The history and current epidemiology of malaria in Kalimantan, Indonesia

Abstract

Kalimantan is a part of Indonesia, which occupies the southern three-quarters of the island of Borneo, sharing a border with the Malaysian states of Sabah and Sarawak. Although most areas of Kalimantan have low and stable transmission of Plasmodium falciparum and Plasmodium vivax, there are relatively high case numbers in the province of East Kalimantan. Two aspects of malaria endemicity in Kalimantan differentiate it from the rest of Indonesia, namely recent deforestation and potential exposure to the zoonotic malaria caused by Plasmodium knowlesi that occurs in relatively large numbers in adjacent Malaysian Borneo. In the present review, the history of malaria and its current epidemiology in Kalimantan are examined, including control and eradication efforts over the past two centuries, mosquito vector prevalence, anti-malarial use and parasite resistance, and the available data from case reports of knowlesi malaria and the presence of conditions which would support transmission of this zoonotic infection.

Keywords: Epidemiology; History; Kalimantan; Malaria; Plasmodium knowlesi.

Fig. 1

Kalimantan map showing its five provinces and relationship to Malaysian Borneo

Fig. 2

Age distribution of malaria notifications in Kalimantan in 2019 and 2020

Fig. 3

Mapping of Anopheles spp. distribution in Indonesian Kalimantan (adapted from Elyazar et al. [69])

Fig. 4

Map of Plasmodium knowlesi malaria risk on the island of Borneo as adapted from Shearer et al. [73]. The darker the shaded area, the higher the risk