A review of strategies for enhancing the completeness of notifiable disease reporting.

Notifiable disease surveillance systems provide essential data for infectious disease prevention and control programs at the local, state, and national levels. Given that reporting completeness is known to vary considerably, this review identifies methods that can reliably enhance completeness of reporting. These surveillance-related activities include initiating active surveillance when appropriate; implementing automated, electronic laboratory-based reporting; strengthening ties with clinicians and other key partners in notifiable disease reporting; and increasing the use of laboratory diagnostic tests in identifying new cases. Despite ample data in support of these strategies, notifiable disease surveillance continues to receive insufficient attention and resources. Recent attention to public health preparedness provides an opportunity to strengthen notifiable disease surveillance and enhance completeness of reporting.     

Disease reporting from an automated laboratory-based reporting system to a state health department via local county health departments

OBJECTIVE: The authors assessed the completeness of disease reporting from a managed care organization's automated laboratory-based reporting system to the California Department of Health Services (CDHS) via local public health departments. METHODS: The authors identified all positive laboratory tests for 1997 from the computerized database of Kaiser Permanente Northern California for seven infections for which there are statutory reporting requirements: Campylobacter jejuni, Chlamydia trachomatis, Cryptosporidium parvum, hepatitis A, Neisseria meningitidis, Neisseria gonorrhoeae, and Salmonella (N = 7,331 reports). Cases were then matched by computer query to records of cases reported to CDHS. To determine why cases were not found in CDHS records, a sample of un-matched cases was searched at two county health departments. RESULTS: Overall, 84.5% (95% CI 83.4, 85.6) of the laboratory reports submitted with accompanying demographic information were successfully matched with cases in the CDHS disease surveillance database. Frequency of matching for specific diseases ranged from 79.4% (95% CI 75.6, 83.3) for N. gonorrhoeae to 88.4% (95% CI 85.3, 91.6) for C. jejuni. Reports were more likely to be matched when the county of residence was the same as the county of the health care facility. At the county level, reasons for failure of cases to be forwarded to CDHS included: errors due to manual data entry, failure to forward information from the county of diagnosis to the county of residence, and incorrect disease coding. CONCLUSION: Automated laboratory-based reporting is highly effective, but some data are lost with off-line transfer of information. To optimize surveillance accuracy and completeness, reporting at all levels should be done via direct electronic data transfer.     

Automatic electronic laboratory-based reporting of notifiable infectious diseases at a large health system

Electronic laboratory-based reporting, developed by the UPMC Health System, Pittsburgh, Pennsylvania, was evaluated to determine if it could be integrated into the conventional paper-based reporting system. We reviewed reports of 10 infectious diseases from 8 UPMC hospitals that reported to the Allegheny County Health Department in southwestern Pennsylvania during January 1-November 26, 2000. Electronic reports were received a median of 4 days earlier than conventional reports. The completeness of reporting was 74% (95% confidence interval [CI] 66% to 81%) for the electronic laboratory-based reporting and 65% (95% CI 57% to 73%) for the conventional paper-based reporting system (p>0.05). Most reports (88%) missed by electronic laboratory-based reporting were caused by using free text. Automatic reporting was more rapid and as complete as conventional reporting. Using standardized coding and minimizing free text usage will increase the completeness of electronic laboratory-based reporting.     

Evaluation of reporting timeliness of public health surveillance systems for infectious diseases

Background  

Timeliness is a key performance measure of public health surveillance systems. Timeliness can vary by disease, intended use of the data, and public health system level. Studies were reviewed to describe methods used to evaluate timeliness and the reporting timeliness of National Notifiable Diseases Surveillance System (NNDSS) data was evaluated to determine if this system could support timely notification and state response to multistate outbreaks.     

Multifaceted syndromic surveillance in a public health department using the early aberration reporting system.

