Evaluation of the Surveillance System for Hand, Foot, and Mouth Disease and Enterovirus Fever, at Mahasarakham Hospital

Abstract

Hand foot and mouth disease(HFMD) and enterovirus infections are among the top 10 public health concerns in Maha Sarakham Province. A comparison between medical records and surveillance reports in Form 506 from 2018 to 2022 revealed significant discrepancies in the number of reported cases. This study aimed to investigate the quantitative and qualitative characteristics of the surveillance system for hand, foot, and mouth disease and enterovirus infection. It is a quantitative study that collected patient data from medical records, including both outpatient and inpatient departments, based on specific ICD-10 codes for services rendered between January 1 and December 31, 2022. These data were compared with epidemiological surveillance reports (506 reports). The qualitative aspect involved interviewing responsible personnel and stakeholders involved in the surveillance of HFMD and enterovirus at Maha Sarakham Hospitals and Maha Sarakham Provincial Health Offices.

The results showed that the completeness of the 506 surveillance system was 71.31%, which was primarily due to delays in ICD-10 coding. Epidemiological staff needed to retrieve data retrospectively within 24 hours, resulting in some patients not being included in the 506 reporting system. ICD-10 codes B084 and B085, specific to HFMD, accounted for 91.43% of the cases. The positive predictive value was 96.13%, attributed to clear guidelines and staff adherence to established protocols. In terms of representativeness, the data from the epidemiological surveillance system were representative of the hospital’s patient data, with trends and characteristics aligning closely in terms of gender, age, and date of illness onset, achieving 100% timeliness. Data accuracy was high, with variables such as patient name and type reported correctly in all cases, while other variables had accuracy rates ranging from 74.13% to 95.40%, with the lowest being the date of illness onset.The evaluation of the surveillance system revealed that it was swift in reporting, stable, and flexible. Stakeholders recognized its benefits and ease of use. However, the completeness of the system was still 71.31%, primarily due to delays in ICD-10 coding, requiring retrospective data retrieval by epidemiological staff. It is recommended that epidemiology and medical record staff, along with related personnel, establish an agreement on the timeline for assigning ICD-10 codes and reporting within the 506 system. This would improve the completeness or sensitivity of reporting, which would ultimately enhance the surveillance, prevention, and control of the disease.