IMMUNITY TO DIPHTHERIAE AND TETANUS OF PRIMARY SCHOOL DROP-OUT CHILDREN (7-15 YEARS) IN NORTH JAKARTA MUNICIPALITY

Written by C. S. Whinie Lestar, Dyah Widyaningrum, Sumarno, Farida Siburian

Abstract. According to the Ministry of Education & Culture in 1999 there were 13.67 % dropouts from primary schools and MI (Madrasah Ibtidaiyah) and 3.5 % children who have never attended school. Since 1998 health services for primary/ MI school age namely BIAS program has been carried out. However, up to now there has been no diphtheriae and tetanus BIAS program for school dropouts or those children who never attended school. If school dropouts children do not get DT and TT BIAS immunization, it will influence Tetanus Neonatorum Elimination target, and delay the target achievement to stop immunization for childbearing age and pregnant women in 2005. It will also increase the possibility of diphtheriae outbreak accurence. A cross sectional study to 109 children school drop out was conducted in North Jakarta municipality during March to December 2001. The objective of the study was to identify the immunization status and to measure the immunity status of primary/MI school dropouts or those children who have never attended school (7 through 15 years). Interview was carried out with their parents too. The proportion of primary school dropouts in North Jakarta was 4.4 %, whereby the highest was found in Kalibaru, Subdistrict Cilincing (11.1 %). The highest percentage of immunization for diphtheria and tetanus were TT 0 (34%) and D 1 (39%). Fifty point nine percent (n = 106) of school dropouts showed protective antibody for tetanus (titre  1 IU/ml with Elisa test) with a geometric mean titre (GMT) of 0.4625 IU/ml while 75 % of drop out students showed protective antibody level of diphtheriae (titre  0.01 IU/ml with netralization test) with GMT of 0.0248 IU/ml. This results were less than BIAS research result to primary school students showed 100 % (n = 61) protective antibody level with GMT of 0.7408 IU/ml and GMT of 9.1157 IU/ml of diphtheriae and tetanus. It showed that school dropouts children or those who never attended school still required immunization through BIAS program.

Keywords : diphtheria, tetanus, BIAS, school drop out.