Measles Surveillance Evaluation in 46 Hospitals of Health Service Network Region 2, 2012

Abstract

The Department of Disease Control, Ministry of Public Health, Thailand has adopted the measles elimination program as a commitment among WHO member states, which aims to eliminate measles by the year 2020. The DDC launched the measles elimination program at the Provincial Health Offices since 2011. In 2012, Office of Diseases Prevention and Control 9, Bureau of Epidemiology and 5 Provincial Health Offices conducted evaluation on measles surveillance in 46 hospitals of the Health Service Network Region 2. Objectives of the study were to determine features of quantitative attributes of the measles surveillance system and give recommendations. We reviewed the medical records with assigned ICD10 code from 46 hospitals during 1 January - 31 December 2011. Case definition of measles from Bureau of Epidemiology was used. Total 1,858 cases were reviewed and 226 cases met the case definition. However, only 56 cases out of 226 cases were reported to the surveillance system (sensitivity 24.8%) and only 56 cases out of 117 reported cases met the definition (PVP 47.9%). Types of gender revealed same representativeness, but median age between 506 report and medical records (9 years vs 2 years) were extremely different. Accuracy of records was 83.9% and timeliness was 87.5%. Executives as well as practitioners in the hospitals did not understand the policies and guidelines of measles elimination program well. The recorder had a reshuffle and many doctors diagnosed measles with high specificity and clinical records were not well obtained. Therefore, informing the definitions and surveillance guidelines to executives and clinicians was remarkably important in order to increase accuracy of the measles elimination program.