| Summary: | <p>Abstract</p> <p>Background</p> <p>Multidrug resistance has emerged to both <it>Plasmodium vivax </it>and <it>Plasmodium falciparum </it>and yet the comparative epidemiology of these infections is poorly defined.</p> <p>Methods</p> <p>All laboratory-confirmed episodes of malaria in Timika, Papua, Indonesia, presenting to community primary care clinics and an inpatient facility were reviewed over a two-year period. In addition information was gathered from a house-to-house survey to quantify the prevalence of malaria and treatment-seeking behaviour of people with fever.</p> <p>Results</p> <p>Between January 2004 and December 2005, 99,158 laboratory-confirmed episodes of malaria were reported, of which 58% (57,938) were attributable to <it>P. falciparum </it>and 37% (36,471) to <it>P. vivax</it>. Malaria was most likely to be attributable to pure <it>P. vivax </it>in children under one year of age (55% 2,684/4,889). In the household survey, the prevalence of asexual parasitaemia was 7.5% (290/3,890) for <it>P. falciparum </it>and 6.4% (248/3,890) for <it>P. vivax</it>. The prevalence of <it>P. falciparum </it>infection peaked in young adults aged 15–25 years (9.8% 69/707), compared to <it>P. vivax </it>infection which peaked in children aged 1 to 4 years (9.5% 61/642). Overall 35% (1,813/5,255) of people questioned reported a febrile episode in the preceding month. Of the 60% of people who were estimated to have had malaria, only 39% would have been detected by the surveillance network. The overall incidence of malaria was therefore estimated as 876 per 1,000 per year (Range: 711–906).</p> <p>Conclusion</p> <p>In this region of multidrug-resistant <it>P. vivax </it>and <it>P. falciparum</it>, both species are associated with substantial morbidity, but with significant differences in the age-related risk of infection.</p>
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