AK, Hollander GA, McMichael A. Evolution of the immune system in humans from infancy to old age. Proc R Soc B. 2015 Dec 22;282(1821):20143085. doi: 10.1098/rspb.2014.3085
Stefani A, Kurniawan B, Rudiyanto W. Hubungan Antara Usia dan Jenis PlasmodiumTerhadap Kadar Hemoglobin Pada Penderita Malaria di Wilayah Kerja Puskesmas Hanura Kabupaten Pesawaran. Medical Journal of Lampung University. 2019;8(1). Available from: http://repository.lppm.unila.ac.id/17016/1/2306-3026-1-PB.pdf
Shankar H, Singh MP, Hussain SSA, Phookan S, Singh K, Mishra N. Epidemiology of malaria and anemia in high and low malaria-endemic North-Eastern districts of India. Front Public Health. 2022 Jul 28;10:940898. doi: 10.3389/fpubh.2022.940898
Agency of Health Research and Development. Indonesia Basic Health Research 2018 [Internet]. Jakarta; 2019. Available from: http://www.depkes.go.id/resources/download/info-terkini/materi_rakorpop_2018/Hasil%20Riskesdas%202018.pdf
Wirth JP, Woodruff BA, Engle-Stone R, Namaste SM, Temple VJ, Petry N, et al. Predictors of anemia in women of reproductive age: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Am J Clin Nutr. 2017 Jul;106(Suppl 1):416S-427S. doi: 10.3945/ajcn.116.143073
Gautam S, Min H, Kim H, Jeong H-S. Determining factors for the prevalence of anemia in women of reproductive age in Nepal: Evidence from recent national survey data. PLoS ONE. 2019;14(6):e0218288. doi: 10.1371/journal.pone.0218288
Sumbele IUN, Bopda OSM, Kimbi HK, Ning TR, Nkuo-Akenji T. Nutritional status of children in a malaria meso endemic area: cross sectional study on prevalence, intensity, predictors, influence on malaria parasitaemia and anaemia severity. BMC Public Health. 2015 Dec;15(1):1099. doi: 10.1186/s12889-015-2462-2
Douglas NM, Lampah DA, Kenangalem E, Simpson JA, Poespoprodjo JR, Sugiarto P, et al. Major Burden of Severe Anemia from Non-Falciparum Malaria Species in Southern Papua: A Hospital-Based Surveillance Study. Hviid L, editor. PLoS Med. 2013 Dec 17;10(12):e1001575. doi: 10.1371/journal.pmed.1001575
Sutanto I, Ismid I. Buku Ajar Parasitologi Kedokteran. 4th ed. Badan Penerbit FKUI; 2017. Available from: https://lin.ui.ac.id/m/detail.jsp?id=20463714&lokasi=lokal
Baratawidjaja K, Rengganis I. Imunologi infeksi dalam: Imunologi dasar. Jakarta: Balai Penerbit FKUI; 2009. Available from: https://lib.ui.ac.id/detail?id=20417471