{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T06:41:45Z","timestamp":1780641705507,"version":"3.54.1"},"reference-count":24,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2,7]]},"abstract":"<jats:p>Artemisinin combination therapy is recommended for the treatment of multidrug resistant <jats:italic>Plasmodium falciparum<\/jats:italic> and <jats:italic>Plasmodium vivax<\/jats:italic>. In March 2006, antimalarial policy in Indonesia was changed to a unified treatment with dihydroartemisinin-piperaquine for all species of malaria because of the low efficacy of previous drug treatments. In 2013, a randomized cross-sectional household survey in Papua was used to collect data on demographics, parasite positivity, treatment-seeking behavior, diagnosis and treatment of malaria, and household costs. Results were compared with a similar survey undertaken in 2005. A total of 800 households with 4,010 individuals were included in the 2013 survey. The prevalence of malaria parasitemia was 12% (348\/2,795). Of the individuals who sought treatment of fever, 67% (66\/98) reported attending a public provider at least once compared with 46% (349\/764) before policy change (<jats:italic>P<\/jats:italic> &lt; 0.001). During the 100 visits to healthcare providers, 95% (95) included a blood test for malaria and 74% (64\/86) resulted in the recommended antimalarial for the diagnosed species, the corresponding figures before policy change were 48% (433\/894) and 23% (78\/336). The proportion of individuals seeking treatment more than once fell from 14% (107\/764) before policy change to 2% (2\/98) after policy change (<jats:italic>P<\/jats:italic> = 0.005). The mean indirect cost per fever episode requiring treatment seeking decreased from US$44.2 in 2005 to US$33.8 in 2013 (<jats:italic>P<\/jats:italic> = 0.006). The implementation of a highly effective antimalarial treatment was associated with better adherence of healthcare providers in both the public and private sectors and a reduction in clinical malaria and household costs.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0680","type":"journal-article","created":{"date-parts":[[2017,12,27]],"date-time":"2017-12-27T07:00:34Z","timestamp":1514358034000},"page":"543-550","source":"Crossref","is-referenced-by-count":21,"title":["Treatment-Seeking Behavior after the Implementation of a Unified Policy of Dihydroartemisinin-Piperaquine for the Treatment of Uncomplicated Malaria in Papua, Indonesia"],"prefix":"10.4269","volume":"98","author":[{"given":"Angela","family":"Devine","sequence":"first","affiliation":[{"name":"Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand;"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enny","family":"Kenangalem","sequence":"additional","affiliation":[{"name":"Timika Malaria Research Program, Papuan Health and Community Development Foundation, Timika, Papua, Indonesia;"},{"name":"Mimika District Health Authority, Timika, Papua, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faustina Helena","family":"Burdam","sequence":"additional","affiliation":[{"name":"Mimika District Health Authority, Timika, Papua, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas M.","family":"Anstey","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne Rini","family":"Poespoprodjo","sequence":"additional","affiliation":[{"name":"Timika Malaria Research Program, Papuan Health and Community Development Foundation, Timika, Papua, Indonesia;"},{"name":"Mimika District Health Authority, Timika, Papua, Indonesia;"},{"name":"Department of Child Health, Faculty of Medicine, University Gadjah Mada, Yogyakarta, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ric N.","family":"Price","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom;"},{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunmay","family":"Yeung","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","author":"Statistics Indonesia (Badan Pusat Statistik\u2014BPS), National Population and Family Planning Board (BKKBN), Kementerian Kesehatan, (Kemenkes\u2014MOH), ICF International","year":"2013"},{"key":"b2","author":"World Health Organization","year":"2015"},{"key":"b3","series-title":"PLoS One","first-page":"e0160917","article-title":"Asymptomatic vivax and falciparum parasitaemia with helminth co-infection: major risk factors for anaemia in early life","volume":"11","author":"Burdam","year":"2016"},{"key":"b4","series-title":"PLoS One","first-page":"e0165340","article-title":"Submicroscopic and asymptomatic Plasmodium parasitaemia associated with significant risk of anaemia in Papua, Indonesia","volume":"11","author":"Pava","year":"2016"},{"key":"b5","series-title":"Trans R Soc Trop Med Hyg","first-page":"351","article-title":"Therapeutic response of multidrug-resistant Plasmodium falciparum and P. vivax to chloroquine and sulfadoxine-pyrimethamine in southern Papua, Indonesia","volume":"101","author":"Ratcliff","year":"2007"},{"key":"b6","series-title":"Am J Trop Med Hyg","first-page":"416","article-title":"Very high risk of therapeutic failure with chloroquine for uncomplicated Plasmodium falciparum and P. vivax malaria in Indonesian Papua","volume":"68","author":"Sumawinata","year":"2003"},{"key":"b7","series-title":"Antimicrob Agents Chemother","first-page":"3947","article-title":"Therapeutic efficacies of artesunate-sulfadoxine-pyrimethamine and chloroquine-sulfadoxine-pyrimethamine in vivax malaria pilot studies: relationship to Plasmodium vivax dhfr mutations","volume":"46","author":"Tjitra","year":"2002"},{"key":"b8","series-title":"Lancet","first-page":"757","article-title":"Two fixed-dose artemisinin combinations for drug-resistant falciparum and vivax malaria in Papua, Indonesia: an open-label randomised 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prevalence, drug resistance and control in Indonesia","volume":"74","author":"Elyazar","year":"2011"},{"key":"b13","author":"ORC Macro","year":"2005"},{"key":"b14","author":"StataCorp","year":"2015"},{"key":"b15","author":"R Core Team","year":"2015"},{"key":"b16","series-title":"BMC Genet","first-page":"94","article-title":"Discriminant analysis of principal components: a new method for the analysis of genetically structured populations","volume":"11","author":"Jombart","year":"2010"},{"key":"b17","author":"OECD","year":"2017"},{"key":"b18","author":"OANDA","year":"2005"},{"key":"b19","author":"The World Bank","year":"2015"},{"key":"b20","series-title":"Soc Sci Med","first-page":"501","article-title":"A critical review of behavioral issues related to malaria control in sub-Saharan Africa: what contributions have social scientists made?","volume":"59","author":"Williams","year":"2004"},{"key":"b21","author":"ACTwatch Group and PSI\/Cambodia","year":"2011"},{"key":"b22","author":"ACTwatch Group and PSI\/Myanmar","year":"2012"},{"key":"b23","author":"Population Services International and ACTwatch","year":"2015"},{"key":"b24","author":"Mimika DHO","year":"2005"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/98\/2\/article-p543.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/98\/2\/article-p543.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/98\/2\/article-p543.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T23:04:45Z","timestamp":1722467085000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/98\/2\/article-p543.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,7]]},"references-count":24,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.17-0680","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,7]]}}}