Evaluation of the melioidosis surveillance system in Roi et Hospital, Roi et Province, Thailand, 2021–2022

Abstract

Background: Northeastern Thailand has the highest incidence rate of melioidosis. The clinical manifestations of this disease vary among the patients. Some patients can develop severe symptoms leading to fatal outcomes. The melioidosis morbidity rate of Roi et province has dramatically increased from 7.85 per 100,000 population in 2021 to 27.23 per 100,000 population in 2022. According to the situation that turned worse, the surveillance system evaluation then became the first priority of activities to be conducted. The aims were to determine the quantitative and qualitative attributes of the surveillance system and to improve the system more efficiently.

Methods: The cross–sectional study was performed. For quantitative attributes, we reviewed medical records that diagnosed melioidosis and related disease from 1 January 2021–31 December 2022, Roi et Hospital. We used case definitions followed “Thailand guideline of infectious disease definition 2020 (TGID–2020) and ‘by doctors’ diagnoses”. For qualitative attributes, we interviewed health personnel who involved in Epidemiology Surveillance System 506 (R506).

Results: For case definitions followed TGID–2020 and by doctors’ diagnoses showed ‘Sensitivity VS Positive Predictive Value’ were ‘30.38% VS 39.38%’ and ‘29.03% VS 52.40%’, respectively. All variables had completely filled. Most variables were 100% accuracy, except Sex, Type of patients, Diagnostic date and Onset date were only 97.8%, 65.4%, 50.7% and 36.0%, respectively. The age, gender, race and month of diagnosis variables could be representative. The timeliness was 38.70%. For qualitative attributes, the surveillance system was simple and stable, the staff could work interchangeably and the health personnel accepted the surveillance system but still did not use the surveillance information as much as possible.

Recommendations: We recommend the epidemiologists should 1) communicate with staffs from different departments to develop the efficient disease surveillance system 2) clarify the system and procedures for diseases reporting and 3) sharing disease situation reports to other departments inside the hospital as well as the networks outside the hospital in order to use for patient care planning and disease surveillance in the community.