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Prieto-Campo Á, Batista AD, Magalhães Silva T, Herdeiro MT, Roque F, Figueiras A, Zapata-Cachafeiro M. Understanding vaccination hesitation among health professionals: a systematic review of qualitative studies. Public Health 2024; 226:17-26. [PMID: 37980837 DOI: 10.1016/j.puhe.2023.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES In terms of vaccination, people trust healthcare professionals (HCPs) more than any other source of information. They are the cornerstone of vaccination as they can move undecided populations not only towards vaccination but also towards non-vaccination. The aim of this systematic review was to explore the knowledge, beliefs, attitudes, and barriers associated with own vaccination and patient recommendation in HCPs. STUDY DESIGN This study incorporated a systematic review. METHODS A systematic review of studies published from January 1, 2000, to June 1, 2020, was conducted by searching PubMed and EMBASE electronic databases. Qualitative studies reporting outcomes related to knowledge, attitudes, or barriers related to vaccination/recommendation by healthcare personnel were included. The guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. RESULTS From a total of 2916 studies identified, 36 articles met the inclusion criteria. Some of the factors cited by the HCP that may contribute to vaccine hesitancy were (a) concerns regarding safety or efficacy of vaccines (23 articles); (b) time constraints (21 articles); (c) lack of knowledge about the vaccination/vaccine (19 articles); (d) costs (13 articles); (e) distrust of pharmaceutical industry (8 articles); and (f) considering oneself insusceptible (7 articles), stock shortage (7 articles), lack of personnel (5 articles), and feelings of unnecessary vaccination (5 articles). CONCLUSIONS Our review suggests that interventions to combat vaccine hesitancy should increase HCP education on vaccine efficacy and safety, as well as intervene on health system factors such as cost and time per visit. In this way, we could tackle the problem of vaccine hesitancy, which seriously threatens global public health.
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Affiliation(s)
- Á Prieto-Campo
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain
| | - A D Batista
- Department of Medical Sciences, University of Aveiro, 3810-193, Aveiro, Portugal
| | - T Magalhães Silva
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - M T Herdeiro
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - F Roque
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Avenida Dr. Francisco Sá Carneiro, no. ° 50, 6300-559, Guarda, Portugal; Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Av. Infante D. Henrique, 6200-506, Covilhã, Portugal; Escola Superior de Saúde, Instituto Politécnico da Guarda Rua da Cadeia, 6300-035, Guarda, Portugal.
| | - A Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - M Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
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Aniwada E, Ibiok N, Ossai E, Nwobi E, Uzochukwu BC. The effect of training and provision of logistic support on disease surveillance and notification system in private health facilities in Enugu State, Nigeria. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_226_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Qamruddin AA, Qamruddin R, Malik A. Analysis and Factors Associated with Measles in Larut, Matang and Selama Districts, Perak, Malaysia. Malays J Med Sci 2020; 27:130-140. [PMID: 33154709 PMCID: PMC7605828 DOI: 10.21315/mjms2020.27.5.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 09/12/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To determine the incidence rate of measles and the factors associated with confirmed measles cases in Larut, Matang and Selama districts. METHODS Cross-sectional analysis was carried out looking at all suspected and laboratory-confirmed measles cases in Larut, Matang and Selama districts between 2015 and 2019. Multiple logistic regression analysis was used to determine the associated factors for laboratory-confirmed measles cases. RESULTS The incidence rate for suspected measles showed an increasing trend from 2015-2019. For laboratory-confirmed measles cases, the incidence rate showed more variation with an increase to 36.11 per million population in 2017 from 5.67 per million population in 2015. The incidence rate later decreased to 10.99 per million population in 2018 and increased again to 24.47 per million population in 2019. From multiple logistic regression analysis, cases that fulfilled the case definition of measles were more likely to be laboratory-confirmed measles. On the other hand, a prior history of measles immunisation was a protective factor. CONCLUSION Measles incidence is increasing in trend. Any suspected measles cases that fulfilled the clinical case definitions need to be further investigated. Immunisation should be promoted as they are effective in preventing and eliminating measles.
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Affiliation(s)
| | | | - Ayu Malik
- Larut Matang and Selama District Health Office, Perak, Malaysia
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Building the hospital event-based surveillance system in Viet Nam: a qualitative study to identify potential facilitators and barriers for event reporting. Western Pac Surveill Response J 2020; 11:10-20. [PMID: 33936855 PMCID: PMC8053901 DOI: 10.5365/wpsar.2019.10.1.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction Hospitals are a key source of information for the early identification of emerging disease outbreaks and acute public health events for risk assessment, decision-making and public health response. The objective of this study was to identify potential facilitators and barriers for event reporting from the curative sector to the preventive medicine sector in Viet Nam. Methods In 2016, we conducted 18 semi-structured, in-depth interviews, as well as nine focus group discussions, with representatives from the curative and preventive medicine sectors in four provinces. We transcribed the interviews and focus group discussions and used thematic analysis to identify the factors that appeared to affect public health event reporting. Results We identified five major themes. First, the lack of a legal framework to guide reporting meant hospital staff relied on internal procedures that varied from hospital to hospital, which sometimes delayed reporting. Second, participants stated the importance of an enabling environment, such as leadership support and having focal points for reporting, to facilitate reporting. Third, participants described the potential benefits of reporting, such as support provided during outbreaks and information received about local outbreaks. Fourth, some challenges prohibited timely reporting such as not perceiving reporting to be the task of the curative sector and hesitancy to report without laboratory confirmation. Finally, limited resources and specialist capacities in remote areas hindered timely detection and reporting of unusual events. Discussion This study identified potential opportunities to promote the detection and reporting of unusual events from health-care workers to the public health sector, and thus to improve the overall health security system in Viet Nam.The influenza virus is a respiratory pathogen that is transmitted through respiratory droplets. 1 During seasonal influenza epidemics, high attack rates cause a significant public health burden. 2 The infection is usually self-limited in young adults but can lead to severe infections in people in high-risk groups, including elderly people (> 65 years old), pregnant women, children aged 6-59 months and adults with chronic illnesses. 3.
