Pulmonary tuberculosis surveillance evaluation at Klongluang Hospital, Pathum Thani Province, Thailand, fiscal year 2017

Abstract

Background: Pulmonary tuberculosis (TB) is an important public health problem and a leading cause of death in the world. The numbers of cases in Klongluang Hospital from the service database (HosXP) were 264 in 2017 while in the TB registration database (Tuberculosis Case Management: TBCM) showed 115 cases. This significant difference led to need for TBCM surveillance evaluation. We conducted this surveillance evaluation with objectives to describe the qualitative and quantitative attributes of the current TBCM system in Klongluang Hospital.
Method: We included the medical records of patients who got diagnosed as TB, or other respiratory tract diseases, or got test sputum for acid fast bacilli (AFB), or registered in TBCM. We reviewed and set the case definition as patients aged 1 1 years old or above who received medical treatment at Klongluang Hospital during 1 st October 2016 to 30th September 2017 and resided in Klongluang district, and had symptoms of fever or cough or weight loss, and chest X-ray showed cavity, or reticulonodular or military infiltration. In order to understand the process, acceptability and simplicity of the TBCM, thirty five staff members involving the surveillance system were interviewed to determine qualitative attributes, including the policy and operation level.
Results: The results showed that the sensitivity of TBCM was 85.35% and predictive positive value was 98.52%. They were higher value when compared to the other evaluation study in a hospital in 2 0 1 3 which showed the sensitivity and the predictive value positive were 75.27% and 75.29% respectively. All the staff members mentioned the usefulness of TBCM, they knew how to process system and felt simply to report.
Conclusion: The sensitivity and predictive positive value of the TBCM in Klongluang Hospital were good and the program should be further developed and improved for better procedural understanding and user friendliness with hope of its long term and sustainable use.