Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
ABSTRACT
Background: in recent years, diphtheria has reemerged in several countries including Venezuela, Yemen, Bangladesh, and Haiti. Similarly, Indonesia also showed an increased number of diphtheria cases in 2010-2017 despite the Diphteria, Tetanus, Pertussis (DTP) immunization program applied in Indonesia for children. This study aimed to evaluate the epidemiology of diphtheria cases which occurred in Indonesia during 2010-2017. Methods: this was a retrospective study of diphtheria cases in Indonesia. The following source of data about diphtheria disease burden and vaccine coverage was obtained from Ministry of Health Republic of Indonesia, Indonesian Pediatric Society and World Health Organization South East Asia Regional Office. Results: the number of diphtheria cases in Indonesia were distributed across 30 provinces with a total of 811 cases in 2011; 1,192 cases in 2012; 296 cases in 2014; and 939 cases in 2017. Based on age group, the highest number of case fatality rate were in age group of 5-9 years old. Diphtheria immunization coverage in Indonesia among children was fluctuated, reported as 67.7 % in 2007, 61.9 % in 2010, 75.6% in 2013 and 61.3% in 2018. In addition to that, the organization of internal medicine has recommend booster of DPT immunization every 10 years for those children that had received complete DPT vaccination during childhood, however this was not applied. As the countermeasure towards this trend, the Ministry of Health implemented three rounds of Outbreak Response Immunization (ORI) targeted for the age group of 0-1-6 months old and 1-18 years old in 2017 and tailor approached for adults that had exposed to cases. Banten, DKI Jakarta and West Java were the first three provinces to implement this program considering their condensed population and high risk of disease transmission. Conclusion: in Indonesia, there was dramatic increase of diphtheria case in 2010-2017, where immunization in children should be reinforced by increasing coverage more than 95% and adult boosted vaccination approaches should be initiated to prevent the spread of these fatal diphtheria diseases in Indonesia.

Abstrak :
Difteri menjadi penyumbang kejadian luar biasa KLB bagi sebagian wilayah di Indonesia, tidak terkecuali dengan wilayah Provinsi Jawa Barat. Kejadian difteri yang tercatat pada tahun 2015 dan 2016 terekam naik. Kasus difteri meningkat dari 59 kasus menjadi 153 kasus. Kota Depok menjadi salah satu penyumbang kasus yang memiliki angka kejadian yang fluktuatif. Tren penyakit sempat menurun pada 2013-2015, namun kemudian naik pada tahun 2016 menjadi 8 kasus. Penelitian ini membahas tentang bagaimana implementasi kebijakan, yang dilihat dari sumber kebijakan, pengaturan sumber daya, karakteristik instansi pelaksana, struktur birokrasi, komunikasi, pengaruh disposisi dan keadaan sosial-ekonomi dan politik dalam pengendalian Kejadian Luar Biasa KLB difteri dan Outbreak Response Immunization ORI di Kota Depok tahun 2017. Jenis penelitian ini adalah penelitian kualitatif dengan desain deskriptif, melalui wawancara mendalam dan telaah dokumen. Hasil penelitian menunjukkan bahwa masih terbatasnya sumber daya terutama SDM, kurangnya kepedulian lintas sektor dan faktor lingkungan sosial, yakni adanya penolakan dari masyarakat untuk vaksinasi, menjadi tantangan dalam pengendalian Kejadian Luar Biasa KLB difteri dan Outbreak Response Immunization ORI di Kota Depok. Diharapkan, kepada implementor kebijakan dapat berkomitmen untuk bekerja sama dengan baik, dan memperhatikan faktor-faktor yang berpengaruh dalam implementasi kebijakan, serta dukungan pemerintah dalam menyediakan vaksin yang halal dan aman serta penelitian mengenai bioterorisme juga dapat dilakukan sebagai pemecahan kasus difteri yang fluktuatif setiap tahunnya.

---

Diphtheria is contributor of outbreak KLB for some regions in Indonesia, included West Java Province. Diphtheria cases recorded increased through 2015 2016, cases increased from 59 cases to 153 cases. Depok City became one of the contributors of cases that have fluctuating incidents. Disease trends have declined in 2013 2015, but then increased in 2016 to 8 cases. This study discusses policy implementation, viewed from policy sources, resource arrangements, the characteristics of implementing agencies, bureaucratic structures, communications, the influence of dispositions and socio economic and political circumstances in control of Diphtheria Outbreak and Outbreak Response Immunization ORI in Depok City in 2017. This type of research is qualitative research with descriptive design, through in depth interviews and document review. The results showed that the limited resources, especially human resources, the lack of cross sectoral concern and social environment factors, like the rejection of some community for vaccination, became a challenge in controlling the Diphtheria Outbreak and Outbreak Response Immunization ORI in Depok City. It is expected that policy implementers can commit to working together, and taking into the influential factors in policy implementation, as well as government support in providing halal and safe vaccines and research on bioterrorism can also be done as solving cases of diphtheria fluctuating annually.