Indonesia is still facing the problem of infectious disease control and the emergence of a re-emerging disease in addition to the face of emerging infection and New emerging infection deseases deseases, as well as the increasing trend of non-communicable diseases (degenerative) caused due to life style. This indicates the occurrence of disease epidemiologic transition, so that Indonesia is facing a double burden at the same time (double burden).
Filariasis or elephantiasis or in Indonesian known as elephantiasis, and in some areas call elephantiasis is a disease caused by the filarial worm infection.
Pathogenesis
Disease elephantiasis is caused by nematode worms of the group, namely Wucheraria bancrofti, Brugia malayi and Brugia timori. The three types of worms that cause elephantiasis disease by means of transmission and clinical symptoms, as well as the same treatment. Female worms will produce (give birth) larvae, called microfilariae, which will migrate into the circulatory system. Disease elephantiasis is mainly due to the adult worms live in the lymph channels. The worms will damage the lymph channels that resulted in the lymph fluid can not be channeled properly, causing swelling in the legs and arms. Adult worms can live for 5-7 years in the lymph nodes.
Filariasis or elephantiasis, or elephantiasis disease is a disease caused by infection with the filarial worms are transmitted through mosquito bites. The disease is widespread in rural and urban areas. Can attack all groups regardless of age and gender. In the world there are 1.3 billion people at risk of contracting the disease elephantiasis in more than 83 countries and 60% of cases are in Southeast Asia.
Epidemiology
Currently in Indonesia microfilaria prevalence rate is an average of 19% this means that 40 million people could be suffering from filariasis in the future if it is not implemented Bulk Drug Prevention filariasis and planned activities towards elimination of filariasis in Indonesia in 2020 (Ministry of Health, 2010)
Almost the whole of Indonesia is filariasis endemic areas, especially eastern Indonesia which have a higher prevalence. Since 2000 to 2009 in the report as many as 11 914 cases of chronic filariasis cases spread over 401 districts / cities. The results of clinical case reports of chronic filariasis of the district / city followed up with a survey of filariasis endemicity, until 2009 there were 337 districts / cities and 135 districts endemic / non-endemic town.
Prevalence of microfilariae average nationally in Indonesia based on finger blood survey (SDJ) 19.78%. Prevalence of microfilariae in Maluku, Papua, West Papua, East Nusa Tenggara and North Maluku are generally higher (1.14 to 38, 57%), when dibandungkan with other islands in Indonesia (Ministry of Health, 2010)
Macroeconomic Situation
During the years 2002 - 2008, Indonesia's population increased by an average of 1:33% per year, while the Gross Domestic Product (GDP) per capita has increased almost 3-fold (from U.S. $ 743.3 to U.S. $ 2.200.8). According to WHO, the percentage of health expenditure to GDP Indonesia in 2006 was 2.5% (World Health Statistics, 2009). Data from the Ministry of Health indicate that health spending showed a tendency to increase from year to year. Despite showing improvement, funding for the program ranged filariasis only less than 1% of the funds for the Ministry of Health (MoH, 2010)
Disease elephantiasis is a disease that previously forgotten. Can lead to disability, stigma, psychosocial and decreased productivity of patients and their environment. It is estimated that the economic losses reached 43 trillion rupiah (MoH, 2010), if not done Bulk Drug Prevention filariasis. Handling has been done, but because of existing constraints resulting outcome is not maximized.
Countermeasures
Filariasis Elimination Program is one of the national priority programs combating infectious diseases in accordance with the Decree of the President of the Republic of Indonesia Number 7 of 2005 on the National Medium Term Development Plan 2004-2009. The general objective of filariasis filariasis elimination program is no longer a public health problem in Indonesia in 2020. Meanwhile, a special purpose program is (a) the decrease in the numbers of microfilariae (mf rate) to <1% in each regency / municipality, (b) prevent and limiting disability due to filariasis.
Control of filariasis with diethylcarbamazine citrate drug administration (DEC) has been amended several times since the start of the method of filariasis control program in 1970. Drug administration of DEC combined with albendazole en masse in a single dose once a year for at least 5 years in a row is very powerful to break the chain filariasis transmission, so it can support the efforts of filariasis elimination 2020
Elimination Program
Acceleration of filariasis elimination programs pursued by the year 2020, conducted by a gradual five-year starting 2010-2014. Filariasis elimination programs are planned through 2014 on the basis of justification: (1) In endemic areas with a number greater than 1%, the transmission can be prevented by the Bulk Drug Prevention program filariasis (POMP filariasis) once a year, for at least five consecutive years. (2) The prevalence of the chronic manifestations of filariasis in 401 districts / cities can be prevented and limited impact kecacatannnya with clinical case management; (3) At least 85% of the population at risk of contracting filariasis filariasis endemic areas must be identified POMP filariasis.
Currently filariasis has become one of the priority diseases to be eliminated, reinforced by the WHO's decision to declare 2000 "The Global Goal of Elimination of Lymphatic Filariasis as a Public Health Problem by the Year 2020". Indonesia agreed to eliminate filariasis as part of a global filariasis elimination.
