Comparing laboratory surveillance with the notifiable diseases surveillance system in South Africa

Benson, F.G.; Musekiwa, Alfred; Blumberg, Lucille; Rispel, Laetitia C.

doi:10.1016/j.ijid.2017.03.007

Cited by 15 publications

(24 citation statements)

References 34 publications

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“…A 2015 empirical study that compared South African notifications and laboratory surveillance, found that only 1.5% of suspected measles and meningococcal meningitis cases were notified [ 42 ]. This in sharp contrast to the HCP self-reports of 92% notification.…”

Section: Discussionmentioning

confidence: 99%

Health care providers’ compliance with the notifiable diseases surveillance system in South Africa

2018

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BackgroundThe 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.MethodsA 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.ResultsThe 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.ConclusionsThe 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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Section: Discussionmentioning

confidence: 99%

Health care providers’ compliance with the notifiable diseases surveillance system in South Africa

2018

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“…Several years ago, reporting rates of medical practitioners and laboratories differed; 75% of cases were reported by laboratories, 20% by medical practitioners and almost 5% by both, with laboratories reporting more quickly than medical practitioners [ 19 , 20 ]. Recently, Benson et al, [ 21 ], reported that the laboratory system reported more cases of three tracer diseases in South Africa (measles, meningococcal meningitis and typhoid) compared to the NDSS, with laboratories scoring higher on system attributes such as completeness, stability and representativeness.…”

Section: Discussionmentioning

confidence: 99%

Exploring the knowledge, attitudes and practices (KAP) of health care professionals on viral hepatitis notification in Gauteng, South Africa, 2015

Mathatha

Manamela²,

Musekiwa

et al. 2018

Arch Public Health

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BackgroundData 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.MethodsA 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.ResultsOf 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.ConclusionsOverall, 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 materialThe online version of this article (10.1186/s13690-018-0319-8) contains supplementary material, which is available to authorized users.

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“…In Ireland, in a study published in 2018, the infectious diseases reporting system covered 87% of the laboratory reported cases [14]. In another study in South Africa, the comparison was again between national surveillance and the laboratory surveillance, and the authors report sensitivity under different scenarios that ranges between 98% and 99% [15].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the national surveillance system for invasive meningococcal disease, Italy, 2015–2018

et al. 2021

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Enhanced laboratory-based surveillance of invasive meningococcal disease (IMD) in Italy was only assessed indirectly by numerically comparing surveillance data cases with hospital discharge records (HDR). In this study, we evaluated the completeness, timeliness and sensitivity of the IMD surveillance in Italy from 2015 to 2018. Completeness and timeliness were described at the national and subnational level. A capture-recapture analysis was conducted to evaluate the sensitivity and positive predictive value (PPV) using HDR as the external source with a combination of deterministic and probabilistic approaches. The characteristics of the unmatched vs. matched cases were compared using multivariable Poisson modeling. Overall, the completeness of data improved, except for specific variables. Timeliness of notifications also improved to a median of 4 days from onset to reporting. For the years 2015–2017, the sensitivity of the surveillance was estimated at 71.4% and the PPV at 77.5%, changing to 80.6% and 66.9% respectively after removing cases with a secondary meningitis diagnosis. We noted substantial sub-national differences. In 2018 sensitivity was 66.5% (135/203) and the PPV was 79.4% (135/170). The adjusted relative risk of being unmatched in 2015–2017 was higher in cases that were ≥60 years, had missing information or symptom onset in December. The IMD surveillance system overall performs well with completeness and timeliness improving in time. Specific challenges identified for individual variables should guide further improvement. Notwithstanding limitations posed by the comparison database, sensitivity and PPV are promising. The study highlights that promoting etiological ascertainment in people ≥60 years and addressing sub-national challenges are the main current challenges to address.

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Comparing laboratory surveillance with the notifiable diseases surveillance system in South Africa

Abstract: Compared to laboratory surveillance, the NDSS performed poorly on most system attributes. Revitalization of the NDSS in South Africa is recommended to address the completeness, stability, and representativeness of the system.

Cited by 15 publications

References 34 publications

Health care providers’ compliance with the notifiable diseases surveillance system in South Africa

Health care providers’ compliance with the notifiable diseases surveillance system in South Africa

Exploring the knowledge, attitudes and practices (KAP) of health care professionals on viral hepatitis notification in Gauteng, South Africa, 2015

Evaluation of the national surveillance system for invasive meningococcal disease, Italy, 2015–2018

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