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DENGUE

HEMORRHAGIC
FEVER
DISEASES IN TROPICAL COASTAL REGION
BACKGROUND

Prior to 1970, only 9 countries experienced


dengue outbreaks, but now DBD is an endemic
disease in more than 100 countries, including
Africa, the Americas, the Eastern Mediterranean,
Southeast Asia, and the Western Pacific which
has the highest rates of dengue cases (WHO,
2014).
Beberapa tahun terakhir, kasus Demam Berdarah Dengue
(DBD) seringkali muncul di musim pancaroba, khususnya
bulan Januari di awal tahun seperti sekarang ini. Karena
itu, masyarakat perlu mengetahui penyebab penyakit
DBD, mengenali tanda dan gejalanya, sehingga mampu
mencegah dan menanggulangi dengan baik. Pada
tahun 2014, sampai pertengahan bulan Desember
tercatat penderita DBD di 34 provinsi di Indonesia
sebanyak 71.668 orang, dan 641 diantaranya meninggal
dunia. Angka tersebut lebih rendah dibandingkan tahun
sebelumnya, yakni tahun 2013 dengan jumlah penderita
sebanyak 112.511 orang dan jumlah kasus meninggal
sebanyak 871 penderita.
What is called Dengue
Fever (DHF)?
Infectious diseases caused by dengue virus

Transmitted by Aedes aegepty mosquitoes

Attacking all ages

More attacking children

There is an increasing trend of people with


DHF in adults
CIRCLE OF DHF
Signs and Symptoms of
Dengue Disease

Thrombocytopenia
( <=150.000 / mm3)

A sudden high fever,


lasting for 2 - 7 days, Signs of bleeding
then falls quickly

Diferential Diagnosis
Liver enlargement
Chikungunya (DC)

Hemoconcentration
(elevation of
hematocrit by 20%)
INCIDENCE RATE

Incidence Rate (IR) of dengue disease in


Indonesia since 1968 - 2015 tends to increase. This
can happen because of the climate change that
affects the vector life. In addition, behavioral
factors and community participation are still
lacking in the activities of PSN (Mosquito Nest
Eradication), as well as the factor of population
increase and the increase of population mobility
which is accompanied by the increase of
transportation infrastructure facilities make DBD
easier and wider.
Incidence rate DHF per 100,000 population in Indonesia Year 1968
- 2015

Source: Director General of P2B2 Ministry of Health RI 2016


Incidence rate DHF per 100,000 population in Indonesia 2015

Source: Director General of P2B2 Ministry of Health RI 2016


The mortality rate (Case Fatality Rate / CFR) is
very high, at 41.4% in the beginning of dengue
cases spread in Indonesia.

By 2015, the provinces with the highest CFR are


Gorontalo (6.06%), Maluku (6%), and West Papua
(4.55%). Provinces with the highest CFR generally
with the highest IR provinces.
Case Fatality Rate DHF per 100,000 population in Indonesia Year
1968 - 2015

Source: Director General of P2B2 Ministry of Health RI 2016


Incidence rate DHF per 100,000 population in Indonesia 2015

Source: Director General of P2B2 Ministry of Health RI 2016


The top five CFR DHF provinces per 100,000 population in
Indonesia from 2011 to 2015

Source: Director General of P2B2 Ministry of Health RI 2016


The number of reported cases of
Extraordinary Occurrence DHF increased,
from 1,081 cases in 2014 to 8,030 cases by
2015.
The incidence of extraordinary DHF events, the number of
provinces and districts / cities of 2014 - 2015

Source: Director General of P2B2 Ministry of Health RI 2016


The number of deaths and CFR on the extraordinary incidence of
DHF from 2014 to 2015

Source: Director General of P2B2 Ministry of Health RI 2016


DHF CONTROL EFFORT

Management of the environment


Environmental modification
Environmental manipulation
Changes in habitat or human behavior
Biological control
Control with chemicals
THANK YOU