Modeling the transmission dynamics and control strategies during the 2017 diphtheria outbreak in Jakarta, Indonesia.

Djaafara BA., Adrian V., Eriawati E., Elyazar IRF., Hamers RL., Baird JK., Thwaites GE., Clapham HE.

Diphtheria has resurged globally, including in Indonesia, despite widespread vaccination since the 1970s. Knowledge gaps persist in understanding contemporary transmission drivers and effective outbreak control, especially in densely populated areas like Jakarta. We analyzed the 2017 Jakarta outbreak data and developed a compartmental model incorporating estimates of population susceptibility and asymptomatic carriers. Key epidemiological parameters were estimated, and various control measures were simulated. Our study found overall diphtheria susceptibility at 12.9 % (95 % CrI: 8.6 %-19.0 %) and 28.0 % (95 % CrI: 20.5 %-36.0 %) in children under 5 under different modeling scenarios, which were below the 'herd immunity threshold'. We estimated asymptomatic carriers to be highly prevalent, substantially contributing to the reproduction number. The model indicated that contact tracing and treating suspected cases and their contacts were more effective in preventing new cases than catch-up vaccination alone. These findings provide valuable insights for future outbreak management strategies in similar settings.

DOI

10.1016/j.idm.2025.08.004

Type

Journal article

Publication Date

2026-03-01T00:00:00+00:00

Volume

11

Pages

1 - 15

Total pages

14

Addresses

Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.

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