Epidemiology of Rotavirus in Indonesia

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Rotavirus is a diarrhoea illness that is very common in children under five years. Studies conducted on the disease show that almost every child has been infected with rotavirus at a certain stage of growth. After infection, the body of a child develops the immunity to counter the subsequent infections of the disease. The disease rarely infects adults. According to Roalkvam (2013, p. 112), this disease is believed to cause death of several children and infants in the world, especially in the developing nations. Indonesia is one of the nations that have greatly been affected by the disease. A study was carried out in 2008 in Indonesia to check the levels of infection amongst the infants. This study indicated that about 99 children aged below five years were hospitalized and were diagnosed with diarrhoea. Out of the 99 cases of diarrhoea, 66 patients tested positive with rotavirus. This resulted to 67%. Most children affected were those aged between 23 months and below. In addition, all children were affected, irrespective of sex. The strains of the virus discovered were varying ranging from G1 to G9 (Schuller 2010, p. 18). These results clearly show that the rotavirus disease adversely affects Indonesia and there is a need to ensure that effective mechanisms are put in place to curb the effect of the rotavirus in this nation. However, most of studies done from 1979 onwards in Indonesia show that the rotavirus infection level has significantly reduced over the past 20 years.

Description of the Rotavirus (Primary Prevention/Control Strategy)

The pattern of rotavirus infection in Indonesia cannot be monitored due to the unavailability of the infection records. The nation has not kept the records, which makes monitoring a bit challenging, even though it faces the challenge of rotavirus infection. Although rotavirus is known to be the common cause of diarrhoea among infants in this nation, the statistics show that its rate of infection is reducing greatly (Remington 2011, p. 98). This is due to the sanitation and hygienic improvements championed by humanitarian organizations and governmental agencies in charge of public health. The availability of antibiotics to counter the rotavirus infection has contributed to control the disease. These are the primary prevention measures as far as prevention of this disease in Indonesia is concerned. However, these measures have not helped in controlling the disease effectively.

Most nations, such as the United States, are applying various strategies to control the disease. Some nations use vaccines and other strategies, such as awareness creation. In Indonesia, things are a bit different since different measures are applied, which are sometimes ineffective (Siswanto et al. 2009, p.62). This nation has not been able to apply comprehensive strategies to mitigate this challenge because of lack of rotavirus data. This makes it complex for the nation to apply the relevant strategies to control the disease. In spite of this challenge, many studies have been conducted to introduce the use of vaccine as a strategy to control the disease. Many efforts in surveillance have now been made to check the magnitude of rotavirus infection in Indonesia. Currently, the Indonesians are campaigning and pressurising the policy makers to introduce vaccines for rotavirus. To make this more effective, the nation should be encouraged to collaborate with all health providers, governmental agencies, and all communities in creating awareness over rotavirus disease. According to statistics from World Health Organization, there is an urgent need for Indonesia to amend and implement health policies to address rotavirus disease.

Current Challenges Associated With Controlling the Disease

As discussed earlier, developing countries are highly affected by the rotavirus. Although the vaccine for this disease is licensed, in many developing countries, immunization has not been conducted effectively. Indonesia being one of the developing countries is not an exemption. The efforts to control rotavirus disease in this nation are faced by several challenges.

Illiteracy levels in Indonesia are very high. This means that many citizens have acquired little or no education. Education is vital for the success of a nation. In a state where there is poor or lack of education, ignorance would always prevail. Many Indonesian mothers do not take issues of diarrhoea in their children serious (Schroten 2007, p. 57). It is only when the situation persists and seems to threaten the life of a child that they can seek medical help. In addition, many families in Indonesia are faced with poverty challenges that make it hard for many to afford hospital bills for their infants. Hence, with a sick child, a mother may opt to apply herbal medicines that are locally available although non-effective than go to hospital.

Another challenge associated with the control of rotavirus disease in Indonesia is lack of previous infection data. As discussed earlier, this nation lacks the data, which is vital in tracing the magnitude and infection levels for effective control. This is considered one of the greatest challenges that the nation is facing in its fight against this disease. Monitoring the impacts of the vaccine for rotavirus in this nation is still a challenge that needs to be addressed if any fruits are to be realised. This nation has successfully carried out joint campaigns with all stakeholders including its government, but still much has to be done. According to Pollard (2006, p. 87), although the vaccine for rotavirus has been licensed, in many developing countries, such as Indonesia, much should be done to improve immunization levels in the country. What complicates the whole process of immunization in Indonesia is poor infrastructure. Lack of infrastructure has greatly affected immunization programs in this nation. Other challenges, such as financial problems and lack of other necessary logistics, affect disease control strategies.

Although vaccines against this disease have been applied in many developing nations, including Indonesia, there is lack of evidence to demonstrate the efficiency of the current rotavirus vaccine. For this reason, efforts to fight this disease using the current strategy are fruitless. What has made the situation more complex is the lack of necessary resources. Thomsin (2008, p. 36) points out that there is a need to improve the current vaccines against this disease for better results.

