Reviewer #1: Dear Authors,

The manuscript really described the external factors such as behavioural and environmental factors
that can contribute to escalate malaria incidence in Muara Enim Regency.

I missed several tables mentioned in your manuscript such as Table 1, Table 3, Table 5, Table 7 and
Table 9. I wonder if these are Table 2, Table 4, Table 6, Table 8 and Table 10?

Also, you mentioned indigenous malaria cases in Muara Enim. I wonder if you have genotyped those
'indigenous' malaria parasite? I think you cannot just say indigenous unless you have genotyped the
malaria parasites from Muara Enim and genotype the 5 malaria cases claimed to be indigenous case
to be tested against those malaria parasites database from the area?

I need the authors to clarify several points:

1. Line 129, close/far of breeding places or cattle pens, please define close/far in meters/feet.

Jawab : Variabel Breeding Place, Cara Ukur ? Cara ukur : wawancara dan observasi langsung
dilapangan menggunakan GPS Essensials

Definition: Reference ???

Dekat jika jarak breeding place dalam radius <100 meter dari rumah.

Jauh, jika tidak terdapat tempat perindukan nyamuk atau berada pada radius >100 meter dari
rumah. (Seuk. 2021)

2. Line 145, 1:1 ratio for case study versus case control?

Jawab: Rasio Kasus:Kontrol adalah 1:1 ????

Formula nya ?

Sebelum menghitung total sampel dilakukan perhitungan besar sampel dengan menggunakan
rumus 2 beda proporsi, setelah didapatkan nilai n, maka dilakukan perhitungan teknik perhitungan
Stratified Random Sampling. Berikut hasil perhitungan Stratified Random Sampling :

Tabel 2. 2 Hasil Perhitungan Stratified Random Sampling

Pembagian
Tahun Sampel Minimal
No Total kasus pertahun (a) sampel (d)
Kasus (c)
= (a/b) x c
1 2018 56 56/83 x 46 = 31
2 2019 19 46 19/83 x 46 = 10
3 2020 8 8/83 x 46 = 4 
Total 83 (b) 45
Dari tabel diatas didapatkan bahwa sampel kasus yang digunakan dalam penelitian ini sebanyak 45
sampel kasus. Untuk menghindari drop out dan missing data maka dilakukan penambahan sebanyak
20% yakni 9 sampel, sehingga total sampel kasus menjadi 54 sampel dengan menggunakan
perbandingan 1:1 maka didapatkan bahwa sampel kontrol sebanyak 54 sampel, didapatkan total
keseluruhan sampel sebanyak 108 sampel.

Tabel Hasil Perhitungan Besaran Sampel

No Variabel P1 P2 N Sumber
1 Usia 0,53 0,20 33 Mustafa, 2018

2 Masa kerja 0,59 0,19 23 Cote et al, 2021

3 Lama kerja 0.71 0,28 21 Salas et al, 2021

4 Pendidikan 0,488 0,216 25 Aschale et al, 2018

5 Kebiasaan menggunakan 0,79 0,50 42 Cirera et al, 2020
kelambu
6 Kebiasaan menggunakan 0,77 0,23 13 Nurbayani et al,
obat anti nyamuk 2013
7 Kebiasaan keluar rumah 0,80 0,31 15 Nkwenty et al,
pada malam hari 2019
8 Self medication 0,50 0,06 12 Salas et al, 2021
9 Keberadaan tempat 0,40 0,07 25 Kajeguka et al,
perindukan nyamuk (breeding 2016
place)
10 Keberadaan tempat 0,50 0,10 20 Yibikon et al, 2020
peristirahatan nyamuk (resting
place)
11 Pengetahuan 0,31 0,69 26 Darmiah et al,
2019
12 Sikap 0,74 0,26 16 Engkeng et al,
2017
13 Perilaku 0,34 0,06 31 Lario et al, 2016

14 Kondisi dinding rumah 0,045 0,3 34 Mwalimu et al,

2020
15 Keberadaan langit-langit rumah 0,11 0,615 13 Triwahyuni, 2016

16 Kondisi lantai rumah 0,71 0,2 14 Mwalimu et al,

2020
3. How do you choose your control? Those who are living closest to case study? Are you going to take
all of those living closest to your study case or random?

Jawab:

Teknik pengambilan sampel kontrol diambil dari tetangga terdekat kasus dengan menggunakan
“individual matching” berdasarkan jenis kelamin yang nantinya dipilih dengan menggunakan sistem
random sampling memakai undian kertas minimal 3 tetangga terdekat dari kelompok kasus sehingga
dipilih satu nomor yang akan dijadikan sampel kontrol.

