Saravalee Suphakarn

[Saravalee Suphakarn]

The result from TAM could represent the relative usefulness of the new technology such as the new technology could reduce the working time, increase productivity rate, provide more information etc. which reflex the perceive usefulness.

[Saravalee Suphakarn]

From the research question “why they are not using bednets?”, the qualitative study could answer this question. Firstly, analyzing the data from the survey might help to describe the characteristics of the respondents who are no using the bednets. After that qualitative method such as participant observation and semi-structured interviews be single used or combined together for deep understanding and answer the question.

[Saravalee Suphakarn]

One confounder that associate with contact pattern and age is average income per month. People’s income affect their lifestyle, activities, and also contact pattern, which often relate with age and occupation.

[Saravalee Suphakarn]

The external variables that might influence an individuals’ perceived ease of use or perceived usefulness of a new technology such as internet accessibility/quality, technical support, and lack of electronic devices. These are important factors to use or perceived usefulness of a new technology.

[Saravalee Suphakarn]

The combination of these information would be able to identify me.

Sex: female
Age: 27 years old
Job position: Veterinarian Practitioner
Workplace: Veterinary Research and Development Center, Eastern Region

[Saravalee Suphakarn]

Effectiveness : ability to achieve the right result/therapeutic effect in the real condition
Efficacy : capacity to achieve the right result under control condition
Efficiency : ratio of the right output and the resource

[Saravalee Suphakarn]

Item no. 3 , page 341

“A significant test result (P <= 0.05) means that the test hypothesis is false or should be rejected”

This quote is wrong because a small p-value isn’t always refer to a null hypothesis should be rejected, such as a large random error, and before concluded should make sure about all assumptions of the test. P-value lesser than or equal to 0.05 only tell that the observation differences from the hypothesis prediction.

[Saravalee Suphakarn]

I’m a veterinarian at the veterinary research and development center (lower southern region) under the Department of Livestock Development (DLD), Thailand. My job has responsibilities about using laboratory technique for animal disease diagnosis which necessary to apply statistic and epidemiology for my routine work and research projects. I learned the biostatistic course when I was a veterinary student and have some experience for using statistical technique such as in my final project of the Bachelors Degree. Now my routine work mostly perform the descriptive statistic, the inferential statistic is particularly used for the research project.

[Saravalee Suphakarn]

Maternal mortality rate

Definition : The maternal mortality rate is a rate of death of women wile pregnant or within 42 days after pregnancy termination due to causes related to or aggravated by the pregnancy or pregnancy management, but not from accidental or incidental cause.

Calculation: The maternal mortality rate is calculated from the number of maternal death divided by the women years of exposure for women in the interested time and population.

Usefulness: The maternal mortality rate able to captures the likelihood of both becoming pregnant and dying during pregnant. The indicator can reflects the capacity of health system to effectively prevent and address the complications that able occur during pregnancy period.

[Saravalee Suphakarn]

Dear all staff,

I couldn’t access “Supplementary Reading: Decision Tree Result Evaluation in R”. I’m not sure about it cause from availability of the resource or it relate to my missing something from the class announcement. Please check it again. Thank you very much.

Saravalee S.

[Saravalee Suphakarn]

– The intervention I would like to consider in my modelling is oral rabies vaccine. The model will compared between non-oral rabies vaccine situation and oral rabies vaccine implemented situation.

– According to my modelling about the rabies last week, I followed the model structure from Laager M. (2018). The model consist of 4 compartment including susceptible population (S), vaccination population (V), exposure population (E), and infected population (I) that link between compartments with 7 parameters. The oral rabies vaccine doesn’t change the model structure but change the value of some parameters.

– The characteristic of the intervention including percent of vaccine coverage, vaccine efficiency, and rate of loss of vaccine efficacy.