Local health departments concerned with early detection of potential terrorist threats are beginning to explore novel approaches to syndromic surveillance. Using the Early Aberration Reporting System (EARS) developed by the Centers for Disease Control and Prevention, a metropolitan health department in Tennessee and five community partners have agreed to exchange data in order to implement a multifaceted syndromic surveillance system for early detection of a biological attack. This article describes how we used EARS as the foundation for implementing a surveillance system that encompasses a rich variety of data sources. We address technical requirements for operating EARS, recommend staffing and training prerequisites, describe the involvement of our data partners, and provide details related to data transfer and analysis, review, and response protocol. Other health departments may find this information useful as a general model for implementing EARS-based syndromic surveillance systems in their own jurisdictions.     

泰安市法定传染病报告质量与管理现状调查

目的 2004年初泰安市与国家同时启用了疾病预防控制信息报告系统,2018年是实行传染病网络直报的第14年。本研究调查泰安市法定传染病报告质量和管理现状,为进一步规范疫情工作模式提供科学依据。方法采用分层多阶段随机抽样方法抽取2017年10月及2018年1、4、7月4个月6个县市区30家医疗机构。对2018年度行政部门用于传染病信息报告管理工作的经费保障、组织开展传染病报告管理督导检查、奖励机制建立等情况进行调查;了解疾控机构日常监测、技术指导和评估、技术培训以及网络直报专职人员和设备配备情况;对医疗机构诊疗记录登记情况、院内自查、评估及相关技术培训等工作进行调查,了解医疗机构电子病历系统中传染病报告管理功能。结果泰安市法定传染病报告率为99.72%,报告及时率为99.86%,纸质(电子)报告卡填写完整率为99.54%,传染病报告卡填写准确率为98.61%,报告卡与网报卡片内容一致率为99.54%,报告卡有效证件号码填写完整率为99.54%。不同类别医疗机构传染病报告及时率差异有统计学意义,χ~2=7.004,P0.05;纸质传染病报告卡与网络报告一致率差异有统计学意义,χ~2=10.020,P0.05。共抽查法定传染病病例2 138例,其中门诊病例1 564例,住院病例574例;涉及病种17种,覆盖全市主要流行的法定传染病病种总数70%。6家卫生行政部门、6家疾病预防控制机构和30家医疗机构传染病报告质量和效率均有所提升。结论泰安市法定传染病网络直报管理情况基本完善,传染病报告质量有待提高,管理模式和报告工作还需进一步规范。     

东营市法定传染病报告管理质量评价

受全球化、人类行为方式的变化以及环境因素等方面的影响,从某种意义上讲,传染病已取代来自敌对国直接的军事威胁而成为国际社会及各国政府面临的严峻挑战[1],提示各国政府要重视传染病的预防控制工作。传染病疫情报告是法定传染病预防控制的重要内容之一,全面、及时、准确的疫情报告是防止疫情蔓延的信息来源,是评价预防控制措施效果及探讨流行规律的重要依据[2]。为了解2004年第一年实行法定传染病网络直报报告管理质量,加强东营市疫情报告工作的监督管理,提高疫情报告的及时性、敏感性及准确性,于2005年1月在全市范围内开展对医疗卫生单…     

Case study of the integration of a local health department and a community health center.

As rural communities struggle to sustain health services locally, innovative alternatives to traditional programs are being developed. A significant adaptation is the rural health network or alliance that links local health departments and community health centers. The authors describe how a rural local health department and community health center, the core organizations in publicly sponsored primary care, came to share a building and administrative and service activities. Both the details of this alliance and its development are examined. The case history reveals that circumstance and State involvement were the catalysts for service integration, more so than the need for or the benefits of the arrangement. The closure of a county-owned hospital created a situation in which State officials were able to broker a cooperative agreement between the two agencies. This case study suggests two hypotheses: that need for integrated services alone may not be sufficient to catalyze the development of primary care alliances and that strong policy support may override any local and internal resistance to integration.     

泰安市百日咳流行特征传染病报告系统数据分析

目的 近年来,全球百日咳发病率明显上升,部分地区甚至出现百日咳爆发,本研究通过分析泰安市2015-2018年儿童百日咳的分布特征,为百日咳诊治与防控工作提供科学依据.方法 采用描述性方法,对泰安市2015-2018年法定传染病报告系统中的百日咳病例个案数据进行分析,包括年龄分布、地区分布和时间分布等.结果 泰安市201...