title: Cholera in Indonesia in 1993-1999.
abstract: Cholera-specific surveillance in Indonesia was initiated to identify the introduction of the newly recognized Vibrio cholerae non-O1, O139 serotype. Findings from seven years (1993-1999) of surveillance efforts also yielded regional profiles of the importance of cholera in both epidemic and sporadic diarrheal disease occurrence throughout the archipelago. A two-fold surveillance strategy was pursued involving 1) outbreak investigations, and 2) hospital-based case recognition. Rectal swabs were transported to Jakarta for culture and isolates were characterized by serotypic identification. Outbreak findings showed that V. cholerae O1, Ogawa serotype, was the predominant etiology in all 17 instances of investigated epidemic transmission. Monitoring of eight hospitals representing seven provinces provided 6,882 specimens, of which 9% were culture positive for V. cholerae: 589 (9%) for O1 and 20 (< 1%) for non-O1 strains. Proportional representation of V. cholerae O1 among cases of sporadic diarrheal illness was variable, ranging from 13% in Jakarta to < 1% in Batam. Overall, 98% of V. cholerae O1 cases were the Ogawa serotype. There was no instance of non-O1, O139 serotype introduction in either epidemic or sporadic disease form. Anti-microbial drug susceptibility was consistently demonstrated, both temporally and spatially, except against colistin. Evidence is provided that epidemic and sporadic cholera occurrence in western Indonesia is associated with periods of low rainfall. Conversely, in the more eastern portion of the country, heavy rainfall may have contributed to epidemic cholera transmission.
authors.affiliation: National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia.
authors.forename: C H
authors.initials: CH
authors.lastname: Simanjuntak
authors.forename: W
authors.initials: W
authors.lastname: Larasati
authors.forename: S
authors.initials: S
authors.lastname: Arjoso
authors.forename: M
authors.initials: M
authors.lastname: Putri
authors.forename: M
authors.initials: M
authors.lastname: Lesmana
authors.forename: B A
authors.initials: BA
authors.lastname: Oyofo
authors.forename: N
authors.initials: N
authors.lastname: Sukri
authors.forename: D
authors.initials: D
authors.lastname: Nurdin
authors.forename: R P
authors.initials: RP
authors.lastname: Kusumaningrum
authors.forename: N H
authors.initials: NH
authors.lastname: Punjabi
authors.forename: D
authors.initials: D
authors.lastname: Subekti
authors.forename: S
authors.initials: S
authors.lastname: Djelantik
authors.lastname: Sukarma
authors.lastname: Sriwati
authors.lastname: Muzahar
authors.forename: A
authors.initials: A
authors.lastname: Lubis
authors.forename: H
authors.initials: H
authors.lastname: Siregar
authors.forename: B
authors.initials: B
authors.lastname: Mas'ud
authors.forename: M
authors.initials: M
authors.lastname: Abdi
authors.forename: A
authors.initials: A
authors.lastname: Sumardiati
authors.forename: S
authors.initials: S
authors.lastname: Wibisana
authors.lastname: Hendarwanto
authors.forename: B
authors.initials: B
authors.lastname: Setiawan
authors.forename: W
authors.initials: W
authors.lastname: Santoso
authors.forename: E
authors.initials: E
authors.lastname: Putra
authors.forename: S
authors.initials: S
authors.lastname: Sarumpaet
authors.forename: H
authors.initials: H
authors.lastname: Ma'ani
authors.forename: C
authors.initials: C
authors.lastname: Lebron
authors.forename: S A
authors.initials: SA
authors.lastname: Soeparmanto
authors.forename: J R
authors.initials: JR
authors.lastname: Campbell
authors.forename: A L
authors.initials: AL
authors.lastname: Corwin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000382:microbiology; D003967:Diarrhea / Q000382:microbiology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011891:Rain; D012621:Seasons; D014734:Vibrio cholerae / Q000302:isolation & purification*