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PubMedDate not supplied

Notification of meningococcal disease and Haemophilus influenzae meningitis: a requirement for public health action.

------------------------------------------------------------------------ ------------------------------------------------------------------------ ------------------------------------------------------------------------ ---------------------------meningitis was ascertained for the years 1987-1991. Laboratory record review identified positive blood culture and cerebro-spinal fluid isolates for 4 Dublin hospitals serving the paediatric population of the Eastern Health Board. Infectious disease registers, inspected for evidence of notification, revealed than only 44% of culture positive cases had been notified. The notification rate for Haemophilus meningitis (33%) was significantly lower than that for meningococcal disease (53%). All laboratory identified cases should have been notified. Public health assessment is required for each condition as rifampicin prophylaxis can prevent secondary cases in close contacts of both diseases. Improved notification is essential, not just to comply with the law but more importantly, for better management of these diseases.

Child↗
PubMed1995

The role of private medical practitioners and their interactions with public health services in Asian countries.

This paper aims to review the role of private practitioners and their interactions with public health services in developing countries, focusing largely on the Asian region. Evidence on the distribution of health facilities, manpower, health expenditures and utilization rates shows that private practitioners are significant health care providers in many Asian countries. Limited information has been published on interactions between public and private providers despite their co-existence. Issues related to enforcement of regulations, human resources, patient referrals and disease notifications, are examined.

Asia↗
PubMed2000

Evaluation of the SIMI system, an experimental computerised network for the surveillance of communicable diseases in Italy.

In Italy, the current communicable disease notification system is organised as follows: in each region, Local Health Units (LHU) fill in and forward case report forms (CRF) to the Regional Health Authority, which send aggregated and individual notifications to several central-level institutions. In most regions, all data are recorded manually on hardcopy. Although most relevant data from CRFs are eventually entered into a computerised database at the National Institute of Statistics (ISTAT), the national database is only available 3-4 years later and no data-quality control is performed at that time. To improve the quality and timeliness of notification, in 1994, the Istituto Superiore di Sanità (the National Institute of Health) began to develop an experimental computerised surveillance network for communicable diseases (referred to as 'SIMI'). Specifically, a software was created and distributed to the LHUs and the Regional Health Authorities; staff training was performed; and feedback and analyses of collected data was promoted. SIMI was evaluated in the 13 regions that were participating in 1997 (out of a total of 20 regions in Italy), using criteria commonly used for surveillance systems (i.e., completeness and coherence of data, case definitions, costs, timeliness, and feedback). SIMI was implemented at a limited cost and the data collected were observed to have had a high degree of completeness and internal consistency. The SIMI system has since been adopted for the routine notification of communicable diseases in nearly all regions. Similar evaluations will be necessary for assessing the performance of the various notification systems used across Europe and to include them in a European network.

Communicable Disease Control↗
PubMed2001

Strategies for partner notification for sexually transmitted diseases.

BACKGROUND: Partner notification has been practiced for decades, with substantial resources directed towards it, and with little evidence on whether it has made a public health impact on disease transmission. Most of the evaluations were not randomized controlled trials, and were conducted in the United States, prior to the HIV/AIDS epidemic. There are reasons to question whether partner notification for gonorrhoea and chlamydia is applicable to HIV. It is also questionable whether interventions for the developed world are applicable to the developing world. OBJECTIVES: This review aims to compare the effects of various sexually transmitted disease (STD) partner notification strategies, including to compare provider referral with contract and patient referral, and to compare different patient referral strategies to each other. In addition to updating previous reviews, it addresses partner notification in developing countries as well as in developed countries, with particular consideration for HIV/AIDS. It attempts to address some of the methodological limitations of earlier reviews. SEARCH STRATEGY: The search strategy included MEDLINE, EMBASE, Psychological Abstracts, Sociological Abstracts, the Cochrane Controlled Trials register, the proceedings of the International AIDS Conferences and the International Society for STD Research meetings. SELECTION CRITERIA: The review includes published or unpublished randomised controlled trials (RCTs) comparing two or more partner notification strategies for people diagnosed with STDs. DATA COLLECTION AND ANALYSIS: For each comparison within each study, the difference in the rate of partners elicited, notified, medically evaluated, harmed, etc, the 95% confidence interval, and if significant, the numbers needed to treat (NNT) were calculated. MAIN RESULTS: We found 11 RCTs, including 8014 participants. Only two trials were conducted in developing countries, and only two trials were conducted among HIV positive patients. There was some risk of bias in all the included trials. The review found moderately strong evidence that: 1. provider referral alone, or the choice between patient and provider referral, when compared with patient referral among patients with HIV or any STD, increases the rate of partners presenting for medical evaluation; 2. contract referral, when compared with patient referral among patients with gonorrhoea, results in more partners presenting for medical evaluation; 3. verbal, nurse-given health education together with patient-centred counselling by lay workers, when compared with standard care among patients with any STD, results in small increases in the rate of partners treated. REVIEWER'S CONCLUSIONS: There is a need for evaluations of interventions combining provider training and patient education, and for evaluations conducted in developing countries. All partner notification evaluations, but especially those among HIV positive patients, need to measure potential harmful effects, such as domestic violence, to ensure that partner notification does more good than harm.

