Malaria and COVID-19

 Since December 2020 cases of pneumonia were found in several residents in Hubei, Wuhan, China, which was then identified as the SARS-CoV 2 virus or known as COVID-19, this infection has spread widely to almost all countries in the world thus  in March 2020 it was declared as a pandemic.

 The impact of COVID-19 infection on the health of the world's population is enormous, thus all efforts are being made to try to prevent and limit the spread of the disease. The entire focus and efforts of the State and the world are focused on COVID-19. This has an impact on efforts to eradicate other diseases, one of which is malaria. Efforts to eliminate malaria have been carried out since 50 years ago. These efforts are not easy because they have to face resistance to anti-malarial drugs. The standard medicine to treat malaria at this time is Artemisin combination therapy (ACT), but cases of ACT resistance have been reported in Cambodia, Thailand and several other countries in the world.

 The large impact of malaria in the form of high morbidity and mortality, especially faced by countries in Africa. The existence of the COVID-19 pandemic has certainly made the handling of malaria even more difficult. There is literature stating that malaria infection can be a significant comorbid for COVID-19. The presence of COVID-19 also makes it difficult for malaria patients to access health facilities. This incident does not only occur in Africa, which has a high malaria case, thus condition also found in several countries in the world including Indonesia.

The malaria endemic areas in Indonesia are dominated by the eastern part of Indonesia, among others, Papua NTT, West Papua, Maluku, North Maluku which have high endemicity. There is one province apart from Papua and NTT which has a district with high endemicity, namely East Kalimantan Province with the regency is Penajaman Paser Utara. In 2019, 250,644 cases were found, 86 percent of which occurred in Papua, namely 216,380 cases,  followed by NTT with 12,909 cases and West Papua Province with 7,079 cases. In Indonesia, several provinces have been declared malaria free, including DKI Jakarta, East Java, Bali.

Based on the data from the Ministry of Health, it is stated that there are 4 percent or 23 districts / cities and around 1.1 percent or 2.9 million Indonesians who are still living in areas with high potential for malaria infection. In areas with moderate and high endemicity of malaria, it will be very worrying especially in the current state of the COVID-19 pandemic, where hospital capacity is almost filled with COVID-19 patients.

Quoted from the Department of Health's Basic Health Research Data in the year of 2019, the following is a list of provinces and the number of districts/ cities were included  malaria endemicity category in the year 2019.

Central Java; 33 areas (districts / cities) free of malaria, 2 low endemic

• Aceh; 21 malaria free areas (elimination), 2 low endemic

•           West Sumatra; 17 malaria free areas (elimination), 1 low endemic

• Bangka Belitung Islands; there are 6 malaria free areas, 1 low endemic

•           West Java; there are 23 elimination areas, 4 low endemic

• Riau; 10 malaria-free areas, 2 low endemic

•           South Sulawesi; 20 malaria free areas, 4 low endemic

•           West Sulawesi; there are 5 malaria free areas, 1 low endemic

• Yogyakarta; there are 4 malaria free areas, 1 low endemic

• Banten; 6 malaria free areas, 2 low endemic

• Lampung; there are 11 malaria-free areas, 3 low endemic areas, 1 moderate endemic area

•           Central Kalimantan; 10 malaria free areas, 4 low endemic

• Jambi; there are 7 malaria free areas, 4 low endemic

•           North Sumatra; there are 21 malaria-free areas, 11 low endemic, 1 moderate endemic

•           South Borneo; 7 areas free of malaria, 6 low endemic

•           Southeast Sulawesi; 9 were malaria free, 7 were low endemic, 1 was moderate endemic

•           South Sumatra; 8 malaria-free areas, 9 low endemic

•           Riau islands; there are 3 malaria-free areas, 3 low endemic, 1 moderate endemic

•           North Sulawesi; there are 6 malaria free areas, 9 low endemic

•           Central Sulawesi; 5 malaria free areas, 8 low endemic

• Gorontalo; there are 2 malaria free areas, 4 low endemic

• Bengkulu; there are 3 malaria free areas, 7 are low endemic

•           West Nusa Tenggara; 3 malaria free areas, 7 low endemic

•           West Kalimantan; 3 elimination areas, 11 low endemic

•           East Kalimantan; there are 3 elimination areas, 5 low endemic, 1 moderate endemic, 1 high endemic

•           North Kalimantan; 1 elimination area, 4 low endemic

• North Maluku; 8 low endemic, 2 moderate endemic

• Maluku; 8 low endemic, 3 moderate endemic

•           East Nusa Tenggara; 15 low endemic, 4 moderate endemic, 3 high endemic

•           West Papua; there are 3 low endemic areas, 6 moderate endemic areas, 4 high endemic areas

• Papua; there are 4 low endemic, 10 moderate endemic, and 15 high endemic