DENGUE VECTOR CONTROL

PROGRAMME IN INDONESIA

Supratman Sukowati

National Institute of Health Research and

Development

Dengue

Malaria

Lymphatic Filariasis

Vector Borne Diseases in Indonesia

Lymphatic Filariasis

Japanese encephalitis

Chikungunya

2

Situation of DHF

INDONESIA

Source Data: WHO 2004-2010

ENDEMICITY OF DHF IN INDONESIA, 2012

<20 20-50 >50

IR=incidence rate (per 100,000 penduduk)

IR & CFR of DHF in INDONESIA

1968-2012

40.00

60.00

80.00

IR &

CF

R

IR 2011: 27,67/ 100.000

population

IR 2012: 36,82 /100.000

population

CFR

0.00

20.00

19

68

19

70

19

72

19

74

19

76

19

78

19

80

19

82

19

84

19

86

19

88

19

90

19

92

19

94

19

96

19

98

20

00

20

02

20

04

20

06

20

08

20

10

20

12

IR &

CF

R

TAHUN IR/100.000

CFR 2011: 0,91%

CFR 2012:0,90

%

Trend of DHF Case in 3 years

0

5000

10000

15000

20000

25000

Jan

Feb

Mar

Apr

May Jun

Jul

Aug

Sep Oct

Nov

Dec Jan

Feb

Mar

Apr

May Jun

Jul

Aug

Sep Oct

Nov

Dec Jan

Feb

Mar

Apr

May Jun

Jul

Aug

Sep Oct

Nov

Dec

Trend of DHF case 2010 - 2012

Kasus

2010 2011 2012Ja

n

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep Oct

Nov

Dec Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep Oct

Nov

Dec Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep Oct

Nov

Dec

0.00

20.00

40.00

60.00

80.00

2010 20112012

65.70

27.67 36,82

IR of DHF, 2010-2012

IR

0,84%

0,86%

0,88%

0,90%

0,92%

20102011

2012

0,87%

0,91%

0,90%

CFR of DHF,

2010-2012

CFR

Kasus DBD s.d 3 Juni2013

• IR Prov. DKI Jakarta 44.70 per-100.000 penddk

• CFR 0,23% (10 kasus)

2,500

3,000

GRAFIK JUMLAH KASUS DBD HASIL PE PER BULAN DI PROVINSI DKI JAKARTA TAHUN 2009-2013

J F M A M J J A S O N D

2009 2,122 2,107 2,830 2,783 2,470 2,018 1,730 891 456 333 342 653 2010 1,486 1,815 2,570 2,431 1,640 1,193 1,387 1,569 1,302 1,181 1,544 1,1672011 1,093 801 820 550 482 565 595 534 354 340 293 330 2012 752 848 1,004 882 886 709 524 313 190 159 163 239 2013 695 764 818 1,217 870

-

500

1,000

1,500

2,000

2,500

INCIDENCE OF DHF WITHIN 5 YEARS

Indicator Progress

2012

TARGET (RENSTRA KEMENKES TH 2010-2014)

2010 2011 2012 2013 2014

Incidence rate DHF

(IR/100.000 pdd)

33,6 55 54 53 52 51

IR : 33,6/100.000 pdd

MONTHLY INCIDENCE RATE (IR) OF DHF WITHIN 3 YEARS

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

MDGs GOAL MDGs GOAL

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

1111

ISSUE ON VECTOR BORNE DISEASES CONTROL

1. MDGs, post MDG, neglected diseases2. The burden of the diseases3. Outbreak (re/new emerging diseases) : season,

population movement, physical environment change4. new emerging diseases/ vector borne

disease (by international traffic)disease (by international traffic)3. Externality of decentralization4. Health system strengthening5. Resistance of drug (malaria), insecticide6. Local specific diseases

INTEGRATED VECTOR MANAGEMENT

– Based on the knowledge of vector species & bio-ecology, 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 – 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• Integrated approach

• Evidence-based

• Research & Development

• Capacity building

• Monev

Action1. Guideline, socialization, implementation � Ministry of

health Decree (Permenkes 374/2010) in Vector control2. Strengthening Partnership with other related institutions

for implementation program,3. Capacity building of HRD4. Insectarium.5. Integrated program6. Epidemiological mapping (aspect of cases & vector)7. Evidence based of VBDC Should

be Rational, Effective, Effisiens, Sustainable, Acceptableand 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.

Vector species,BIO-ECOLOGY &

INSECTICIDERESISTANCE

Social and Ecologicalcontex

Vector density

VECTOR BORNE DISEASES

Agent/&

Immunological

Vector control

Vector densityEffectiveness &longivety

Disease Transmission

Herd immunityPHYSICAL ENVIRONMENT

plus

3MLarvaciding

IkanisasiObat Nyamuk Semprot

Obat Nyamuk Gosok

Net

plusPencahayaan

Ventilasi

Kasa