Appearance a case of polio affecting a 7-year-old boy in Pidie District, Aceh in early November 2022 amaze the audience. Because, for nearly a decade, this disease was rarely heard of. Especially up In 2014 the World Health Organization (WHO) declared Indonesia polio-free.
The Ministry of Health determines the status of poliomyelitis epidemics (KLB). reinvigorate polio immunization in different districts of Aceh province. The Minister of Health points to polio vaccination in Pidie in children finished in another week.
The results of this polio case show public health surveillance system that doesn’t work. In fact, polio is actually a disease can be easily prevented through immunization (PD3I).
Another issue is basic immunization coverage, including immunization against poliomyelitis, in Aceh it is among the lowest and tends to drop.
Transmission and impact models
Poliomyelitis, also known as poliomyelitis, is a disease caused by enterovirusesa genus of virus that causes disease in humans and animals.
The polio virus is highly contagious and usually invasive nervous system in children five years and under. The means of transmission of the virus is the mouth or nose. Generally, this virus is spread through food (oral transmission) or drinking water contaminated with the feces of polio patients (transmission through the patient’s feces).
Environmental health factors such as sanitation bad and defecation (BAB) everywhere places also contribute to the spread of the polio virus.
In the case of Aceh, said the health minister Polio cases are thought to have originated from attenuated viruses in the polio vaccine from the bodies of children who defecate in rivers.
Polio virus infection can also be fatal reduce a person’s quality of life consequence permanent paralysis and even ending in death.
In the context of health policies and programs, inadequate polio prevention efforts can do this affect health care financing a country.
Immunization: a key factor in the prevention of poliomyelitis
Since 1988, WHO has started worldwide eradication of polio. The program has succeeded in reducing more than 99 percent of polio cases.
However, there are three countries: Afghanistan, Pakistan and Nigeria that still have status endemic for the transmission of wild poliomyelitis.
In Indonesia, immunization against polio has actually become part of the program basic immunization since 1982.
Unfortunately, the program didn’t work effectively and was unable to stop the spread of the wild polio virus. Then, from 1995 the government started further immunization activities through National Polio Immunization Week (PIN)..
Immunization is effective way to prevent polio infection. Giving polio vaccine done by dripping into the mouth 4 times, i.e. when the baby was born and when the baby was 2, 3 and 4 months old. Prevention is strengthened by immunizing two doses of injectable polio before the child is 1 year old.
AMONG THE PHOTOS/Ampelsa/hp
The resurgence of polio cases in Aceh is reinforced by findings that immunization coverage has so far been suboptimal. Before the polio case emerged in Aceh, Outbreaks of polio have occurred in Yahukimo, Papua, in 2018.
According to Data from the Central Statistical Office (BPS)., basic immunization coverage in Aceh province is one of the lowest. Coverage in the province, in fact, decreased year on year, 23.9% in 2017, falling to 17.32% in 2019.
Health profile data 2021 it also shows that Aceh, West Papua and Papua provinces are the three provinces with the lowest polio immunization coverage in Indonesia.
Read more:
How can Indonesia maintain its polio-free status?
Undermining routine health services during a pandemic
The pandemic condition has made vaccination coverage ever more excruciating. This is because the program’s priorities and activities are focused on managing COVID-19.
Data from the Ministry of Health show that basic immunization coverage in 2020 it dropped dramatically. The ministry expects 92% of children to receive basic immunization by 2020, but in reality only 84%.
The reason is the restriction on the mobility of the population to break the transmission chain of the COVID-19. The Puskesmas prioritizes efforts to address COVID-19 so that routine health services others are somewhat excluded. Similarly, Posyandu’s activities had ceased.
This has the effect of weakening public health surveillance, i.e. the process of collecting, processing, analyzing and interpreting data and health cases and problems in a systematic and continuous way as well as disseminating information. In fact, surveillance can be the spearhead in managing an outbreak.
Misinformation and misperceptions about vaccinations
One of the still low factors in vaccination coverage is related to the knowledge, attitudes and behaviors of the community. It cannot be denied, even low vaccination coverage is strongly influenced by its prevalence disinformation in the community resulting in denial of immunization.
Our research on LIPI Population Research Center Health Team in 2017 regarding the basic vaccination coverage in Medan City confirmed this.
As many as 5.3% of the 400 mothers with children under 2 who participated in the study refused to vaccinate their children. Their reasons varied: fear of adverse events after immunization (AEFI), such as fever, and the assumption that children already have natural antibodies to ward off infectious diseases, such as smallpox and measles.
Interesting, The anti-vaccine movement has been going on for a long time one of which is influenced by the views of religious leaders or the beliefs of a region.
Misperceptions about vaccines have also been found in studies at Nigeria which cites the refusal of the vaccine because it is considered a conspiracy theory to control the number of certain ethnic groups or groups.
The importance of intersectoral synergy
The re-emergence of polio cases in Indonesia demonstrates that polio-free status must be carefully maintained continuous (continuous) effort..
The weakening of the achievement of basic health immunization during the pandemic shows the importance of innovation in the implementation of activities, for example through regular home visits.
This is important to ensure that the public health surveillance system works optimally. The hope is to be able to detect new cases early, as well as reduce transmission.
The challenge of education amidst a massive flow of information makes this effort just not belongs to the health sectorbut it also requires the active role of the community, formal and informal figures (including religious leaders, traditional leaders), academics and the media.
We need a joint effort to break the chain of transmission so we can maintain polio-free status.
