Husada Dominicus, Hartini Yustika, Nuringhati Kalista Wahyu, Tindage Sandy Grace, Mustikasari Rahma Ira, Kartina Leny, Puspitasari Dwiyanti, Basuki Parwati S, Moedjito Ismoedijanto, Zumaroh Zumaroh, Susanto Hugeng, Wulandari Wahyu, Anggraini Sulvy Dwi, Triyono Erwin Astha
Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia.
Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia.
Trop Med Infect Dis. 2024 Sep 7;9(9):204. doi: 10.3390/tropicalmed9090204.
A high incidence of diphtheria cases in children in East Java province, Indonesia, has been observed since the beginning of this century. Despite many efforts, the outbreaks continue. This study aims to explain the high incidence of diphtheria in children in East Java province since 2013. This cross-sectional surveillance report-based study used data from 38 districts in East Java since 1 January 2013. Collected data included demographics, clinical information, additional examinations, immunization history, and close contact management. Over eleven years, there were 4009 diphtheria patients, of whom 2921 (72.86%) were under 18 years of age. Boys (59.77%) outnumbered girls, and the most common age category was >60-144 months (51.66%). Most cases had incomplete or zero immunization (76.16%). Tonsillopharyngeal diphtheria was the most common type (69.60%). The five top districts with the most cases were Surabaya, Sidoarjo, Kabupaten Blitar, Kota Malang, and Kabupaten Malang. The eleven-year case fatality rate (CFR) was 2.36% (69/2921). This study shows that diphtheria cases in children and adolescents in East Java have consistently been high, and low immunization coverage might still be the leading cause. There has also been a shift in the district distribution. Diphtheria outbreaks require complete and sustainable efforts, not just outbreak response immunizations.
自本世纪初以来，印度尼西亚东爪哇省儿童白喉病例的发病率一直很高。尽管做出了许多努力，但疫情仍在持续。本研究旨在解释自2013年以来东爪哇省儿童白喉发病率居高不下的原因。这项基于横断面监测报告的研究使用了自2013年1月1日起东爪哇38个地区的数据。收集的数据包括人口统计学、临床信息、额外检查、免疫史和密切接触者管理。在十一年间，共有4009例白喉患者，其中2921例（72.86%）年龄在18岁以下。男孩（59.77%）的数量超过女孩，最常见的年龄组是>60 - 144个月（51.66%）。大多数病例的免疫接种不完整或为零（76.16%）。扁桃体咽白喉是最常见的类型（69.60%）。病例数最多的五个地区是泗水、锡都阿佐、勿里达县、玛琅市和玛琅县。十一年的病死率（CFR）为2.36%（69/2921）。本研究表明，东爪哇儿童和青少年的白喉病例一直居高不下，免疫接种覆盖率低可能仍是主要原因。地区分布也发生了变化。白喉疫情需要全面和可持续的努力，而不仅仅是疫情应对免疫接种。