Chlamydia Infections↗
PubMed2005

[Epidemiology and surveillance of legionella infections].

Since 1987, in France, Legionella infection is a notifiable disease. Notification should be transmitted by the clinician to the referent public health physician in the Direction départementale des Affaires sanitaires et sociales. Criteria for certain and probable cases have been defined. From this level, nationwide information is centralised in the institut de veille sanitaire. The public health physician is responsible for the inquiry in the health care facility or community setting and for action taking as appropriate. After isolation, Legionella strains are further studied in the Centre national de référence in Lyon. This center is also responsible for typing of environmental strains. In 2002, the incidence of notified legionellosis was 1,7 per 100,000 inhabitants and the mortality rate of 13%. Median age was 61 years and the sex-ratio M/F of 2.9. Only 39 cases were nosocomial. Very few cases have been observed in children, almost all in immunocompromised patients. Legionellosis is of exceptional occurrence in neonates, but the lethality is high. Treatment guidelines have been published in France only for adult patients.

Disease Notification↗
PubMed1994

Knowledge of infectious disease reporting amongst military and civilian medical officers.

Anecdotally expressed concern over the military/civilian interface regarding infectious disease notification, and the current review of procedures in both civilian and military settings prompted this study. Its aim was to quantify knowledge of doctors involved in the provision of care to Army personnel and their dependants in the United Kingdom regarding infectious disease reporting and make recommendations to improve the process. A questionnaire was sent to all such military and civilian doctors in the Southern Military District of England. The group was no less knowledgeable than others studied previously. Differences were found in the knowledge of reporting procedures between civilian and military doctors, with military hospital doctors demonstrating particularly poor knowledge. It is recommended that specific instruction on all aspects of infectious disease reporting be given to doctors joining the Army and to civilian GPs involved in care of the Military.

Disease Notification↗
PubMed2006

Joint spatial analysis of gastrointestinal infectious diseases.

A major obstacle in the spatial analysis of infectious disease surveillance data is the problem of under-reporting. This article investigates the possibility of inferring reporting rates through joint statistical modelling of several infectious diseases with different aetiologies. Once variation in under-reporting can be estimated, geographic risk patterns for infections associated with specific food vehicles may be discerned. We adopt the shared component model, proposed by Knorr-Held and Best for two chronic diseases and further extended by (Held L, Natario I, Fenton S, Rue H, Becker N. Towards joint disease mapping. Statistical Methods in Medical Research 2005b; 14: 61-82) for more than two chronic diseases to the infectious disease setting. Our goal is to estimate a shared component, common to all diseases, which may be interpreted as representing the spatial variation in reporting rates. Additional components are introduced to describe the real spatial variation of the different diseases. Of course, this interpretation is only allowed under specific assumptions, in particular, the geographical variation in under-reporting should be similar for the diseases considered. In addition, it is vital that the data do not contain large local outbreaks, so adjustment based on a time series method recently proposed by (Held L, Höhle M, Hofmann M. A statistical framework for the analysis of multivariate infectious disease surveillance data. Statistical Modelling 2005a; 5: 187-99) is made at a preliminary stage. We will illustrate our approach through the analysis of gastrointestinal diseases notification data obtained from the German infectious disease surveillance system, administered by the Robert Koch Institute in Berlin.

Adolescent↗
PubMed2006

[Epidemiologic surveillance of measles and rubella in Campinas (SP), Brazil: the reliability of the data].

