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Korean Journal of Epidemiology 1985;7(2): 240-252.
입원 장티푸스 환자의 신고에 관한 연구
김윤구, 정태화, 송철, 이명원, 김정순, 오대규
A study on the status of reporting typhoid fever cases admitted
Yoon Goo Kim, Tae Wha Joung, Chul Song, Myung Won Lee, Joung Soon Kim, Dae Kyu Oh
Abstract
The objective of this study is to find out current status of reporting and managing one of the most important communicable diseases in Korea, typhoid fever, as well as identifying reasons of poor reporting in order to provide necessary information for an improved reporting system. This study was carried out on typhoid fever patients who had been admitted to hospitals located in Seoul during the year of 1984. On the reasons and problems associated with poor reporting, the medical staff, both regular and house staff, were surveyed through structured self-recording questionnaire with the help of hospital administration offices. Information on the hospitalized cases were collected from laboratory and medical records and reported cases from health centers. The summarized results are as followings: 1) The total number of typhoid fever cases reported to the health centers and city government was 403 patients of whom only 103 cases(26%) were bacteriologically confirmed by isolating S. typhi. Eighty percent of these patients were reported by hospitals. 2) On the other hand, the total number of confirmed cases identified in study hospitals were 489 patiens among whom only 16.4% had been reported to the health centers. The reporting rate varied widely ranging from 0% to 57% by medica institute regardless of type of the hospital. 3) The analysis of the patient group revealed that there were more females than males and 56% of the patients belonged to the 20~39 years age group. There was no difference in person characteristics between reported and non-reported cases. The number of cases occurred by month did not show much difference although there was a tendency of clustering more cases in winter season. 4) The average duration of the illness from the onset to the hospital admission was about 12 days and 63% of these patiens had received medical care of some sort before the admission. Also the average duration of hospitalization was about 12 days. The duration of admission was significantly longer for reported group when compared with that of non-reported group (p<0.001). 5) Follow-up care for the discharged patients was done only for a part of patients (54%), the worst the follow-up stool cultures for only 11% of the patients. 6) The major reasons for not reporting typhoid fever cases stated by the medical doctors were complicated and bothersome administrative process demanded by health center when they report a case(47%) and possibility of misdiagnosis(28%). The most of the medical staff, however, strongly showed their insight or sense of responsibility for reporting communicable diseases. 7) The necessity of nurse epidemiologist employed in hospital for control of hospital infection and reporting communicable diseases was recognized by 62% of the doctors, and 52% of them showed a strong intention to adopt the system. The larger the hospitals the more doctors agreeing the new system, the nurse epidemiologist.


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