HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ompusunggu, S. Articles by Jacobson, J. A. Search for Related Content PubMed Articles by Ompusunggu, S. Articles by Jacobson, J. A.

Confirmation of Japanese Encephalitis as an Endemic Human Disease Through Sentinel Surveillance in Indonesia

Japanese encephalitis (JE) results in significant mortality and disability in children in Asia. In Indonesia, despite recognition of JE virus transmission, reports of human disease have been few and from limited geographic areas. Hospital-based surveillance for acute encephalitis syndrome (AES) and JE in children 15 years of age and under was undertaken in 15 hospitals in six provinces from 2005 to 2006. High- and low-risk provinces in geographically dispersed areas were included. Health center-based surveillance also was undertaken in one province. Eighty-two JE cases were confirmed among 1,496 AES cases detected. JE cases were confirmed in all provinces, but the proportion varied between 18% and 2% among provinces of different risk levels. Children younger than 10 years of age represented 95% of JE cases, and 47% of all cases either died or were disabled. The study shows JE is an endemic human disease across Indonesia. Immunization strategies are being considered.

Received June 28, 2008. Accepted for publication August 31, 2008.

Acknowledgments: The authors thank all the members of the study team—national, provincial, and district staff—who were part of the surveillance work. In particular, we thank Gendro Wahyuhono, Djoko Yuwono, and Bambang Heriyanto (NIHRD, Indonesia). We thank the patients and their families for being agreeable to provide information. We also thank Jane Cardosa and Phaik Hooi Tio for providing technical assistance for transfer of the IgM ELISA technology, for provision of monoclonal antibodies and antigens, and for quality control and confirmatory testing (Universiti Sarawak Malaysia); Widyati Santoso, Mardiana Agustini, and Iwan Ariawan for data analysis (PATH Indonesia); Jodi Udd for assistance with manuscript preparation (PATH USA); and Asheena Khalakdina, Deborah Phillips, Chutima Suraratdecha, and Chris Victor for review of the manuscript (PATH USA).

Financial support: The JE project at PATH provided funding to the Indonesian Ministry of Health for this work. The Bill & Melinda Gates Foundation provided funding to the JE project at PATH.

Disclosure: The authors report no conflicts of interest.

^* Address correspondence to Susan L. Hills, PATH, 1455 NW Leary Way, Seattle, WA 98107. E-mail: shills{at}path.org

Authors’ addresses: Sahat Ompusunggu, Masri Sembiring Maha, Ni Ketut Susilarini, Agus Suwandono, and Endang R. Sedyaningsih, National Institute of Health Research and Development, Indonesia. Jl. Percetakan Negara 29, Jakarta 10560, Indonesia, Tel: 62-21-424-4375, Fax: 62-21-424-5386, E-mails: sahat{at}litbang.depkes.go.id, masri{at}litbang.depkes.go.id, susilarini{at}litbang.depkes.go.id, asuwandono{at}yahoo.co.id, and esedyani{at}indo.net.id. Susan L. Hills and Julie A. Jacobson, PATH, 1455 NW Leary Way, Seattle, WA 98107, Tel: 1-206-285-3500, Fax: 1-206-285-6619, E-mails: shills{at}path.org and Julie.Jacobson{at}gatesfoundation.org. Vanda A. Moniaga, Anton Widjaya, and Agus Sasmito, PATH, TIFA Building, 10th Floor, Suite 1001, Jl. Kuningan Barat 26, Jakarta 12710, Indonesia, Tel: 62-21-520-0737, Fax: 62-21-520-0621, E-mails: vanda{at}path.org, widjaya{at}path.org, and asasmito{at}hotmail.com.

Reprint requests: Japanese Encephalitis Project, PATH, 1455 NW Leary Way, Seattle, WA 98107, E-mail: jeproject{at}path.org.