Health workers’ capacity of infectious disease reporting in rural Jiangxi Province, China

Abstract

Background: A nationwide web-based case reporting system for notifiable infectious disease has been established in China after SARS outbreak. The effectiveness of this system depends majorly on health workers’ capacity of identifying and awareness of reporting infectious cases. Methods: Two counties in Jiangxi Province were purposively selected as study sites. All the clinic doctors from township hospitals and village health stations at the study sites were chosen as subjects. Self-designed questionnaires were applied to collect information on their knowledge and experiences of infectious disease surveillance. Hardware conditions and laboratory equipments of all healthcare institutions at the study sites were investigated as well. Totally 79 township doctors and 355 village doctors from 392 healthcare institutions were investigated in October, 2010. Results: Village health stations had no equipment for laboratory test, and only a part of township hospitals had the ability to carry out blood test (73.0%), urine test (78.4%), liver function test (35.1%), hepatitis B test (51.4%) and renal function test (27.0%). For common infectious diseases like tuberculosis, influenza, hepatitis A&B and infectious diarrhea, most township and village doctors were able to identify their main symptoms, but when came to less common infectious diseases, a considerable part of doctors failed to report the main symptoms due to limited knowledge and experience, including plague (73.3%), cholera (42.5%), rabies (47.3%), schistosomiasis (48.0%), malaria (31.4%) and epidemic hemorrhagic fever (21.0%). Although 100% township hospitals and 81.6% village health stations had at least one computer for daily work, doctors used paper-based outpatient log to record patients’ demographic, clinical and treatment information. Based on their self-reporting, only 80.2% doctors kept a complete record of each visiting patient on the outpatient log, which constituted the source data for national surveillance system. Conclusion: Mainly relying on clinical diagnosis, doctors may not have sufficient capacity in identifying less common infectious diseases. Incomplete outpatient log recording could jeopardize the quality of surveillance data and case tracing in an outbreak. Training on infectious disease surveillance should be strengthened among rural health workers. The study is part of a big project-ISSC financially supported by a grant under the European Union Framework Program 7 (project no: 241900).