DENGUE VECTOR CONTROL PROGRAMME IN INDONESIA
Supratman Sukowati National Institute of Health Research and Development
Vector Borne Diseases in Indonesia Dengue Malaria Lymphatic Filariasis Japanese encephalitis Chikungunya
2
Situation of DHF
INDONESIA
Source Data: WHO 2004-2010
ENDEMICITY OF DHF IN INDONESIA, 2012
50
IR=incidence rate (per 100,000 penduduk)
IR & CFR of DHF in INDONESIA 1968-2012 IR 2012: 36,82 /100.000 population
80.00 IR 2011: 27,67/ 100.000 population
40.00
2012
2010
2006
2004
2002
2000
1998
1996
1994
1992
1990
1988
1986
1984
1982
1980
1978
1976
1974
1972
1970
0.00
2008
CFR 2012: 0,90 %
20.00
1968
IR & CFR
60.00
CFR 2011: 0,91%
TAHUN
IR/100.000
Trend of DHF Case in 3 years Trend of DHF case 2010 - 2012 25000 20000
2010
15000
2011
2012
10000
Kasus
5000
Dec
Oct
0,91%
0,92%
65.70
60.00
0,90%
0,90%
40.00
Nov
Sep
Jul
Aug
CFR of DHF, 2010-2012
IR of DHF, 2010-2012 80.00
Jun
Apr
May
Mar
Jan
Feb
Dec
Oct
Nov
Sep
Aug
Jul
Jun
Apr
May
Mar
Jan
Feb
Dec
Oct
Nov
Sep
Jul
Aug
Jun
Apr
May
Mar
Jan
Feb
0
27.67
0,88%
36,82
20.00
IR
0.00
0,87% CFR
0,86% 0,84%
2010
2011
2012
2010
2011
2012
Kasus DBD s.d 3 Juni2013 • IR Prov. DKI Jakarta 44.70 per-100.000 penddk • CFR 0,23% (10 kasus) GRAFIK JUMLAH KASUS DBD HASIL PE PER BULAN DI PROVINSI DKI JAKARTA TAHUN 2009-2013 3,000 2,500 2,000 1,500 1,000 500 -
J
F
M
A
M
J
J
A
S
O
N
D
2009 2,122 2010 1,486
2,107
2,830
2,783
2,470
2,018
1,730
891
456
333
342
653
1,815
2,570
2,431
1,640
1,193
1,387
1,569
1,302
1,181
1,544
1,167
2011 1,093 2012 752
801
820
550
482
565
595
534
354
340
293
330
848
1,004
882
886
709
524
313
190
159
163
239
2013
764
818
1,217
870
695
INCIDENCE OF DHF WITHIN 5 YEARS Indicator
Progress 2012
Incidence rate DHF (IR/100.000 pdd)
33,6
TARGET (RENSTRA KEMENKES TH 2010-2014)
2010
2011
2012
2013
2014
55
54
53
52
51
IR : 33,6/100.000 pdd MONTHLY INCIDENCE RATE (IR) OF DHF WITHIN 3 YEARS
MDGs GOAL GOAL 1 : TO SOLVE THE POVERTY AND HUNGER GOAL 2 : ACHIEVING BASIC EDUCATION FOR ALLS GOAL 3 : EQUITY OF GENDER AND WOMEN EMPOVERNMENT GOAL 4 : DECREASING THE CHILD MORTALITY GOAL 5 : IMPROVING MOTHER HEALTH GOAL 6 : CONTROL HIV /AIDS, MALARIA, DHF AND OTHER TRANSMITTED DISEASES (TB) GOAL 7 : ASSURED ENVIRONMENT SUSTAINABILITY LINGKUNGAN HIDUP GOAL 8 : IMPROVING PARTNERSHIP FOR DEVELOPMENT GLOBALLY
11
11
ISSUE ON VECTOR BORNE DISEASES CONTROL 1. MDGs, post MDG, neglected diseases 2. The burden of the diseases 3. Outbreak (re/new emerging diseases) : season, population movement, physical environment change 4. new emerging diseases/ vector borne disease (by international traffic) 3. Externality of decentralization 4. Health system strengthening 5. Resistance of drug (malaria), insecticide 6. Local specific diseases
INTEGRATED VECTOR MANAGEMENT – Based on the knowledge of vector species & bioecology, transmission risk endemicity, and local specific (KAP and environment/breeding places) – Application of more than one interventions methods, combination and synergist; – Collaboration and partnership within the health programme & other sectors ; – engagement with local communities and other stakeholders; – a public health regulatory and legislative framework
Challanges PROGRAM MANAGEMENT – HUMAN RESOURCE DEVELOPMENT Medical Entomologist, Technical & Functional Training & Education
– MANAGEMENT SUPPORT Logistic, facility, fund, regulation/guide – PARTNERSHIP AND NETWORKING
INFORMATION SYSTEM DEVELOPMENT - Vector Surveillance in District level. - Networking of Surveillance & Vector control INTEGRATED PROGRAM - Integrated Vector Surveillance (IVS) - Integrated Vector Management (IVM)
IVM STRATEGY
• Advocacy, social mobilization and legislation • Collaboration within the health sector and Intersector (partnership) • Integrated approach • Evidence-based • Research & Development • Capacity building • Monev
Action 1. Guideline, socialization, implementation Ministry of health Decree (Permenkes 374/2010) in Vector control 2. Strengthening Partnership with other related institutions for implementation program, 3. Capacity building of HRD 4. Insectarium. 5. Integrated program 6. Epidemiological mapping (aspect of cases & vector) 7. Evidence based of VBDC Should be Rational, Effective, Effisiens, Sustainable, Acceptable and Affordable (REESAA)
. PROGRAMME OF DHF IN INDONESIA 1. Source reduction or sanitation (PSN) to reduce the breeding places , Popular with 3M plus (menutup/coverage, menguras/emptied and mengubur/buried unused containers), 2. Improving water supplies, 3. Biological control such predatory fish and others, 4. Insecticide control (spraying /fogging, and larva control 5. Health education and community empowernment, 6. Partnership, and (lesson learnt from Purwokerto) 7. Regulation 8. Research and Development.
Social and Ecological contex
Vector species, BIO-ECOLOGY & INSECTICIDE RESISTANCE
Agent/ & Immunological
VECTOR BORNE DISEASES
Vector density Effectiveness &longivety
Vector control
Disease Transmission Herd immunity PHYSICAL ENVIRONMENT
3M
Larvaciding Ikanisasi
Obat Nyamuk Semprot Obat Nyamuk Gosok
Net
plus Pencahayaan Ventilasi
Kasa
