An evaluation of hand, foot and mouth disease surveillance in a district group of public health centers in Bangkok area under the Bangkok Metropolitan Administration

Abstract

Background: Background: In 2015-2017, Hand, foot, and mouth disease [HFMD] cases in a district group of health care centers in Bangkok (the 12 public health centers and hospitals) from the surveillance system (R506), were reported a total of 840, 1795, and 1432 cases, respectively. But the 12 public health centers were reported only 28, 99, and 49 cases, respectively. It was showed relatively lower than a total of HFMD cases. Therefore, we aimed to perform the surveillance evaluation of HFMD and to describe the quantitative and qualitative attributes and to improve the surveillance system in Bangkok.
Methods: A cross-sectional study was conducted to study the quantitative attributes and qualitative attributes. Purposive sampling was done. Data were collected during 1 January 2016–31 December 2017 by reviewed medical records, electronic medical records and referral cards to analyze the quantitative attributes. Furthermore, members of surveillance system staff were interviewed to analyze the qualitative attributes.
Results: A total of 43 cases met the case definition of the surveillance but only 40 cases were reported in the surveillance. The sensitivity of HFMD surveillance was 93.02%. The positive predictive value was 28.98%. Majority of data accuracy were above 80%. Gender variable and date of reports variable were 100% of data accuracy. The representativeness was good in gender and age. Timeliness in the surveillance system was 82.61%. Among the opinion of staff members in the public health centers and the communicable disease department of Health department, Bangkok Metropolitan Administration, it was found that HFMD surveillance was good in acceptability, flexibility, stability and usefulness.
Conclusions and discussions: Overall, the attributes of quantitative and qualitative of surveillance system were good. The result from this study was low positive predictive value. Therefore, surveillance system staff should attend a training course of the HFMD definition. The HFMD cases of the public health centers from R506 were quite low because some herpangina cases were not reported in the surveillance. Additionally, there are many hospitals located in this district group thus some patients would rather go to the hospital than the public health center.