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All Journal Jurnal Kesehatan Lingkungan indonesia Media Kesehatan Masyarakat Indonesia JURNAL KESEHATAN LINGKUNGAN (Journal of Environmental Health) Public Health of Indonesia Jurnal Kedokteran dan Kesehatan Jurnal Nasional Ilmu Kesehatan International Journal of Nursing and Health Services (IJNHS) Jurnal Ilmu Kesehatan Indian Journal of Forensic Medicine & Toxicology JKMM ENVIRONMENTAL OCCUPATIONAL HEALTH AND SAFETY JOURNAL Hasanuddin Journal of Public Health Journal of Public Health and Pharmacy Ruang Komunitas : Jurnal Pengabdian Masyarakat
Anwar Mallongi
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Humanities Civil Engineering, Building, Construction & Architecture Dentistry Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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Non-adherence to medication, malaria relapse, and asymptomatic reservoirs in malaria transmission: A narrative review Sahiddin, Muhamad; Ishak, Hasanuddin; Arsin, Andi Arsunan; Mallongi, Anwar; Arsyad, Muhammad; Hamid, Firdaus
Public Health of Indonesia Vol. 11 No. 4 (2025): October - December
Publisher : YCAB Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36685/phi.v11i4.1032

Abstract

Background: Malaria elimination remains a pressing global health priority, yet progress is hindered by interconnected human-driven factors that sustain residual transmission. Objectives: This review aims to integrate and analyze key factors driving residual malaria transmission, particularly non-adherence to anti-malarial medication, relapse of Plasmodium vivax and P. falciparum infections, and the persistence of asymptomatic parasite reservoirs. Methods: A narrative review was conducted by synthesizing findings from peer-reviewed studies, including observational studies, clinical trials, and program evaluations. Relevant articles were identified through PubMed, Scopus, Google Scholar, and Web of Science databases. Results: Demographic, behavioral, and health system factors were consistently associated with incomplete treatment, which in turn doubled relapse risk and extended the duration of gametocyte carriage. Biological factors, such as dormant hypnozoites and CYP2D6 polymorphisms that reduce primaquine metabolism, increased the likelihood of recurrent infections. Additionally, asymptomatic carriers disproportionately younger and mobile populations sustained transmission beyond the reach of routine surveillance. Unlike previous reviews that examined these factors separately, this review integrates them into a unified framework, emphasizing their synergistic effects on residual transmission and identifying leverage points for targeted interventions. Conclusion: Addressing residual malaria transmission requires coordinated strategies, including community-supervised or directly observed radical cure regimens, genotype-informed dosing strategies, molecular surveillance for asymptomatic infections, and culturally tailored adherence support. These interventions are essential to strengthen malaria elimination programs and advance progress toward national and global goals by 2030. Keywords: adherence medication; relapse; transmission; endemic; malaria
Co-Authors A. Indahwaty Sidin A.Indahwaty Sidin Achmad Indra Awaluddin Adityawarman, Raihan Muammar Iffat Adziim, A. Muh. Faudzul Agus Bintara Birawida Aminuddin Syam Amqam, Hasnawati Andi Arsunan Arsin Andi Jamalina Andriyani Andriyani Anwar Daud Anwar Daud Ary Handayani Asih, Erny Balebu, Dwi Wahyu Bidullah, Ramli Burhanuddin Bahar Erniyasih, Erniyasih Ernyasih, Ernyasih Ernyasih, Ernyasih Fajar Septian Anwar Fajrini, Fini Fini Fajrini Firda Ayu Salsabilla Firmansyah, Andi Yudia Sari Gilang Anugerah Munggaran Gracia Victoria Souisa, Gracia Victoria Hamid, Firdaus Hasan Hasyim Hasanuddin Ishak Hasnawati Amqam Herawati Herawati hidayat hidayat Ilmansyah, Salsabila Tamara Putri Irmawati, St. Lusida, Nurmalia Lutfiah Lutfiah M Alimin Maidin Mahatma Lamuru Makmur Selomo Maldi Prasetyo Maming Maria Kanan Megasari, Wa Ode Muammar Muammar Muh. Fajaruddin Natsir Muhammad Arsyad Muhammad Hatta Mukono Munaya Fauziah Noor Latifah Nur Juliana Nurfatmala Nurfatmala Nurmalia Lusida Putri, Vivinda Trisnowati R Silalahi, Steven Rabbaniyah, Rabbaniyah Rahman, Muhammad Abeliandri Ramadani, Asty Suci Ridwan Amiruddin ridwan haerun Ruslan La Ane, Ruslan La Sahiddin, Muhamad Sakati, Sandy Novriyanto Sessu, We Ya’dilu Tenri SG, Hardiman Shabrina Vashtinia Putri Tryanda Sila, Nurlia Stang Stang Sumarni Sumarni Taufiqurrochman, Taufiqurrochman Tjowari, Elizabeth Lydia Todingan, Melisa Wesam AL Madhoun Winalda Eka Pratiwi YULIATI