Analysis Of The Dominant Factor That Influences The Events Of Malaria In The Hypoendemic Area In North Sumatra: Development Of The Prediction Model Of The Diagnosis Of Malaria Asymptomatic In Prime Health Services

Feb 27, 2025 by ADMIN 214 views

Analysis of the Dominant Factor that Influences the Events of Malaria in the Hypoendemic Area in North Sumatra: Development of the Prediction Model of the Diagnosis of Malaria Asymptomatic in Prime Health Services

Introduction

Malaria is a significant public health problem in many parts of the world, including Indonesia. In the hypoendemic area of North Sumatra, malaria is a major concern due to its potential to spread and cause outbreaks. Asymptomatic malaria, which is infected with malaria parasites without clinical symptoms, is a significant source of new transmission. The inability to detect and handle this condition can thwart malaria elimination efforts. Therefore, it is essential to develop a prediction model of diagnosis for asymptomatic malaria to detect and handle cases more effectively.

Background

Asymptomatic malaria detection is generally carried out with PCR, a more sensitive method than microscopic examination and RDT, because it checks greater blood volume. However, PCR is difficult to apply in primary health services. The biggest challenge now is the accuracy of the diagnosis to detect asymptomatic malaria, especially in primary health services. This study aims to build a risk factor model and diagnosis prediction model to detect asymptomatic malaria in the North Sumatra Hypoendemis region.

Methodology

This study was conducted in Batubara Regency, from March to December 2015. The research subject was observed for two weeks and two periods of malaria suffering. The diagnosis of malaria is established by a microscopic examination that uses a greater blood volume. Serial examination is carried out on the 2nd day (serial examination 1), day 8 (serial examination 2) and day 15 (serial examination 3).

Results

The results showed that 20.3% (188 people) positive subjects of asymptomatic malaria on the first microscopic examination, 3.7% (34 people) on serial examination 1 and 3% (28 people) on serial examination 2. Risk factors models, which Formed by factors such as age, the availability of malaria drugs, access to health workers, and the quality of the use of mosquito nets, can explain the occurrence of asymptomatic malaria by 76.5%. This model can be used as a guideline for intervention in risk factors. Increasing the proportion of each risk factor can cause an increase in malaria cases. The risk factor model can also be used as an indicator of serial examination in primary health services that do not have a laboratory, with diagnosis prediction capabilities reaching 73.3%(IK95%: 69.6%-76.9%).

Development of the Prediction Model of Diagnosis for Asymptomatic Malaria

The prediction model of asymptomatic malaria diagnosis is formed by factors such as the availability of malaria drugs, access to health workers, the quality of the use of mosquito nets, HB levels, eosinophils, neutrophils, lymphocytes, and monocytes. This model can be used as an indicator of serial inspection on primary services that have a laboratory, with detection capability reaching 94.6%(IK95%: 93.1%-96.1%).

Discussion

This study shows that the interaction between dominant factors affects asymptomatic malaria can be used as a prediction model of diagnosis and become an indicator in determining serial examination for asymptomatic malaria detection. This model can help health workers to detect and handle asymptomatic malaria cases more effectively, so that malaria elimination efforts can run more optimally.

Additional Analysis and Explanation

The Importance of Early Detection

This study shows that serial examination with certain intervals can increase the detection of asymptomatic malaria cases. This is important because the existence of asymptomatic cases can accelerate the spread of malaria.

The Role of Primary Health Services

This study shows that primary health services can play an important role in efforts to detect asymptomatic malaria, although it does not have a complete laboratory. The risk factor model can be used to identify individuals who are at high risk of asymptomatic malaria infected, so they can be further examined.

The Importance of Intervention

Risk factor models can be used as a basis for targeted interventions to reduce the rate of asymptomatic malaria transmission. Appropriate interventions include increasing access to malaria drugs, increasing access to health workers, and improving the quality of mosquito nets.

Conclusion

The development of the prediction model of diagnosis for asymptomatic malaria can be an effective tool for early detection and handling of asymptomatic malaria cases, especially in the hypoendemic region. This model can be used as a guideline for determining the right serial examination, as well as helping health workers to focus on high-risk groups. The use of this model is expected to increase the success of malaria elimination efforts in Indonesia.

