Hope is placed in 200 vials of Fomepizole, an antidote to acute kidney injury (AKI) in children. This drug inhibits the deterioration of the kidneys to prevent death.
By
KOMPAS EDITOR
·3 minutes read
KEMENTERIAN KESEHATAN
A total of 200 vials of fomepizole have been received by the Indonesian Ministry of Health from Japan on a grant basis. Fomepizole is an antidote used for patients with atypical progressive acute renal impairment.
To this day, cases of death in children with atypical progressive acute kidney injury are still high. Until 26 October 2022, 269 cases were reported across 34 provinces in the country. Of that figure, there were 157 deaths or 58.3 percent of the total number of cases.
The death rate being above 50 percent and the wide coverage has led the people to urge the government to declare this an extraordinary occurrence (KLB). However, the government typically declares an extraordinary event for infectious diseases.
The definition of an extraordinary occurrence is defined in Health Ministerial Regulation No. 82/2014 concerning the control of infectious diseases. According to Article 22, extraordinary occurrences are determined by considerations of epidemiology, socio-culture, security, economy, science and technology as well as the impact disasters have on society. As such, this can still apply to acute kidney injury despite the disease not being contagious.
The regulation mentions several types of infectious diseases that can trigger an extraordinary occurrence of an outbreak. Notably, COVID-19, which was not included in the 2014 regulation, was declared an extraordinary occurrence.
In other words, there is a reason behind the public’s urge to declare extraordinary occurrence status for AKI in children in hopes that the government would treat the disease with extraordinary occurrence guidelines, such as forming a rapid response task force at the central, provincial, district and city levels for early detection, response, reporting and recommendations for countermeasures.
PANDU WIYOGA
The couple Eva Nurmala (34) and Lamhari (39), look at their third child, Nasifa (2.8), from behind a mirror in the pediatric intensive care unit (PICU) at the Batam Business Administration Hospital, Batam City, Riau Islands, Thursday (27/10/2022). Nasifa has been hospitalized since a month ago due to acute kidney injury..
On one hand, the Health Ministry, the Indonesian Pediatrician Association (IDAI), the Food and Drug Monitoring Agency (BPOM) and other related parties have made many efforts: from mitigation measures to the standardization of case management, the discovery of harmful contaminants in dissolving syrups for children’s medicine, their correlation to acute kidney injury as well as banning drugs suspected of containing said contaminants.
The exact cause behind the sudden spike in cases in the last two months is still unknown. How do we explain cases where parents claimed that their children did not consume syrups at all? Or cases that only occurred in Indonesia and Gambia? Or the absence of cases in India, which is the largest source of medicinal raw materials in Indonesia?
This means that a thorough epidemiological study is needed to explain the pattern of the spread of the disease, its related events, factors that play a role and ways to control it. People deserve an explanation for what really happened. Was it caused by the non-standard manufacturing process of medicine in Indonesia? Or the minimal inspection in product quality? Or the people’s habit to self-medicate?
We are grateful that 200 vials of Fomepizole have arrived and are ready to be distributed. We hope that there will be no more cases or deaths. Therefore, the government is obligated to provide information on the issue and take precautionary measures so that the incident does not repeat itself.
