Comparison of Characteristics in Children and Adult Living in

Malaria Endemic Area

Ayodhia Pitaloka Pasaribu, Syahril Pasaribu

Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

Keywords: Malaria, children, adult.

Abstract: Malaria is still a public health problem worldwide with nearly 500,000 death cases in 2014. Indonesian

government has put a lot of efforts to achieve malaria elimination in 2030. Defining characteristics of the

people living in malaria endemic area will help achieving better malaria control. We did a descriptive study

in Tanjung Leidong, Labuhanbatu Utara, Indonesia and screened 67 subjects who came to the health centre.

We analyzed the data using STATA ver 15.1. We found that 28 subjects were positive for malaria, among

those 11 were children and 17 were adults. Parasitaemia was slightly higher in children compared to adult.

Haemoglobin level in adult was slightly higher than in children. We conclude that malaria in Tanjung Leidong

is more common in adult with milder symptom than in children.

1 INTRODUCTION

Despite all the efforts toward malaria elimination,

malaria is still one of public health problem in the

world with more than half a million people die in

2014 (WHO, 2014). Indonesia is one of malaria

endemic countries that determined to achieve

elimination in 2030 and has generally succeeded in

reducing malaria cases over these few decades

(MoHoR, 2016), however malaria still remains

endemic in some regions, including North Sumatera,

in western part of Indonesia. In 2010, we still found

around 300 malaria cases in Tanjung Leidong

District, Labuhanbatu Utara Regency (Pasaribu et al.,

2013). To have a successful malaria control, all

aspects involving host, agent and environment have

to be covered (Paaijmans et al., 2010). One strategy

to combat malaria is through understanding the

epidemiology and characteristics of the host, in

endemic areas it means the people living in the

community (CDC, 2012). The aim of this study is to

compare the possible characteristics occur both in

children and adult to develop the specific strategy for

malaria control.

2 METHODS

In between June-July 2018, we screened 67 subjects

who came to the health center with fever or history of

fever. Personal information such as age, sex,

temperature and occupation were collected. Blood

was collected from finger prick and examined for

hemoglobin level and malaria examination.

Diagnosis of malaria was done by rapid diagnostic

test then confirmed by microscopy. Malaria blood

smear was made according to the World Health

Organization procedure (WHO, 2010). Malaria

smears was read by a certified microscopist.

Data were analyzed using STATA ver 15.1.

Descriptive data was presented as percentage, mean

and standard deviation.

This study has been approved by the Ethics

Committee of Medical Faculty, Universitas Sumatera

Utara/H. Adam Malik General Hospital.

3 RESULTS

From 67 subjects screened, we found 28 (41.79%)

were positive for vivax malaria. Plasmodium vivax is

the only malaria species found in this study. Among

those 28 subjects, 11 were children and 17 were adult

(figure 1).

Mean age for children was 9.25 years and 32.8

years for adult. Mean body temperature was 37.6

for children and 37.4

C for adult. The characteristics

of subjects are explained in table 1.

Pasaribu, A. and Pasaribu, S.

Comparison of Characteristics in Children and Adult Living in Malaria Endemic Area.

DOI: 10.5220/0010083306730675

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

673-675

ISBN: 978-989-758-449-7

673

Figure 1: Trial profile.

Mean temperature in subjects with malaria was

38.3

C compared to 36.7

C without malaria. There

were 32 subjects came to the health center with fever,

and all positive for malaria was having fever at the

time of admission (28/32).

Table 1: Subject characteristic comparison between

children and adult.

Subject profile Children Adult

Sex (N,%) N= 24 N=43

Female 10

(

41.67

)

(

41.86

)

Male 14

(

58.33

)

(

58.14

)

Malaria

(

N,%

)

N=24 N=43

Positive 11 (45.83) 17 (39.53)

Negative 13 (54.17) 26 (58.14)

Body weight

(

mean,SD,k

N=23, 21.87

(

9.16

)

N=41, 55.80

(

17.49

)

Age

(

mean,SD,

ear

)

N=24, 9.25

(

3.30

)

N= 43, 32.8

(

13.51

)

Temperature

(mean,SD,

N=24, 37.6

(0.88)

N=43, 37.4

(0.92)

From the laboratory result we found that the mean

haemoglobin level in malaria subjects are comparable

to nonmalaria (12.2gr/dL vs 12.9gr/dL). The mean

haemoglobin level in children was lower than adult

(11.65gr/dL vs 13.22gr/dL). Mean asexual parasite in

children was 209.67/µL compared to adult

1578.61/µL. The finding of laboratory examination is

shown in table 2.

Table 2: Comparison of laboratory examination between

children and adult.

Laboratory

rofile

Children Adult

Haemoglobin

(

mean,SD,

r/dL

)

N=24, 11.65

(

1.48

)

N=41, 13.22

(

1.19

)

Asexual

parasitemia

(

mean,SD,/

)

N=11, 2096,67

(4093.55)

N=17, 1578.61

(3389.85)

Sexual

parasitemia

(

mean,SD,/

)

N=11, 660

(845.41)

N=17, 794.42

(1234.07)

4 DISCUSSION

Malaria remains one of the greatest public health

problem in the world (WHO, 2014). In Indonesia, the

government has committed to achieve malaria

elimination in 2030. Many efforts has been done and

we can see declining number of malaria cases and

malaria free in Java island, however, there are still

many works need to be done for Sumatera and east

Indonesia (MoHoR, 2016).

In our study, we found that more malaria cases

were found in adult compared to children. This

finding is similar to the study done in China in 2012-

2014 where adult age between 35-49 years are the

predominant age group (Xu et al., 2016). This is

because adult go outside the house more often than

children eq. for work.

The study done by Kwak et al. (2013) in Korea

found that about 98.8% subjects who had malaria

were having fever. This similar result is also found in

our study where all of our malaria subjects came to

the health centre with fever.

In previous study done by Camargo et al. (2018),

the mean parasitaemia found was below 2000

parasite/µL, while in our study, we found that

parasitaemia was higher in children (>2000

parasite/µL) compared to adult (<2000 parasite/µL).

This can be explained by the partial immunity that

adult has but not in children.

Our finding showed that haemoglobin level in

adult was higher compared to children. This is similar

to the result from the study done by Siqueira et al.

(2014) that showed children haemoglobin level was

lower.

5 CONCLUSIONS

Malaria affects more commonly in adult than in

children, however the symptom and lab result in adult

is milder than in children.

ACKNOWLEDGEMENTS

We would like to thank Directorate of Research,

Technology and Higher Education (RISTEKDIKTI)

for providing us the grant from DRPM scheme 2018

to do this study.

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

674

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