Evaluation of Dengue Surveillance System in Pathum Thani Hospital, Pathum Thani Province, Thailand, 2021–2022

Abstract

Background: In 2021-2022, Pathum Thani Province observed an unusually low number of dengue fever cases compared to 2018-2020. This period coincided with the COVID-19 pandemic, which may have impacted the effectiveness of the dengue reporting system. This study aimed to evaluate the dengue surveillance system in Pathum Thani Province to assess its performance and identify areas for improvement.

Methods: A cross-sectional study was conducted on patients who received services at Pathum Thani Hospital between January 1, 2021, and December 31, 2022. We assessed both quantitative and qualitative attributes of the dengue surveillance system. The quantitative assessment included all 600 medical records from patients diagnosed with dengue fever or related conditions, and 193 reports of dengue cases. All 193 cases from report 506, identified using ICD-10 codes A90, A91, and other febrile illnesses, were included. The qualitative assessment involved interviews with hospital staff involved in the dengue surveillance and reporting system.

Results: The evaluation of the dengue surveillance system at Pathum Thani Hospital revealed a sensitivity of 52.90% and a positive predictive value of 85.49%. Data completeness was 100%. Data accuracy was high for most variables, except for patient type and date of onset, which had accuracies of 96.97% and 91.52%, respectively. The data were representative in terms of both sex and age. Timeliness of reporting was high, at 100%. The qualitative assessment indicated that the dengue surveillance system was useful for disease investigation, control, and planning dengue prevention strategies. Staff and administrators were able to utilize the data promptly. Staff participated in and accepted the system. However, the complexity had been reduced performance when there had been changed in responsibility. The system demonstrated good flexibility and stability. However there was no public process of dengue surveillance system to networks and officer. It should be improved by enhancing the data sharing system and providing staff training to increase effectiveness.

Conclusions: The dengue surveillance system at Pathum Thani Hospital had a good reporting process, but its sensitivity needs improvement. The in chart staff was transferred to a COVID-19 reporting role, leaving no one to report the case. A key weakness was the system's complexity, making it difficult for others to take over, which negatively impacts overall sensitivity.

Recommendations: A comprehensive evaluation of the dengue surveillance system in general hospitals and community hospitals throughout the province was recommended. This will provide a more representative understanding of the challenges and facilitate the development of a province-wide surveillance system improvement plan.