Epidemiological Investigation in Diphtheria Control in Banda Aceh, Indonesia

Background: Extraordinary events (KLB) diph­theria are still found in the city of Banda Aceh. An action is needed to break the chain of diph­theria cases and reduce the number of diphtheria mor­bidity or mortality, one of which is by con­ducting an epidemiological investiga-tion of diph­theria. This study aims to see how the implementation of diphtheria epidemiology investigations in the city of Banda Aceh and how it relates to the presence of diphtheria cases in the city of Banda Aceh. Subjects and Method: This was a qua­­li­ta­tive multiplecase study. Data were collect­ed by con­ducting interviews with doctors in five sample com­munity health center in Ban­da Aceh City. Community health centers were se­lect­­ed by pur­posive sampling based on primary data regard­ing the distribution of diphthe­ria during 2017 and 2018 in Banda Aceh City. This study combined source tri-angulation. The source triangulation infor­mant is surveil­lance who serv­ed in the Banda Aceh City Health Service. Results: The epidemiological investigation effort at the puskesmas began by immediately send­ing a diphtheria fast-moving team to carry out a chronological-related survey of cases and collect data on close contacts in the case envi­ron­ment. In close contact data collection there are com­munity health center that do not record com­plete close contact so prophylaxis cannot cover all close contacts. The stage of exa­mi­na­tion of throat or nose specimens for close con­tact is also not carried out in some com­munity health center. Conclusion: Epidemiological investigations play an important role in breaking the chain of diph­­theria distribution. Skipping stages in epidemiological investigations can provide a gap for the development of diphtheria in the case envi­ronment. Puskesmas that carry out a com­­plete stage of epidemiological investigation are proven to be able to eradicate the incidence of diphtheria in their working area. Keyword s : diphtheria, surveillance, epidemio­logy investigation Correspondence: Zahratul Aini. Masters Program in Family Medi­cine, Universitas Sebelas Maret, Jl. Ir. Su­tami 36A, Surakarta 57126, Central Java. E­mail: dr.­zahratulaini@gmail.com. Mobile: +62­8­­1360003­747. Journal of Epidemiology and Public Health (2020), 05(02): 141-149 https://doi.org/10.26911/jepublichealth.2020.05.02.02