CONGENITAL RUBELLA SYNDROME (CRS) SURVEILLANCE

INDONESIA
APRIL 2023

Tim Kerja Imunisasi WUS, Surveilans PD3I & KIPI

Direktorat Pengelolaan Imunisasi
Direktorat Jenderal Pencegahan dan Pengendalian Penyakit
Kementerian Kesehatan RI

Data as of 08 Mei 2023

 CRS Surveillance Sentinel Hospital Map
Aceh
RSU Dr. Zainoel Abidin Kalimantan Timur New Sentinel: Maluku Utara
RSUD H A Wahab RSUD Dr. Chasan Basoeri
Sumatera Utara Sulawesi Utara Ternate
Sjahranie
RSUP H. ADAM MALIK RSUP Prof. Dr.
R. D. KANDOU
Riau
RSUD Arifin Achmad New sentinel: Papua
RSUD Jayapura
Sumatera Selatan
RS Moh. Hoesin

Sumatera Barat Jawa Barat

RSU Dr. M.Jamil • RS Hasan Sadikin Kalimantan
• RS Mata Cicendo Selatan Sulawesi Selatan
DKI Jakarta RSUD Ulin RSUP dr. WAHIDIN
• RSUPN CIPTO SUDIROHUSODO
MANGUNKUSUMO
• RSAB HARAPAN KITA New sentinel: Maluku
RSUP dr Johannes Leimena
Jawa Tengah
RSUP dr. KARIADI

Bali New Sentinel: NTT

Yogyakarta CRS Surveillance provinces
RSUP SANGLAH RSUD Prof. Dr. W Z Johannes
RSUP DR. SARDJITO Kupang Sentinel Hospital
Jawa Timur
• RSUD dr. SOETOMO New Sentinel Hospital
• RSU Dr. Saiful Anwar
Reference Lab
 Ringkasan Kasus CRS, Indonesia 2015 - 2023

JUMLAH SUSPEK KLASIFIKASI

TAHUN
CRS CRS PASTI CRS KLINIS DISCARDED
2015 298 36 60 202
2016 336 65 113 158
2017 532 54 151 327
2018 534 97 135 302
2019 664 35 176 453
2020 457 10 112 335
2021 916 29 200 687
2022 1026 25 148 853
2023 186 5 41 132
Data as of 08 Mei 2023
 Suspect CRS cases by Month
2021 - 2023
Penemuan Kasus Suspek CRS Per Bulan
Periode 2020 - 2023
2021 (n=916) 2022 (n=1026) 2023 (n=186)
180
165
160

140

120 117
109 111
100 102 103 101
96 94
85 81 84
80 77 79
71 75 71
68 67
60 58 55
45 45 47
40 40 36
29
20 17
0
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Des

Data as of 08 Mei 2023

 Trend of National Reporting Rate
CRS Surveillance, 2015 – 2023
3.5
3.16
3 2.83

2.5
Reporting Rate

2 1.8
1.71 1.74

1.5 1.33
1.14 1.07
1
1

0.5

0
2015 2016 2017 2018 2019 2020 2021 2022 2023*
Year

Annual Reporting Rate Target (1 / 10,000 live birth)

Data as of 08 Mei 2023
*Reporting rate tahun 2023 dihitung berdasakan target TW2
 Reporting Rate

0.00
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
5.00
3.17
RSU Dr. Zainoel Abidin 16.25
7.80
5.29
RSUP H. ADAM MALIK 4.81
0.29
1.15
RSU Dr. M.Jamil 1.53
0.77
1.30
RSUD Arifin Achmad,Pekanbaru 1.22
0.76
1.07
RSUP dr. M. HOESIN 1.52
0.38
2.67
RSUPN CIPTO MANGUNKUSUMO 3.44
0.00
1.28
RSAB HARAPAN KITA 2.97
1.05

2021
2.98
RSUP dr. HASAN SADIKIN 0.94
0.39
2.99
RS MATA CICENDO BANDUNG 2.34

2022
2.13
2.11
RSUP dr. KARIADI 1.55
0.08
4.94

2023
RSUP DR. SARDJITO 2.40
Sentinel Hospital 2.33
1.09
RSUD dr. SOETOMO 3.22
Data as 08 Mei 2023 0.71
1.48
RSU Dr. Saiful Anwar 1.79
0.97
1.51
RSUD Ulin Banjarmasin 1.37
0.82
5.10
RSUD H A Wahab Sjahranie 3.11
Target (1/10.000 live birth)