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Otsu S, Do H, Ha TA, Ngo TH, Tran QD, Condell O, Le TV, Ngu ND, Hoang TV, Dang TQ, Tran PD, Tran PTN, Lai AT, Kato M, Chiu C. Enhancing hospital event-based surveillance system – Findings from a pilot study, Vietnam, 2017-2018. GLOBAL SECURITY: HEALTH, SCIENCE AND POLICY 2020. [DOI: 10.1080/23779497.2020.1786431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Satoko Otsu
- Disease Control and Health Emergency Program, World Health Organization Vietnam Country Office, Ha Noi, Vietnam
| | - Hien Do
- Disease Control and Health Emergency Program, World Health Organization Vietnam Country Office, Ha Noi, Vietnam
| | - Tuan Anh Ha
- Epidemiology Department, Pasteur Institute Nha Trang, Nha Trang, Vietnam
| | - Tu H. Ngo
- Department of Communicable Disease Control, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Quang D. Tran
- General Department of Preventive Medicine, Division of Communicable Disease Control, Ha Noi, Vietnam
| | - Orla Condell
- Disease Control and Health Emergency Program, World Health Organization Vietnam Country Office, Ha Noi, Vietnam
| | - Tuan V. Le
- Disease Control and Health Emergency Program, World Health Organization Vietnam Country Office, Ha Noi, Vietnam
| | - Nghia D. Ngu
- Department of Communicable Disease Control, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Thanh V. Hoang
- Epidemiology Department, Pasteur Institute Nha Trang, Nha Trang, Vietnam
| | - Tan Q. Dang
- General Department of Preventive Medicine, Division of Communicable Disease Control, Ha Noi, Vietnam
| | - Phu D. Tran
- General Department of Preventive Medicine, Division of Communicable Disease Control, Ha Noi, Vietnam
| | - Phuong T. N. Tran
- Binh Thuan Provincial Centre of Disease Control, Binh Thuan, Vietnam
| | - Anh T. Lai
- Nam Dinh Provincial Centre of Disease Control, Nam Dinh, Vietnam
| | - Masaya Kato
- Disease Control and Health Emergency Program, World Health Organization Vietnam Country Office, Ha Noi, Vietnam
| | - Cindy Chiu
- Disease Control and Health Emergency Program, World Health Organization Vietnam Country Office, Ha Noi, Vietnam
- Department of Community Health, School of Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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Mathatha ED, Manamela JM, Musekiwa A, Prabdial-Sing N. Exploring the knowledge, attitudes and practices (KAP) of health care professionals on viral hepatitis notification in Gauteng, South Africa, 2015. ACTA ACUST UNITED AC 2018; 76:75. [PMID: 30555693 PMCID: PMC6282396 DOI: 10.1186/s13690-018-0319-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/30/2018] [Indexed: 02/07/2023]
Abstract
Background Data on viral hepatitis in South Africa is scarce. Although viral hepatitis A, B and C are notifiable conditions in South Africa, discrepancies have been noted in the number of viral hepatitis cases notified by the National Department of Health (NDOH) compared with laboratory confirmed cases from the National Institute for Communicable Diseases (NICD). The aim of the study was to assess the knowledge, attitudes and practices of health care professionals on the notification of viral hepatitis A, B and C. Methods A descriptive, cross-sectional study on 385 health care professionals was conducted at Charlotte Maxeke Johannesburg Academic and Tshwane District hospitals in Gauteng province, South Africa, between March and May 2015. A pre-tested, structured questionnaire with 21 (6 demographic and 15 knowledge, attitudes, and practice (KAP)) questions was used to collect information from invited participants. A score was assigned to each KAP question and a mean (SD) score was calculated for each section. Data were analyzed using descriptive statistics in STATA version 13. Results Of the total 385 respondents, 65% (n = 250) were nurses and 35% (n = 135) were doctors. The overall mean knowledge score for health care professionals was 2.0 ± 1.6 (mean ± SD) out of a score of 6 regarding viral hepatitis notification. Overall mean scores of practice and attitude towards notification were higher at 2.9 ± 0.4 and 3.3 ± 0.7, out of a score of 4 and 5, respectively. Lack of training, poor knowledge, a complex process and excessive workload were some of the reasons for poor notification of viral hepatitis. Conclusions Overall, knowledge on notification of viral hepatitis was poor among health care professionals. Adequate training on viral hepatitis, notification process, roles and responsibilities of health care professionals to notify and the implication of viral hepatitis notifications is recommended to improve reporting rate of notifiable diseases and referrals to increase linkage to care. Electronic supplementary material The online version of this article (10.1186/s13690-018-0319-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eva D Mathatha
- 1School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Private bag x323, Pretoria, 0007 South Africa.,2South African Field Epidemiology Training Program, National Institute for Communicable Diseases (NICD), Johannesburg, South Africa
| | - Jack M Manamela
- 3Centre for Vaccines and Immunology, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Alfred Musekiwa
- 1School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Private bag x323, Pretoria, 0007 South Africa.,2South African Field Epidemiology Training Program, National Institute for Communicable Diseases (NICD), Johannesburg, South Africa
| | - Nishi Prabdial-Sing
- 3Centre for Vaccines and Immunology, National Institute for Communicable Diseases, Johannesburg, South Africa.,4Department of Virology, School of Pathology, University of Witwatersrand, Johannesburg, South Africa
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Fill MMA, Murphree R, Pettit AC. Health Care Provider Knowledge and Attitudes Regarding Reporting Diseases and Events to Public Health Authorities in Tennessee. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 23:581-588. [PMID: 27997480 PMCID: PMC5474221 DOI: 10.1097/phh.0000000000000492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT In the United States, state laws require health care providers to report specific diseases and events to public health authorities, a fundamental facet of disease surveillance. However, reporting by providers is often inconsistent, infrequent, and delayed. OBJECTIVE To examine knowledge, attitudes, and practices regarding provider disease reporting and to understand current barriers to provider disease reporting. DESIGN A cross-sectional study was conducted via an anonymous, standardized electronic survey. SETTING The survey was conducted at Vanderbilt University Medical Center, a large, tertiary academic medical center in Nashville, Tennessee. PARTICIPANTS Health care providers in 4 specialties (internal medicine, pediatrics, obstetrics-gynecology, and emergency medicine). MAIN OUTCOME MEASURE(S) Knowledge of and attitudes regarding provider reporting of diseases to public health authorities in Tennessee. RESULTS The majority of providers acknowledged