Evaluation of the Varicella Zoster surveillance system in students group of community hospitals of Phra Nakhon Si Ayutthaya

Abstract

     Varicella is a public health problem among children in Thailand. Phra Nakhon Si Ayutthaya incidence is higher than Thailand’s median. This study aims to evaluate a reporting system of Varicella Zoster in student groups in community hospitals of Phra Nakhon Si Ayutthaya. The study is a cross-sectional design and conducted among patients with signs and symptoms of varicella-like infections who are aged from 5 to 21 years and had visited any of community hospitals from January 1, 2016 and October 31, 2017. Direct standardization and triple classification were implemented to classify community hospital by disease incidences in three groups (high, moderate, and low-incidence). Based on the ICD-10 system, medical records were collected and checked with the case definition. Principal five quantitative attributes were determined (sensitivity, positive predictive value, representativeness, accuracy, and timeliness). Stakeholders of surveillance system were interviewed to evaluate qualitative attributes (acceptability, flexibility, stability, simplicity, and usefulness). Results showed 320 of 326 medical records that met the case definition were reported (sensitivity = 98.2%) and 320 of 342 medical records that were reported met the definition (PPV = 93.6%). The representative, accuracy and general data was good but timeliness was not good (75.54%). The flexibility was poor due to insufficient staff. Instability of network system caused delays and misreporting. The other qualitative attributes showed respectable results from stakeholder. Sufficient staffs and
network stability are the keys to improving the report system.