[Saravalee Suphakarn]

Rabies is viral zoonotic disease cause by Rabies virus (Rabies lyssavirus, Genus Lyssavirus). All mammal species could be infected with rabies virus including humans, dogs, and domestic cats. The virus is transmitted through direct contact, such as broken skin or mucous membranes in eyes, nose, or mouth, with saliva or nervous system tissue of infected host (cdc, 2019). After entering host, the virus invade to exon of peripheral nervous system (PNS) and it is transported in a retrograde direction to central nervous system (CNS). Rapid viral replication happen within the CNS, the results in pathologic effect of nerve cell and tissue such as encephalitis. The virus also spread from the CNS to the adjacent tissue via peripheral nerve including tissue of salivary gland. Many of virus are shed through saliva from the infected salivary gland at the time of clinical sign onset. Rabies patient present progressive neurologic signs that consistent from encephalitis or myelitis, for example, dysphagia, hydrophobia, and paresis. Once symptoms of the disease develop, rabies is inevitably fatal to both animals and humans (WHO, ). Although rabies hasn’t no effective treatment, it is preventable. For humans, have to avoid contract with risk animals or saliva and nervous tissue, which possible contain the virus. If accidental biting or scratching happens, the patient should receive post-exposure prophylaxis (PEP) as soon as possible. Vaccination is effective preventing measure for both human and animals

Model structure:
For rabies transmission from dog to dog, there is 4 compartment in the model
1. Susceptible population (S)
2. Vaccination population (V)
3. Exposure population (E)
3. Infected population (I)
Which Total population (N) = S + V + E + I

Parameter
– Rate of loss of vaccine efficacy (lambda)
– Rate of vaccination in population (alpha)
– Efficacy of vaccine (nu)
– Mortality rate (mu)
– Transmission rate (beta)
– Rate of progression from exposed to infected state (sigma)
– Probability of exposed developing rabies (kappa)

R-code
library(deSolve)

SVEI.dyn <- function(t,var,par)
{
S <- var[1]
V <- var[2]
E <- var[3]
I <- var[4]
N <- S+V+E+I

lambda <- par[1]
alpha <- par[2]
nu <- par[3]
mu <- par[4]
beta <- par[5]
sigma <- par[6]
kappa <- par[7]

dS <- (V*lambda) – (beta*keppa*I/N) – (nu*alpha*S)
dV <- (nu*alpha*S) + (nu*alpha*E) – (V*lambda)
dE <- (beta*keppa*I/N) – (nu*alpha*E) – (sigma*E)
dI <- sigma*E

# Return the 3 values
list(c(dS,dV,dE, dI))
}

lambda <- 5.5*(10^-3)
alpha <- 2.96*(10^-3)
nu <- 0.94
mu <- 1.23
beta <- 0.0292
sigma <- 0.239
kappa <- 0.49

SVEI.par <- c(lambda,alpha,nu,mu,beta,sigma,keppa)
SVEI.init <- c(100,50,1,0)
SVEI.t <- seq(0,365,by=1)
SVEI.sol <- lsoda(SVEI.init, SVEI.t, SVEI.dyn, SVEI.par)

TIME <- SVEI.sol[,1]
S <- SVEI.sol[,2]
V <- SVEI.sol[,3]
E <- SVEI.sol[,4]
I <- SVEI.sol[,5]
N <- S + V + E + I

plot(0,main=’Rabies in dog population model’, xlab=’Time (day)’, ylab=’Number’, col=’blue’, ylim=c(0,100))

lines(SIR.sol[,2],type=’l’,col=’blue’)
lines(SIR.sol[,3],type=’l’,col=’green’)
lines(SIR.sol[,4],type=’l’,col=’orange’)
lines(SIR.sol[,5],type=’l’,col=’red’)

legend(locator(1),legend=c(“Susceptible”,”Vaccinated”,”Exposed”,”Infected”),col=c(“blue”,”green”,”orange”, “red”))

References
Laager, M. Mathematical modelling of dog rabies transmission in N’Djamena, Chad (Dissertation). Basel: University of Basel; 2018. 106p.

[Saravalee Suphakarn]

You may need to attribute london.gen to the data.boroughs before merge, as command below.

