Evaluation of Dengue Surveillance System, Maha Sarakham province, Thailand, 2020

Abstract

Background: In 2020, Dengue was the top five diseases of Maha Sarakham province. There were 1,401 reported cases and 2 death cases. According to the accuracy of these data, how to report in the 506 Surveillance System was very important. In order to know the quantitative and qualitative attributes of the surveillance system, therefore we conducted the evaluation of 506 Surveillance System (Dengue), Maha Sarakham province, 1st January–31st October 2020.
Methods: The cross-sectional study was performed. For quantitative attributes, we reviewed medical records that diagnosed dengue and related disease. The multi-stage sampling was conducted. First, we chose 4 hospitals from each level of hospital capacity by convenience sampling. Second, we collected the medical records from each hospital by systemic sampling. We used case definitions followed “Thailand guideline of infectious disease definition 2001 (TGID-2001)” and “by doctors’ diagnoses”. For qualitative attributes, we interviewed health personnel who involved in 506 Surveillance System.
Results: All hospitals had clear disease reporting steps. The data were collected by hospital epidemiologist. For case definitions followed “TGID-2001” and “by doctors’ diagnoses” showed ‘Sensitivity VS Positive Predictive Value’ were ‘47.4% VS 32.7%’ and ‘46.60% VS 94.39%’, respectively. All variables had completely filled. Most variables were 83.2–100% accuracy except ‘Onset date’ was only 61.2%. We found ‘Age’ could represent the population. Reporting within 3 days was 86.73%. For qualitative attributes, 1) The reporting system was simple according to the clear working process and using software programs/social media for disease reporting, 2) Some hospital system was inflexible according to the scarcity of hospital epidemiologist, 3) The health personnel accepted the importance the surveillance system, 4) The surveillance system was stable according to the strong policy and close monitoring by managerial level, and 5) Health personnel used the information from surveillance system.
Recommendations: We recommend 1) health agencies communicate how to report the cases in the surveillance system to health personnel, 2) Epidemiologist should monitor and evaluate their dengue surveillance systems periodically, and 3) health agencies set at least two persons who are responsible for disease reporting in order to maintain the system resiliency.