Evaluation of the Surveillance System for Hand, Foot and Mouth Disease and Severe Enterovirus Infection among Children Aged 0–9 Years in Nam Pat District, Uttaradit Province, Thailand, 2025

Abstract

Hand, foot and mouth disease (HFMD) is a common infectious disease in children and may lead to severe complications and death. According to the disease surveillance report of Nam Pat District, Uttaradit Province, Thailand, in 2025, the incidence rate of HFMD was 262.80 per 100,000 population, ranking fourth among the nine districts in Uttaradit Province. Several cluster outbreaks were identified in child development centers and primary schools, and one pediatric patient required hospitalization.

This study was a cross-sectional descriptive study using both quantitative and qualitative methods. Data were collected from January 1 to December 31, 2025, from medical records of patients receiving services in Nam Pat District from three sources: Nam Pat Hospital, subdistrict health-promoting hospitals, and private clinics.

The evaluation of the surveillance system showed an overall sensitivity of 62.69%. The sensitivity of surveillance data from subdistrict health-promoting hospitals was 24.49%, while that from private clinics was 0%. The positive predictive value was 100%. Representativeness of the data was good. Timeliness within three days was 100%, data accuracy was 100%, and data completeness was 85.71%. The main issue affecting completeness was the inconsistency and lack of linkage between information systems, particularly regarding the date of onset.

The qualitative assessment indicated that the surveillance system was simple, acceptable, flexible, and stable. However, limitations were identified regarding reporting accuracy, including incorrect ICD-10 coding, misunderstanding of disease coding procedures, and the absence of a clear reporting pathway for private clinics to submit cases into the DDS surveillance system. Therefore, revision of disease definitions and improvement of ICD-10 coding practices in public health facilities, as well as establishing a reporting mechanism for private clinics, are recommended to improve the sensitivity of the surveillance system in the future.