E.cutoff <- c(70, 100, 120, 140, 180)
cat.E <- cut(unlist(data.suicides$E), breaks = E.cutoff, include.lowest = T)
maps.cat.E <- data.frame(ID=data.suicides$ID, cat.E=cat.E)
data.boroughs <- attr(london.gen, “data”)
attr(london.gen, “data”) <- merge(data.boroughs, maps.cat.E, by=”ID”)
spplot(obj = london.gen, zcol = “cat.E”, main=list(label=”Expected case”, cex=1), col.regions=gray(seq(0.9,0.1,length=4)))

Hope it can solve your problem.

[Saravalee Suphakarn]

1. Why was the author interested in investigating the suicide problem in Thailand during the time?

The study used the data during 2011 because it is only year that alcohol data consumption available and the suicide rate has generally been rising since this year.

2. Each of students picks one potential risk factor mentioned in the paper and explains how the variable can contribute to the suicide rate?

Divorce rate is one of the potential risk factor that had coefficient about 0.505 and 0.670 with significant at 0.01 level from the model 1 and the model 2, respectively. Suffering from the divorce cause from feel alone, depression, stress. In addition psychological problem, divorced person also face with financial problem and social blaming especially in traditional society like Thailand. As the author mention, suicide often occur when individuals feel they do not belong to a family, community, or society and thus lack social integration. Divorced person is high probability to feel like that and risk to suicide.

3. How statistical modeling can contribute to investigate the epidemiology and spatial aspects of Thai suicide problem?

The statistical modeling prove the hypothesis in epidemiology and spatial, demonstrate the relation between various factors and the effect in term of quantitative data. The result of the study point out socioeconomic factors that should be concerns in Thailand and also be used to plan, improve, correct policy or any relative law to reduce suicide rate in Thailand.

[Saravalee Suphakarn]

For convince those with low digital literacy skills to use electronic recording and reporting system, I think each organization should start with assessment them about the attitude, knowledge, and practice of digital skills. Sometime I found that low skills isn’t just the results of lack of knowledge or practices, it include not quite good attitude or mindset of people. The results from the assessment may help you to plan for training or implement course to improve their skills.

[Saravalee Suphakarn]

1. There are many reason that location in epidemiological research have not been incorporate as much as possible. Actually, location is one part of description in epidemiology that compose of place time and person. Availability of data, data quality, and incomplete data cause researcher can’t bring it of analysis. Other reason is about the knowledge or practice of the researcher and practitioner. Some field epidemiology practitioners are interested for spatial analysis but they don’t have enough knowledge or don’t have the experience in spatial program analysis. Some of them think that spatial analysis need special program that hard to do or learning.

Good and wide attitude building in spatial epidemiology for use in research of multidisciplinary science. Short courses or training in concepts and using spatial epidemiology can raise the attitude, knowledge, and practice. However, for the field practitioner, their organization support is important. Not just the financial support but also opportunity support.

2. There are three important factors that determine potential of the disease including person, environment, and agent. The place where an individual lives or works should be considered because it related with the environment. Example in a infectious disease, each location has different environmental data such as temperature, humidity, light intensity directly affect virus–host interactions. People in the same place share the same environmental factors such as the water pump in Cholera epidemic.

[Saravalee Suphakarn]

1. Make sure that your operation is correct
2. Make sure that you click on “Select Features”, not choose any options in triangle bottom beside it.
3. Do you have any notification bar show on the top of map page after click the “Select Features”?
– If the program can follow your command, the blue bar of the results will show temporarily
– If the program can’t follow your command, the orange bar with text ‘No matching features found’ will show temporarily
Saravalee sup

[Saravalee Suphakarn]

According to the topic of AMR surveillance system in animal on the floor, Department of Livestock Development (DLD) of Thailand participated to develop Thailand’s National Strategic Plan on Antimicrobial Resistance 2017-2021 which had the collaboration between many stakeholders including DLD, MOPH and international organization like FAO, WHO, and OIE. DLD plan and implement the projects about AMR under the responsible of Division of Animal Feed and Veterinary Products Control (AFVC). They have the projects for surveillance and monitoring of AMR and AMU in livestock. One of the projects under this strategies plan is about the development of “The Animal Antimicrobial Resistance Monitoring Information System (AARMIS)”. I can’t access more data for the progression of this project, but I think it very interesting for future sharing the AMR data between human health sector and animal sector.

