Srisasi Gandahusada



The most important protozoan parasites in Indonesia are the malaria parasites, Toxoplasma gondii and Entamoeba histolytica.

After the second world war the residual insecticides and effective antimalarial drugs were used in the control of malaria. After development of resistance among mosquitoes to insecticides, the Malaria Control Programme was switched over to the Malaria Eradication Programme. Malaria incidence dropped heavily. However, due to the quick development of vector resistance and financial limitations, malaria came back and so did the Malaria Control Programme. P. falciparum and P.vivax are the most common species in Indonesia. Important vectors are An. sundaicus, An. aconitus, An. maculatus, An. hyrcanus group, An. balabacensis, An. farauti etc. An. sundaicus and An. aconitus have developed resistance to DDT and Dieldrin in Java.

In 1959 the Malaria Eradication Programme was started in Java, Bali and Lampung. In 1965 the API dropped to 0,15 per thousand. From 1966 onwards malaria transmission was on the increase, because spraying activities were slowed down, but dropped again from 1974 onwards by occasional residual house spraying with DDT or Fenitrothion, malaria surveillance and treatment of malaria cases, resulting in an API of 0.18 per thousand in 1987. At present malaria is not transmitted in Jakarta and in capitals of the provinces and kabupatens, except in Irian Jaya, Nusa Tenggara Timur and one or two other provinces, but it still exists in rural areas. The distribution of chloroquine resistant P.falciparum is patchy. Resistance is at the RI, RII and RUT levels.

The main problems of malaria control are : the increasing development of resistance of the vector to insecticides, the change of An.aconitus from zoophili to anthropophili and from indoor to outdoor biting, the increasing resistance of P.falciparum to chloroquine, the shortage of skilled manpower and limitation of budget.

In Indonesia many newborns with congenital anomalies are found. T. gondii as one of the causes, is widely spread in man and animals. The prevalence of Toxoplasma antibodies in man varies from 2 % to 63 %, in cats and other animals it can reach up to 75%. Confirmed cases of congenital toxoplasmosis are reported. The diagnosis of toxoplasmosis in the Department of Parasitology, University of Indonesia is done with detection of specific IgM and IgG antibodies with ELISA. A test for antigenemia to get a rapid and direct diagnosis of active infection is not yet available. A suitable Toxoplasma vaccine to prevent toxoplasmosis would be desirable. E. histolytica infection is endemic throughout the archipelago. The prevalence rates are 18% to 25% . Extraintestinal infection mostly occurs in the liver. Pulmonary amebiasis is occasionally found. Medication with metronidazole has obtained good results. Diagnosis of extraintestinal amebiasis in our laboratory is by the immunodiffusion test, which is not capable to differentiate active infection from infection in the past. A more accurate diagnosis would be the use of monoclonal antibodies to detect antigens.


Protozoan parasites; Malaria parasites; Toxoplasma gondii; Entamoeba histolytica

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Buletin Penelitian Kesehatan (Bulletin of Health Research, p-ISSN: 0125-9695. e-ISSN: 2338-3453) is published by Badan Penelitian dan Pengembangan Kesehatan, Ministry of Health of Republic of Indonesia
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