RESUMO
In 2019, Indonesia and the other countries in the World Health Organization South-East Asia Region adopted the goal of measles and rubella elimination by 2023. This report describes Indonesia's progress toward measles and rubella elimination during 2013-2022. During this period, coverage with a first dose of measles-containing vaccine (MCV) decreased from 87% to 84%, and coverage with a second MCV dose decreased from 76% to 67%. After rubella vaccine was introduced in 2017, coverage with the first dose of rubella-containing vaccine increased approximately fivefold, from 15% in 2017 to 84% in 2022. During 2013-2021, annual reported measles incidence decreased by 95%, from 33.2 to 1.4 cases per million population; reported rubella incidence decreased 89%, from 9.3 to 1.0 cases per million population. However, a large surge in measles and rubella cases occurred in 2022, with a reported measles incidence of 29 cases per million and a reported rubella incidence of 3 per million, primarily related to disruption in immunization services caused by the COVID-19 pandemic. In 2022, approximately 26 million children (an estimated 73% of the target population) received a combined measles- and rubella-containing vaccine during supplementary immunization activities completed in 32 provinces. Progress toward measles and rubella elimination in Indonesia has been made; however, continued and urgent efforts are needed to restore routine immunization services that were adversely affected by the COVID-19 pandemic and close immunity gaps to accelerate progress toward measles and rubella elimination.
Assuntos
Erradicação de Doenças , Vacina contra Sarampo , Sarampo , Vacina contra Rubéola , Rubéola (Sarampo Alemão) , Criança , Humanos , Lactente , COVID-19/epidemiologia , Erradicação de Doenças/tendências , Programas de Imunização , Incidência , Indonésia/epidemiologia , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vacina contra Sarampo/administração & dosagem , Pandemias , Vigilância da População , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Vacina contra Rubéola/administração & dosagemRESUMO
The COVID-19 pandemic has had an unprecedented impact on health, society, and the economy globally and in Indonesia. The World Health Organization (WHO) recommended the use of intra-action reviews (IARs) to identify best practices, gaps, and lessons learned to make real-time improvements to the COVID-19 response. The Emergency Committee of the International Health Regulations (2005) has recommended that countries share COVID-19 best practices and lessons learned with peer countries through IARs. Using WHO-established methodology, we conducted the first IAR of Indonesia's COVID-19 response from January through August 2020. The review covered 10 thematic areas (pillars): (1) command and coordination; (2) operational support and logistics; (3) surveillance, rapid response teams, risk assessment, and field investigation; (4) laboratories; (5) case management; (6) infection prevention and control; (7) risk communication and community empowerment; (8) points of entry, international travel, and transportation; (9) large-scale social restrictions; and (10) maintaining essential health services and systems. We held focus group discussions with a variety of stakeholders from a range of government departments, provincial health offices, and nongovernmental organizations. We used the results of the focus group discussions and other key findings from the IAR to formulate recommendations. The IAR identified key areas for improvement at national and subnational levels across all 10 pillars. Priority recommendations included improving multisectoral coordination and monitoring of COVID-19 response plan indicators; strengthening implementation of public health response measures, including case detection, isolation, infection prevention and control, contact tracing, and quarantine; and improving data collection, analysis, and reporting to inform public health risk assessment and response. The IAR is a useful tool for reviewing progress and identifying areas to improve the COVID-19 response in real time and provides a means to share information on areas of need with COVID-19 response partners and contributes to International Health Regulations (2005) core capacity development.