A Dengue Diseases Surveillance Evaluation in Phitsanulok Province, Thailand, 2013

Abstract

Introduction: Dengue virus infection is a major national public health problem. In 2013, a total of 1,247 dengue cases in Phitsanulok province were reported and the incidence rate was 150.13 per 100,000 population. The highest and lowest dengue incident rates by district in Phitsanulok were 289.88 and 52.3 per 100,000 population, respectively. Almost 6 times difference between the incidence rates of these two districts made us to evaluate surveillance of the dengue diseases. The purposes of this study is to determine the quantitative and qualitative attributes in the highest and lowest dengue case reported districts in Phitsanulok, and to improve dengue surveillance systems in Phitsanulok.
Methods: A cross-sectional retrospective study. Two district hospitals in Phitsanulok where was the highest and lowest incidence in 2013 had been selected. We reviewed medical records of all patients who had been treated and had been diagnosed with ICD-10 codes at both hospitals in March, July and November 2013. We interviewed all healthcare staffs involving dengue surveillance system in both hospitals.
Results: Quantitative attributes: Sensitivity of the highest and lowest dengue case reported hospitals were 29.57% and 8.33%, respectively. Positive predictive value of the highest dengue case reported hospital was higher than the lowest one, 66.64% and 12.5% respectively. There was difference of representativeness in both hospitals, about the proportions of male to female ratio in the highest (1:1.5 and 1:1.3) and lowest (1:1.7 and 1:1.4) dengue case reported areas. Both hospitals had 100% accuracy and timeliness. Qualitative attributes: There was no significant change of system description, flexibility, acceptability, stability and usefulness between the highest and lowest dengue case reported hospitals. But simplicity showed difference as the highest case reported hospital represented more complex works than the lowest one.
Discussions and conclusion: The reported of dengue disease in both highest and lowest incidence hospitals was under. The lowest dengue incidence hospital was also poor positive predictive value. Both two hospitals were similar in terms system description, flexibility, acceptability, stability and usefulness between the highest and lowest dengue case reported hospitals. The improvement of dengue diseases surveillance was recommended.