they cared for patients with reportable diseases (362/435, 83.2%) and believed that it was their responsibility to report to public health authorities (429/436, 98.4%); however, less than half had ever reported a case (206/436, 47.2%). The median percent correct on the knowledge assessment of Tennessee reportable diseases and conditions was 81.3% (interquartile range = 68.8-87.5). Providers cited a lack of knowledge of which diseases are reportable (186/429, 43.3%) and the logistics of reporting (153/429, 35.7%) as the primary barriers for compliance. CONCLUSION Most providers acknowledged they cared for patients with reportable diseases and believed they had an obligation to report to public health authorities. However, a lack of knowledge about reporting was frequently described as a limitation to report effectively. Many knowledge deficits were significantly greater among residents than other providers.The policy and practice implications of these findings include a demonstrated need for education of providers about disease reporting as well as development of more convenient reporting mechanisms. Fundamental knowledge of reportable disease requirements and procedures is critical for participation in the broader public health system.
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Affiliation(s)
- Mary-Margaret A Fill
- Departments of Internal Medicine and Pediatrics (Dr Fill) and Division of Infectious Diseases, Department of Internal Medicine (Dr Pettit), Vanderbilt University Medical Center, Nashville, Tennessee; Tennessee Department of Health, Nashville, Tennessee (Dr Murphree); and Career Epidemiology Field Officer Program, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Murphree)
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Benson FG, Levin J, Rispel LC. Health care providers' compliance with the notifiable diseases surveillance system in South Africa. PLoS One 2018; 13:e0195194. [PMID: 29630627 PMCID: PMC5891014 DOI: 10.1371/journal.pone.0195194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 03/14/2018] [Indexed: 11/19/2022] Open
Abstract
Background The optimal performance of a notifiable disease surveillance system (NDSS) is dependent on health care provider (HCP) compliance with communicable disease notification. HCP compliance ensures appropriate investigation and control measures by relevant health care authorities. This study examines the compliance of HCPs with the NDSS in South Africa and factors associated with their compliance. Methods A cross-sectional survey was carried out in three randomly selected provinces. We stratified by type of facility, and recruited clusters of HCPs on survey day to participate. All consenting HCPs in the randomly selected health care facilities on the day of the survey, completed a questionnaire that elicited information on socio-demographic characteristics and notification practices. The data were analysed using STATA® 14, using the identifiers for stratum and cluster as well as the calculated sampling weights. Results The study found that 58% of 919 HCPs diagnosed a notifiable disease in the year preceding the survey. The majority of these professionals (92%) indicated that they had reported the disease, but only 51% of those notified the disease/s correctly to the Department of Health. Paediatricians were less likely to notify correctly (OR 0.01, 95% CI 0.00–0.12, p = 0.001). The factors that influenced notification were HCPs perceptions of workload (OR 0.84, 95% CI 0.70–0.99, p = 0.043) and that notification data are not useful (OR 0.84, 95% CI 0.71–0.99, p = 0.040). The study found no association between correct notification and HCPs’ willingness to notify, experience or training on the NDSS, understanding of the purpose of the NDSS, knowledge of what to notify, or perception of feedback given. Conclusions The compliance of HCPs in South Africa with the NDSS is suboptimal. In light of the important role of HCPs in the effective functioning of the NDSS, information on NDSS usefulness and guidelines on correct notification procedures are needed to increase their compliance.
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Affiliation(s)
- Frew Gerald Benson
- Gauteng Department of Health, Rahima Moosa Hospital, Newclare, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
- * E-mail:
| | - Jonathan Levin
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
| | - Laetitia Charmaine Rispel
- Centre for Health Policy, Department of Science and Technology/National Research Foundation, SARChI Chair on the Health Workforce, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
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Vraukó K, Jancsó Z, Kalabay L, Lukács A, Maráczi G, Mester L, Nánási A, Rinfel J, Sárosi T, Tamás F, Varga A, Vitrai J, Rurik I. An appraisal: how notifiable infectious diseases are reported by Hungarian family physicians. BMC Infect Dis 2018; 18:45. [PMID: 29343216 PMCID: PMC5773032 DOI: 10.1186/s12879-018-2948-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Within the frame of National Epidemiological Surveillance System, family physicians have an obligation to report infections and suspicions cases. The aim of this study was to evaluate the knowledge, attitudes, daily practice and the reporting activities of Hungarian family physicians regarding to infectious diseases. METHODS A self-administered survey was developed, validated and used. The survey was completed by family physicians who had taken part in continuous medical educational programmes of all Hungarian medical faculties. The questionnaire, consisting demographic questions and 10 statements about their reporting habits were completed by 347 doctors, 8% of the total number of family physicians. The data were processed in a cross-sectional design with general linear model. RESULTS According to the majority of responders, the current reporting system works efficiently. Rural physicians were mainly agreed, that reporting is not a simply obligation, it is a professional task as well. They were less hindered in daily work by reporting activities, waited less for laboratory confirmation before reporting, reported suspicious cases more frequently. Practitioner's based in urban settlements preferred to await laboratory tests before reporting and were hindered less by failures of the electronic reporting system. Older physicians trusted more in the recent system and they wished to increase the number of reports. Female physicians have higher consciousness in epidemiology. They were mostly in agreement that even severe infectious diseases can be diagnosed at primary care level and their daily practices were less burdened by reporting duties. CONCLUSIONS Both the epidemiological knowledge of general practitioners' and the electronic surveillance systems should be improved. There is a need to develope the electronic infrastructure of primary care. More and regular control is also expected by the health care authorities, beside the synthesis of professional and governmental expectations and regulations.
