Husada Dominicus, Nuringhati Kalista W, Tindage Sandy G, Mustikasari Rahma I, Kartina Leny, Puspitasari Dwiyanti, Basuki Parwati S, Moedjito Ismoedijanto, Yuliandari Rosita D, Sukristina Nanik
Department of Child Health, Faculty of Medicine Universitas Airlangga, Surabaya, IDN.
Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya, IDN.
Cureus. 2024 Aug 15;16(8):e66949. doi: 10.7759/cureus.66949. eCollection 2024 Aug.
Introduction Indonesia has a high incidence of diphtheria, especially in children. Surabaya has become a government regional reference center, as it is the capital of East Java province, which has the highest rate of diphtheria across the 38 regions. The aim of this study is to report our six-year pediatric diphtheria data, focusing on comparisons between before and during the pandemic era. Method This surveillance report was collected from community health centers and hospitals throughout Surabaya from January 1, 2017 to December 31, 2022. Collected data included demographic characteristics, clinical and laboratory aspects, the health centers, immunization history, and management. As per Indonesian guidelines, the diagnosis of diphtheria in this country requires a positive microbiological culture or approval from the National Experts on Diphtheria Committee. Results In total, there were 112 cases, of which 89 were found before the pandemic era. Although the number of cases declined during 2020-2022, the predominant age group, the immunization status, and the most common type of diphtheria remained consistent with pre-pandemic trends. Most cases had incomplete immunization or unimmunized children (67.8%), with the age group of 5-12 years old (44.6%), and with tonsillar diphtheria (83%). The case fatality ratio was 1.8%. Regarding the biovar of , gravis is the most frequent finding. Conclusion The incidence of diphtheria cases in children in Surabaya was significantly lower during the pandemic. Although immunization coverage was not better, preventive measures during the pandemic may have played a role. Most patients did not have complete immunization histories during the study period, and the predominant type was tonsillar diphtheria. Since the trend in 2021-2022 increased, routine surveillance is essential.
引言
印度尼西亚白喉发病率很高，尤其是在儿童中。泗水已成为政府区域参考中心，因为它是东爪哇省的首府，该省在38个地区中白喉发病率最高。本研究的目的是报告我们六年的儿科白喉数据，重点是大流行时代之前和期间的比较。
方法
本监测报告收集了2017年1月1日至2022年12月31日泗水市各社区卫生中心和医院的数据。收集的数据包括人口统计学特征、临床和实验室方面、卫生中心、免疫史和管理情况。根据印度尼西亚的指南，该国白喉的诊断需要微生物培养阳性或白喉国家专家委员会的批准。
结果
总共112例病例，其中89例在大流行时代之前发现。虽然2020 - 2022年期间病例数有所下降，但主要年龄组、免疫状况和最常见的白喉类型与大流行前的趋势保持一致。大多数病例是免疫不完全或未免疫的儿童（67.8%），年龄组为5 - 12岁（44.6%），扁桃体白喉（83%）。病死率为1.8%。关于生物变种，重型是最常见的发现。
结论
泗水市儿童白喉病例的发病率在大流行期间显著降低。虽然免疫覆盖率没有提高，但大流行期间的预防措施可能起到了作用。在研究期间，大多数患者没有完整的免疫史，主要类型是扁桃体白喉。由于2021 - 2022年呈上升趋势，常规监测至关重要。
