Abstract
BackgroundWith the increase of international travels, infectious disease control is gaining a greater importance across regional borders. Adequate surveillance system function is crucial to prevent a global spread of infectious disease at the earliest stage. There have been limited reports on the characteristics of infectious disease surveillance in Asia. The authors studied the timeliness of the Korean National Notifiable Disease Surveillance System with regard to major notifiable diseases from 2001 to 2006.MethodsSix notifiable infectious diseases reported relatively frequently were included in this study. Five diseases were selected by the criteria of reported cases > 100 per year: typhoid fever, shigellosis, mumps, scrub typhus, and hemorrhagic fever with renal syndrome. In addition, dengue fever was also included to represent an emerging disease, despite its low number of cases. The diseases were compared for the proportion notified within the recommended time limits, median time lags, and for the cumulative distribution of time lags at each surveillance step between symptom onset and date of notification to the Korea Centers for Disease Control and Prevention (KCDC).ResultsThe proportion of cases reported in time was lower for disease groups with a recommended time limit of 1 day compared with 7 days (60%–70% vs. > 80%). The median time from disease onset to notification to KCDC ranged between 6 and 20 days. The median time from onset to registration at the local level ranged between 2 and 15 days. Distribution of time lags showed that main delays arose in the time from onset to diagnosis. There were variations in timeliness by disease categories and surveillance steps.ConclusionTime from disease onset to diagnosis generally contributed most to the delay in reporting. It is needed to promote public education and to improve clinical guidelines. Rapid reporting by doctors should be encouraged, and unification of recommended reporting time limit can be helpful. Our study also demonstrates the utility of the overall assessment of time-lag distributions for disease-specific strategies to improve surveillance.
Highlights
With the increase of international travels, infectious disease control is gaining a greater importance across regional borders
Doctors' timely reporting to the Public Health Center (PHC) was highest for shigellosis (85.3%) and lowest for dengue fever (60.2%) (p < 0.0001), the limits were both 1 day
35% of dengue fever cases were reported in time to the Korea Centers for Disease Control and Prevention (KCDC), whereas ≥ 90% of the diseases in Group II and III were reported in time
Summary
With the increase of international travels, infectious disease control is gaining a greater importance across regional borders. Effective public health services for the control and prevention of infectious diseases involve surveillance as a critical element [1]. The aim of infectious diseases surveillance is to initiate public health action in response to changes in the incidence of the disease [2]. Many studies have assessed the timeliness of surveillance systems by evaluating the time lag or bottleneck phenomenon of each surveillance step [2,8,9,10,11], comparing clinical and laboratory surveillance [12,13], and comparing electronic and conventional (paper-based) methods [10,14,15]. The WHO introduced guidelines for evaluating and monitoring surveillance systems According to these guidelines, timeliness should be evaluated for specific surveillance steps for each disease and should be fully assessed from the time of infection to central reporting [3]. The conceptual framework provided by the WHO is useful to evaluate surveillance systems in many contexts
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