Surveillance for Severe Acute Respiratory Infection as one approach to enhance Global Health Security in Indonesia

Latar Belakang: Sistem surveilans nasional untuk infeksi saluran pernafasan akut berat (SARI) dapatmemberikan informasi penting tentang sirkulasi virus influenza, menyediakan sistem untuk mengendalikankejadian luar biasa yang mengancam keamanan dan keselamatan masyarakat serta menyediakandata untuk sistem surveilans influenza global (GISRS). Kemampuan Indonesia untuk mendeteksi dan mengendalikanpenyakit menular penting untuk keamanan kesehatan dunia. Penelitian ini bertujuan untukmenilai sistem surveilans ISPA berat Indonesia (SIBI) dan pemanfaatan untuk memantau patogen prioritaslainnya sebagai upaya meningkatkan keamanan kesehatan global. Metode: penilaian atribut surveilans melalui review laporan, analisis data dan interview staff yang terlibatdalam sistem surveilans. Semua kasus yang memenuhi kriteria SARI pada bulan Mei 2013 – April 2015 ikutserta dalam penelitian. Data epidemiologi dan virologi dianalisis. Kelengkapan dan kemudahan sistem untukmencapai tujuan surveilans influenza dan mendukung surveilans penyakit infeksi baru (emerging) dikaji. Hasil: Sebanyak 1,806 kasus SARI dan 1,697 (94%) spesimen dilakukan pemeriksaan virus influenza.Sebanyak 200 (12%) positif influenza, terdiri dari 46% influenza A(H3N2), 18% A(H1N1)pdm09 dan 37%influenza B. Hasil penilaian terhadap sistem surveilans didapatkan kesesuaian pelaksanaan untuk semuaatribut surveilans melebihi target >80%, kelengkapan laporan online 95%, kesesuaian kasus terhadapdefinisi kasus 100%, kasus yang diambil spesimen 94% dan hasil laboratorium diinput ke database secaraonline 100%. Sistem surveilans untuk dengue dan infeksi arbovirus lainnya sudah terlaksana di unitrawat jalan dan gawat darurat di sentinel SARI surveilans. Kesimpulan: SIBI dapat disesuaikan untuk menggabungkan surveilans penyakit lain yang menunjukkankegunaan dan fleksibilitas dalam mendukung keamanan kesehatan global. Kata kunci: keamanan kesehatan global, surveilans, influenza, Indonesia AbstractBackground: The existing national surveillance system for severe acute respiratory infection (SARI) providescritical information on influenza virus circulation, provides a system to control influenza outbreaks that threatenthe safety and security of the population and feeds data into the global influenza surveillance and responsesystem (GISRS). Indonesia’s ability to detect and control communicable diseases is critical for global healthsecurity. The aim of this study was to assess the SARI surveillance system and utility for monitoring other prioritypathogens as an effort to enhance global health security. Methods: Surveillance attributes were assessed by reviewing records, data analysis and through interviewedwith staffs involved in the surveillance system. All patients at six sentinel hospitals who meet the SARI casedefinition during May 2013 – April 2015 were enrolled. Epidemiological and virological data were analyzed.The surveillance system utility for its influenza surveillance objectives and flexibility to support surveillance ofemerging infectious diseases were assessed. Resuts: A total of 1,806 SARI cases were reported of which 1,697 (94%) had specimens tested for influenza viruses.Of those tested, 200 (12%) were positive, of which 46% were influenza A(H3N2), 18% A(H1N1)pdm09and 37% influenza B viruses. The system exceeded the targets of >80% adherence for most attributes: 95% forcompleteness of online reporting, 100% for cases adhering to the case definition, 94% for cases with specimenscollected and 100% of laboratory results uploaded to the online database. A surveillance system for dengue andother arbovirus infections was established in the outpatient/emergency units at the SARI surveillance sentinel.Conclusion: SIBI was adjusted to incorporate surveillance for other priority diseases indicating its utility andflexibility to support global health security Keywords: Global Health Security, surveillance, influenza, Indonesia