Laboratory-based Acute Flaccid Paralysis surveillance pre-polio free certification: Indonesia experience, 2003-2013

Abstract

Latar belakang: Virus Polio Liar dapat menyebabkan kelumpuhan dan dapat dicegah dengan imunisasi. Untuk memonitor transmisi virus polio liar dilakukan surveilans Acute Flaccid Paralysis (AFP) dan investigasi laboratorium yang telah dimulai sejak tahun 1995 di Indonesia. Virus polio liar Indigenous terakhir ditemukan di Indonesia tahun 1995. Indonesia masih memiliki ancaman importasi virus polio liar dari negara endemis dan mutasi virus polio dari vaksin yang menyebakan kelumpuhan yang sama seperti virus polio liar. Artikel ini bertujuan untuk memberikan gambaran mengenai surveilans AFP berbasis laboratorium di Indonesia pada tahun 2003-2013 sehingga mengantarkan Indonesia sebagai negara bebas polio pada tahun 2014.
 Metode: Data yang dianalisis adalah data kasus AFP seluruh Indonesia periode tahun 2003-2013. Data didapat dari laboratorium jejaring laboratorium Polio di Jakarta, Bandung, Surabaya dan Sub Direktorat Surveilans, Direktorat Surveilans dan Karantina Kesehatan, Direktorat Jenderal Pencegahan dan Pengendalian Penyakit. Data di analisis menggunakan program Microsoft Excel.
 Hasil: Sebanyak 305 kasus AFP yang disebabkan oleh infeksi virus polio liar tipe 1 impor ditemukan pada tahun 2005 dan 2006. Terdapat 39 kasus AFP yang disebabkan cVDPV tipe 1 ditemukan di Pulau Madura pada tahun 2005. Virus polio liar tipe 1 hanya ditemukan di pulau Sumatera dan Jawa. Penyebaran Virus polio berhasil dihentikan pada tahun 2006 dan sudah tidak ditemukan lagi hingga tahun 2013.
 Kesimpulan: Surveilans AFP berbasis laboratorium yang baik berhasil memantau dan mendeteksi sirkulasi virus polio. Peningkatan kinerja surveillance AFP diperlukan untuk membuktikan terhentinya transmisi virus polio sehingga eradikasi polio secara global dapat diraih. 
 Kata kunci: surveilans, laboratorium polio, Acute Flaccid Paralysis
 
 Abstract
 Background: Wild Poliovirus can cause flaccid paralysis and can be prevented by immunization. To monitor wild polio virus transmission, Acute Flaccid Paralysis (AFP) surveillance and laboratory investigations was initiated in 1995 in Indonesia. The last indigenous wild poliovirus found at 1995 in Indonesia. Indonesia still has the threat of imported wild polio viruses from endemic countries and poliovirus mutation from vaccine that can cause paralytic as well as wild poliovirus. The aim of this article is to describe the laboratory-based AFP surveillance in Indonesia from 2003-2013 so that it had led the Indonesia certified for polio free in 2014.
 Methods: Data analysis performed on AFP cases data from all provinces in Indonesia period of 2013-2014. Data were collected from polio laboratories network in Jakarta, Bandung, Surabaya and the Sub Directorate of Surveillance, Directorate of Surveillance and Health Quarantine, Directorate General of Disease Prevention and Control. Data were analyzed using Microsoft Excel program.
 Results: 305 paralysis cases were caused by imported type 1 wild poliovirus infection were found in 2005 and 2006. 39 paralysis cases caused by type 1 cVDPV infection were also found on Madura Island in 2005. Type 1 wild polioviruses only found on the Sumatra and Java island. The wild poliovirus transmission was stopped in 2006 and was no longer found until 2013.
 Conclusion: Good laboratory-based AFP surveillance has been successfully monitoring and detecting the circulation of the poliovirus. Improved AFP surveillance performance is needed to prove cessation of poliovirus transmission so that eradication of poliovirus can be achieved globally.
 Keywords: surveillance, polio laboratory, Acute Flaccid Paralysis

Evaluation of the Acute Flaccid Paralysis Surveillance System of Polio Free in East Java, Indonesia, 2019

“…Adequate specimen examination which includes examination of stool can contain poliovirus. The polio virus in feces is not only found in children who have just been immunized but in children who are not immunized but are infected with the polio virus through the oral faecal of immunized children (9) . Figure 3 shows that the percentage of adequate specimens in 2014 to 2017 has been more than 80%.…”