Indonesia South-East Asia Region

I. Epidemiological profile
Population (UN) 2015 % Parasites and vectors
High transmission (> 1 case per 1000 population) 30,300,000 12 Plasmodium species: P. falciparum (55%), P.vivax (44%)
Low transmission (0-1 cases per 1000 population) 37,000,000 14 Major anopheles species: An. sundaicus, An. balabacensis, An. maculatus, An. farauti, An. subpictus, An. subpictus
Malaria-free (0 cases) 190,000,000 74 Reported confirmed cases (health facility): 217,025 Estimated cases: 1,300,000 [990,000 ; 1,600,000]
Total 257,560,000 Confirmed cases at community level: -
Reported deaths: 157 Estimated deaths: 1,900 [160 ; 3,600]

II. Intervention policies and strategies

Intervention Policies/strategies Yes/No Adopted Antimalarial treatment policy Medicine Year adopted
ITN ITNs/ LLINs distributed free of charge Yes 2004 First-line treatment of unconfirmed malaria - -
ITNs/ LLINs distributed to all age groups Yes 2004 First-line treatment of P. falciparum DHA-PP+PQ 2008
IRS IRS is recommended Yes 1959 Treatment failure of P. falciparum QN+D+PQ 2004
DDT is authorized for IRS No - Treatment of severe malaria AM; AS; QN 2004
Larval control Use of larval control recommended Yes 1990 Treatment of P. vivax DHA-PP+PQ(14d) 2008
IPT IPT used to prevent malaria during pregnancy N/A - Dosage of Primaquine for radical treatment of P. vivax 0.25 mg/Kg (14 days)
Diagnosis Patients of all ages should receive diagnostic test Yes 2007 Type pf RDT used P.f + all species (Combo)
Malaria diagnosis is free of charge in the public sector Yes 1959
Treatment ACT is free of charge for all ages in public sector Yes 2004
The sale of oral artemisinin-based monotherapies (oAMTs) Never allowed 2010
Single dose of primaquine is used as gametocidal medicine for
P. falciparum Yes 2004

Primaquine is used for radical treatment of P. vivax Yes 2004 Therapeutic efficacy tests (clinical and parasitological failure, %)
G6PD test is a requirement before treatment with primaquine No - Medicine Year Min Median Max Follow-up No of studies Species
Directly observed treatment with primaquine is undertaken No -
System for monitoring adverse reactions to antimalarials exists Yes 2016

Surveillance ACD for case investigation (reactive) Yes 1965

ACD of febrile cases at community level (pro-active) Insecticide susceptibility bioassays (reported resistance to at least one insecticide for any vector at any locality)
Yes 1965
Mass screening is undertaken Year Pyrethroid DDT Carbamate Organophosphate Species/complex tested
Yes 1965
Uncomplicated P. falciparum cases routinely admitted 20112014 Yes No Yes No An. subpictus s.l., An. sundaicus s.l., other
Yes 1990
Uncomplicated P. vivax cases routinely admitted Yes 1990
Foci and case investigation undertaken - -
Case reporting from private sector is mandatory Yes 1984

III. Financing Sources of financing Government expenditure by intervention in 2015

50
Contribution ($USm)

40 Insecticides & spray materials

ITNs
30 Diagnostic testing
Antimalarial medicines
20 Monitoring and Evaluation
Human Resources & Technical Assistance
10 Management and other costs
Pie chart includes 32% of total expenditures
0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Gov. expend. Global Fund World Bank USAID/PMI WHO/UNICEF Others

IV. Coverage Coverage of ITN and IRS Cases tested and treated in public sector

100 100

80 80
Population (%)

60 60
(%)

40 40

20 20

0 0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Source: DHS 2007 Source: DHS 2007, DHS 2012, Other Nat.*

Suspected cases tested Antimalarials distributed vs reported cases

At high risk protected with ITNs All ages who slept under an ITN (survey) % <5 fever cases who had a finger/ heel stick ACTs distributed vs reported P. f. cases
Households with at least one ITN (survey) At high risk protected with IRS ACTs as % of all antimalarials received by <5 (survey) Primaquine distributed vs reported P. v. cases

V. Impact Cases treated Test positivity

100 100

80 80
Tests (%)

60 60
(%)

40 40

20 20

0 0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Source: DHS 2007

% fever cases <5 seeking treatment at public HF (survey) Parasite prevalence Slide positivity rate RDT positivity rate
Reporting completeness

Confirmed malaria cases per 1000 and ABER Malaria admissions and deaths (per 100 000)

8 4 200 0.4
7
6 150 0.3
Cases per 1000

3
Admissions

5
ABER (%)

Deaths

4 2 100 0.2
3
2 1 50 0.1
1
0 0 0 0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

ABER (microscopy & RDT) Cases (all species) Cases (P. vivax) Admissions (all species) Admissions (P.vivax)
Deaths (all species) Deaths (P. vivax)