Perceived Advantages and Challenges

As mentioned earlier, there has been a concerted effort to ensure that rotavirus is eliminated in this country. Indonesia has been one of the countries that are affected by this disease, which is spreading especially among children aged below five years. According to Quadros (2004, p. 56), efforts have been underway to help deal with the issue of rotavirus in developing countries. The reason is that these developing countries feel the biggest impact of this virus in infants. With the increasing infant mortality rate caused by rotavirus among other diseases, the government of this country, in conjunction with the World Health Organization, Centre for Disease Control and Prevention and PETH among other organizations around the world, have been fighting to find the best vaccines that could be used to help combat this infectious disease. Although there are vaccines in the market, which are already in use and considered effective in combating this infectious disease, the above-mentioned bodies and others have been working closely with various governments to come up with new and better ways of managing this disease. Coming up with new strategies of managing this disease has its pros and cons, as discussed in the subsequent sections.

One of the most important advantage of using new strategies is that it helps in coming up with a mechanism that would help eliminate this complication. For a long time, smallpox was one of the dreaded diseases in the world, claiming hundreds of thousands of lives every year. However, this was brought to an end when the vaccine was found. Rotavirus is just as undesirable disease as smallpox. There is a need to eliminate this infectious disease in all countries around the world. This is what the new strategies seek to offer. The current strategies have proven to be very effective in managing this infection. However, they have failed to help eliminate this infection. Artenstein (2010, p. 78) reports that in developed countries, such as the United States, which uses the current existing vaccines, there has been up to 86 percent drop in this cases. In developing countries, such as Indonesia, the reduction has been with a percentage of about 63 percent. This is a good sign that the existing vaccines are helpful in managing this infectious disease. However, new strategies are aimed at eliminating this disease from the world in totality. This makes it more advantageous. Another factor that makes this new strategy advantageous is that it allows the relevant medical research authorities advance their techniques in dealing with this and other related diseases. The more time these experts spend in the laboratory trying to develop new medication, the better these medications would be and the lower their prices. This time would help these relevant authorities in developing other related medications that might be used in conjunction with the vaccines to help ensure that this disease is effectively fought.

However, it is important to note that this new strategy comes with some extra cost, which at times may be very high. As it was mentioned, the existing medication has not proven to be completely ineffective. If it registered an 87 percent reduction in the level of infection in the United States, it means that when used properly, the current mechanisms can be effective enough to help combat this disease (Kosuke et al. 2012, 1245). The extra cost that is incurred by implementing this new strategy is therefore not necessary. The new strategies will also need approval from various authorities. This would consume a lot of time that would have been used in advancing the existing strategies or making people implement them more effectively.

Rationale for or against Introducing the New Strategy vs. Relying on Current Prevention Methods

As discussed above, there are efforts to introduce new strategies in combating this disease, despite the existence of the current mechanisms. According to Ortene (1986, p. 78), in the field of medication, there is a need to have continuous research in order to be able to fight the current diseases more effectively. This is because some of these diseases tend to develop resistance to some medication when they are exposed to it for a long time. The exposure makes the disease adapt to the medication, and this would make the disease completely ineffective. For this reason, it is necessary to adopt new preventive measures that would be as dynamic as the disease can be. This continuous research on the best strategies that can be used to combat this disease may also be helpful in developing some superior medication that can be used in the hospitals. This would not only help in combating this disease, but also other related medical complications.

Relying on current prevention methods may be cost effective to the relevant authorities. It is also true that the existing methods would not need any approval by the relevant authorities before they can be put to use because they are already approved. However, it is worth noting that this strategy may not be appropriate because of the changing environmental factors (Siswanto et al. 2009, F70). With the changing of environmental conditions, the virus also changes its characteristics, and this means that a method that was previously used to combat this disease may continue being less effective. As time goes by, the medication would become ineffective because the virus shall have changed its characteristics to the levels where it cannot be managed by the drug. In order to eliminate such conditions, the best strategy is to develop a culture of continuous development of new strategies of managing the infection.

List of References

Artenstein, A 2010, Vaccines: A biography, Springer, New York.

Kosuke, K, O’Brien, M, Goveia, G, Mast, C & Khoury, A 2012, “Burden of rotavirus gastroenteritis and distribution of rotavirus strains in Asia”, A systematic review Vaccine, Vol. 30, no. 7, pp. 1244–1254.

Ortene, G 1986, New vaccine development: Establishing priorities, National Academy Press, Washington.

Pollard, A 2006, Hot topics in infection and immunity in children, Springer, New York.

Quadros, C 2004, Vaccines: Preventing disease & protecting health, Pan American Health Organization, Washington.

Remington, J 2011, Infectious diseases of the fetus and newborn infant, Elsevier, Philadelphia.

Roalkvam, S 2013, Protecting the world’s children: Immunization policies and practice, Oxford University Press, Oxford.

Schroten, H 2007, Pediatric infectious diseases revisited, Birkhäuser, Basel.

Schuller, M 2010, PCR for clinical microbiology: An Australian and international perspective, Springer, Dordrecht.

Siswanto, A, Kilgore, P, Kosen, S, Soenarto, Y, Aminah, S, Cahyono, A, Ulfa, M, & Tholib, A 2009, “Economic evaluation of a routine rotavirus vaccination program in Indonesia”, Rotavirus in Asia, Vol. 27, no. 5, pp. 67–74.

Siswanto, A, Yati, S, Bresee, J, Tholib, A, Aminah, S, Cahyono, A, Gentsch, J, Kilgore, P & Glass, R 2009, “Rotavirus surveillance to determine disease burden and epidemiology in Java, Indonesia”, Rotavirus in Asia, Vol. 27, no. 4, pp. 61-66.

Thomsin, M 2008, Seasonal forecasts, climatic change and human health: Health and climate, Springer, Dordrecht.

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