Surveillance for Severe Acute Respiratory Infection as one approach to enhance Global Health Security in Indonesia
Abstract
Latar Belakang: Sistem surveilans nasional untuk infeksi saluran pernafasan akut berat (SARI) dapat
memberikan informasi penting tentang sirkulasi virus influenza, menyediakan sistem untuk mengendalikan
kejadian luar biasa yang mengancam keamanan dan keselamatan masyarakat serta menyediakan
data untuk sistem surveilans influenza global (GISRS). Kemampuan Indonesia untuk mendeteksi dan mengendalikan
penyakit menular penting untuk keamanan kesehatan dunia. Penelitian ini bertujuan untuk
menilai sistem surveilans ISPA berat Indonesia (SIBI) dan pemanfaatan untuk memantau patogen prioritas
lainnya sebagai upaya meningkatkan keamanan kesehatan global.
Metode: penilaian atribut surveilans melalui review laporan, analisis data dan interview staff yang terlibat
dalam sistem surveilans. Semua kasus yang memenuhi kriteria SARI pada bulan Mei 2013 – April 2015 ikut
serta dalam penelitian. Data epidemiologi dan virologi dianalisis. Kelengkapan dan kemudahan sistem untuk
mencapai tujuan surveilans influenza dan mendukung surveilans penyakit infeksi baru (emerging) dikaji.
Hasil: Sebanyak 1,806 kasus SARI dan 1,697 (94%) spesimen dilakukan pemeriksaan virus influenza.
Sebanyak 200 (12%) positif influenza, terdiri dari 46% influenza A(H3N2), 18% A(H1N1)pdm09 dan 37%
influenza B. Hasil penilaian terhadap sistem surveilans didapatkan kesesuaian pelaksanaan untuk semua
atribut surveilans melebihi target >80%, kelengkapan laporan online 95%, kesesuaian kasus terhadap
definisi kasus 100%, kasus yang diambil spesimen 94% dan hasil laboratorium diinput ke database secara
online 100%. Sistem surveilans untuk dengue dan infeksi arbovirus lainnya sudah terlaksana di unit
rawat jalan dan gawat darurat di sentinel SARI surveilans.
Kesimpulan: SIBI dapat disesuaikan untuk menggabungkan surveilans penyakit lain yang menunjukkan
kegunaan dan fleksibilitas dalam mendukung keamanan kesehatan global.
Kata kunci: keamanan kesehatan global, surveilans, influenza, Indonesia
Abstract
Background: The existing national surveillance system for severe acute respiratory infection (SARI) provides
critical information on influenza virus circulation, provides a system to control influenza outbreaks that threaten
the safety and security of the population and feeds data into the global influenza surveillance and response
system (GISRS). Indonesia’s ability to detect and control communicable diseases is critical for global health
security. The aim of this study was to assess the SARI surveillance system and utility for monitoring other priority
pathogens as an effort to enhance global health security.
Methods: Surveillance attributes were assessed by reviewing records, data analysis and through interviewed
with staffs involved in the surveillance system. All patients at six sentinel hospitals who meet the SARI case
definition during May 2013 – April 2015 were enrolled. Epidemiological and virological data were analyzed.
The surveillance system utility for its influenza surveillance objectives and flexibility to support surveillance of
emerging infectious diseases were assessed.
Resuts: A total of 1,806 SARI cases were reported of which 1,697 (94%) had specimens tested for influenza viruses.
Of those tested, 200 (12%) were positive, of which 46% were influenza A(H3N2), 18% A(H1N1)pdm09
and 37% influenza B viruses. The system exceeded the targets of >80% adherence for most attributes: 95% for
completeness of online reporting, 100% for cases adhering to the case definition, 94% for cases with specimens
collected and 100% of laboratory results uploaded to the online database. A surveillance system for dengue and
other arbovirus infections was established in the outpatient/emergency units at the SARI surveillance sentinel.
Conclusion: SIBI was adjusted to incorporate surveillance for other priority diseases indicating its utility and
flexibility to support global health security
Keywords: Global Health Security, surveillance, influenza, Indonesia
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