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Polymorphisms in the Aminolevulinic Acid Dehydratase (ALAD) gene responsible for the ALAD1 and ALAD2 alleles have been implicated in susceptibility to lead toxicity. This study aimed to determine the allelic frequency of ALAD2 among children living in Bogor District, Indonesia, and its association with blood lead levels (BLLs) and lead toxicity. A cross-sectional study involving 128 children was conducted during September-October 2019 in the former ULAB area in Cinangka Village. The ALAD polymorphism, BLLs, and hematological parameters were evaluated. Blood samples were taken for dried blood spotting on filter paper, blood film, and BLL measurement. The PCR amplification and sequencing of the genomic DNA revealed the presence of two forms of the ALAD2 allele: 177C and 177T with a frequency of 0.05. Analysis of the correlation between the ALAD2 allele, BLLs, and basophilic stippling revealed that ALAD2 carriers had a five times higher risk of high BLLs, (OR = 5.359, p-value = 0.155) and had a slightly higher risk of exhibiting basophilic stippling (OR = 1.09, p-value = 1.000). Although not statistically significant, these findings suggested that the ALAD genotype may modify BLLs and lead to toxicity. The ALAD2 allele (177T) is firstly reported in any population in the world. [ABSTRACT FROM AUTHOR]

Abstract Background Sabang Municipality, in Aceh Province, Indonesia, plans to initiate a malaria elimination programme in 2013. A baseline survey of the distribution of malaria in the municipality was conducted to lay the foundations for an evidence-based programme and to assess the island’s readiness to begin the elimination process. Methods The entire population of the municipality was screened for malaria infection and G6PD deficiency. Specimens collected included blood slides, blots and tubes for selected households. Results and Discussion Samples were collected from 16,229 residents. Microscopic examination of the blood smears revealed 12 malaria infections; 10 with Plasmodium falciparum and 2 with Plasmodium vivax. To confirm the parasite prevalence, polymerase chain reaction (PCR) diagnosis was performed on the entire positive cases by microscopy and randomized 10% of the microscopically negative blood samples. PCR revealed an additional 11 subjects with malaria; one P. falciparum infection from the village of Paya Keunekai, and nine P. vivax infections and one mixed P. falciparum/P. vivax infection from the village of Batee Shok. The overall slide positivity rate was 0.074% (CI 95%: 0.070 – 0.078) and PCR corrected prevalence 0,590% (CI 95%: 0.582 – 0.597). Analysis of 937 blood samples for G6PD deficiency revealed two subjects (0.2%) of deficient G6PD. Analysis of several genes of the parasite, such as Pfdhfr, Pfdhps, Pfmdr1, Pfcrt, Pfmsp1, Pfmsp2, Pvdhfr, Pvdhps, Pvmdr1 and host gene, such as G6PD gene revealed that both P. falciparum and P. vivax carried the mutation associated with chloroquine resistance. Conclusion Malariometric and host genetic analysis indicated that there is a low prevalence of both malaria and G6PD deficiency in the population of Sabang Municipality. Nevertheless, malaria cases were clustered in three rural villages and efforts for malaria elimination in Sabang should be particularly focused on those three villages.

Background: The decline in intensity of malaria transmission in many areas now emphasizes greater importance of understanding the epidemiology of low to moderate transmission settings. Marked heterogeneity in infection risk within these populations creates opportunities to understand transmission and guide resource allocation to greater impact., Methods: In this study, we examined spatial patterns of malaria transmission in a hypo- to meso-endemic area of eastern Indonesia using malaria prevalence data collected from a cross-sectional socio-demographic and parasitological survey conducted from August to November 2010. An entomological survey performed in parallel, identified, mapped, and monitored local anopheline larval habitats., Results: A single spatial cluster of higher malaria prevalence was detected during the study period (relative risk=2.13; log likelihood ratio=20.7; P<0.001). In hierarchical multivariate regression models, risk of parasitemia was inversely correlated with distance to five Anopheles sundaicus known larval habitats [odds ratio (OR)=0.21; 95% confidence interval (CI)=0.14-0.32; P<0.001], which were located in a geographically restricted band adjacent to the coastline. Increasing distance from these sites predicted increased hemoglobin level across age strata after adjusting for confounders (OR=1.6; 95% CI=1.30-1.98; P<0.001)., Conclusion: Significant clustering of malaria parasitemia in close proximity to very specific and relatively few An. sundaicus larval habitats has direct implications for local control strategy, policy, and practice. These findings suggest that larval source management could achieve profound if not complete impact in this region.