The surveillance system in health centers in northeastern Thailand.

In this study we assessed the existing communicable disease surveillance system in health centers of a province in northeastern Thailand. The first part of the study was an examination of medical records from 11 local health centers: 649 were examined for sensitivity, positive predictive value, and representativeness; and 433 were examined for timeliness and data quality. The second part of the study looked at 50 local officers from 11 local health centers, 1 district health office, 1 community hospital, and 8 sub-district administrative organizations. Quantitative data was collected through a review of medical records. Qualitative data was collected by focus groups and in-depth interviews. The reporting of suspected cases was 50.8%. Sensitivity was low for common diseases. Positive predictive value was lowest for fever of unknown origin (0%). Data quality for the date of onset and diagnosis was low. Case reporting was considered timely in only 45% of cases. Health officers perceived the surveillance system as not being up-to-date. They only collected data in a district without data analysis; the information provided by the system is not representative of the true epidemiological situation countrywide and cannot be used to help monitor disease patterns and trends. In conclusion, health officers should report diseases according to symptoms and analyze data continuously to identify urgent problem and elicit prompt responses.

[1]  Samuel L Groseclose,et al.  Evaluation of reporting timeliness of public health surveillance systems for infectious diseases , 2004, BMC public health.

[2]  D. Pollock,et al.  Evaluation and Overview of the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance Project (NEISS-CADES) , 2007, Medical care.

[3]  K. Ekdahl,et al.  Sensitivity of the Swedish statutory surveillance system for communicable diseases 1998–2002, assessed by the capture–recapture method , 2005, Epidemiology and Infection.

[4]  L. Lee,et al.  Updated guidelines for evaluating public health surveillance systems: recommendations from the Guidelines Working Group. , 2001, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[5]  M. Pappaioanou,et al.  The data for decision making project: assessment of surveillance systems in developing countries to improve access to public health information. , 2008, Public health.

[6]  Chen-Kang Chang,et al.  Evaluation of the National Notifiable Disease Surveillance System in Taiwan: an example of varicella reporting. , 2007, Vaccine.

[7]  Assessment of infectious disease surveillance--Uganda, 2000. , 2000, MMWR. Morbidity and mortality weekly report.

[8]  Thailand. Krasūang Sāthāranasuk.  Thailand health profile , 1977 .

[9]  Helvi Kyngäs,et al.  The qualitative content analysis process. , 2008, Journal of advanced nursing.

[10]  M. Djibuti,et al.  Health systems barriers to effective use of infectious disease surveillance data in the context of decentralization in Georgia: a qualitative study. , 2007, Health policy.

[11]  M. Kramer,et al.  Evaluation of National Tsutsugamushi Disease Surveillance--Japan, 2000. , 2002, Japanese journal of infectious diseases.

[12]  N. Ndayimirije,et al.  Structure and performance of infectious disease surveillance and response, United Republic of Tanzania, 1998. , 2002, Bulletin of the World Health Organization.