สถาบันวิจัยระบบสาธารณสุข

In fiscal year 2009, Mae Hong Son Province suffered a severe and large outbreak of dengue hemorrhagic fever; it has the second high incidence rate in the country for that disease. This study was aimed at describing epidemiological data of patients at Srisangwan Hospital in Maung district, Mae Hong Son Province, from January 1 to October 30, 2009. The study also reviewed criteria of diagnosis by physicians, and lag time of patient-access to the hospital and of disease-control in the community by a disease-control team. Results may reveal the outcomes of diagnoses and lead to improvement of disease-control management. It was found that complete patient files were available for 502 cases. The incidence rate in the age groups 11-20 years, 21-30 years and 31-40 years were 1.94, 1.52 and 0.77 per cent, respectively. A high number of cases occured in June and July. The most affected sub-districts were Jong-kum, Pang-mu, and Pa-bong. According to the criteria of diagnosis, the study found that 37.65 per cent had no record of abdominal examination and 32.47 per cent had no record of abnormal bleeding sign or tourniquet examination. However, a dengue rapid test-kit was used in 59.36 per cent of the cases. In the first visit, cases were diagnosed as dengue hemorrhagic fever or suspected cases (40.85%), acute febrile illness (36.85%), and respiratory syndrome (17.13%). The lag time of first visit to the hospital was on average 1.91 days; the lag time for being diagnosed as a case of dengue hemorrhagic fever or a suspected cose was on average 3.51 days, and disease control in the community was performed within 1.19 days after case notification. Results showed the age group affected was mostly adult. Criteria for diagnosis by physicians were not fulfilled to a certain extent; on the other hand, more rapid test-kits were used instead in a large proportion of the cases. Therefore, indications to use the kits should be scrutinized and training courses should be set up regularly. Though disease control was implemented shortly after notification, the number of cases still increased continuously. Therefore, the efficiency and management of the disease control team should be reviewed.