Evaluation of melioidosis surveillance system in the hospitals of Public Health Region 4, 2018 - 2020

Abstract

This study is mixed method research that combines quantitative and qualitative studies to evaluate the melioidosis surveillance system in Health Region 4 by randomly selecting 6 health facilities from regional hospitals, general hospitals, and community hospitals. The study also reviewed the medical records of 388 patients in a 3-year period (2018 – 2020) and interviewed 29 relevant medical personnel, including administrators, medical units, epidemiologists, medical statisticians, and laboratory personnel. The results found that melioidosis was underreported with a sensitivity of 39.0% and a positive predictive value of 76.5%. The data can represent both personnel and locations. Only areas with few patients were not reported. The time of illness could not be represented. The median timeliness was 29 days (0 – 592 days). Some variables, such as age and onset of illness, were inaccurate. The in-depth interviews showed that the system was responsive. In addition, some staff were unacquainted with melioidosis and R506, even though the staff directly responsible were familiar with the surveillance system. However, problems with data incompleteness were found, such as duplication, incorrect data, and insufficient staff. Recommendations are to review the surveillance process in all health facilities, enhance knowledge of melioidosis and definition of disease reporting in the surveillance system for staff, provide rapid diagnostic kits to reduce delays in confirmation testing, use laboratory results in detection, display data (dashboard) for use in supporting disease surveillance and control, and develop a hospital information system (HIS) that can add the onset date and screen symptoms.