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Affiliation(s)
- Katalin Vraukó
- Faculty of Public Health, Department Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
- Government Office for Békés County, Department of Public Health, Békéscsaba, Hungary
| | - Zoltán Jancsó
- Faculty of Public Health, Department Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - László Kalabay
- Faculty of Medicine, Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Andrea Lukács
- Faculty of Medicine, Department of Dermatology, Semmelweis University, Budapest, Hungary
| | - Gabriella Maráczi
- Government Office for Békés County, Department of Public Health, Békéscsaba, Hungary
| | - Lajos Mester
- Faculty of Medicine, Department Family Medicine, University of Szeged, Szeged, Hungary
| | - Anna Nánási
- Faculty of Public Health, Department Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - József Rinfel
- Institute of Primary Care, University of Pécs, Pécs, Hungary
| | - Tamás Sárosi
- Government Office for Békés County, Department of Public Health, Békéscsaba, Hungary
| | - Ferenc Tamás
- Faculty of Medicine, Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Albert Varga
- Faculty of Medicine, Department Family Medicine, University of Szeged, Szeged, Hungary
| | - József Vitrai
- National Institute for Health Development, Budapest, Hungary
| | - Imre Rurik
- Faculty of Public Health, Department Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
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Soe HHK, Than NN, Lwin H, Phyu KL, Htay MNN, Moe S, Abas AL. Knowledge and attitude of mandatory infectious disease notification among final year medical students. J Family Med Prim Care 2018; 7:756-761. [PMID: 30234049 PMCID: PMC6131987 DOI: 10.4103/jfmpc.jfmpc_300_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Disease surveillance is one of the major components to combat against infectious diseases. As health-care professionals are indispensable to mandatory notifiable disease surveillance, their knowledge and attitudes toward infectious disease notification played an important role for timely and effective reporting to the surveillance system. Therefore, we aimed to determine the knowledge of mandatory notifiable infectious diseases in Malaysia and attitude towards infectious disease reporting among final year medical students. Methods A cross-sectional study was conducted from May to June 2017 in the private medical college in Malaysia. Materials and Methods We purposively selected the final year (semester 10) medical students and a total of 124 students participated in this study. We collected data using a self-administered, structured questionnaire. Data were analyzed using descriptive statistics, independent t-test, and one-way analysis of variance. Results Among the final year medical students, 47.5% had moderate knowledge but 4.2% had good knowledge of mandatory infectious disease notification. Only 3.2% of the students correctly answered all the notifiable diseases listed in the questionnaire. Most of the students had positive attitude toward communicable diseases reporting, rewards, and penalty for notification. There was no significant relationship between sociodemographic characteristics and knowledge and attitude of infectious disease notification. Conclusions The majority of the final year medical students had moderate level of knowledge and positive attitude of infectious disease notification; however, there were some deficiencies. Better instruction and training on infectious disease notification procedures of Malaysia should be provided to the final year medical students which could not only reduce underreporting but also improve timely and effective reporting in future.
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Affiliation(s)
- Htoo Htoo Kyaw Soe
- Department of Community Medicine, Melaka-Manipal Medical College (Manipal Academy of Higher Education (MAHE)), Melaka, Malaysia
| | - Nan Nitra Than
- Department of Community Medicine, Melaka-Manipal Medical College (Manipal Academy of Higher Education (MAHE)), Melaka, Malaysia
| | - Htay Lwin
- Department of Community Medicine, Melaka-Manipal Medical College (Manipal Academy of Higher Education (MAHE)), Melaka, Malaysia
| | - Khine Lynn Phyu
- Department of Paediatrics, Melaka-Manipal Medical College (Manipal Academy of Higher Education (MAHE)), Melaka, Malaysia
| | - Mila Nu Nu Htay
- Department of Community Medicine, Melaka-Manipal Medical College (Manipal Academy of Higher Education (MAHE)), Melaka, Malaysia
| | - Soe Moe
- Department of Community Medicine, Melaka-Manipal Medical College (Manipal Academy of Higher Education (MAHE)), Melaka, Malaysia
| | - Adinegara Lutfi Abas
- Department of Community Medicine, Melaka-Manipal Medical College (Manipal Academy of Higher Education (MAHE)), Melaka, Malaysia
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Bronner A, Morignat E, Calavas D. Respective influence of veterinarians and local institutional stakeholders on the event-driven surveillance system for bovine brucellosis in France. BMC Vet Res 2015; 11:179. [PMID: 26231986 PMCID: PMC4522074 DOI: 10.1186/s12917-015-0499-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 07/20/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The event-driven surveillance system for bovine brucellosis implemented in France aims to ensure the early detection of cases of bovine brucellosis, a disease of which the country has been declared free since 2005. It consists of mandatory notification of bovine abortions by farmers and veterinarians. However, as underlined by a previous qualitative study, several factors influence the decision-making process of actors in the field. This process is particularly influenced by the level of cooperation between institutional stakeholders in their département (a French département being an administrative and territorial unit), veterinarians and farmers. In this context, the objectives of this study were 1) to quantify the respective influence of veterinarians and all local institutional stakeholders on the proportion of notifying farmers and identify which actors have most influence on farmers' decisions; 2) to analyse whether the influence of veterinarians is correlated with that of local institutional stakeholders. RESULTS In addition to factors relating to the farm itself (production type and herd size), the proportion of notifying farmers was influenced by the number of veterinarians per practice and the veterinary practice's membership of a technical association. This proportion was also influenced by unknown factors relating to the veterinary practice and, to a lesser extent, the département in which the farm was located. There was no correlation between variability in the proportion of notifying farmers among veterinary practices per département and the effect of the département itself. CONCLUSION To our knowledge, this is the first study to quantify the influence of veterinarians and local institutional stakeholders on the notification process for a mandatory disease. In addition to carrying out regulatory interventions, veterinarians play a major role in encouraging farmers to participate in the surveillance systems. The results of this study, combined with a previous qualitative study, shed light on the need to consolidate the involvement of veterinarians and local stakeholders in the organisation of surveillance by national institutional bodies.
