Evaluation of pulmonary tuberculosis surveillance system at Bang Pakong hospital, Bang Pakong district, Chachoengsao province, fiscal year 2021–2022

Abstract

Introduction: Pulmonary tuberculosis is a significant contagious disease and a global public health problem, ranking fifth in the highest morbidity rate of communicable diseases in Bang Pakong District, with a mortality rate of 16.22% in 2022. In the fiscal year 2021–2022, data from the HosXP program reported 133 pulmonary TB cases, while 89 cases were enrolled in the National Tuberculosis Information Program (NTIP) program. Almost two-fold difference was observed between these databases. Therefore, this study aims to evaluate the pulmonary tuberculosis surveillance system at Bang Pakong Hospital, Chachoengsao Province, in terms of both quantitative and qualitative characteristics.
Methods: A cross–sectional study was conducted to evaluate tuberculosis surveillance at Bang Pakong Hospital from October 1, 2021 to September 30, 2022. The quantitative data were collected from outpatient and inpatient records, sputum findings, records from patients receiving rifampicin, and the NTIP report. Additionally, eighteen health personnel involved in the surveillance system were interviewed to determine qualitative attributes of the surveillance system. Both quantitative and qualitative data were analyzed using descriptive statistics; percentage, median, mean, minimum, and maximum.
Results: The patients records of Bang Pakong Hospital from October 1, 2020 to September 30, 2022 reported 1,940 patients, were reviewed in this study. They were 133 patients from TB codes, and 1,807 patients from non–TB codes. Among these cases, 102 patients were included as TB cases based on the definition, 78 cases were from TB codes, and 24 were from non-TB codes. The NTIP report identified 89 cases according to the definition. The sensitivity of surveillance system was 87.25% and the positive predictive value (PVP) was 100%. Thirteen patients, who were not reported to the NTIP program, include AIDS patients treated in the ARV clinic and patients who requested treatment in other provinces according to their universal coverage scheme and social security scheme. The accuracy of variables in the report, including the accuracy of the date of registration, address, age, name-surname-gender, and timeliness was 88.76%, 89.89%, 98.88%, 100%, and 97.75%, respectively. In terms of representation, the data of both systems were similar and can be representation. The health personnel agreed that the TB surveillance system was useful, acceptable, and stable. However, the system is needed to be adjusted in terms of difficulty as the input data comprise of many pages. Moreover, the data must be reported to multiple programs.
Conclusions: The pulmonary tuberculosis surveillance system of Bang Pakong Hospital, Chachoengsao Province has high sensitivity, high positive predictive value, high accuracy, and can be representation. The qualitative data showed that the system was acceptable, useful, and stable. However, patients’ data from HosXP program should be verified before importing it into NTIP program to ensure data completeness and enhance sensitivity.