Timeliness Of Surveillance System Research Articles

Under-ascertainment, under-reporting and timeliness of Iranian communicable disease surveillance system for zoonotic diseases

ObjectivesThe important steps in controlling infectious diseases are fast detection, proper treatment and on-time reporting of cases to the appropriate authorities. This study was conducted to evaluate the quality of Iranian communicable diseases surveillance system (CDSS) for zoonotic diseases in rural areas of Fars province (Iran's third largest province). Study designThe three most important evaluation indices of CDSS, namely under-ascertainment, under-reporting and timeliness, for the three most common zoonotic diseases were measured using independent data source obtained from door-to-door interviews and patients' medical records. MethodsInterviews were conducted with 48,771 households in rural areas of Fars province from April 2014 to March 2015. The medical and registration data were obtained from the CDSS and medical or health centres. ResultsUnder-ascertainment, total under-reporting and timeliness (delay from the time of onset of symptoms to the time of visiting a medical or health centre, to the time of reporting visited cases to the highest level of CDSS) for leishmaniasis were 19.6%, 42.5% and 81.61 days (48.95 due to system delay), respectively. The corresponding indices for brucellosis were 0%, 41.8% and 56.5 days (22 due to system delay), respectively. For animal bite, the corresponding indices were 7.83%, 13.07% and less than 72 h, respectively (no system delay). ConclusionsAlthough the status of case reporting and timeliness of surveillance system in public sectors providing medical services are clearly better than those of the private sectors, the indices are far from the level needed by CDSS to be able to detect and handle epidemics on time. Training health personnel, especially physicians, from public and private sectors to secure their cooperation along with routine and indebt evaluation are necessary to improve CDSS in Iran.

Group A streptococcal bacteraemias in Denmark 1987–1989

A retrospective study of laboratory-verified cases of Group A Streptococcal bacteraemias in Denmark was conducted for the period 1987-1989 after a sudden increase occurred during the winter 1988-1989. The aim of the study was to describe the epidemiology in the period and to compare cases during the outbreak period with cases in a period with a baseline risk. Based on isolates, a total of 242 cases in 240 patients were included in the study and information on previous health of the patients, source of infection (community-acquired or nosocomial) and outcome were obtained from hospital records. During the epidemic period the total incidence increased three-fold. The frequency of type 1 increased from 1 in 5 to 1 in 2. The number of previously healthy individuals falling ill with type 1 increased 25-fold. The relative increase was higher among patients with community-acquired infection than among patients with nosocomial infection. The lethality rate was 48% during the epidemic in which 38% of the cases occurred. As early diagnosis and treatment are the two most important measures to prevent serious outcome, effectiveness and timeliness of surveillance systems are of extreme importance.