The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64340

Molly Brady¹, Jirapat Kanlayanaphotporn, MD, MPH², Panatsaya Chantate³, Somrak Chantra, MD⁴, Suvaj Siasiriwattana, MD, MPH³, Scott F. Dowell, MD, MPH⁵, and Sonja J Olsen, PhD⁵. (1) Department of International Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, 7th floor, Atlanta, GA 30322, 404-727-1301, mabrady@sph.emory.edu, (2) Bureau of Epidemiology, Thai Ministry of Public Health, Tivanon Road, Nonthaburi, 11000, Thailand, (3) Sakaeo Provincial Health Office, Thai Ministry of Public Health, 3rd Floor, Sakaeo, 27000, Thailand, (4) Crown Prince Hospital, Thai Ministry of Public Health, 4th Floor, Sakaeo, 27000, Thailand, (5) International Emerging Infections Program, Centers for Disease Control and Prevention, Department of Medical Sciences, 1st Floor, Building 2, Nonthaburi, 11000, Thailand

Background: In 2000, pneumonia was the leading cause of mortality and the third leading cause of morbidity in Thailand. Pneumonia surveillance is important to estimate burden of disease and evaluate interventions. Methods: We evaluated the pneumonia surveillance system in Sakaeo province by analyzing three years (1999-2001) of electronic data collected by the standard reporting form used in all government and some private facilities; comparing deaths reported through surveillance to death certificate data; and interviewing a random sample of health care personnel who collect the surveillance data. Results: An average of 925 pneumonia cases was reported each year, with an average annual incidence of 211 per 100,000 persons. Age-specific incidence peaked at 1418 per 100,000 for children < 5 years. In 1999 and 2000, there were 7 and 6 pneumonia deaths, respectively reported through the surveillance system, compared with 28 and 53, respectively, reported by death certificate. Of 72 health care personnel interviewed, 62 (82%) reported receiving training, but most of this was informal. Although a case definition for pneumonia was formalized in 1997, it is not uniformly applied. Conditions reported as pneumonia varied: when asked about specific examples, 79% of those interviewed would report “tuberculosis with pneumonia” as a case of pneumonia, while 44% would report “bronchitis rule out pneumonia”. Conclusions: This surveillance system highlights the importance of pneumonia in Thailand. Weaknesses of this system include non-standardized application of the case definition and underreporting of deaths. Formal training of surveillance personnel may increase the reliability and completeness of the data.

Learning Objectives:

• At the conclusion of this session, the participants in the session will be able to:
• 1. List the strengths and limitations of passive public health surveillance systems.
• 2. Recognize the need for standard case definitions in a surveillance system.
• 3. Recognize the importance of training health care personnel responsible for collecting surveillance data.

Keywords: Surveillance,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.