Evaluation of tuberculosis public health surveillance, Al-Madinah province, kingdom of Saudi Arabia
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To evaluate the quality of the data, the sensitivity of the surveillance, and the completeness of identification and investigation of patient's contacts for the tuberculosis (TB) surveillance program in Al-Madinah province. The surveillance program is responsible for data collection, analysis, feedback, as well as the implementation of actions and has a significant role in controlling and eliminating the disease. Methods: The study covered the TB surveillance program in Al-Madinah province in 2011. First, we reviewed all the notifications, treatment cards, and register books, as well as monthly and quarterly reports, for completeness and accuracy of data. Then, we searched for the missed cases that were not reported. Finally, we reviewed all the patients' contacts' reports to assess the degree of completion of identification and investigation. Results: The results revealed high completeness rates for demographic and disease data and low completeness rates for the test result fields. The sputum smear and chest x-ray fields were 80% complete. Furthermore, the tuberculin test field was left blank in 108 cases (46% completeness). Moreover, the sputum culture field was completed only in 63 reports (31.5% completeness). The lowest completeness was seen in the HIV test result field, where only 50 cases (25%) were completed. The contact identification and investigation showed that 42 smear-positive cases' contacts were not identified. Out of the 448 contacts identified, only 301 (67%) of them were investigated. The review of hospital records and lab registers showed that 244 cases were not reported, in spite of the fact that 213 of them (87.3%) were confirmed by labs. Conclusion: The results indicated that the rates of completeness for the different notification report fields varied; the lab result and HIV test fields had the lowest rates of completion. Also, over half of patients' contacts were not identified or investigated, and there were a significant number of unreported cases, most of which were laboratory confirmed. Finally, we found a number of discrepancies between the treatment cards, logbooks and the reported data.