PARASITOLOGICAL SURVEY IN GORONTALO NORTH SULAWESI, INDONESIAt E.E. STAFFORD, S. MASRI and K. SORENSEN U.S. Naval Medical Research Unit No.2, Jakarta Detachment, APO San Francisco 96356. INTRODUCTION area are primarily fishermen and traders, although some coconut and clove cultivation In Indonesia autochthonous human Schisto­ is b::ing attempted. Apparently there has soma japonicum has been reported only from been no controlled immigration into the area the Lindu and Napu valleys of Central Sula­ and the population consists of indigenous wesi (Celeb::s). Examination of stools of mountain people who are predominantly of more than 5,000 persons from other areas of the Moslem religion. Central and South Sulawesi failed to reveal schistosome ova except from individuals who MATERIALS AND METHODS had lived or visited the endemic areas (Sudo­ mo and Carney, 1974). Nevertheless, efforts Capillary blood was obtained from finger at further delineating the distribution of this . tips between the hours of 2000 and 2400. debilitating pathogen are required and this Thick and thin malaria smears were made paper presents prevalences of human intesti­ onto glass microscope slides and air dried for nal and blood parasites from the Gorontalo 12 hours. Thin smears were fixed in methanol area of North Sulawesi. This study is a con·· and both thin and thick smears were stained tinuation of a series of such projects by in 3-4 per cent Giemsa (PH 6.8 - 7.2) for 1 NAMRU-2 and the Directorate General of hour. The thick preparation dehaemoglo­ Communicable Disease Control of the Indo­ binized while staining. Thick smears for nesian Ministry of Health. microfilariae examination were prepared by dispersing 20 ~Ll of heparinized capillary blood DESCRIPTION OF AREA onto glass microscope slides and drying for 12 hours. These preparations were dehemoglo­ Villages surveyed were Bilungala, Tam­ binized for 10 minutes with tap water, dried, bulilato and Taludaa southeast of the muni­ fixed in methanol and stained with Giemsa. cipality of Gorontalo on the Minahasa penin­ At the time of blood collections, subjects sula of North Sulawesi (Fig. 1). The study were given stool boxes and instructed to area is situated north of the equator (120°12'­ return the following day with a sample of 123°28'E, 00°18' - 00023'N) in a low coastal their faeces. One or two grams of faeces was area (altitude 10 m) bordering the Molucca placed into screw cap vials containing 15 ml sea. Inhabitants of this sparsely populated of 10% formalin and mixed thoroughly. tThis study was supported through funds provided Specimens were subsequently examined by by the Naval Medical Research and Dave]opment Command,NavyDepartmentforWork Unit MR041.­ direct and formalin-ether concentration 09.01-143. methods. The opinions and ass~rtions contained herein are those of the authors and are not to be construed as official or as reflecting the views of the Navy Depart­ RESULTS ment or the Naval Service at large. Reprint requests toPublicationsOffice,NAMRU-2, A total of 156 stool specimens were exa­ Box 14, APO'San Francisco 96262 or 7-1 Kung Yuan Road, Taipei, Taiwan. mined. Table 1 lists prevalences of parasites Vol. 7 No. 3 September 1976 405 SOUTHEAST ASIAN J. TROP. MED. PUB. HLTH. 45' 123°E 15' 30' 45' , --­' ..... , ..... NORTH SULAWESI , Limboti \ Lake .... , ,--------"... I °30' N L---------.. 1030'N ~~"",....., ,.....,,....., ,....",....., TOMINI BAY f"J"""";""'",...., ,...., ,...." q '" 0° 0° SULAWESI 0 ~ IRIAN i JAYA I 11 'Wo­ ~ '\ (. , c:P.cl o '(, ~oa=~=:'2P D 1000E IIOOE 1200E 130"E 1400E Fig. I-The Gorontalo Region of North Sulawesi. from the three villages surveyed while Table 2 A. lumbricoides and T. trichiura occurred lists the distribution by age, sex, and the total commonly in alI groups as did hookworm, or overall prevalences. The most common however, the prevalence of hookworm helminths were Trichuris trichiura (79%) appeared to increase with advancing age and followed by Ascaris lumbricoides (72%), A. lumbricoides and T. trichiura either hookworm (54%) and dicrocoeliid-like egg occurred at a constant rate throughout or (25 %). Enterobius vermicularis was found in declined in older age groups (Table 2). The 3 %of the stools examined. occurrence of E. vermicularis appears not to Entamoeba coli (19%) was the most pre­ be affected by age, but the presence of dicro­ valent intestinal protozoan while the preva­ coeliid-like ova was much more pronounced lence rates of other intestinal protozoans were in the 50 year age group (60%). There was Entamoeba histolytica (10%), Iodamoeba little correlation between age and the pre­ biitschlii (6%), Endolimax nana and Giardia valence of E. histolytica; E. coli, E. nana, I. lamblia (5%) and Chilomastix mesnili (1%). biitschlii, G. lamblia or