OBJECTIVE: To evaluate and validate the information concerning measles and rubella from the Brazilian National Disease Notification System (BNDNS) (Sistema Nacional de Informação de Agravos de Notificação, or SINAN) for Campinas, a large city in the state of São Paulo, Brazil, using as a reference the data from a control system, the Syndromic Surveillance System for Fever and Exanthem (SSSFE) (Sistema de Vigilância Sindrômica de Febre e Exantema, or VigiFEx), which operated from May 2003 through June 2004. METHOD: In our study we compared: (1) annual data from BNDNS for the years 1999 through 2003 and (2) data from BNDNS and data from SSSFE for the period of June 2003 through May 2004. We analyzed the rate of completion for key fields (record number, date of notification, and city of notification) as well as for name of disease, date of first symptoms, name of patient, birth date and age, sex, city of residence, date of investigation, immunization history, presence of exanthem, date at start of exanthem, presence of fever, suspected cases among pregnant women, signs and symptoms, date of collection of first sample, results with the sample, virus isolation, final classification, criteria for confirmation/exclusion of cases, diagnosis of excluded patients, development of the case, and date of closure. The level of agreement between the recorded cases in the two data banks was also analyzed. RESULTS: From June 2003 through May 2004, 211 suspected cases of measles or rubella were identified in SSSFE and 275 in BNDNS. All the records had complete information concerning the three key fields. The rate of completion was also 100% for patient name, disease, and city of residence. The completion rate was higher than 95% for date of investigation, measles vaccine, measles and rubella vaccine, and rubella vaccine. A lower completion rate was found for other vaccination variables (number of doses and date of last dose) and for exanthem, fever, and date of start of exanthem. The two information systems were not completely consistent, particularly in terms of variables related to epidemiologic background, clinical data, and case closure. The quality of the SSSFE data was higher. CONCLUSIONS: Epidemiologic surveillance, immunization, and laboratory information systems need to undergo routine evaluation to ensure that the data are reliable and can support the planning of public health efforts.

Adult↗
PubMedDate not supplied

[Surveillance report on Diseases of Compulsory Notification in Navarra. 1999].

The Epidemiological Surveillance System of Navarra includes the notification of 33 transmissible infectious diseases, to which epidemic outbreaks of any aetiology and cause are added. Reporting to the system is carried out on a weekly basis by every doctor who suspects or diagnoses any of these processes. In our autonomous community, Diseases of Compulsory Notification (DCN) are reported to the Section for the Control of Infectious Diseases and Outbreaks of the Public Health Institute on a weekly basis by the doctors of Primary and Specialised Care. Subsequently, the information is sent to the National Epidemiology Centre where data from the autonomous communities is centralised. In 1999, under the heading of diseases of respiratory transmission, 59,159 cases of Flu were reported; 65% of total annual cases were reported in the first 9 weeks of the year, with a maximum in week 4 when 6,826 cases were reported. 18 cases of Meningococcal Disease were reported to the system. Sixteen cases were confirmed microbiologically and appeared in a sporadic way. With respect to the causative serogroup, serogroup C was isolated on 8 occasions. On 7 occasions Neisseria meningitidis serogroup B was isolated. By age groups, 4 cases were declared in infants of 2 years of age (Rate: 46.1 per 100,000), nine cases in children between 2 and 9 years of age (1.53 per 100,000) and the remaining 2 cases in persons aged 20 years or over (0.49 per 100,000). 15 cases of Legionellosis were declared in 1999, all under the clinical form of pneumonia. These were isolated cases in persons of middle or advanced age. No indication was found of prior tourist trips to areas of high prevalence. In the majority of cases the origin was considered to be in the community, while one outbreak was identified as nosocomial. Similarly, there was a notable increase in the declaration of cases of Paludism, with 16 cases (EI: 5.33) affecting travellers and immigrants.

English Abstract↗
PubMed2000

Notification of occupational diseases by general practitioners in the Western Cape.

BACKGROUND: Notification of occupational diseases to the Department of Labour (and in limited situations to other agencies) is an important aspect of surveillance and planning for interventions as well as compensation. A survey of general practitioners (GPs) was conducted to assess their knowledge and practice with regard to reporting of occupational diseases. DESIGN: Descriptive telephonic survey. SETTING: Independent general practices in the Western Cape. PARTICIPANTS: One hundred and forty GPs were randomly selected from a provincial sampling frame of 1,000 GPs. MAIN OUTCOME MEASURES: Knowledge of notification procedures for occupational diseases, and problems encountered with the reporting system. RESULTS: Of a total of 109 GPs interviewed, 75% had diagnosed more than one case of occupational disease in the last 6 months. Twenty-four per cent of the total (95% confidence interval (CI) 16-32%) indicated that they were aware of the notification requirements, and 5% (95% CI 0.8-9%) knew the appropriate legislation. Only one GP notified the appropriate authority once the diagnosis was made. Factors influencing their reporting practice included lack of guidelines for diagnosis of common work-related conditions, lack of information regarding referral channels, problems with communicating with the patient and employer, and poor knowledge of the reporting process itself. Lack of motivation as a result of poor feedback on cases reported and the labour-intensive administration required, were also cited as factors. CONCLUSION: Although the majority of GPs diagnose occupational diseases, knowledge and practice regarding notification are poor. Recommendations to overcome obstacles to notification include a simplified, uniform notification system, adequate training and support of GPs, and timeous feedback to GPs.

