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At least 19 recordsLinked to original sources

Meningococcal disease in New Zealand: an audit of disease notification and contact management.

AIMS: To determine variations in practice across New Zealand for the notification and contact management of meningococcal disease and recommend action. METHODS: A retrospective survey using a questionnaire conducted during August and September 1992. The disease notification component of the audit looked only at process (post notification) rather than completeness of notification. RESULTS: The results indicated that there was considerable variation in practice across the country. Concerns expressed by respondents related to the availability of and payment for prescribed prophylactic antibiotics, contact definition, protocol availability and the appropriate delegation of duties. Deficiencies were identified in the above areas of concern as well as in follow-up procedures for contacts, record keeping and communication. CONCLUSIONS: Major variations in practice across the country which may be counterproductive to outbreak control should be minimised. A minority of area health boards (AHBs) and districts have well developed protocols that could be the basis for developing standards of good practice for the whole country.

Aftercare

The EPI in Borno State, Nigeria: impact on routine disease notifications and hospital admissions.

An earlier report on the Nigerian expanded programme on immunization (EPI), covering 1974-1988, failed to demonstrate a clear-cut impact of the programme. This report attempts to determine the effectiveness of EPI in Borno State, Nigeria. We analysed trends in routine notifications for diphtheria, pertussis, tetanus, tuberculosis, measles, and pneumonia, from 1985 to 1991; data on poliomyelitis were excluded because of poor documentation, while we included data on pneumonia for comparison. We also performed a before (1983-1987) after (1988-1991) comparison in terms of the intensifications of EPI by age-specific strata amongst paediatric hospitalization for all EPI diseases at the University of Maiduguri Teaching Hospital, the sole referral hospital for childhood infectious diseases. Our results show an apparent reduction in morbidity from diphtheria, pertussis, tetanus, measles and pneumonia, and this was particularly prominent following intense vaccinations between 1988 and 1991. The reduction in these EPI diseases and pneumonia occurred despite the prevailing adverse socioeconomic conditions, and the absence of a specific control strategy for pneumonia in Nigeria. On the other hand, in spite of national BCG coverage of about 90% there has been a recent (1989-1991) increase in the registered cases of tuberculosis in infants and older children in Borno State. There is a need to intensify other intervention measures alongside EPI activities.

Adult

Notification of disease. Worthwhile or not?

Disease notification is part of the community surveillance system for control of infectious diseases, but it has fallen into disuse. Understanding the goals and mechanisms of surveillance allows us to respond most appropriately to the needs of both our patients and the community.

Australia

Notification of infectious diseases by general practitioners in New South Wales. Survey before and after the introduction of the Public Health Act 1991 (NSW)

OBJECTIVE: To evaluate attitudes and knowledge about infectious disease notification and the self-reported notifying practices of general practitioners in New South Wales before and after the introduction of the Public Health Act 1991 (NSW). DESIGN: A survey of a random sample of general practitioners in NSW before and after the introduction of the Act. RESULTS: The percentage of doctors who considered notification to be very important increased (57% "before" v. 67% "after"; P = 0.02), as did the percentage who believed that notification usually leads to preventive action (41% v. 54%; P = 0.04). There was no increase in self-reported notification (50% v. 54% who reported notifying cases of notifiable diseases "always, or almost always"; P = 0.42). CONCLUSIONS: Notification of infectious disease by doctors remains suboptimal, but may improve over time as the impact of the new Act is felt. Feedback to doctors showing that preventive action is taken as a result of their notifications may be the most effective way to improve notification practices.

Attitude of Health Personnel

[Evaluation of the information provided by the system of compulsory notification of diseases].

In order to assess activities of epidemiological surveillance resulting from the statutory notification system, a total of 17,394 notification records of eight infectious diseases (brucellosis, bacillary dysentery, typhoid fever, viral hepatitis, meningococcal infection, rickettsioses other than exanthematous typhus, pulmonary tuberculosis, and tuberculosis of other organs) together with 10,503 epidemiological surveys submitted to the "Servei Territorial de Salut Pública" of the province of Barcelona between 1982 and 1986 were reviewed. In notification records, data to locate physicians were the most commonly found (between 92.6% and 99.4% according to disease), whereas in epidemiological surveys, clinical and analytical data were the most frequently encountered. The inclusion of data of epidemiological interest ranged from 3.6 to 68.6%. In order to improve efficacy of the statutory notification system a proposal is made to reduce the extension of epidemiological surveys in terms of requesting only necessary data to establish appropriate measures in each case.

Communicable Disease Control

General practice awareness of notifiable infectious diseases.

The Acheson Report concluded that the process of infectious disease notification in England and Wales was unsatisfactory and recommended that it should be reviewed. However, the success of any notification system will depend on the knowledge and motivation of general practitioners, who are responsible for a large proportion of infectious disease notifications. A district-wide telephone survey was conducted in Croydon among general practitioners to assess the level of awareness of which diseases are on the statutory notification list. Respondents' opinions were also sought on the composition of the present list. Results indicated that a generally high level of awareness contrasted with a relative paucity in knowledge of certain of the more common diseases. Differences in knowledge were not associated with the sex, the length of time since the doctor qualified or the number of partners in the particular practice. Motivation may be a particularly important factor underlying the present incompleteness of notifications. A large proportion of doctors stated that legionellosis, AIDS, brucellosis and listeriosis merited statutory notification.

Communicable Disease Control