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The burden of diarrhoea, shigellosis, and cholera in North Jakarta, Indonesia: findings from 24 months surveillance

Agtini, Magdarina D., Soeharno, Rooswanti, Lesmana, Murad, Punjabi, Narain H., Simanjuntak, Cyrus, Wangsasaputra, Ferry, Nurdin, Dazwir, Pulungsih, Sri Pandam, Rofiq, Ainur, Santoso, Hari, Pujarwoto, H., Sjahrurachman, Agus, Sudarmono, Pratiwi, von Seidlein, Lorenz, Deen, Jacqueline L., Ali, Mohammad, Lee, Hyejon, Kim, Deok Ryun, Han, Oakpil, Park, Jin K. and et al. (2005). The burden of diarrhoea, shigellosis, and cholera in North Jakarta, Indonesia: findings from 24 months surveillance. BMC Infectious Diseases,5(1):89-99.

Document type: Journal Article
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Title The burden of diarrhoea, shigellosis, and cholera in North Jakarta, Indonesia: findings from 24 months surveillance
Author Agtini, Magdarina D.
Soeharno, Rooswanti
Lesmana, Murad
Punjabi, Narain H.
Simanjuntak, Cyrus
Wangsasaputra, Ferry
Nurdin, Dazwir
Pulungsih, Sri Pandam
Rofiq, Ainur
Santoso, Hari
Pujarwoto, H.
Sjahrurachman, Agus
Sudarmono, Pratiwi
von Seidlein, Lorenz
Deen, Jacqueline L.
Ali, Mohammad
Lee, Hyejon
Kim, Deok Ryun
Han, Oakpil
Park, Jin K.
et al.
Journal Name BMC Infectious Diseases
Publication Date 2005
Volume Number 5
Issue Number 1
ISSN 1471-2334   (check CDU catalogue open catalogue search in new window)
Start Page 89
End Page 99
Total Pages 11
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
Abstract Background: In preparation of vaccines trials to estimate protection against shigellosis and cholera we conducted a two-year community-based surveillance study in an impoverished area of North Jakarta which provided updated information on the disease burden in the area.

Methods: We conducted a two-year community-based surveillance study from August 2001 to July 2003 in an impoverished area of North Jakarta to assess the burden of diarrhoea, shigellosis, and cholera. At participating health care providers, a case report form was completed and stool sample collected from cases presenting with diarrhoea.

Results: Infants had the highest incidences of diarrhoea (759/1 000/year) and cholera (4/1 000/year). Diarrhea incidence was significantly higher in boys under 5 years (387/1 000/year) than girls under 5 years (309/1 000/year; p < 0.001). Children aged 1 to 2 years had the highest incidence of shigellosis (32/1 000/year). Shigella flexneri was the most common Shigella species isolated and 73% to 95% of these isolates were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol and tetracycline but remain susceptible to nalidixic acid, ciprofloxacin, and ceftriaxone. We found an overall incidence of cholera of 0.5/1 000/year. Cholera was most common in children, with the highest incidence at 4/1 000/year in those less than 1 year of age. Of the 154 V. cholerae O1 isolates, 89 (58%) were of the El Tor Ogawa serotype and 65 (42%) were El Tor Inaba. Thirty-four percent of patients with cholera were intravenously rehydrated and 22% required hospitalization. V. parahaemolyticus infections were detected sporadically but increased from July 2002 onwards.

Conclusion: Diarrhoea causes a heavy public health burden in Jakarta particularly in young children. The impact of shigellosis is exacerbated by the threat of antimicrobial resistance, whereas that of cholera is aggravated by its severe manifestations.
Keywords shigellosis
two-year community-based surveillance study
North Jakarta
disease burden
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