2.61
CRS Surveillance, 2021 – 2023

6.73
RSUP SANGLAH 5.76
0.60
0.97
RSUP dr. WAHIDIN SUDIROHUSODO 1.25
1.25
Trend of Reporting Rate 18 Sentinel Hospital

1.89
RSUP Prof. Dr. R. D. KANDOU 1.08
0.54

RSUP Dr. Johannes Leimena Ambon

5.10

RSUD Dr. H. Chasan Boesoirie Ternate

0.00

RSUD Prof. Dr. W Z Johannes Kupang

0.00

RSUD Jayapura
0.00
2.83
INDONESIA 3.16
1.07
 DISTRIBUTION OF SUSPECT CRS BY 22 SENTINEL HOSPITALS
INDONESIA, 2021 - 2023
2021 2022 2023 (Triwulan 2)
RSU Dr. Zainoel Abidin 11 11 RSU Dr. Zainoel Abidin 6
33 RSU Dr. Zainoel Abidin 153 41
30 RSUP H. ADAM MALIK 14
RSUP H. ADAM MALIK 147 RSUP H. ADAM MALIK 30 4
149
RSU Dr. M.Jamil 5
11 4
RSU Dr. M.Jamil 12 RSU Dr. M.Jamil 11
15 RSUD Arifin Achmad,Pekanbaru 7
5
RSUD Arifin Achmad,Pekanbaru 16 16
17 RSUD Arifin Achmad,Pekanbaru 16 RSUP dr. M. HOESIN 8
3
RSUP dr. M. HOESIN 16 16 9
17 RSUP dr. M. HOESIN 23 RSUPN CIPTO MANGUNKUSUMO 0
16 RSAB HARAPAN KITA 9
RSUPN CIPTO MANGUNKUSUMO 46 RSUPN CIPTO MANGUNKUSUMO 16 9
56
RSUP dr. HASAN SADIKIN 31
RSAB HARAPAN KITA 16 16 12
22 RSAB HARAPAN KITA 45
RS MATA CICENDO BANDUNG 11
65 22
RSUP dr. HASAN SADIKIN 182 RSUP dr. HASAN SADIKIN 65
25
61 RSUP dr. KARIADI 2
RS MATA CICENDO BANDUNG 22 22
61 RS MATA CICENDO BANDUNG 48 RSUP DR. SARDJITO 3
7
RSUP dr. KARIADI 52 52 RSUD dr. SOETOMO 27
105 RSUP dr. KARIADI 77 19
5 RSU Dr. Saiful Anwar 27
RSUP DR. SARDJITO 28 RSUP DR. SARDJITO 5 26
12
RSUD Ulin Banjarmasin 4
56 3
RSUD dr. SOETOMO 59 RSUD dr. SOETOMO 56
172 RSUD H A Wahab Sjahranie 3
8
RSU Dr. Saiful Anwar 56 56
80 RSU Dr. Saiful Anwar 80 RSUP SANGLAH 4
2
RSUD Ulin Banjarmasin 8 8 7
11 RSUD Ulin Banjarmasin 10 RSUP dr. WAHIDIN… 9
8 RSUP Prof. Dr. R. D. KANDOU 2
RSUD H A Wahab Sjahranie 31 RSUD H A Wahab Sjahranie 8 1
16
RSUP Dr. Johannes Leimena… 2
RSUP SANGLAH 6 6 9
44 RSUP SANGLAH 34
RSUD Dr. H. Chasan Boesoirie… 1
17 0
RSUP dr. WAHIDIN… 14 RSUP dr. WAHIDIN… 17
6
18 RSUD Prof. Dr. W Z Johannes… 0
RSUP Prof. Dr. R. D. KANDOU 4 4
7 RSUP Prof. Dr. R. D. KANDOU 4 RSUD Jayapura 0
4

0 50 100 150 200 0 100 200 0 20 40 60

Target Penemuan Kasus Setahun Suspek CRS Target Penemuan Kasus (Jan-Des) Suspek CRS Target Penemuan Kasus (TW 2) Suspek CRS

Belum memenuhi target

 Classification of CRS Cases
22 Sentinel Hospital, 2015 - 2023
100%

90%

80%
47%
Number of suspected CRS cases

70% 57%
61%
68% 69% 73% 75%
60% 83% 71%

50%

40%
34%
30% 25%
20% 28%
20% 25%
25% 22% 22%
10% 19% 18% 14%
12% 10% 6% 2% 3% 2% 3%
0%
2015 2016 2017 2018 2019 2020 2021 Suspect = 2022 Suspect = 2023 Suspect =
Suspect = 298 Suspect = 336 Suspect = 558 Suspect = 534 Suspect = 664 Suspect = 469 916 cases 1026 cases 186 Suspects
cases cases cases cases cases cases
CRS Pasti CRS Klinis CRI Discarded Pending

Data as of 08 Mei 2023

 Clinical CRS Factors in CRS Surveillance
2018 - 2023
100%
14% 15% 17%
90% 22% 23% 24%
80%
16%
Number of Clinical CRS Cases

24%
70% 29%

34% 28%
60%

50% 54%

40%
67%
30% 61%
56%
49%
20% 44%

10% 22%

0%
2018 2019 2020 2021 2022 2023
Clinical CRS = 135 cases Clinical CRS = 163 cases Clinical CRS = 100 cases Clinical CRS = 200 cases Clinical CRS = 148 cases Clinical CRS = 41 cases
Period

