Evolution of Dengue Prevention and Control Programme in Indonesia

Dengue fever (DF)/dengue haemorrhagic fever (DHF) has emerged as an important public health problem in Indonesia due to the high morbidity and mortality in children. According to the Ministry of Health, DHF is ranked as number 8 among the ten most important infectious diseases in the country in terms of funding and political commitment. Currently, more than 300 districts are reporting cases and more than 200 million people living in urban and rural areas are at risk. Social and economic impacts of the disease are second only to malaria. Dengue often spreads rapidly affecting a great number of people during epidemics. Dengue is an environmental issue and many factors contribute to the occurrence of the disease. These include population growth, rural-urban migration, intra-city population movement, inadequate water and sanitation services and lifestyles that contribute to making conditions favourable for mosquito breeding, circulation of multiple DENV strains of serotypes and ineffective national control programme. The critical strategies for prevention and control of DF/DHF include: (i) DF/DHF case and vector surveillance; (ii) disease management; and (iii) changing behaviour of communities and building partnerships in order to reduce the abundance of, or improve the management of larval habitats. The proposed new initiatives for strengthening the DF/DHF control programme include laws and regulations related to programme implementation and environmental conditions and strengthening partnerships with the aim of decentralization of governance.