[Saravalee Suphakarn]

Thank for all of your help!!

[Saravalee Suphakarn]

My wrap-up assignment, please follow this link http://prnt.sc/13kztp4

[Saravalee Suphakarn]

Please follow this link http://prnt.sc/13aohfz for my wrap-this week.

[Saravalee Suphakarn]

My wrap-up of week2, please follow this link http://prnt.sc/131keps

[Saravalee Suphakarn]

My wrap-up for the 1st week topic “AI and Ethics in health care”
I can’t upload my picture to the page, please follow this link https://prnt.sc/12r8hd2
Thank you!

[Saravalee Suphakarn]

Thank you Khaing Zin Zin Htwe for your great CRF. It cover all of the variables that need in the study. Your design in this CRF is easy to read, fill in, and follow the form. I very impress about the choices that often have the third option excluded from “Yes ” and “No” answer such as “unknow”, “Not done”, and “No examined”. These could be one of the measure to increase data validity and I forgot it in my CRF.

I have some suggestion for improving you CRF. First, base on my knowledge and my experience, any titer of antibody doesn’t has unit because it report in form of dilution (1:2 , 1:4 , 1:8 etc.). Thus, the unit column in laboratory data is redundancy. Second, because this study plan to study and collect data in Thailand, the units of weight and high that often use are kilograms in weight and centimeters in high. If the CRF form specify to fill in these data in inch and Ib unit, might difficult for collector to change the unit and increase their work.

Thank you for your hard work. If you have any opinion to discussion please let me know.

[Saravalee Suphakarn]

For my previous experience, I did all these process (User authentication and access control level, Edit check and logical check, Data backup and recovery plan) except audit trial or time stamp process. However, in very process didn’t fully operational and still had the weak point or defect that should improve in the future project.

I have ever used Google Form as a eCRF to collect data and export to excel file format Then used Microsoft Excel to manipulate and analysis the data. Google Form can set the access control level for the data. Study site staffs who are collector or interviewers can’t access to the collected data or change it, just authorized person can access and change it. Data manager can observe and check collected data that been sent to the system thought function of Google Form or link to Google Sheet. The platform doesn’t allow to sent feedback or data clarification form to the collectors. After closed the system, collected data are stored in Google cloud and exported as Excel file for backup in hard drives.

[Saravalee Suphakarn]

The units of body weight and high should be specified.

[Saravalee Suphakarn]

The data standard provide understanding of the data to other staff and researchers who are interested in the data. The data standard play a role as international language to communicate people around the world. If the dataset hasn’t standard, just only editor or designer can understand the meaning of variables name/value of variable/date pattern/units that used in the dataset. Other study staff who might have responsibility to use the dataset such as statistician difficult to understand it and can’t take advantage as well as possible. Other researchers also lack inconvenient to understand and apply the dataset.

[Saravalee Suphakarn]

From my last data collection project that prior told in the fist discussion topic, I involve in many step of data management workflow including…
– protocol discussion
– data design
– data acquisition
– CRF development
– database setup
– data entry screen test
– data validation
– data standard and coding
– external data merging
– data manipulation and analysis
– writing study report

The project has various limitation such as time, person, budget. Especially for time, the limitation caused the project didn’t well plan. However, the team attemptำก to kept the quality and reliable of the data and the report. The processes that were not implemented in the project and I think it should be done for improve the project are…
– DMP development
– database access control
– data entry screen test (we implemented, but the real end users didn’t involve the test)
– Investigator meeting or CRF completion training
– database lock and security

[Saravalee Suphakarn]

Since October, 2020 to early of this month, I had opportunity to participate in the improve surveillance plan for Avian Influenza (AI) project. My responsibility was collection data to summary production cycle of poultry in Thailand. It consisted of five sub-population of poultry that I have to collect the data including free-grazing duck, backyard poultry, layer chicken, meat-type duck, and broiler chicken.

