Evaluation of the Gonorrhea Surveillance System at a Hospital in Chaiyaphum Province, 2019–2023

Abstract

Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. Data retrieved from the Disease Surveillance Report System 506 (R506) between 2012 and 2021 indicate that gonorrhea incidence rates consistently exceed those of other sexually transmitted infections. In 2023, the incidence rate in Chaiyaphum Province surged threefold. To facilitate more efficient and timely reporting, the Bureau of Epidemiology developed a Digital Disease Surveillance (DDS) system utilizing an Application Programming Interface (API). Consequently, this study aimed to assess the gonorrhea surveillance system, describing the surveillance system, examining both the qualitative and quantitative attributes, and comparing the R506 and DDS systems. A mixed-methods approach was employed. The case definition for gonorrhea followed the Department of Disease Control’s criteria for patients treated at the hospital from January 1, 2019, to December 31, 2023. The results found that the hospital utilized surveillance data for proactive screening and case-finding plans. Comparative data between the R506 and DDS systems revealed that 1) sensitivity was 45.07% and 60.00%, respectively, with low rates attributed to personnel structure changes and personnel unawareness of reporting requirements; 2) positive predictive value (PPV) was 82.58% and 83.33%; 3) data completeness was 100% for both systems; 4) accuracy of the date of onset was 22.58% and 33.33%; and 5) timeliness was 26.67% and 100.00%. When comparing the R506 and DDS systems, users reported higher satisfaction with the DDS system due to its user-friendly interface and simplified procedures. However, no significant differences in sensitivity and PPV were observed between the two systems. In conclusion, the sensitivity was relatively low due to a lack of awareness among staff regarding the necessity of disease reporting. Therefore, it is necessary to build the capacity of staff responsible for disease surveillance reporting and to provide clear reporting guidelines or manuals. In addition, the case definition for gonorrhea reporting in the surveillance system should be reviewed with all relevant staff to improve the efficacy of disease prevention and control.