Indonesia South-East Asia Region

I. Epidemiological profile
Population (UN) 2016 % Parasites and vectors
High transmission (> 1 case per 1000 population) 16,700,000 6 Plasmodium species: P. falciparum (62%), P.vivax (37%)
Low transmission (0-1 cases per 1000 population) 244,000,000 94 Major anopheles species: An. sundaicus, An. balabacensis, An. maculatus, An. farauti, An. subpictus, An. subpictus
Malaria-free (0 cases) - - Reported confirmed cases (health facility): 218,450 Estimated cases: 1,281,000 [1,004,000–1,643,000]
Total 261,100,000 Confirmed cases at community level: -
Reported deaths: 161 Estimated deaths: 2,200 [160–4,000]

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 2006 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 of 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 2010 Therapeutic efficacy tests (clinical and parasitological failure, %)
The sale of oral artemisinin-based monotherapies (oAMTs) Is banned 2010 Medicine Year(s) Min Median Max Follow-up No. of studies Species
Single dose of primaquine is used as gametocidal medicine for
P. falciparum Yes 2010

Primaquine is used for radical treatment of P. vivax Yes 2010

G6PD test is a requirement before treatment with primaquine No -
Directly observed treatment with primaquine is undertaken No - Insecticide resistance tests (mosquito mortality, %)
System for monitoring adverse reactions to antimalarials exists Yes 2016 Insecticide class Years Min Mean Max No. of sites Species

ACD for case investigation (reactive) Organochlorines 2011-2011 1 1 1 1 An. sundaicus s.l.
Surveillance Yes 1965
ACD of febrile cases at community level (pro-active) Organophosphates 2011-2014 0.9 1 1 10 An. barbirostris, An. subpictus s.l.,+ other
Yes 1965
Mass screening is undertaken Carbamates 2011-2016 0.7 1 1 26 An. barbirostris, An. subpictus s.l.,+ other
Yes 1965
Uncomplicated P. falciparum cases routinely admitted Pyrethroids 2011-2016 0.3 0.9 1 31 An. barbirostris, An. subpictus s.l.,+ other
Yes 1990
Uncomplicated P. vivax cases routinely admitted Yes 1990
Foci and case investigation undertaken No -
Case reporting from private sector is mandatory Yes 1984

III. Financing Sources of financing Government expenditure by intervention in 2016

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
0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

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 2016 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source: DHS 2007 Source: DHS 2012

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 2016 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
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)

2 12 200 0.4

10
1.5 150 0.3
Cases per 1000

Admissions

8
ABER (%)

Deaths

1 6 100 0.2

4
0.5 50 0.1
2

0 0 0 0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

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