Decrease of malaria morbidity with community participation in central Java
Pribadi, W.; Rukmono, B.; Santoso, S.S.; Soeripto, N.; Lokollo, D.M.; Soeharyo
Southeast Asian Journal of Tropical Medicine and Public Health 23(3): 389-396
1992
ISSN/ISBN: 0125-1562 PMID: 1488690 Document Number: 399043
Malaria is still a problem in Java-Bali, although the Malaria Eradication Program started in the 1950's. In the First National Five Year Development Plan it was changed to the Malaria Control Program with the aim to reduce the morbidity and mortality rates through surveillance and spraying interventions using the primary health care approach. In 1984 in Central Java there were malaria areas with an average annual parasite incidence (API) between 1 and 7.5 promille covering about six million population, nearly one third of the population of Central Java. In this study an intervention alternative was carried out with weakly chloroquine prophylaxis to children below 10 years of age in 3 malaria areas of central Java, namely the villages Bedono Kluwung and Kalikutes in Purworejo Regency and Pablengan in Karang Anyar Regency. Health education about malaria with a learning module was conducted by key persons as an element of community participation. The activities of the key persons increased the ongoing surveillance. After one and a half years intervention (July 1985-February 1987) the spleen rates, parasite rates and fever cases dropped to nearly zero in the three study villages. From the results of this study it was recommended that in a malaria risk area with an API of more than 1 promille, intervention with collective chloroquine protection to children below 10 years of age could reduce the API to 1 promille or less. This intervention should be carried out if there is an increase of cases in the area to prevent small outbreaks. The time of chloroquine intake should be limited; it should be discontinued when fever cases have dropped significantly. Thereafter it should be followed up by insecticide spraying. This recommendation does not exclude the outlines of the program that surveillance with early diagnosis followed up with rational radical treatment is the best weapon to control malaria through the primary health care approach.