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Affiliation(s)
- Anne Bronner
- ANSES-Lyon, Unité Epidémiologie, 31 avenue Tony Garnier, 69364, Lyon, Cedex 07, France.
| | - Eric Morignat
- ANSES-Lyon, Unité Epidémiologie, 31 avenue Tony Garnier, 69364, Lyon, Cedex 07, France.
| | - Didier Calavas
- ANSES-Lyon, Unité Epidémiologie, 31 avenue Tony Garnier, 69364, Lyon, Cedex 07, France.
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Tóth Csabáné Vraukó K, Vitrai J, Mucsi G, Rurik I. [Study of infectious disease reporting by family physicians]. Orv Hetil 2014; 155:1228-35. [PMID: 25095283 DOI: 10.1556/oh.2014.29903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Reporting liability of family physicians/general practitioners is the keystone for proper surveillance of infectious diseases. AIM The aim of the study was to find out why some of the family physicians neglect to report infectious diseases to the health authorities and determine their motivation and attitude towards the infectious disease reporting system. METHOD Self-fill-in questionnaire was used to obtain data. Of the 228 family physicians who were called to participate in the study 116 family physicians sent back evaluable questionnaires. Descriptive statistic method was used to analyze the data and determine the reporting frequencies and ratios. RESULTS Family physicians reported nearly 50% of all reported cases of infectious diseases. The main reason of underreporting was the lack of knowledge about the rules of the reporting system. According to most family physicians, an online based reporting system would be much more efficient instead of a paper based one. CONCLUSIONS The authors conclude that education of family physicians would be mandatory in order to improve reporting of infectious diseases.
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Affiliation(s)
- Katalin Tóth Csabáné Vraukó
- Debreceni Egyetem, Népegészségügyi Kar Családorvosi és Foglalkozás-egészségügyi Tanszék Debrecen Móricz Zs. krt. 22. 4032 Békés Megyei Kormányhivatal Népegészségügyi Szakigazgatási Szerve Békéscsaba
| | | | - Gyula Mucsi
- Békés Megyei Kormányhivatal Népegészségügyi Szakigazgatási Szerve Békéscsaba
| | - Imre Rurik
- Debreceni Egyetem, Népegészségügyi Kar Családorvosi és Foglalkozás-egészségügyi Tanszék Debrecen Móricz Zs. krt. 22. 4032
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Bronner A, Hénaux V, Vergne T, Vinard JL, Morignat E, Hendrikx P, Calavas D, Gay E. Assessing the mandatory bovine abortion notification system in France using unilist capture-recapture approach. PLoS One 2013; 8:e63246. [PMID: 23691004 PMCID: PMC3653928 DOI: 10.1371/journal.pone.0063246] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 04/01/2013] [Indexed: 11/18/2022] Open
Abstract
The mandatory bovine abortion notification system in France aims to detect as soon as possible any resurgence of bovine brucellosis. However, under-reporting seems to be a major limitation of this system. We used a unilist capture-recapture approach to assess the sensitivity, i.e. the proportion of farmers who reported at least one abortion among those who detected such events, and representativeness of the system during 2006-2011. We implemented a zero-inflated Poisson model to estimate the proportion of farmers who detected at least one abortion, and among them, the proportion of farmers not reporting. We also applied a hurdle model to evaluate the effect of factors influencing the notification process. We found that the overall surveillance sensitivity was about 34%, and was higher in beef than dairy cattle farms. The observed increase in the proportion of notifying farmers from 2007 to 2009 resulted from an increase in the surveillance sensitivity in 2007/2008 and an increase in the proportion of farmers who detected at least one abortion in 2008/2009. These patterns suggest a raise in farmers' awareness in 2007/2008 when the Bluetongue Virus (BTV) was detected in France, followed by an increase in the number of abortions in 2008/2009 as BTV spread across the country. Our study indicated a lack of sensitivity of the mandatory bovine abortion notification system, raising concerns about the ability to detect brucellosis outbreaks early. With the increasing need to survey the zoonotic Rift Valley Fever and Q fever diseases that may also cause bovine abortions, our approach is of primary interest for animal health stakeholders to develop information programs to increase abortion notifications. Our framework combining hurdle and ZIP models may also be applied to estimate the completeness of other clinical surveillance systems.
