Influenza surveillance system evaluation in Narathiwat Province, Thailand, 2019

Abstract

Background: In 2019, Narathiwat was the second rank province in the lower southern region that had the highest incidence rate of influenza. The influenza outbreaks were occurred every year. This study then was conducted in order to describe the disease reporting steps, identify the qualitative and quantitative attributes of the influenza surveillance system and provide the recommendations for prevention and control measures.
Methods: A cross–sectional study was performed among 3 hospitals in Narathiwat. These hospitals were selected by stratified sampling. For quantitative attributes, we reviewed the medical records which were diagnosed with influenza and associated diseases during January 1–December 31, 2019. We used the disease definitions announced by the Division of Epidemiology, Thailand. For qualitative attributes, we interviewed personnel who involved in the disease surveillance system.
Results: Among total of 25,417 medical records, 952 cases met with the case definitions and 139 cases were reported. The sensitivity was 14.60%. Among total of 806 reported cases in 506 report, 139 cases met the case definitions. The positive value predictive was 17.25%. All variables were recorded completely. All variables were recorded 100% accuracy except ‘onset date’ which was 10.9% accuracy. The cases reported within 3 days were 94.5%. The variables: ‘Age’ ‘Onset month’ and ‘Subdistrict’ could represent the surveillance system. The surveillance system was simple, flexible and the surveillance data was used in the process of planning for the prevention and control measures.
Conclusions: We recommend the epidemiologists announce the disease surveillance definitions of influenza to related health personnel, announce the situation of influenza to health networks at all levels and send the random specimens for influenza virus genotype testing in order to support the decision making for disease control measures., and the provincial health office cooperate with the hospitals to develop the warning/inspection systems in order to help the health personnel to clarify the data before submitting in the disease reporting system.