Data Collection↗
PubMed1985

Ectopic pregnancy in Queensland, 1971-1980.

An examination of data from the Queensland Hospital Morbidity Collection indicated that the incidence of ectopic pregnancy as a proportion of total births appeared to have doubled between 1971 and 1980. Similar trends were evident in two other Australian regions. A review of possible biases suggested that the true rate of increase was unlikely to be much lower than that observed. In Queensland, venereal disease notifications in women and admissions to hospital for inflammatory diseases of the female reproductive organs have shown an analogous rise.

Adult↗
PubMed1989

The case for worker notification.

There is currently a heated debate about whether the U.S. Congress should enact the High Risk Occupational Disease Notification and Prevention Act. This Act would set up an orderly system for identifying, notifying, and assisting workers at high risk of occupational disease. Significant underpinning for this legislation comes from three pilot projects conducted by the National Institute for Occupational Safety and Health and the Workers' Institute for Safety and Health. These projects demonstrate that notification and intervention for occupational high-risk groups can be implemented feasibly within the existing structures of community health and labor management relations. These projects also suggest that, contrary to the views of opponents of current legislation, it is the absence of systematic programs that leads to massive litigation and high costs. At present, these costs are borne by workers and society.

Humans↗
PubMed1994

Local notification of infectious diseases--a neglected tool.

A country-wide survey of consultants in communicable disease control (CCDCs) was conducted to assess the use of Section 16 of the Public Health (Control of Disease) Act, 1984 for the local notification of infectious diseases. A response rate of 84% was achieved. The results indicate that, although the power is generally little used, 24 local authorities have locally notifiable diseases and at least eight CCDCs are actively considering the use of Section 16. The power may be particularly valuable as an additional tool in the surveillance of 'clinically diagnosed' and locally troublesome infections such as scabies.

Communicable Disease Control↗
PubMedDate not supplied

[Mandatory notification of communicable diseases: what physicians think].

OBJECTIVE: To find out the opinion of family doctors concerning the statutory notification of communicable diseases (SNCD) and to analyse factors associated to a good attitude towards SNCD. SETTING: Guimarães Health Centre, Guimarães. METHODS: Analytical cross-sectional study. Questionnaire survey. The 52 family doctors of the Health Centre were asked to express their opinion on some issues, including the utility of SNCD, reasons for the under-reporting of communicable diseases, up-to-dateness of the list of notifiable conditions, facility of filling in the notification form, and their own attitude towards notification. The variables utility of SNCD and attitude towards notification were then considered together with other variables (including postgraduate time, length of the family doctor's lists of patients, working in exclusivity, and how the degree of general practitioner is obtained). RESULTS: The SNCD was considered at least somewhat useful by 96% of the doctors. Thirty percent of the doctors considered excess work and/or lack of time as the main reason for under-reporting, and 29% it attributed to lack of sufficient motivation. The list of notifiable conditions was considered out dated by 46% of the doctors. Thirty eight percent of them considered the multiple notification of a case of disease not inconvenient and 54% stated that they had used it to notify all or almost all of cases they knew. The doctors who worked exclusively as civil servants and who had smaller lists of patients seemed to have a greater compliance regarding notification (p < 0.05). CONCLUSIONS: The majority of doctors considered the notification useful. They attributed the under-reporting to some conditions that are difficult to change. In this population, the doctors who worked exclusively as civil servants and who had smaller lists of patients showed a more favourable attitude towards reporting notifiable conditions.

Adult↗
PubMed2003

[Infection surveillance in North Rhine-Westphalia--standard reports, barometer and early warning system].

The increasing significance of communicable diseases requires new surveillance tools. Modern electronic instruments in analysis and communication replace the former "handbased" statistics and allow the development of early warning systems. In North Rhine-Westphalia (NRW) the Institute of Public Health started an approach to develop a modular surveillance system prior to the the implementation of the new German infectious disease protection act. The first module called "Automated infectious disease notifications and information system (AIM+)" generates various standard hypertext reports which are published as "Infectious disease reports NRW" on the internet (www.loegd.nrw.de). In addition the infectious disease information is linked with a geographical information system (GIS) giving spatial and temporal patterns. The second module called "Infectious disease barometer NRW" offers a quick actual overview highlighting several selected diseases. It can be electronically sent out to any interested person. The third module "Early warning system" realizes an effective early detection system by combining six statistical procedures with a total of 11 separate methods. In case of detecting clusters and outbreaks it automatically generates warning reports to the responsible parties. All three modules together improve the epidemiological surveillance of the population in NRW, support the translation of information to prevention and control measures, and therefore strengthen epidemiological policy-making.

Communicable Disease Control↗