Abstract
Background: Diphtheria remains a health problem, especially in developing countries. In November 2017, the Indonesian Ministry of Health stated that there was a diphtheria outbreak in Indonesia. East Kalimantan is one of the provinces that experienced this disease outbreak. This study analyzes the risk factors for diphtheria outbreak in children aged 1-10 years. Methods: A case-control study was conducted on 37 respondents. Research variables consist of immunization status against diphtheria, pertussis and tetanus (DPT), nutritional status, children mobility, source of transmission, physical home environment (natural lighting, ventilation area, occupancy density, wall and floor type), knowledge of diphtheria and attitudes towards the diphtheria prevention program. Results: We found that the most of the children who had diphtheria had been immunized against DPT. Additionally the nutritional status of children (p=0.049), mobility (p=0.000) and the source of transmission (p=0.020) were significantly associated with diphtheria. Conclusions: Child/parent mobility (OR=8.456) is the main risk factor for diphtheria outbreak. It is recommended to limit the mobility of children to travel to areas that are experiencing increased cases of diphtheria, improve the nutritional status, and further research on the effectiveness of diphtheria vaccine.
Highlights
Vaccination programs have succeeded in reducing the incidence of diphtheria in the world, diphtheria remains a health problem, especially in the Asian region
Analysis of the variables The results of the bivariate test showed that nutritional status (p=0.049) (OR=4.457), mobility (p
Multivariate analysis performed on the variables which proved to be significantly associated with the incidence of diphtheria, i.e. nutritional status, mobility and source of transmission
Summary
Vaccination programs have succeeded in reducing the incidence of diphtheria in the world, diphtheria remains a health problem, especially in the Asian region. In November 2017, the Indonesian Ministry of Health stated that there was a diphtheria outbreak in Indonesia This is based on reports from various provincial health offices, with 593 cases documented between 1 January and 1 November 2017. East Kalimantan is one of the provinces that experienced a diphtheria outbreak, with all cases occurring in children aged 1–10 years[3]. This study analyzes the risk factors for diphtheria outbreak in children aged 1-10 years. It is recommended to limit the mobility of children to travel to areas that are experiencing increased cases of diphtheria, improve the nutritional status, and further research on the effectiveness of diphtheria vaccine
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