ASPEK PERTAHANAN BIOLOGI (BIODEFENSE) PADA PENUGASAN OPERASI PRAJURIT TNI DI LUAR NEGERI

Background. Biodefense in military operation assignments is an efforts to defend against biological agents that used as weapons by the sides involved in a conflict, as well as against endemic infectious diseases. The Garuda XXIII Contingent has been on assignment in Lebanon since 2005, and the Garuda XX Contingent in the Democratic Republic of Congo (DRC) since 2003. Hepatitis B in Lebanon and Malaria in DRC are endemic infectious diseases that are highly prevalent in each respective area. Objective. To assess how exposure towards endemic infectious diseases and other biological agents affect personnel health status, as well as the effectiveness of preparation and precautionary measures. Method. Cohort study was performed on 275 Lebanon Team members and 175 DRC team members. Pre-deployment data was obtained from health selection examination results, on-deployment data from medical records taken throughout the deployment period, post-deployment data from the post-deployment health examination. Statistical analysis was carried out using the Chi-square and multivariat technique, molecular analysis was carried out on hepatitis B virus and malarial Plasmodium DNA. Result. There was a significant decline (p=0.000) in the post deployment health status of personnel from both deployment areas, as well as significant health status decline (p=0.032) among members infected by endemic diseases during their deployment. 8 members (2.9%) of the Lebanon team were found as hepatitis B positive based on rapid test examination, confirmed through serology and molecular (PCR and genotyping) methods. These methods show all specimens are consistent with the hepatitis B genotype B (HBV/B) cluster, thus it is highly likely that infection occurred not in Lebanon, but in Indonesia prior to deployment. Microscope and PCR analysis were carried out for 4 members of the DRC team who were diagnosed with P. vivax infection during deployment, results show no Plasmodium DNA. Physical examination on infectious disease cases during and after deployments did not yield any clinical symptoms of biological agent infections that might have been used as weapons. Conclusion. Exposure of endemic diseases results in a decline in post-deployment health conditions. Physical examinations do not show any evidence of exposure from biological agents that may be used as weapons. Keywords: Biodefense, infectious endemic diseases and other biological agents, health status