Background: The World Health Organization reported Indonesia as one of the countries with the most prevalent cases of diphtheria worldwide. The microbiological aspects of diphtheria-inducing bacteria are of great significance in tracing disease transmission and case management. However, clinical aspects are critical for updating clinical features and case management in the field, which may sometimes differ from theoretical foundations. Objectives: This study aimed to identify the microbiological and clinical aspects, including molecular typing and case fatality rates, in diphtheria-confirmed cases from the capital city of Indonesia, Jakarta, and surrounding areas in 2017. Methods: The microbiological aspect of 40 diphtheria-confirmed cases were obtained by re-identify diphtheria-inducing bacteria isolated from the samples, while the clinical aspects of the cases were obtained from the medical records and epidemiological data. The chi-square test was used to examine the correlation between fatal cases and myocarditis and diphtheria antitoxin administration delay. In this study, P ≤ 0.05 was set as the significance level. Results: All 40 diphtheria confirmed cases were induced by toxigenic Corynebacterium diphtheriae with two biotypes, namely intermedius (60.0%) and mitis (40.0%). There are six sequence types of bacteria with two main sequence types, ie, ST534 (46.4%) and ST377 (35.7%). The proportions of cases that had a fever and sore throat were 72.5% and 77.5%, respectively; however, the prevalence rates of the cases with pseudomembrane and bull neck were 100% and 47%, respectively. Most cases were administered a combination of penicillin or erythromycin with other antibiotics (40%), and 22.5% of the cases only received penicillin. Myocarditis was noticed in three fatal cases, and their relationship was statistically significant (P = 0.000). All five fatal cases (12.5% of cases) received diphtheria antitoxin (DAT) lately or had not received it yet. Conclusions: Toxigenic C. diphtheriae with two biotypes (namely mitis and intermedius) and two main sequence types (ie, ST534 and ST377) was the causative agent of diphtheria-confirmed cases from Jakarta and surrounding areas in 2017. It was also concluded that those fatal cases were correlated with myocarditis complications.

Background: Pandeglang, a district in Banten province, Indonesia, was the worst affected area of the Sunda Strait tsunami which occurred on 22nd December, 2018. Aside from threats of communicable disease outbreaks, the district faced the challenges of managing non-communicable diseases (NCD) in the community. Purpose: The aim of the study is to describe the post tsunami impact on cases of hypertension and diabetes mellitus and the expected one-year projections of these diseases in the district of Pandeglang, Banten. Methods: In January 2019, we collected primary data from Pandeglang District Health Office (DHO) and 15 Public Health Centres (PHCs) that were heavily affected by the tsunami. Surveillance officers were also interviewed for their subjective opinions on disease projections in both the DHO and PHCs. Aggregated data of cases presenting to the PHCs for assistance were analysed in relation to the post tsunami period. The diseases of interest included hypertension and diabetes mellitus. Results: Reported cases of hypertension and diabetes mellitus increased a few days after the tsunami. For hypertension, the cases spiked on the 5th and 8th days, but for diabetes mellitus the spike came much later. Average cases of hypertension and diabetes mellitus per PHC were 62 and 3, respectively. At district and PHC level, hypertension and diabetes mellitus were considered as minor contributing factors to the morbidity and mortality in the affected communities. The projection of these diseases was optimistic after the first month. Conclusion: It can be concluded that the volume of cases with hypertension and diabetes in the district of Pandeglang tended to be in the first few weeks post tsunami These diseases are projected to lessen in the second month after the disaster due to the recovery of local health services.