4. Line 151, what is the difference in your behavioural factors (habit of going out at night and habit of
hanging clothes) to environmental factors (habit of going out at night and habit of hanging clothes?
in Line 151-152.

5. Line 170, perhaps it should be Table 8 instead of Table 4?

Reviewer #2:

1. Please provide reference for sentence line 75-80.

2.

3. In the introduction, it was not clear why authors choose to do the study in this area with API < 1,
please justify more

Jawab: Berdasarkan angka API Kabupaten Muara Enim memang berstatus endemis rendah (<1), akan
tetapi Kabupaten Muara Enim merupakan salah satu dari 3 Kabupaten yang mempunyai angka kasus
malaria tertinggi dalam kurun waktu 3 tahun terakhir dan dari seluruh kasus tersebut, sebagian
besar merupakan kasus Indigenous dimana terdapat penularan setempat yang artinya target
eliminasi malaria tidak dapat dicapai jika dalam kurun waktu 3 tahun terakhir masih ditemukan kasus
Indigenous malaria di daerah tersebut.

3. Please check thoroughly for grammatical errors and typo.

Reviewer #3: This manuscript presents a small, case-control study of risk factors for malaria in Muara
Enim Regency in Indonesia based on routinely collected data from the national routine malaria data
collection system - E-SISMAL. A total of 49 cases and 49 controls were included across three years
(2018-2020) of the study. The authors conclude that proximity to mosquito breeding sites, use of
insect repellant and wire netting on ventilation inlets impact odds of malaria. These are biologically
plausible findings. The study has some flaws that limit the reliability of the results and the
manuscript presentation could be improved significantly. My specific comments are listed below:
Major

1. As far as I can tell, the authors have not presented or controlled for age or sex in their analyses.
Age in particular is a major determinant of malaria risk and could quite feasibly be associated with
factors such as use of insect repellant. If available, both age and sex should be included in the
authors' models. The authors should also state whether they attempted to match controls by age as
well as gender.

Adjusted by age ? Menggunakan jenis kelamin karena peneliti melihat kondisi dilapangan, jika
melihat berdasarkan umur maka ditakutkan tidak ditemukan responden yang memiliki karakteristik
yang sama dengan responden kasus, karena yang dilihat bukan hanya dari karakteristik responden,
tetapi karakteristik lingkungan sekitar juga. Sehingga yang dilakukan pencocokan adalah jenis kelamin

Multivariate ?

2. The authors do not present a specific statistical analysis section in the methods. It would be
important to know what the process was for selection of variables to include in multivariable models,
whether there was any assessment of goodness of fit, whether there was any correction for multiple
comparisons and what statistics package was used. Given there was stratification of enrolment by
year, allowance needs to be made for clustering by year in the regression models. The authors' use of
the terms "univariate" and "bivariate" analysis although stictly correct seems a bit unusual and
created some confusion on my part. They would be better to refer to descriptive analyses and
univariable and multivariable logistic regression in my view.

Analysis descriptive and inferential?

3. It is not clear whether a questionnaire was also administered to cases

Jawab: Instrumen berupa Kuesioner diberikan ke semua participant baik kasus ataupun kontrol.

4. The authors expend a large amount of text on their methods for sample size calculation. They
estimated a sample size of 46 was necessary to achieve appropriate power. As a result of this, a
significant proportion of cases diagnosed during the three years of accrual were excluded. This
seems a real pity when retrospective data collection from E-SISMAL and questionnaires was
presumably fairly straight-forward.

Jawab: Perhitungan sample minimal didapat berdasarkan formula uji hipotesis proporsi pada dua
populasi dengan power sebesar 80%

Minor

5. The first paragraph of the results section is difficult to read because of all the repetition

6. There doesn't appear to be a table 7 or a table 9 despite references to these in the text

7. The authors need to define their independent variables with more detail. For example, what
constitues use of mosquitor repellent? Use once a day or once a month?m Does this refer to indoor
residual spraying or application on the body?
8. There is a lot of repetition of material presented in the tables in the text. The text could be pruned
down quite a lot

9. In table 8, there should be consistency in the order of presentation of binary variables

10. Line 54 - "NTT" needs explanation

Jawab: Akan diperbaiki, NTT merupakan singkatan nama provinsi di Indonesia.

11. There are quite a few typographical errors remaining