A study of the Streptococcus suis surveillance system in a hospital, Lampang Province, Thailand, 2020–2021

Abstract

Backgrounds: Streptococcus suis is a zoonotic disease. Once the infection enters the body, it can cause severe symptoms. Thailand still has the characteristic of consuming uncooked pork, including infection entering the body through wounds. From the 2021, Streptococcus suis surveillance report in Thailand, Lampang province had a high incidence rate. The reporting system had abnormalities in reporting suspected and probable cases, so it was selected as the study area. Evaluate the epidemiologic surveillance system for Streptococcus suis infections in Hospital A by reviewing the completeness and accuracy of reporting, including recognition of the problem, barriers to reporting the disease by reporting agencies, and the true extent of the disease problem.
Methods: A cross-sectional study was conducted to investigate quantitative characteristics. This was done by reviewing the medical records of outpatients and inpatients with diagnoses of Streptococcus suis infection and other diseases with similar symptoms according to the relevant ICD-10-TM codes between January 1, 2020 and December 31, 2021. Qualitative characteristics were studied by interviewing stakeholders of the surveillance system and studying the reporting process for Streptococcus suis infection.
Result: Quantitatively, in a review of 994 medical records, 15 patients met the definition of Streptococcus suis infection, and 4 cases were reported in 506 reports. The weighted sensitivity of the surveillance system was 31.88%. Of the 506 reports, the positive predictive value of the surveillance system was 88.24%. This report cannot be representative of the surveillance system. The quality of the data is 100% completeness, the accuracy is 75–100%, and the timeliness of the surveillance system is 58.82% within 24 hours according to the provincial criteria. Qualitatively, the relevant staff saw the importance and benefits of the monitoring system. The reporting is easy to handle. One can report immediately by phone. Anyone can report Informational documents and reports are available and easily accessible in the hospital system. However, Hospital's data program could not be linked to 506 reports, so disease control staff had to enter the data and check the additional information in 506 reports, which increased the time and procedure required for reporting.
Recommendations: Evaluation of the surveillance system for Streptococcus suis in Hospital A, Lampang Province, Thailand, 2020–2021 reveal that sensitivity was low in the quantitatively. Guidelines for taking medical history and risk history should be revised, including improving the reporting process from the operating room. The positive predictive value is high, representativeness is not yet assured. Accuracy and completeness are of high qualitative value. Qualitatively, relevant staff emphasize an easy-to-report, straightforward, flexible, and sustainable surveillance system. There is a program in place to assist in reporting information. However, a program can also be developed to link data to 506 reports to reduce reporting time and procedures.