Leptospirosis surveillance evaluation in Trang Hospital, Thailand, 2014

Abstract

Background: In 2014, 12 cases of Leptospirosis were reported to surveillance system of Trang hospital while ninety-seven cases were recorded in hospital database system (ICD10). After a Leptospirosis patient was dead in January 2015, evaluation on Leptospirosis surveillance system of Trang hospital was conducted to determine both quantitative and qualitative attributes and to develop the system’s effectiveness.
Methods: Cross sectional study was done by reviewing 97 medical records coded ICD10 A27 and 8,177 medical records coded adjacent ICD10. Simple random sampling technique was used. All stakeholder of the surveillance system were also interviewed.
Results: One hundred eleven cases met the criteria of the study. 18 of them met case definition of Leptospirosis from Bureau of Epidemiology but only two cases were reported to the surveillance system (sensitivity 11.1%). Only 2 out of 12 reported cases of Leptospirosis met the case definition (positive predictive value 16.7%). Completeness of data recording was 100%. Accuracy of age, gender, address and date of diagnosis were 75- 100% while occupation accuracy and timeliness were 50%. Representativeness of gender age and month of illness were low. For qualitative attributes, the system was simple, flexible, and stable but low acceptance and usage from clinicians and other stakeholder.
Conclusions: The surveillance system of Leptospirosis of Trang Hospital had inadequate effectiveness. Sensitivity, PPV and timeliness were very low. More acceptance and usefulness were considered necessary.