Clinical Characteristics, Management and Disease Outcomes of COVID-19 Patients in Indonesia: Clinical Characterisation Protocol (INACO Study)

Funders
University of Oxford
Wellcome

Principal Investigator
Associate Professor Raph Hamers

Duration: 
August 2020 – 2023

The project accrues a prospective observational cohort of hospitalised COVID-19 patients in multiple hospitals in Indonesia.

Background

The global COVID-19/SARS-CoV-2 pandemic disproportionately affects low- and middle-income countries (LMICs), but rigorous research of its clinical management and consequences in those settings is lacking. With the fourth-largest population (270 million) globally, Indonesia is facing tremendous challenges, particularly in Jakarta and other hot zones, with the highest death toll in the region.

Systematic approaches are urgently needed to “learn-as-we-go” by characterising clinical patterns, management and outcomes of hospitalised COVID-19 patients, analysed in an international context, to improve the constantly evolving national response.

The project accrues a prospective observational cohort of hospitalised COVID-19 patients in multiple hospitals in Jakarta and Medan, with additional sites being linked in other cities in Indonesia, to generate this critically needed evidence. Clinical data have been shared with the ISARIC platform to support global data analysis. This work also establishes a research platform for ancillary studies of disease mechanisms and therapeutic intervention studies, including the use of wearable devices for patient monitoring, inflammation markers, and SARS-CoV-2 genomic surveillance.

Aims

  1. To describe the clinical patterns, severity, and current management of COVID-19 patients, estimate the disease outcomes, and identify associated factors in Indonesia.
  2. To inform local clinical practice and national policy based on this evidence and identify specific gaps in care.
  3. To establish a COVID-19 clinical research platform for studies and trials.
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OUCRU Investigators

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Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

5

The Ultimate Prevention: Vaccine Status

What if the volunteer leader had checked everyone’s Tetanus vaccination status before leaving for the field trip?

Vaccination Changes Everything

  • 100% Preventable: As you can see from our play, Tetanus cannot be cured easily once symptoms start and can be costly. But it is almost completely preventable with regular vaccination.
  • 10-Year Rule: Adults need a Tetanus booster shot every 10 years to maintain immunity.
  • Early booster shot: If you receive a deep or dirty cut (such as in the play, one from a rusty tool), you may need a booster if your last shot was more than 5 years ago.

When was your last Tetanus shot? Check your records today — a simple booster is the ultimate protection against unexpected accidents.

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

4

Scenario Solved at Step 5!

Life-saving intervention! Jaw stiffness (lockjaw) is a classic symptom of active Tetanus toxin. Immediate hospital admission is required to secure the airway and control muscle spasms.

What if Tam had an ultimate shield against tetanus—protecting him from rusty tools before the trip even started?

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

3

Scenario Solved at Step 4!

Good call! Healthcare providers depend on the full context. Clearly stating that an injury involved rusted metal alerts the nurse to assess Tetanus exposure immediately.

What if Tam had an ultimate shield against tetanus—protecting him from rusty tools before the trip even started?

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

2

Scenario Solved at Step 3!

Spot on! Social media content often promotes unverified advice that delays crucial medical intervention. Deep, dirty cuts always require professional evaluation within hours.

What if Tam had an ultimate shield against tetanus—protecting him from rusty tools before the trip even started?

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

1

Scenario Solved at Step 2!

Smart choice! Clostridium tetani bacteria thrive in organic material like dirt and leaves. Keeping raw plants out of deep cuts prevents pushing bacterial spores deeper into tissue.

What if Tam had an ultimate shield against tetanus—protecting him from rusty tools before the trip even started?

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

1

Scenario Solved at Step 1!

Great call! By stopping work with high-risk, corroded tools, you removed the physical source of Tetanus exposure entirely before an injury could even happen.

What if Tam had an ultimate shield against tetanus—protecting him from rusty tools before the trip even started?

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