The Epidemiology, Control and Prevention of Dengue Hemorrhagic Fever (DHF) in Indonesia

Dengue Hemorrhagic Fever (DHF) is one of the eight communicable diseases which cause high mortality in children in Indonesia. Since the first outbreak in 1968, incidence rate of DHF has been significantly increasing. The highest number of DHF cases is reported in 1988, with 47,573 cases mostly from the island of Java. DHF is also spreading from 2 regencies in 1968 to 187 regencies in 1992 throughout all the 27 provinces in Indonesia. The Case Fatality Rate (CFR) of DHF in hospital has been gradually decreasing from 41.3% in 1968 to 2.9% in 1992. The number of DHF cases increases mostly during the rainy season (November-January). Since 1976, all of the four Dengue serotypes have been isolated from patients clinically diagnosed as DHF. Dengue-3 and Dengue-2 are interchangeable the dominant serotypes. Aedes aegypti, as the main vector, is found to be wide spread both in houses as well as in public places with House Index in 7 cities decreasing from 36% in 1986 to 28% in 1992. Control and prevention of DHF is based on community participation through village cadres to eliminate breeding places all year around, mass fogging before the expected transmission season, fogging focus in the DHF premises and surrounding places. The future trend of DHF, 1993-1998 is predicted to have the same Incidence Rate, decrease of CFR, due to improvement of water supply, community participation, early diagnosis and treatment and development of probable Dengue vaccine