Interferon gamma release assay post BCG among newborns and family members living in a crowded area in Jakarta, Indonesia.

INTRODUCTION: BCG vaccine is a mandatory for newborn in Indonesia, an endemic tuberculosis (TB) country that ranks second worldwide. A close contact with untreated active pulmonary TB individuals in a crowded area may result in TB disease or otherwise develop a latent TB infection (LTBI), as shown by positive result of interferon gamma release assay (IGRA). OBJECTIVE: To explore LTBI among newborns and their family members living in a crowded area in Jakarta, Indonesia. METHODOLOGY: A prospective analytical study was conducted among newborns between October 2016 and March 2017. IGRA was examined before BCG vaccination and after 12 weeks. In parallel, TB active case finding was performed among family members of the newborns. RESULTS: Out of 135 newborns, only 117 (86.7%) came for BCG vaccination. Of 346 family members screened, 8 (2.3%) were detected as untreated active pulmonary TB, confirmed by positive sputum and/or MTB culture. Family members living in the same house with active TB individuals (p = 0.011, OR 2.69) as well as being males (p = 0.025, OR 1.68) had a significant higher risk of having a positive IGRA. CONCLUSIONS: Untreated pulmonary TB infection in a crowded area infects the surrounding neighbors, resulting in latent TB infection. An active program for detecting pulmonary TB cases and preventive measures need to be taken seriously to contain the potential spread of the infection.

Estimated incidence of influenza-associated severe acute respiratory infections in Indonesia, 2013-2016.

BACKGROUND: Indonesia's hospital-based Severe Acute Respiratory Infection (SARI) surveillance system, Surveilans Infeksi Saluran Pernafasan Akut Berat Indonesia (SIBI), was established in 2013. While respiratory illnesses such as SARI pose a significant problem, there are limited incidence-based data on influenza disease burden in Indonesia. This study aimed to estimate the incidence of influenza-associated SARI in Indonesia during 2013-2016 at three existing SIBI surveillance sites. METHODS: From May 2013 to April 2016, inpatients from sentinel hospitals in three districts of Indonesia (Gunung Kidul, Balikpapan, Deli Serdang) were screened for SARI. Respiratory specimens were collected from eligible inpatients and screened for influenza viruses. Annual incidence rates were calculated using these SIBI-enrolled influenza-positive SARI cases as a numerator, with a denominator catchment population defined through hospital admission survey (HAS) to identify respiratory-coded admissions by age to hospitals in the sentinel site districts. RESULTS: From May 2013 to April 2016, there were 1527 SARI cases enrolled, of whom 1392 (91%) had specimens tested and 199 (14%) were influenza-positive. The overall estimated annual incidence of influenza-associated SARI ranged from 13 to 19 per 100 000 population. Incidence was highest in children aged 0-4 years (82-114 per 100 000 population), followed by children 5-14 years (22-36 per 100 000 population). CONCLUSIONS: Incidence rates of influenza-associated SARI in these districts indicate a substantial burden of influenza hospitalizations in young children in Indonesia. Further studies are needed to examine the influenza burden in other potential risk groups such as pregnant women and the elderly.