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Affiliation(s)
- Anne Bronner
- Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses), Unité Epidémiologie du Laboratoire de Lyon, Lyon, France
| | - Viviane Hénaux
- Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses), Unité Epidémiologie du Laboratoire de Lyon, Lyon, France
| | - Timothée Vergne
- Centre de coopération internationale en recherche agronomique pour le développement (Cirad), Département ES, UR22, TA C22/E, Montpellier, France
- Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses), Laboratoire de Santé animale de Maisons-Alfort, Maisons-Alfort, France
| | - Jean-Luc Vinard
- Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses), Unité Epidémiologie du Laboratoire de Lyon, Lyon, France
| | - Eric Morignat
- Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses), Unité Epidémiologie du Laboratoire de Lyon, Lyon, France
| | - Pascal Hendrikx
- Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses), Unité de surveillance épidémiologique (Survepi), Direction scientifique des laboratoires, Maisons-Alfort, France
| | - Didier Calavas
- Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses), Unité Epidémiologie du Laboratoire de Lyon, Lyon, France
| | - Emilie Gay
- Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses), Unité Epidémiologie du Laboratoire de Lyon, Lyon, France
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Rubio-Cirilo L, Martín-Ríos MD, de Las Casas-Cámara G, Andrés-Prado MJ, Rodríguez-Caravaca G. [Notifiable infectious diseases: knowledge and notification among hospital physicians]. Enferm Infecc Microbiol Clin 2013; 31:643-8. [PMID: 23462466 DOI: 10.1016/j.eimc.2012.12.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 12/20/2012] [Accepted: 12/30/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Notifiable infectious diseases represent a public health hazard, which is why they are under surveillance and must be reported. We tried to assess hospital physicians' knowledge of hospital physicians on notifiable infectious diseases and their self-reported attitudes to notification. METHODS An observational study was conducted using a questionnaire with 11 multiple choice questions, two yes/no questions and one short-answer question. It was distributed to all senior doctors and residents in 19 medical and surgical departments. RESULTS A total of 248 questionnaires were sent out, with a response rate of 79.84%. More than three-quarters (76.3%) of the respondents were senior doctors. As regards specific knowledge about whether a particular disease is a notifiable disease, 29.5% identified correctly 100% of the named diseases, 3.2% could not identify any of them. All urgent named notifiable infectious diseases were correctly identified by 25.3% of physicians. Statistically significant differences were found in the knowledge of notifiable diseases knowledge in medical and surgical departments, as well as for senior doctors (P=.047) and residents (P=.035). A high percentage of medical services (40%) and surgical (70%) department reported never failing to notify. When asked about the causes of under-reporting, 72% did not know whether notification was mandatory or not, and 88% did not know what diseases must be notified. CONCLUSIONS Although many respondents are aware that diseases notification is part of their daily activity, many of them admit under-reporting. There is insufficient knowledge about what diseases are considered notifiable infectious diseases and how to notify them.
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Affiliation(s)
- Laura Rubio-Cirilo
- Departamento de Medicina Preventiva, Hospital Universitario Fundación Alcorcón, Madrid, España.
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Disease reporting among Georgia physicians and laboratories. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2013; 16:535-43. [PMID: 20885184 DOI: 10.1097/phh.0b013e3181cb4324] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Opportunities for improved disease reporting are identified by describing physicians' reporting knowledge and practices as well as reporting knowledge and specimen referral patterns among clinical laboratories in the state of Georgia. In 2005, a sample of physicians(n = 177) and all Georgia clinical laboratories (n = 139) were surveyed about reporting knowledge and practices. Knowledge was greater among physicians who received their medical degree before 1980 (P = .04), accessed e-mail (P< .01), used the Internet to obtain public health information (P < .01), and reported frequently (P= .06). Increased knowledge was not associated with training in reporting (P = .14). Physicians were often unaware of reporting procedures and mechanisms and often did not report because they believed others would report (52%). Laboratory representatives (56%) more often received training on disease reporting than physicians (32%). All laboratories sent some specimens for diagnostic testing at reference laboratories and 35% sent the specimens outside of Georgia. Physicians'characteristics may affect reporting knowledge independent of training on disease reporting, and increased knowledge is associated with increased reporting. Investigation of physician characteristics that contribute to improved reporting, such as an active engagement with public health, could help to guide changes to reporting-related training and technology. Reporting by other health care providers and physicians' perceptions that others will report both indicate that studies of all reporting stakeholders and clear delineation of reporting responsibilities are needed. Extensive specimen referral by laboratories suggests the need for coordination of reporting regulations and responsibilities beyond local boundaries.
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Jones SG, Coulter S, Conner W. Using administrative medical claims data to supplement state disease registry systems for reporting zoonotic infections. J Am Med Inform Assoc 2013; 20:193-8. [PMID: 22811492 PMCID: PMC3555318 DOI: 10.1136/amiajnl-2012-000948] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 06/20/2012] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine what, if any, opportunity exists in using administrative medical claims data for supplemental reporting to the state infectious disease registry system. MATERIALS AND METHODS Cases of five tick-borne (Lyme disease (LD), babesiosis, ehrlichiosis, Rocky Mountain spotted fever (RMSF), tularemia) and two mosquito-borne diseases (West Nile virus, La Crosse viral encephalitis) reported to the Tennessee Department of Health during 2000-2009 were selected for study. Similarly, medically diagnosed cases from a Tennessee-based managed care organization (MCO) claims data warehouse were extracted for the same time period. MCO and Tennessee Department of Health incidence rates were compared using a complete randomized block design within a general linear mixed model to measure potential supplemental reporting opportunity. RESULTS MCO LD incidence was 7.7 times higher (p<0.001) than that reported to the state, possibly indicating significant under-reporting (∼196 unreported cases per year). MCO data also suggest about 33 cases of RMSF go unreported each year in Tennessee (p<0.001). Three cases of babesiosis were discovered using claims data, a significant finding as this disease was only recently confirmed in Tennessee. DISCUSSION Data sharing between MCOs and health departments for vaccine information already exists (eg, the Vaccine Safety Datalink Rapid Cycle Analysis project). There may be a significant opportunity in Tennessee to supplement the current passive infectious disease reporting system with administrative claims data, particularly for LD and RMSF. CONCLUSIONS There are limitations with administrative claims data, but health plans may help bridge data gaps and support the federal administration's vision of combining public and private data into one source.
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Affiliation(s)
- Stephen G Jones
- BlueCross and BlueShield of Tennessee, Chattanooga, TN 37402, USA.
