Leptospirosis surveillance evaluation in public health hospitals, Phang Nga Province, Thailand, 2015

Abstract

Background: In 2015, 29 cases of leptospirosis were reported to the surveillance system in Phang nga Province while 109 cases were diagnosed in the hospitals’ database system (ICD 10). Additionally, there were 3 fatal leptospirosis reported in 2015. Thus we conducted the surveillance evaluation of leptospirosis in all government hospital in Phang Nga Provinces with aimed to determine both qualitative attributes and develop the system’s effectiveness.
Methods: Cross sectional study was done by reviewing 109 medical records in all hospitals in Phang nga Province with ICD10 code A27 and additional 15,836 medical records with ICD10 related to leptospirosis were also reviewed during 1 January – 31 December 2015 and all stakeholders of surveillance system were also interviewed.
Results: Overall 77 cases were met the case definition of leptospirosis in the surveillance system of the Bureau of Epidemiology, but only 29 cases were reported into the surveillance system. The sensitivity was 31.17% and Positive Predictive Value was 82.76%. Completeness of data recording was 100%. The accuracy of age, gender, address, and date of diagnosis were also 100%. Representativeness of sex, gender, age, occupation and date of diagnosis were 100%. For qualitative attributes, the system was simple, flexible, and stable but low acceptance and use from clinicians and other stakeholders.
Conclusions: Overall the leptospirosis surveillance system of the hospitals in Phang Nga Province was good. However, the sensitivity was very low, PPV and timeliness was high due to the reporting wait for clear clinical presentation. The healthcare practitioners can improve the leptospirosis surveillance system by introduction and implementation of case definition to the clinicians and public health staff.