Acute hepatitis B surveillance system evaluation in Buriram hospital and Nang Rong hospital, Buriram province, Thailand, 2019
Keywords:
acute hepatitis B, HBV, surveillance evaluation, BuriramAbstract
Background: Hepatitis is the seventh leading cause of death worldwide, 47% of hepatitis death is caused by hepatitis B virus. Approximately 2.2–3 million people were chronic hepatitis B virus infections in Thailand and trend of the prevalence rate is increasing every year. The Hepatitis B virus surveillance are the one component for monitor the progression of the Elimination of Hepatitis B virus under World Health Organization’s target. This study aims to study the surveillance quantitative and qualitative characteristics reporting system.
Methods: The cross–sectional study was conducted to determine the quantitative attributes of the surveillance system. Data of acute hepatitis B virus patients who visited in 2 hospitals (Buriram Hospital and Nang Rong Hospital) in Buriram Province during 1 January–31 December 2019 were reviewed. A qualitative study was performed to study the reporting process and context of hepatitis B virus surveillance system. The sample size for positive predictive value studies 360 samples and sample size for sensitivity studies 385 samples.
Result: Total of 783 medical records met the R506 case definition (581 cases in Buriram Hospital, and 202 cases in Nang Rong Hospital), while 5,741 records met the case definition for active case finding (5,126 in Buriram Hospital, 615 in Nang Rong Hospital). All R506 783 records were reviewed, and an additional 210 records were sampled from the other ICD–10 codes for reviewed (150 from Buriram Hospital, 60 from Nang Rong Hospital). The sensitivity of the surveillance system of Buriram Hospital was 42.01% and Nang Rong Hospital was 50.60%. The Positive Predictive Value of Buriram Hospital was 29.02% and Nang Rong Hospital was 57.53%. The quality of the data showed inaccuracy in variables, marital status, and date of visit. The timeliness of the reports of Buriram Hospital was 67.39% and Nang Rong Hospital was 38.10%. The study demonstrated that staff and stakeholders acknowledge the importance of hepatitis B surveillance in monitoring the situation and evaluating the elimination program.
Conclusion: The significant number of patients reported to the R506 reporting system did not met the acute hepatitis B virus case definition. This discrepancy, coupled with a relatively low positive predictive value, can be attributed to patients with chronic hepatitis B receiving continuous treatment being misdiagnosed as having a hepatitis B virus (HBV) infection, leading to the ICD–10 code B169 (Acute hepatitis B) being assigned and reported in the R506 system. Therefore, improving the quality and accuracy of the surveillance system requires verifying and accurately coding the diagnosis.
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