Analyses of Reported Viral Hepatitis Cases, Thailand Ministry of Public Health, 2013 – 2017 Pubblico

Abstract

Background

The massive influx of migrants that support Thai economic growth is a challenge for Thai public health. Outbreaks of communicable diseases are a major public health concern; and immigrants may have difficulty accessing preventive and curative healthcare services; they may experience more unfavorable outcomes. The Thai National Surveillance System was created to include reports from non-Thai immigrants; however, the quality of public health surveillance (PHS) data and timeliness has not been evaluated to assess sensitivity and representativeness. This study examined the temporal and geographic trends of hepatitis among Thai and non-Thai residents to evaluate PHS performance, including timeliness.

 

Methods

We analyze reported cases of hepatitis from 2013 – 2017 contained in the Thailand National Surveillance Database. Data cleaning and analyses were done. We analyzed various characteristics between Thai and non-Thai reported cases, using chi-square and unpaired t-tests.

 

Results

While the total number of reported cases of hepatitis decreased during the study period (8,678 to 7,821), reported cases increased among non-Thai residents (2.6% to 3.7%). Case reports of hepatitis A increased over time; reported cases of hepatitis B remained constant; and report cases of hepatitis C and non-specific hepatitis decreased. Reported cases among non-Thai residents were likely to be younger (p<0.001), from an agriculture setting (p<0.001), had greater access to private healthcare (p<0.001), and took a longer time to diagnose (p=0.003). The number of reported cases varied by region (for hepatitis A, the number of reports increased in the north and Bangkok).

 

Conclusions

Analyses of Thai national PHS showed poor efficiency in reporting hepatitis among non-Thai residents, despite their increasing reports over time. Healthcare barriers to non-Thai residents may affect their health status and outcomes. Therefore, we recommend renewing efforts to include non-Thai residents in the Thai national PHS. 

Table of Contents

Introduction and literature review……………………………………………………………1

Methods………………………………………………………………………………………. ........6

Results……………….…………………………………………………………………………........8

           Hepatitis A virus (HAV) infection ……………………………………………………..9

           Hepatitis B virus (HBV) infection …………………………………………………….10

           Hepatitis C virus (HCV) infection …………………………………………………….11

           Non-Specific hepatitis.……………………………………………………………….....12

Discussion…………………………………………………………………………………….........14

Bibliography……………………………………………………………………………………......19

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	Viral Hepatitis Public Health Surveillance
Committee Chair / Thesis Advisor	Scott JN McNabb, PhD, MS, Emory University

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