Cholera in Indonesia in 1993-1999
Cholera in Indonesia in 1993-1999
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DOI：
10.4269/ajtmh.2001.65.788
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发表时间：
2001-12-01
影响因子：
3.3
通讯作者：
Corwin, AL
中科院分区：
文献类型：
--
作者：
Simanjuntak, CH;Larasati, W;Corwin, AL
印度尼西亚启动了霍乱特异性监测，以确定新确认的非O 1型霍乱弧菌O 139血清型的引入。7年（1993-1999年）监测工作的结果也产生了霍乱在整个群岛的流行病和散发性霍乱病发生中的重要性的区域概况。采取了双重监测策略，包括1）疫情调查和2）医院病例识别。将直肠拭子运送至雅加达进行培养，并通过血清型鉴定对分离株进行表征。暴发调查结果表明，O 1型霍乱弧菌（Ogawa血清型）是所有17例调查的流行性传播病例的主要病原。对代表7个省的8家医院的监测提供了6，882份标本，其中9%为霍乱弧菌培养阳性：589份（9%）为01菌株，20份（< 1%）为非O 1菌株。散发性腹泻病例中01型霍乱弧菌的比例各不相同，从雅加达的13%到巴淡岛的< 1%。总体而言，98%的O 1型霍乱弧菌病例为Ogawa血清型。在流行性或散发性疾病形式中没有非O 1，0139血清型引入的实例。除粘菌素外，抗微生物药物敏感性在时间和空间上均得到一致证实。提供的证据表明，流行病和零星的霍乱发生在印度尼西亚西部与降雨量低的时期。相反，在该国较东部地区，暴雨可能助长了流行性霍乱的传播。
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 01 and 20 (< 1%) for non-O1 strains. Proportional representation of V. cholerae 01 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, 0139 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.