Hand-foot-mouth disease and severe enterovirus surveillance evaluation in KhuanDon District, Satun Province, 2011–2015

Abstract

Background: Hand-foot-mouth disease (HFM) was one of the major health problems in Khuandon District. This study was aimed to assess the surveillance system of HFM and severe enterovirus infection in both quantitative and qualitative aspects, and to provide recommendation for improving the surveillance system.
Methods: The OPD and IPD card of HFM, herpangina, severe enterovirus, and other related disease during 2011- 2015 were extracted based on ICD10TM and were reviewed cases reported from the surveillance system. In-depth interview among healthcare workers who involved in surveillance system were conducted to describe the system and assess qualitative aspect HFM was defined as Hand Foot Mouth (B08.4), Herpangina (B08.5), Coxsackie / Enterovirus / Echovirus infection (B34.1) and Severe Enterovirus infection / Enteroviral encephalitis (A85.0), Enteroviral meningitis (A87.0), Viral Myocariditis (B33.22) and Coxsackie / Enterovirus / Echovirus infection (B34.1).
Results: A total of 1,194 medical records were reviewed, and 164 met HFM case definition. No severe enterovirus case was identified. There were, 133 cases reported in the surveillance system. The sensitivity of that disease surveillance system is 72.56%. The positive predictive value of the surveillance was 89.47%. Timeliness of reporting within 72 hours was 100%. The completeness and accuracy were over than 90%, except for variable "date of onset" that only had 6.77% accuracy. The in-depth interview showed that almost all healthcare workers knew about HFM definition and flow of the surveillance. Staff at all levels accepted the HFM surveillance system. Moreover, the data from surveillance were used for policymaking.
Conclusion and Discussion: Although quantitative attributes of the HFM and severe enterovirus surveillance system in KhuanDon District, Satun Province, were in good condition, the accuracy of variable “date of onset” was extremely low because there is no item for date of onset in the hospital database. But the onset date of HFM case can be found in the hospital database. For acceptability of the surveillance system obtained from executives and officers was in good level. Obtained data were utilized in investigation and disease control. Proactive plan was planned to prevent and reduce the outbreak of the disease as well as to utilize resources efficiently.