การประเมนระบบเฝาระวงโรคตดเชอ Streptococcus suis โรงพยาบาลสวรรคประชารกษ ปพ.ศ. 2566 - 2568

Introduction : Streptococcus suis infection is a zoonotic disease commonly found in the Asia region. Nakhon Sawan Province reported a morbidity rate 4.21 times higher than the national average, and Sawanpracharak Hospital observed a significant increase in cases concurrent with two major infrastructure changes: the transition from the R506 to the Digital Disease Surveillance (DDS) reporting system in 2024, and hospital relocation in 2025. No systematic evaluation of this surveillance system had previously been conducted. This study therefore aimed to describe the operational processes of the Streptococcus suis surveillance system, evaluate both its quantitative and qualitative attributes, and propose recommendations to improve the efficiency of the surveillance system. Method : A mixed-methods study was conducted. The quantitative component used a sample of 364 patients receiving care at Sawanpracharak Hospital who met the case definition for Streptococcus suis infection or related diagnostic codes, from January 2023 to December 2025, using stratified random sampling, with medical record review and quantitative data analysis comparing data in the surveillance system. The qualitative component used in-depth interviews with 12 key informants from five professional groups involved in the surveillance system. Results : The surveillance system had a weighted sensitivity of 96.0% and a positive predictive value of 98.75%, reflecting a high level of reporting accuracy. Reporting timeliness exceeded the 80% threshold in all years. For data quality, completeness of the sex, age, ethnicity, and diagnosis date variables was 100%. For representativeness, surveillance system data closely matched hospital database records. Qualitative evaluation found that the system had good acceptability, flexibility, and stability, but limitations in simplicity remained due to the absence of a disease-specific ICD-10 code and duplicated data entry across multiple systems. Conclusions: The Streptococcus suis surveillance system had very good quantitative attributes, and good qualitative attributes in terms of acceptability and flexibility. However, limitations remain in reporting complexity, the absence of a disease-specific code, and stability due to dependence on limited personnel, which may affect the system's long-term sustainability. A disease-specific ICD-10 code should therefore be established, the hospital HIS and DDS systems should be integrated, disease-specific operational guidelines should be developed, and staffing should be increased to match actual workload, in order to enhance the overall efficiency and sustainability of the surveillance system