It used combination of primary and secondary data collection. Because of time limitation, first priority was secondary data collection from old reliable database such as the permission record of poultry transportation. For additional data, the team designed the questionnaires to collect data from target farmers.

The questionnaires on Google form were used as electronic data capture. The questionnaire was distributed through the Department of Livestock Development system to local veterinary officers who then interviewed the households having target poultry.

I found the data quality problem from questionnaires data collection. The dataset had missing data, illogical data, out of range data, and inconsistency data. Probable causes of this problem are inappropriate questionnaire design, unclear question, lack of training for interviewers, lack of communicate between data management team who design the questionnaire and interviewers.

Because the existing databases were not designed for specific purpose of the study, it usually incomplete variable data in one database and essential to merge more than one existing database. The problems is about the different format in each database. Validity data check and data manipulation are necessary for maintain the quality.

[Saravalee Suphakarn]

In Thailand, first main problem is amount of informatician that work in health and public health fields. As Dr. Herman Tolentino mention kin the VDO clip, informatician isn’t just expertise in IT skill or health knowledge but should has both integrated basic knowledge and understanding to design, develop, and implement the information system and information utilization. We need potential organizations or institutes to develop informatician from anyone who interested in the field. In development process of informatician, is one of issue that challenge in health informatics workforce. Human resource development need the support and cooperation. In my opinion, lack of trainer and area for practice the skills are challenge problem that we face. Moreover public awareness about importance of informatician is may be the overall key successful. Authorities who related to health field have to realize the reasons why we need the health informatics workforce. The tools in their hand such as policy making, funding could support and build cooperation for informatician development.

[Saravalee Suphakarn]

In point of view, data sharing has more benefit such as for data of vulnerable population or critical situation. However, as my responsible, I have to consider in others view before share the data. Type of the data, level of its sensitivity, effect of data sharing, privacy, and confidentiality have been concerned. One thing that I think it’s also important and should be clarified is the purpose of data sharing. If we comprehend the objectives, will help to plan and make decision about data sharing easier and effectively.

[Saravalee Suphakarn]

While the facility and efficiency of the health care between the US and South Africa is equivalent, the price that patient have to pay is very different. The problem about the price of US health care, according to the opinion of all participant, is cause from the structure of the system including healthcare insurance, the government policy, tax system etc. Healthcare coverage in US is provided through a combination of private health insurance and public health coverage and US does not have a universal healthcare program, unlike most other developed countries. However, they try to solve the problem by act but it still doesn’t enough.

Health accessibility is one of the most important responsibility of any government that have to provide for all citizen. Although the current system in each country isn’t perfect and has defects, but the structure changing isn’t easy and cause of wide effect. Each country, including Thailand, should do their best to improve the system in the way that proper and suitable to their environment in the country.

[Saravalee Suphakarn]

I agree with the concept of Net Pracharat project about the equality of the people to access the internet. It not just mean the opportunity to use the internet, it also mean the equity to access the data, information, knowledge including the equity to communicate, express the opinion, trade the local products, and anything at all that internet can provide.

In the other hand, I also agree with the article. The surface is positive but what is the true purposes of the project behind the surface. I have 2 points that should be concerned. The first is about the practical using of the network. The number of the WiFi spot, the speed of internet which have the negative feedback from the users. The second point, like everyone concern, is the privacy and security of the personal data. Actually, government has duty to protect and govern data provacy and security, but many people quite worry about it when use the government network. I think this problem reflects confidentiality of the government. The should design the policy to make people confident in their data security.

I believe that Thailand ready for the technology and should develop it. But the government have to be honest with the rights of the people and sincere it.

[Saravalee Suphakarn]

The study review the implementation of EMR in Myanmar, Thailand’s neighbor country. Thailand also have implemented EMR in many sectors and be classified as developing country.

Advantage of EMR including…
– increasing efficiency and quality of data collection, data storage, data management, data analysis, and information utilization.
– reducing time of working and workload.
– providing ability to share and transfer data both internal and between the organizations.
– reducing time and cost of patients
– improving quality of health care to better health of people.

