Tuberculosis surveillance evaluation at Kusuman Hospital, Sakonnakon Province, Thailand, fiscal year 2017

Abstract

Introduction: According to the national pulmonary tuberculosis (TB) prevalence survey in 2012-2013, the estimated pulmonary TB incidence can be as high as 171 per 100,000 population. The reported rate of pulmonary TB in Kusuman District, Sakon Nakhon Province in 2017 was 107 per 100,000 population which was lower than the expected rate. Evaluation of pulmonary TB surveillance system is useful in assessing the disease control surveillance processes to search for pulmonary TB patients who have not yet reached the service and to find ways to develop for a more effective surveillance system. The aim of the study was to determine the quantitative and qualitative attributes of the surveillance system in Kusuman Hospital, Sakon Nakhon Province.
Methods: A cross-sectional study was conducted by reviewing medical records of patients aged ≥ 15 years old with ICD 10 codes of all TB types, having smear-positive sputum for TB from the registration of sputum examination, or receiving rifampicin for treatment in Kusuman Hospital from 1 October 2016 to 30 September 2017. These hospital data were compare to the TB surveillance system (TBCM 2010) to determine quantitative attributes of the surveillance including sensitivity, predictive value positive (PVP), data quality, representativeness, and timeliness. Seventeen health personnel involving the surveillance system were interviewed to determine qualitative attributes including acceptability, usefulness, stability, simplicity, and flexibility of the surveillance system.
Results: Fifty-two TB cases were identified from medical record review and 51 cases were reported in the TB surveillance system. The sensitivity of surveillance was 98 .08% and the PVP was 100%. One TB case receiving treatment at the AIDS clinic was not reported in the TB surveillance system. Differences in data recording between medical record review and TB surveillance were 23.08% for age (1 year difference), 1.92% for address, and 0% for other variables. Data of the surveillance system could be representative. Timeliness of the surveillance system could not be determined. All health personnel stated that the surveillance system was acceptable, useful, stable, and flexible. However, 17.65% of the personnel reported some difficulty in using the surveillance system.
Conclusions: The sensitivity and PVP of TB surveillance system in Kusuman Hospital were very high. Data quality was good and could be representative. The surveillance system was acceptable, useful, stable, and flexible. Improvement of the surveillance system to increase simplicity and training of the new personnel involving the surveillance system are useful.