Tidak Diambil Spesimen Tidak Ada Hasil Lab Tidak Ada Spesimen Ulang

Data as of 08 May 2023

 0%
100%

20%
40%
60%
80%

1
2

14
24
RSU Dr. Zainoel Abidin

0
4
RSUP H. ADAM MALIK 0

0
3
1
0

RSU Dr. M.Jamil

0
4
1
0

RSUD Arifin Achmad,Pekanbaru

0
1
2
0

RSUP dr. M. HOESIN

0
RSUPN CIPTO MANGUNKUSUMO

0
8
1

RSAB HARAPAN KITA

0
4
6
2

RSUP dr. HASAN SADIKIN

CRS Pasti
0
1
0

21

RS MATA CICENDO BANDUNG

0
2
0

RSUP dr. KARIADI

CRS Klinis
1
3
3
0

RSUP DR. SARDJITO

CRI
1
2
0

16

RSUD dr. SOETOMO

2023

1
0
0

25

RSU Dr. Saiful Anwar

Data as of 08 May 2023
0
3
0

Discarded

RSUD Ulin Banjarmasin

0
2
6
0

RSUD H A Wahab Sjahranie

Pending
0
2
0

RSUP SANGLAH
1
1
4
3

RSUP dr. WAHIDIN SUDIROHUSODO

0
1
0

RSUP Prof. Dr. R. D. KANDOU

0
4
5
0

RSUP Dr. Johannes Leimena Ambon

Classification of Suspect CRS Cases by Hospital

RSUD Dr. H. Chasan Boesoirie Ternate

0

RSUD Prof. Dr. W Z Johannes Kupang

0

RSUD Jayapura
5
8

41

INDONESIA (19 Provinces)

132
 Cases

10
15
20
25
30
35
40

0
5
36
Congenital Heart Disease
2022 : 46 cases

11
Cataract Congenital

8
Hearing Impairment
Total clinical and Lab confirmed CRS

0
Congenital Glaucoma

Pigmentary Retinopathy
2

Purpura
2023

Data as of 08 May 2023

24

Microcephaly
1

Meningoencephalitis
14

Icteric
Clinical Finding in Clinical and Lab-confirmed CRS

14

Development Delay
3

Splenomegaly
0

Radiolucent Bone Disease

 Multiple Mayor Syndrome in Lab-confirmed CRS
2022 - 2023
Total cases with Lab confirmed CRS
2022 : 25 cases
2022 2023 : 5 cases 2022

Congenital Congenital
Heart Disease Heart Disease
10 cases; 3 cases;
40% 60%
3 cases; 5 cases; 0 case; 0 case;
12 % 20 % 0% 0%
0 1
0% 20%
3 cases; 1 case; 1 case; 0 case;
0 case; 0 case;
12% 0% 4% 20% 0% 0%

Cataract Hearing Cataract Hearing

Congenital Impairment Congenital Impairment

Data as of 08 May 2023

 Age Distribution in Clinical and Lab-confirmed CRS
2022 - 2023

2022 2023
Clinical CRS + CRS confirmed = 173 cases Clinical CRS + CRS confirmed = 46 cases

21.7%
27.7%

72.3%
78.3%

< 6 Bulan 6 - 12 Bulan < 6 Bulan 6 - 12 Bulan

Data as of 08 May 2023

 Age Distribution in Lab-confirmed CRS
2022 - 2023

2022 2023
CRS confirmed = 25 cases CRS confirmed = 5 cases

20.0%

40.0%

60.0%
80.0%

< 6 Bulan 6 - 12 Bulan < 6 Bulan 6 - 12 Bulan

Data as of 08 May 2023
 Mother Age Distribution in Clinical and Lab-confirmed CRS
2022 - 2023

2022 2023
Clinical CRS + CRS confirmed = 173 cases Clinical CRS + CRS confirmed = 46 cases

14 - 19 y
14 - 19 y
Unknown 0.0%
0.0%
17.8%

20 - 29 y 20 - 29 y
Unknown 29.5% 33.3%
33.5% ≥ 40 y
6.7%

≥ 40 y
8.1%
30 - 39 y 30 - 39 y
28.9% 42.2%

Data as of 08 May 2023

 Mother Age Distribution in Lab-confirmed CRS
2022 - 2023

2022 2023
CRS confirmed = 25 cases CRS confirmed = 5 cases

14 - 19 y 14 - 19 y
0.0% 0.0%
Unknown 20 - 29 y
20.0% 20.0%

20 - 29 y
Unknown 36.0% ≥ 40 y
40.0% 0.0%

≥ 40 y
0.0%
30 - 39 y 30 - 39 y
24.0% 60.0%

Data as of 08 May 2023