TY - JOUR
T1 - Spatiotemporal heterogeneity in malaria transmission across Indonesia: analysis of routine surveillance data 2010–2019
AU - Djaafara, Bimandra A.
AU - Sherrard-Smith, Ellie
AU - Churcher, Thomas S.
AU - Fajariyani, Sri Budi
AU - Prameswari, Hellen Dewi
AU - Herdiana, Herdiana
AU - Puspadewi, Riskha Tiara
AU - Lestari, Karina D.
AU - Elyazar, Iqbal R.F.
AU - Walker, Patrick G.T.
PY - 2025/2/28
Y1 - 2025/2/28
N2 - BackgroundIndonesia faces challenges in achieving its goal of eliminating malaria by 2030, with cases stagnating between 2015 and 2019. This study analysed regional epidemiological trends and demographic changes in malaria cases from 2010 to 2019, considering differences in surveillance across the country.MethodsWe analysed national and sub-national malaria routine surveillance data using generalised additive and generalised linear models to assess temporal trends in case reporting, test positivity, demographics, and parasite species distribution while accounting for surveillance variations.ResultsAfter adjusting for increased testing from 2015 onwards, we estimated declining malaria incidence in six of seven Indonesian regions. These regions showed a demographic shift toward older, predominantly male cases, suggesting a transition from household to occupational transmission. In contrast, Papua maintained high transmission with cases concentrated in children. Despite comprising only 2% of Indonesia’s population, Papua’s contribution to national malaria cases rose from 40 to 90% (2010–2019).ConclusionWhile most Indonesian regions progress toward elimination by addressing mobile and migrant populations and P. vivax transmission, Papua shows different patterns with persistently high transmission among children. Achieving nationwide elimination requires enhanced control measures, improved healthcare access, and strengthened multisectoral collaboration to address these region-specific challenges.
AB - BackgroundIndonesia faces challenges in achieving its goal of eliminating malaria by 2030, with cases stagnating between 2015 and 2019. This study analysed regional epidemiological trends and demographic changes in malaria cases from 2010 to 2019, considering differences in surveillance across the country.MethodsWe analysed national and sub-national malaria routine surveillance data using generalised additive and generalised linear models to assess temporal trends in case reporting, test positivity, demographics, and parasite species distribution while accounting for surveillance variations.ResultsAfter adjusting for increased testing from 2015 onwards, we estimated declining malaria incidence in six of seven Indonesian regions. These regions showed a demographic shift toward older, predominantly male cases, suggesting a transition from household to occupational transmission. In contrast, Papua maintained high transmission with cases concentrated in children. Despite comprising only 2% of Indonesia’s population, Papua’s contribution to national malaria cases rose from 40 to 90% (2010–2019).ConclusionWhile most Indonesian regions progress toward elimination by addressing mobile and migrant populations and P. vivax transmission, Papua shows different patterns with persistently high transmission among children. Achieving nationwide elimination requires enhanced control measures, improved healthcare access, and strengthened multisectoral collaboration to address these region-specific challenges.
KW - Elimination
KW - Indonesia
KW - Malaria
KW - Spatiotemporal
KW - Surveillance
U2 - 10.1186/s12916-025-03902-9
DO - 10.1186/s12916-025-03902-9
M3 - Article
SN - 1741-7015
VL - 23
JO - BMC Medicine
JF - BMC Medicine
IS - 1
M1 - 136
ER -
