Hand foot mouth disease and severe enterovirus infection disease surveillance evaluation in patients under 15 years of age, Chanthaburi province, Thailand, 2018

Abstract

Background: In 2017, Chanthaburi province had the highest morbidity rate of hand, foot, and mouth disease in Thailand. We evaluated the hand, foot, and mouth disease and severe enterovirus infection disease surveillance for patients aged under 15 years in Chanthaburi. The objectives were to study the work processes, quantitative and qualitative attributes and to give recommendations.
Method: The cross-sectional study was conducted in 3 hospitals. The study population included hand, foot, and mouth disease, herpangina and severe enterovirus infection disease patients aged under 15 years who visited at the 3 hospitals during 1 January–30 December 2018.
Results: Overall of the 3 hospitals, the sensitivity was 64.13%. The positive predictive value was 92.22%. Some patients were not reported to the surveillance system due to incorrect coding of disease. Staff of some hospitals have a misunderstanding that if a doctor diagnoses a herpangina, it is not eligible to report. And some hospital staff did not use the case definition for surveillance in screening patients, causing patients who did not meet case definition were incorrectly reported in the R506. For the period from the patient being diagnosed to the day the Provincial Health Office received the report, 95.36% of reported cases were done within 7 days. For the period from the date that the Provincial Health Office receives a report to the date that the Division of Epidemiology received a reports, 91.79% of reported cases were done within 7 days. Both administrators and health personnel from every level accepted and understood the importance of the surveillance system. Most hospital staff were aware of the process of disease reporting, participated in and complied to the surveillance protocol. The surveillance system was simple.
Conclusions and Recommendations: To improve the surveillance system, the hospitals should encourage their staff to apply the national case definition for surveillance and report of hand, foot and mouth disease and enterovirus infectious disease for more correct and consistent information from the surveillance system. This is crucial for disease prevention and control planning.