Disadvantage of EMR including…
– privacy and security of personal data have been concerned.
– may increase workload in transition period.
– users have to have basic of computer and technology especially health care provider.
– the system need technology infrastructures, internet access, and power supply.
– human training and technical support is important especially when system downtime.

Although the implementation of EMR need more preparation (human, knowledge, resource), I agree with Wachirawit’s answer, it can be prevent by good management.

[Saravalee Suphakarn]

According to the big health data challenges, the article give some examples of such complexity issues including missing data, selection bias, data analysis and training, interpretation and translational applicability of results, and privacy and ethical issue. I would like to add some opinion and suggestion in each topics.

1. Missing data: This challenges is the most often problems that found when deal with data analysis, but hardest to protect. It directly effect to validity and reliability of the result. The authors suggest to use statistical method to solve the problem. In addition, I think good design data collection procedure that conclusion from the brainstormed of stakeholders also can reduce some omitted data. Because incomprehensibility between data collector (clinician, health care provider, laboratorian) and designer or informatician, listening the opinions from the stakeholders can provide essential information to create suitable and user friendly data collection procedure.

2. Selection bias: In addition from the using many statistic techniques, to reduce selection bias, study design is also important. Criteria for include subjects is beneficial tool to control many factors or variables that affect treatment outcome. However, the validity of the data depend on variables that you can define and control and randomized control trial (RCT) is necessary.

3. Data analysis and training: Knowledge of researchers and clinicians and the development of algorithms are important for big data analysis. To develop both of human resource and knowledge resource need encouragement from many part such as funding and policy support from the government, cooperation from university etc.

4. Interpretation and translational applicability of results: The results from big health data analysis need to integrated and applied with daily practice. For information utilization, researchers have to explain their works in easier to understand while practitioners also have to understand the basic knowledge and applied the results with daily practice. In my opinion, it necessary soft skills for both of them need to develop to full filled the gap.

5. Privacy and ethical issue: Cyber crimes is concerned from everyone. For big health data analysis, it is inevitable to access personal data but consent of owner is also important. Consent form should carefully develop. In the other hand, researchers who have responsible to protect the private data must have preventive measures to reduce risk of breaches as much as possible.

[Saravalee Suphakarn]

According to the four steps to fight corruption in health system, I agree with all of these. All of four, meeting the stakeholder to seek agreement, prioritize and develop pragmatic action, take a holistic view, and sets out what it can offer, look like ideal of resolution plan of this problem. It very good idea and if it is possible, may can reduce percent of corruption in the system. In the other hand, like Mr.Wachirawit answer, the corruption problem in Asia is a culture related problem which more complex than western countries. In addition from ‘the gift’, eastern culture also in the part of patronage system which have been normalized in our society. I think it is challenge issue to solve the corruption problem in Thailand.

[Saravalee Suphakarn]

The development of village health volunteers or VHV is one of important health system improvement of Thailand. Although the example has been developed for 30 years, but the village health volunteer is primary step of the public health system and it is the strongest point of Thailand health network. The project create human resource from the local people who have good understanding about local information and people in the community, by educate them about public health and personal health knowledge. VHV play important role to communicate, transfer health information, knowledge, news, public relation between health care provider to people in local community, promote, and support health care provider in other sectors. It improve health distribution and health level from central or provincial level to the village level. The response from health care provider also faster through the VHV communication way.

The barriers of the project is human and financing. Because everyone have different basic knowledge, how to develop them into the standard is necessary and challenge. The financial for supporting activities of VHV and develop them is also important.

[Saravalee Suphakarn]

For development of disaster recovery plan, I think we should follow the protocol that start with identification and risk analysis followed by classification of risk, risk assessment, determining the effects of disasters, and evaluation of disaster recovery mechanisms. My organization is regional veterinary laboratory and research center, the Department of Livestock Development (DLD). Because it is the latest veterinary research and development center of Thailand, it is a quite small organization, there is no resource as much as bigger center. But the laboratory data in the system is need high security especially preparation for disaster. The center may suitable with replication technology for disaster recovery technology because it can be help for data backup, less overload system, can process the report, and fast recovery time.