C. mesnili, but a decline in the prevalence of most intestinal Most parasites were evently distributed protozoa was seen in persons in the 50 year between the sexes although hookworm, age group. occurred more frequently in males (males 65%, females 42%) and G. lamblia more common Two hundred twenty-six blood films were in females (females 8 %, males 2%). examined for evidence of filariasis and 6 % 406 Vol. 7 No. 3 September 1976 PARASITOLOGICAL SURVEY IN GORONTALO, SULAWESI Table 1 Prevalences of intestinal and blood parasites in populations in three villages in Gorontalo, North Sulawesi, Indonesia. Parasite Taludaa Tambulilato Bilungala Total Intestinal (99)* (30) (27) (156)* Entamoeba histolytica 11 %** 10% 4% 10% Entamoeba coli 19 20 19 19 Endolimax nana 8 0 0 5 Iodamoeba biitschlii 4 7 11 6 Giardia lamblia 5 3 7 5 Chilomastix mesnili 1 0 0 1 Ascaris lumbricoides 78 50 74 72 Trichuris trichiura 78 83 78 79 Hookworm 67 43 22 54 Enterobius vermicularis 3 3 0 3 Dicrocoeliid-like ova 13 70 19 25 Blood Brugia malayi (90)*­ (39) (97) (226)* 2% 21% 4% 6% Plasmodium Jalciparum (121) (40) (102) (263) 0 0 1% 1% ( )* Number examined, ** Percentages to nearest whole number .. were positive for microfilariae of Brugia ma­ however, indicate that the trematode is not layi (Table 1). The village of Tambulilato present. Human infections were not detected had the highest prevalence (21 %) with infec­ by stool examination, nor were small mam­ tions occurring' more commonly in males mals collected and examined found infected. (9 %) than females (4 %) in the older age Furthermore, no oncomelanid snails were groups (Table 2). Only one person of 263 found. examined had Plasmoidum Jalciparum. This infection occurred in a male in the 10-19 age The prevalences of other intestinal parasites group from the village of Bilungala. did not vary remarkably from the results of other such surveys conducted in Sulawesi DISCUSSION (Cross et al., 1972; Carney et al., 1974a,b; Clarke et al., 1974). Infections were generally Since the Minahasa peninsula of North distributed evenly between the sexes and Sulawesi is situated ge.ographically between among different age groups with the single two endemic foci of S. japonicum (Mindanao exception of the high prevalence of dicro­ in the Philippines and the Lindu and Napu coeliid-like ova. These ova were equally pre­ Valleys of Central Sulawesi), the area could sent in males and females and in all age groups also be suspected as being endemic for, the 'but tended to become more common in older parasite. The results of this limited survey persons. Vol. 7 No.. 3 September 1976 407 ~ 00 Table 2 Prevalences of intestinal and blood parasites by age and sex in three villages populations in Gorontalo, North Sulawesi, Indonesia. Age in years Sex Parasite Total 0-9 10-19 20-29 30-39 40-49 50- Male Female Vl ----. 0 Intestinal (33)* (44) (27) (20) (17) (15) (83)* (73) (156)* c::., ;I; Entamoeba histolytica 12%** 9% 11% 10% 0 13% 10% 10% 10% »m Entamoeba coli 18 25 19 25 18 0 22 16 19 .,'" ;> Endolimax nana 3 2 7 10 12 0 4 7 5 :;'" Iodamoeba biitschlii 9 7 7 0 6 0 5 7 6 z <..; Giardia lamblia 6 9 0 5 0 7 2 8 5 >-l ;;0 Chilomastix mesnili 0 0 4 0 0 0 1 0 1 0 '0 Ascaris lumbricoides 88 77 74 60 71 33 71 73 72 ~ Trichuris trichiura 97 77 59 75 76 87 81 77 79 m ~ Hookworm 30 55 70 60 59 67 65 42 54 c:: Enterobius vermicularis 6 0 4 0 0 7 2 3 3 ?''" Dicrocoeliid-like ova 9 25 19 35 24 60 25 25 25 ::r:: Sl ~ -< Blood 2- Brugia malayi (44)* (93) (31) (22) (18) (18) (117)* (109) (226)* -...l 2% 5% 0 5% 17% 17% 9%** 4% 6%* Z Plasmodium Jalciparum (47)* (106) (39) (25) (25) (21) (136) (127) (263) 0 w 0 1% 0 0 0 0 1% 0 1% Vl ( )* Number examined. '9. ** Percentages to nearest whole number. (p 3 cr' ..,(p ...... \0 a­-...l PARASITOLOGICAL SURVEY IN GORONTALO, SULAWESI Digenetic trematodes from the family malayi microillariae were detected in persons Dicrocoeliidae are parasitic in the biliary from Margolembo in the Luwu regency of passages of sheep, goats and other herbivo­ South 'Sulawesi (partono et al., 1972) and rous and omnivorous mammals throughout from the Lindu Valley in Central Sulawesi the world. Infections with Dicrocoelum (Clarke et aI., 1974). Similarly, only B. dendriticum have been reported in Asia, and malayi microfilariae were recovered from while the majority of these were considered persons in the present study and the pre­ spurious, some were genuine as determined by valences compared to other studies has controlled diets (Faust and Russell, 1964). varied; Partono et al., (1972) reported a pre­ Carney et al., (1975) reported dicrocoeliid-like valence of 0.6-33%, Clarke et al., (1974) ova in human stools from Timor, Indonesia approximately 5.%, and the present findings, and suggested that these were spurious infec­ 6%.