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Keramarou M, Evans MR. Completeness of infectious disease notification in the United Kingdom: A systematic review. J Infect 2012; 64:555-64. [PMID: 22414684 DOI: 10.1016/j.jinf.2012.03.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 01/31/2012] [Accepted: 03/02/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Infectious disease legislation in the United Kingdom has recently changed. Our aim was to provide a baseline against which to assess the impact of these changes by synthesising current knowledge on completeness of notification and on factors associated with better reporting rates. METHODS We systematically reviewed the literature for studies reporting completeness of reporting of notifiable infectious diseases in the United Kingdom over the past 35 years. RESULTS Altogether, 46 studies met our search criteria. Reporting completeness varied from 3% to 95% and was most strongly correlated with the disease being reported. Median reporting completeness was 73% (range 6%-93%) for tuberculosis, 65% (range 40%-95%) for meningococcal disease, and 40% (range 3%-87%) for other diseases (Kruskal-Wallis test, p < 0.05). Reporting completeness did not change for either tuberculosis or meningococcal disease over the period studied. In multivariate analysis, none of the factors examined (study size, study time period, number of data sources used to assess completeness, uncorrected or corrected study design) were significantly associated with reporting completeness. CONCLUSION Reporting completeness has not improved over the past three decades. It remains sub-optimal even for diseases which are under enhanced surveillance or are of significant public health importance.
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Affiliation(s)
- Maria Keramarou
- European Programme for Intervention Epidemiology Training, European Centre for Disease Control and Prevention, Stockholm, Sweden
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MacDonald E, Aavitsland P, Bitar D, Borgen K. Detection of events of public health importance under the international health regulations: a toolkit to improve reporting of unusual events by frontline healthcare workers. BMC Public Health 2011; 11:713. [PMID: 21936937 PMCID: PMC3188493 DOI: 10.1186/1471-2458-11-713] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 09/21/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The International Health Regulations (IHR (2005)) require countries to notify WHO of any event which may constitute a public health emergency of international concern. This notification relies on reports of events occurring at the local level reaching the national public health authorities. By June 2012 WHO member states are expected to have implemented the capacity to "detect events involving disease or death above expected levels for the particular time and place" on the local level and report essential information to the appropriate level of public health authority. Our objective was to develop tools to assist European countries improve the reporting of unusual events of public health significance from frontline healthcare workers to public health authorities. METHODS We investigated obstacles and incentives to event reporting through a systematic literature review and expert consultations with national public health officials from various European countries. Multi-day expert meetings and qualitative interviews were used to gather experiences and examples of public health event reporting. Feedback on specific components of the toolkit was collected from healthcare workers and public health officials throughout the design process. RESULTS Evidence from 79 scientific publications, two multi-day expert meetings and seven qualitative interviews stressed the need to clarify concepts and expectations around event reporting in European countries between the frontline and public health authorities. An analytical framework based on three priority areas for improved event reporting (professional engagement, communication and infrastructure) was developed and guided the development of the various tools. We developed a toolkit adaptable to country-specific needs that includes a guidance document for IHR National Focal Points and nine tool templates targeted at clinicians and laboratory staff: five awareness campaign tools, three education and training tools, and an implementation plan. The toolkit emphasizes what to report, the reporting process and the need for follow-up, supported by real examples. CONCLUSION This toolkit addresses the importance of mutual exchange of information between frontline healthcare workers and public health authorities. It may potentially increase frontline healthcare workers' awareness of their role in the detection of events of public health concern, improve communication channels and contribute to creating an enabling environment for event reporting. However, the effectiveness of the toolkit will depend on the national body responsible for dissemination and training.
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Affiliation(s)
- Emily MacDonald
- Department of Infectious Diseases Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
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Nader F, Askarian M. How do Iranian physicians report notifiable diseases? The first report from Iran. Am J Infect Control 2009; 37:500-4. [PMID: 19181425 DOI: 10.1016/j.ajic.2008.09.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Revised: 08/29/2008] [Accepted: 09/03/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Epidemiologic surveillance through notifiable diseases is an essential component of a public health program. Surveillance systems relay mostly on physicians to report notifiable diseases The aim of this study was to identify physicians' knowledge about reporting of notifiable diseases as well as their self-reported practices and perceptions regarding disease reporting barriers and ways to improve compliance. METHOD A validated, reliable self-administered questionnaire addressing knowledge of notifiable diseases, self-reported practices, reasons for noncompliance with reporting requirements, and suggestions to improve compliance with reporting was distributed to 400 general physicians (GPs) attending medical conferences in Shiraz, Iran between March and July 2006. Knowledge was quantified by evaluating the answers to 45 questions (with 1 point awarded for each correct answer). Associations between the independent variables and physician knowledge were modeled using analysis of covariance. RESULT The response rate was 75%. The overall mean score was 17.03 +/- 7.45 (range, 4 to 31). Knowledge of the location of the posted notifiable diseases list was positively associated with score on knowledge questions (F = 4.431; P = .036). Fully 88% of the participants stated that they had never reported a notifiable disease. There was no significant association between the participants' self-reported practices and knowledge question scores. The major barriers to reporting notifiable diseases were the extra time required for reporting and poor knowledge of the list of reportable diseases and reporting requirements. The most frequent suggestions for improving physicians' compliance with disease reporting were to simplify the reporting process and to shift the responsibility for notification to another person, such as a secretary or a nurse. CONCLUSION Our findings suggest poor knowledge of disease notification requirements among GPs. Modifying physisicans' knowledge and motivation, eliminating barriers to disease reporting, and promoting some facilitating factors could help reduce the underreporting of notifiable diseases.
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Affiliation(s)
- Forouz Nader
- Department of Community Medicine, Shiraz University of Medical Sciences, PO Box 71345-1737, Shiraz, Iran.
