Prevention of Tetanus Outbreak Following Natural Disaster in Indonesia: Lessons Learned from Previous Disasters

Abstract

In Indonesia, the Aceh earthquake and tsunami in 2004 killed 127,000 people and caused half a million injuries, while the Yogyakarta earthquake in 2006 caused 5,700 deaths and 37,000 injuries. Because disaster-affected areas are vulnerable to epidemic-prone diseases and tetanus is one such disease that is preventable, we systematically reviewed the literature related to tetanus outbreaks following previous two natural disasters in Indonesia. Based on our findings, recommendations for proper vaccination and education can be made for future countermeasures. Using specified keywords related to tetanus and disasters, relevant documents were screened from PubMed, the WHO website, and books. Reports offering limited data and those released before 2004 were excluded. In all, 16 publications were reviewed systematically. Results show that 106 cases of tetanus occurred in Aceh, with a case fatality ratio (CFR) of 18.9%; 71 cases occurred in Yogyakarta, with CFR of 36.6%. For both outbreaks, most patients had been wounded during scavenging or evacuation after the disaster occurred. Poor access to health care because of limited transportation or hospital facilities, and low vaccination coverage and lack of awareness of tetanus risk contributed to delayed treatment and case severity. Tetanus outbreaks after disasters are preventable by increasing vaccination coverage, improving wound care treatment, and establishing a regular surveillance system, in addition to good practices of disaster management and supportive care following national guidelines. Furthermore, health education for communities should be provided to raise awareness of tetanus risk reduction.

Impact of climate change on dermatological conditions related to flooding: update from the International Society of Dermatology Climate Change Committee

“…These bacteria produce tetanolysin and tetanospasmin toxins causing signs and symptoms most commonly 5–10 days after injury. Unvaccinated populations are especially at risk for morbidity and mortality …”

“…Unvaccinated populations are especially at risk for morbidity and mortality. 27,28 Other unusual bacteria have also been documented in flooding-associated wound infections. One PCR (polymerase chain reaction)-confirmed case of cutaneous melioidosis was reported in a tsunami survivor.…”

The Volunteer's Needs and Preparedness in Assisting Natural Disaster Victims

“…Selain itu, Hat Yai Thailand juga pernah melalui pengalaman bencana banjir berikutan hujan lebat pada November tahun 2000, mengakibatkan kira-kira 32 orang mangsa terkorban manakala 1,700 orang mangsa cedera dan mengalami kerosakan harta benda (Assanangkornchai, Tangboonngam, & Edwards, 2004). Tambahan pula, Indonesia juga antara negara yang berisiko mengalami bencana alam, dua bencana yang pernah berlaku di Indonesia adalah tsunami di Aceh pada Disember tahun 2004 dan gempa bumi di Yogyakarta pada Mei tahun 2006 (Pascapurnama et al, 2016). Selain itu, Malaysia tidak terkecuali mengalami peristiwa bencana iaitu sejak tahun 1993 sehingga 2004, Malaysia telah mengalami 19 bencana alam yang menyebabkan 1,460 kematian dan 821 kecederaan (Ibrahim & Fakhru'l-Razi, 2006).…”

New Development of Disaster-Related and Tropical Infectious Diseases Control

“…In the flood of China, after controlling the other meteorological and socioeconomic factors, malaria, diarrhea, and hepatitis A virus (HAV) infection were significantly related to the flood, both from the spatial and temporal analyses [6]. Tetanus outbreaks were also reported after a tsunami in Indonesia [7]. Global warming is a major cause of these disasters.…”