Abstract
This study was aimed at investigating an outbreak of acute diarrhea during the
period February 20 to March 23, 2006 in Tapanhin district, Phichit Province. It is a descriptive
epidemiological study that was undertaken to identify the problems and the interventions needed to control the disease, using an interview with individual case surveillance,
as designed by the Bureau of Epidemiology, and specimen collection. The study
population comprised 554 cases, including all cases who visited health-care facilities and
those in communities in Tapanhin district. An additional study was based on an observation
of the environmental factors and the disease-control measures. Quantitative data
analysis was presented in percentage, ratio, minimum and maximum, using a computer.
These data analyses were based on triangulation in order to make links, between the
factors and effective implementation.
The study found 554 cases in total (526.67 per 100,000 population). The epidemic
began in the municipal area and spread rapidly to surrounding sub-districts. The highest
prevalence was among children 1-4 years old (3,485 cases per 100,000) and 5-9 years (1,413
cases per 100,000), respectively. Leading symptoms included watery stool (85.35%), and
stomach ache (58.81%). Non-pathogenic bacteria were detected in 94.52% of the cases
based on rectal swab culture, whereas rota virus was detected in 3 of 9 stool cultures. A
centralized operation unit was set up in order to conduct active case surveillance and
control the disease. The interventions were conducted through both sanitation (cleaning
animal slaughter units, markets, and public restrooms) and education of street food-vendors.
As a result, the epidemic was brought under control within four weeks.
The achievement of diarrhea prevention and control requires rapid disease investigation
and community intervention from the district health system. To determine the
root cause of an epidemic, objective data, based on active case surveillance and comprehensive
laboratory examination are helpful.