[Saravalee Suphakarn]

Hospital benefits: High availability HIS provide hospital users such as doctor, laboratorian, and other staff who need to use the information can access it in timely manner. Effective diagnosis, treatment or analysis data are the results of the accessibility. The hospital service system also can continue and increase satisfaction of system users (both patient and hospital staff)
Patient benefits: Patients receive better hospital service and higher quality of diagnosis, treatment and prevention. High quality of hospital service and medication can reduce time and cost that patients have to loss.

[Saravalee Suphakarn]

I never have directly problem about the security CIA of the information system under my control. But my Instagram account be access by other people (Hacker) last year. This is the confidentiality problem that my information were accessed by unauthorized person. It didn’t have big effect or damage, just he/she posted a picture in my account. After that I changed my password and not thing continue happened. Although this problem didn’t largely affect to me, but my confidence with the application was loss. To prevent the problem, the application developers should fix the security of the system and I should check my security of my phone or my web browser that be use to log in the application such as encryption protocol.

[Saravalee Suphakarn]

Thank you for your great presentation about the surveillance stem of the Scrub Typhus. It provide an idea and more information about the disease. I have some questions about the surveillance system. According for your plan, you explain the surveillance system will be utilized as the early warning system but the system doesn’t has any indicators about time of response. Please explain about that in your idea. Thank you.

[Saravalee Suphakarn]

Thank you for the interesting presentation and the viral hepatitis disease is important in both Thailand and Myanmar. I have some questions about the case definition. Could we define hepatitis cases from clinical sign plus from the laboratory result and what is the criteria for blood collection to test the virus?

[Saravalee Suphakarn]

Thank you for reviewing. I my opinion, exposed dogs have probability return to susceptible dogs after they receive immediately post-exposure vaccination. However, the protocol of post-exposed vaccination in animal depended on previous vaccination status. For unvaccinated dog, there is evidence that the use of post-expose vaccine alone will not reliably prevent the disease in these animals. In case that any dog exposes to a confirmed or suspected rabid animal should be assessed, good would cleaning, and vaccinate (according to protocol) by veterinarian as soon as possible. After that strict quarantine is necessary. If the dog current on rabies vaccination, already get good wound cleaning, and received post-expose vaccine, it possible to undeveloped rabies and return to susceptible. In otherwise, the dog didn’t vaccinate before may develop rabies in quarantine period even through already received immediately post-expose vaccine.

[Saravalee Suphakarn]

Yes, I agree with you. In additional, because the race is very broad answer to develop the appropriate checkbox, developer should consider the objective of the study and data of target population.

[Saravalee Suphakarn]

Thank you for your great suggestion!. I’ll attempt to do better in the next time for the training and monitoring data quality.

[Saravalee Suphakarn]

Yes, I think the gap should be full filled. Interviewers are the key person who can determine quality of the data. CRF completion training and explain their specific role and responsibility are important.

[Saravalee Suphakarn]

Thank you for sharing your data collection experience. I also have the problem from the questionnaire design. It make me realize the importance of questionnaire design that affect to data quality. And thank you suggestion from Dr.Saranath. I agree with you that testing and training before implementation would be helpful to decrease the problem.

[Saravalee Suphakarn]

I don’t have expert IT skill. But in by opinion, The wording “please send me the data via email” is one kind of data share. Although the data will not be shared in publish of formal form, the data have been sent to others people. Depend on you policy, consent from etc. to consider that should you share your data by this type? are you ensure in the privacy and confidentiality are kept.

[Saravalee Suphakarn]

It’s a good way to cooperate with the telecommunication companies. The companies are proficient in the network operation, also in data privacy and security. People may increase confidentiality to use the network. The hardest of this way is the conflict of interest between the companies and the government.

[Saravalee Suphakarn]

Thank you for your kind answers. It’s my new information that hepatitis virus be testing in all people for the high prevalence countries. Therefore the surveillance could implement as national level surveillance and will be very big data base.

[Author]

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