Persediaan dan Distribusi Obat Anti Virus ke Daerah Pandemik

Abstract

The Avian influenza is a disease passed through poultry to humans, infects the respiration system, and is caused by the Avian Influenza (H5N1) virus. In Indonesia there are 89 reported cases whereas 68 ended in death, so Case Fatality Rate (CFR) 76.4%. Patients are treated with anti- viral drugs when showing symptoms of acute influenza, and a fever >38o for 2 days. Especially for oseltamivir treatments, patients must be comfirmed with the A/H5N1 virus positive, PCR Influenza A/H5N1 positive. Tests of Immunofluorescencesa (IFA) have found antigent (positive) with the usage of Influenza H5N1 monoclonal antibody, and the increase of the titer antibody of a specific Influenza A/H5N1 convalence phase (paired sera) with neutrality tests as much as 4 times the previous grade (acute phase). There are 4 antiviral drugs that can be used for the influenza pandemic: M2 inhibitor (amantadine and rimantadine) and Neuraminidase inhibitor (oseltamivir and zanamivir). The government has distributed 563.800 capsules of oseltamivir (tamiflu) in 2005 and 12.000.000 capsule in 2006. The following is an example of estimating the number of oseltamivir capsules to be stock piled for a population: If the population = a people, the number of people going tobe protected 25% = (0.25 x a ) people,every people will received 2 treatment and two profilaxis (b = 4), the dosage needed is 1 time (c = 1) and asume that a pandemic will happen twice (d = 2), the amount of oseltamivir that must be provided: 0.25 x a x b x c x d packs or equivalent to 20 x a capsules of oseltamivir (1 pack of oseltamivir contains 10 capsules). Using the same method of calculation the amount to be stockpiled for ten pandemic areas in Indonesia as follows (in packs): North Sumatera 2.912.414, West Sumatera 1.062.233, South Sumatera 1.724.919, Lampung 1.685.360, DKI Jakarta 2.097.361, West Java 8.932.384, Central Java 7.807.235, East Java 8.695.910, Banten 2.024.695, and South Sulawesi 2.014.907.