An evaluation of acute flaccid paralysis surveillance system, Srisangworn Sukhothai Hospital, Sukhothai Province, Thailand in 2019, 2021–2022

Abstract

Background: Acute flaccid paralysis (AFP) surveillance system is one strategy for polio eradication. The report of AFP cases must be complete in order for the surveillance system to be sensitive enough and lead to rapid investigation and control of the disease. Therefore, it is necessary to evaluate the surveillance system. To know the quantitative and qualitative characteristics and provide suggestions to improve the system even further.

Methods: Cross-sectional study of the surveillance system for acute flaccid paralysis. By studying quantitative characteristics from two types of data sources: reports in the 506-surveillance system and patient medical records. Both outpatients and inpatients who are under 15 years of age who have symptoms of acute muscle paralysis or patients according to ICD-10 TM codes, 37 disease groups and qualitative characteristics, including interviews with people involved in the disease surveillance system at all levels

Results: From the review of patient medical records based on 37 disease groups coded by ICD-10 TM in the years 2019, 2021, and 2022, a total of 259 cases were examined. Ten cases met the reporting definition for AFP, of which only five were reported into the surveillance system. This results in a sensitivity of 50% and a positive predictive value of 50%. In 2019, 50% of eligible cases were reported. However, no cases were reported into the surveillance system in 2021 and 2022. The quality of the reported data found that most variables can be recorded correctly, except for the variables. Name-Surname and the day you started getting sick that the report was 80 percent correct and in terms of representativeness Gender and age variables from data in 506 reports compared with medical records were found to be consistent in the same way. People involved in the surveillance system Recognize and see the importance of the surveillance system this is because it is useful in following up on the disease and vaccination situation in the area. Including giving opinions on the surveillance system there are simple operating steps. Easy to understand and practice the system is quite flexible. But there were problems with the security of the surveillance system.

Discussions and Conclusion: The AFP surveillance system at Srisangworn Sukhothai Hospital shows low sensitivity and positive predictive value. The system's stability was affected by the COVID-19 outbreak situation. The increased turnover of personnel and the redirection of resources to outbreak response resulted in reduced case detection and reporting into the surveillance system compared to the pre-outbreak period. Therefore, those involved in the surveillance system should develop and prepare in case of the next crisis in order to Increase efficiency in eradicating polio and there should be measures in place to understand those responsible for continuous and sustainable work.