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Tan HF, Yeh CY, Chang HW, Chang CK, Tseng HF. Private doctors' practices, knowledge, and attitude to reporting of communicable diseases: a national survey in Taiwan. BMC Infect Dis 2009; 9:11. [PMID: 19178741 PMCID: PMC2642829 DOI: 10.1186/1471-2334-9-11] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Accepted: 01/29/2009] [Indexed: 11/10/2022] Open
Abstract
Background Epidemiological surveillance of infectious diseases through the mandatory-reporting system is crucial in the planning and evaluation of disease control and prevention program. This study investigated the reporting behavior, knowledge, and attitude to reporting communicable disease in private doctors in Taiwan. The differences between the reporting and non-reporting doctors were also explored. Methods A total of 1250 clinics were randomly sampled nationwide by a 2-stage process. Data were collected from 1093 private doctors (87.4% response rate) using a self-administered structured questionnaire. Four hundred and six (37.2%) doctors reported having diagnosed reportable communicable diseases. Among them, 340 (83.5%) have the experiences of reporting. Results The most common reasons for not reporting were "do not want to violate the patient's privacy", "reporting procedure is troublesome", and "not sure whether the diagnosed disease is reportable". Significantly higher proportions of the non-reporting doctors considered the reporting system inconvenient or were not familiar with the system. The highest percentage (65.2%) of the non-reporting doctors considered that a simplified reporting procedure, among all measures, would increase their willingness to report. In addition, a significantly higher proportion of the non-reporting doctors would increase their willingness to report if there has been a good reward for reporting or a penalty for not reporting. Conclusion The most effective way to improve reporting rate may be to modify doctor's attitude to disease reporting. The development of a convenient and widely-accepted reporting system and the establishment of a reward/penalty system may be essential in improving disease reporting compliance in private doctors.
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Affiliation(s)
- Hsiu-Fen Tan
- Department of Healthcare Administration, Chang Jung Christian University, Tainan, Taiwan.
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Majdzadeh R, Pourmalek F. A conditional probability approach to surveillance system sensitivity assessment. Public Health 2007; 122:53-60. [PMID: 17651770 DOI: 10.1016/j.puhe.2007.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2006] [Accepted: 04/11/2007] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the sexually transmitted diseases (STD) surveillance system sensitivity with a conditional probability approach at district level in Darregaz, a frontier town in the north of Iran. STUDY DESIGN A cross-sectional survey. METHODS We used a sample survey of sexually active inhabitants for proxy measurement of the medical service utilization pattern for STD, and interviews with all practitioners to determine their knowledge of STD diagnosis and attitude towards STD reporting as proxy measures of actual STD diagnosis and reporting, respectively. Point estimates of the STD surveillance system sensitivity for each of the health service sectors were derived from multiplying the three proxy measures of sensitivity determinants, i.e., utilization, diagnosis, and reporting, as conditional probabilities. Estimates of sensitivity for all health service sectors were summed to obtain the overall sensitivity. RESULTS The sensitivity of the surveillance system was 21.2% (95% confidence interval (CI) 15.5-25.3%) for detecting symptomatic STD. Of the sexually active inhabitants, 8.9% (95% CI 5.5-14.2%) did not use health services if they contracted STDs. The public health sector's contribution to overall sensitivity (59.6%) was greater than its proportion of service utilization for STD (45.3%). CONCLUSIONS The strengths of the conditional probability approach are feasibility of conducting necessary surveys, decomposing sensitivity into its determinants, and providing evidence for intervention at different points for planning purposes. This approach tends to overestimate the overall sensitivity.
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Affiliation(s)
- R Majdzadeh
- Epidemiology and Biostatistics Department, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran.
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Brabazon ED, O'Farrell A, Murray CA, Carton MW, Finnegan P. Under-reporting of notifiable infectious disease hospitalizations in a health board region in Ireland: room for improvement? Epidemiol Infect 2007; 136:241-7. [PMID: 17394674 PMCID: PMC2870795 DOI: 10.1017/s0950268807008230] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of these diseases in the Irish population at both a local and national level. Anecdotal evidence suggests, however, that the occurrence of notifiable infectious diseases is seriously underestimated. This study aims to assess the level of hospitalization for notifiable infectious diseases for a 6-year period in one health board region in Ireland and to assess whether or not there was any under-reporting during this period. All hospital in-patient admissions from 1997 to 2002 inclusive with a principal diagnosis relating to 'infectious and parasitic diseases' (ICD codes 001-139) of residents from a health board region in Ireland were extracted from the Hospital In-Patient Enquiry System (HIPE). All notifiable infectious diseases were identified based on the 1981 Irish Infectious Disease Regulations and the data were analysed in the statistical package, JMP. These data were compared with the corresponding notification data. Analysis of the hospital in-patient admission data revealed a substantial burden associated with notifiable infectious diseases in this health board region: there were 2758 hospitalizations by 2454 residents, 17,034 bed days and 33 deaths. The statutory notification data comprises both general practitioner and hospital clinician reports of infectious disease. Therefore, only in cases where there are more hospitalizations than notifications can under-reporting be demonstrated. This occurred in nine out of 22 notifiable diseases and amounted to an additional 18% of notifications (or 572 cases) which were 'missed' due to hospital clinician under-reporting. The majority of these under-reported cases were for viral meningitis (45%), infectious mononucleosis (27%), viral hepatitis C unspecified (15%) and acute encephalitis (5.8%). This study has highlighted the extent of under-reporting of hospitalized notifiable infectious diseases, in a health board region in Ireland, which is a cause for concern from a surveillance point of view. If this under-reporting is similar in other health boards, then it would appear that the epidemiology of some notifiable diseases is incomplete both regionally and nationally. This under-reporting negatively impacts on the effectiveness of the notification process as a 'real-time' surveillance tool and an early warning system for outbreaks.
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Affiliation(s)
- E D Brabazon
- Department of Public Health, Population Health Directorate, Health Service Executive, Navan, Co Meath, Ireland.
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