Evaluation of Epidemiological Records of Dengue Cases in the Public Sector during the Last Outbreak

Abstract

The proper recording of cases during an outbreak is a crucial requirement for making public health decisions. The Ministry of Health requires digital reporting through the National Health Surveillance System. Locally, reporting is done later using the B1 paper form (B1p) and the C2 paper form (C2p), which report Dengue cases by epidemiological week (EW). Additionally, physicians record all their consultations in the Digital Medical Record (DMR), which also generates a digital epidemiological C2 form (C2d). Due to this, we decided to compare these records to see if there are any differences between them.

Information from consultations at Municipal Health Centers was downloaded from EW 31 of 2023 to EW 22 of 2024. Additionally, C2p forms sent to the Directorate of Primary Health Care and B1p records sent to the Municipal Epidemiology Directorate were included. Diagnoses of Dengue (A90x) and Hemorrhagic Dengue (A91x) were analyzed. The reference standard for comparisons was the data recorded in the DMR. Percentage differences between records were calculated based on the occurrence of cases by EW and were analyzed using ANOVA and Bonferroni post hoc tests for group differences. SPSS v 27 software was used. A p-value < 0.05 was considered significant.

DMR records were 17,344, C2d: 17,592 (+1.4%). C2p: 16,512 (-4.7%) and B1p: 9,801 (-43.5%). The overall difference was statistically significant, p= 0.017, and post hoc comparisons showed significance for C2d vs. B1p p= 0.046; C2p vs. B1p p= 0.047.

The DMR must be improved to achieve epidemiological reporting that reflects reality. The C2p forms recorded more cases when there were more total consultations. The B1p record proved to be the most inefficient. This information should guide governmental health policies for the monitoring of outbreaks and epidemics, prioritizing ease and speed of reporting over other details.