Recommendations

Based on the findings of this study, the following recommendations are made:

The use of the risk factor model and prediction model of diagnosis for asymptomatic malaria should be implemented in primary health services in the hypoendemic area of North Sumatra.
Health workers should be trained to use the risk factor model and prediction model of diagnosis for asymptomatic malaria.
The availability of malaria drugs, access to health workers, and the quality of the use of mosquito nets should be improved in primary health services.
Serial examination with certain intervals should be carried out to increase the detection of asymptomatic malaria cases.

Limitations of the Study

This study has several limitations, including:

The study was conducted in a single regency in North Sumatra, which may not be representative of the entire hypoendemic area.
The study only included a small number of participants, which may not be representative of the entire population.
The study did not control for other factors that may affect the occurrence of asymptomatic malaria.

Future Research Directions

Future research should focus on:

Validating the risk factor model and prediction model of diagnosis for asymptomatic malaria in other regions.
Conducting a larger-scale study to increase the generalizability of the findings.
Investigating other factors that may affect the occurrence of asymptomatic malaria.

Conclusion

In conclusion, this study has shown that the development of the prediction model of diagnosis for asymptomatic malaria can be an effective tool for early detection and handling of asymptomatic malaria cases, especially in the hypoendemic region. The use of this model is expected to increase the success of malaria elimination efforts in Indonesia.
Q&A: Analysis of the Dominant Factor that Influences the Events of Malaria in the Hypoendemic Area in North Sumatra: Development of the Prediction Model of the Diagnosis of Malaria Asymptomatic in Prime Health Services

Frequently Asked Questions

Q: What is the main objective of this study?

A: The main objective of this study is to develop a risk factor model and diagnosis prediction model to detect asymptomatic malaria in the North Sumatra Hypoendemis region.

Q: What is asymptomatic malaria?

A: Asymptomatic malaria is infected with malaria parasites without clinical symptoms. It is a significant source of new transmission and can accelerate the spread of malaria.

Q: How is asymptomatic malaria detected?

A: Asymptomatic malaria detection is generally carried out with PCR, a more sensitive method than microscopic examination and RDT, because it checks greater blood volume.

Q: What are the challenges in detecting asymptomatic malaria?

A: The biggest challenge now is the accuracy of the diagnosis to detect asymptomatic malaria, especially in primary health services. PCR is difficult to apply in primary health services.

Q: What is the risk factor model?

A: The risk factor model is formed by factors such as age, the availability of malaria drugs, access to health workers, and the quality of the use of mosquito nets. It can explain the occurrence of asymptomatic malaria by 76.5%.

Q: What is the prediction model of diagnosis for asymptomatic malaria?

A: The prediction model of asymptomatic malaria diagnosis is formed by factors such as the availability of malaria drugs, access to health workers, the quality of the use of mosquito nets, HB levels, eosinophils, neutrophils, lymphocytes, and monocytes. It can be used as an indicator of serial inspection on primary services that have a laboratory, with detection capability reaching 94.6%(IK95%: 93.1%-96.1%).

Q: What are the implications of this study?

A: This study shows that the interaction between dominant factors affects asymptomatic malaria can be used as a prediction model of diagnosis and become an indicator in determining serial examination for asymptomatic malaria detection. This model can help health workers to detect and handle asymptomatic malaria cases more effectively, so that malaria elimination efforts can run more optimally.

Q: What are the recommendations of this study?

A: Based on the findings of this study, the following recommendations are made:

The use of the risk factor model and prediction model of diagnosis for asymptomatic malaria should be implemented in primary health services in the hypoendemic area of North Sumatra.
Health workers should be trained to use the risk factor model and prediction model of diagnosis for asymptomatic malaria.
The availability of malaria drugs, access to health workers, and the quality of the use of mosquito nets should be improved in primary health services.
Serial examination with certain intervals should be carried out to increase the detection of asymptomatic malaria cases.

Q: What are the limitations of this study?

A: This study has several limitations, including:

The study was conducted in a single regency in North Sumatra, which may not be representative of the entire hypoendemic area.
The study only included a small number of participants, which may not be representative of the entire population.
The study did not control for other factors that may affect the occurrence of asymptomatic malaria.

Q: What are the future research directions?

A: Future research should focus on:

Validating the risk factor model and prediction model of diagnosis for asymptomatic malaria in other regions.
Conducting a larger-scale study to increase the generalizability of the findings.
Investigating other factors that may affect the occurrence of asymptomatic malaria.