Underreporting and underestimation of gonorrhea cases in the Taiwan National Gonorrhea Notifiable Disease System in the Tainan region: evaluation by a pilot physician-based sentinel surveillance on Neisseria gonorrhoeae infection

Hsieh, Yu Hsiang; Kuo, M. J.; Hsieh, T. C.; Lee, Hsin Chun

doi:10.1016/j.ijid.2009.02.006

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…The pathogens with highly contagious and/or public risk should be totally monitored with mandatory reporting [81]. However, the surveillance systems also have the limitation of underreporting or a lapse of surveillance [82]. The exact incidence and prevalence of PCP are difficult to determine, because the large surveillance system for PCP is not available worldwide, regardless of the clinical burden and severity.…”

Section: Discussionmentioning

confidence: 99%

No Change of Pneumocystis jirovecii Pneumonia after the COVID-19 Pandemic: Multicenter Time-Series Analyses

Kim

Jeon

et al. 2021

JoF

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Consolidated infection control measures imposed by the government and hospitals during COVID-19 pandemic resulted in a sharp decline of respiratory viruses. Based on the issue of whether Pneumocystis jirovecii could be transmitted by airborne and acquired from the environment, we assessed changes in P. jirovecii pneumonia (PCP) cases in a hospital setting before and after COVID-19. We retrospectively collected data of PCP-confirmed inpatients aged ≥18 years (N = 2922) in four university-affiliated hospitals between January 2015 and June 2021. The index and intervention dates were defined as the first time of P. jirovecii diagnosis and January 2020, respectively. We predicted PCP cases for post-COVID-19 and obtained the difference (residuals) between forecasted and observed cases using the autoregressive integrated moving average (ARIMA) and the Bayesian structural time-series (BSTS) models. Overall, the average of observed PCP cases per month in each year were 36.1 and 47.3 for pre- and post-COVID-19, respectively. The estimate for residuals in the ARIMA model was not significantly different in the total PCP-confirmed inpatients (7.4%, p = 0.765). The forecasted PCP cases by the BSTS model were not significantly different from the observed cases in the post-COVID-19 (−0.6%, 95% credible interval; −9.6~9.1%, p = 0.450). The unprecedented strict non-pharmacological interventions did not affect PCP cases.

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Section: Discussionmentioning

confidence: 99%

No Change of Pneumocystis jirovecii Pneumonia after the COVID-19 Pandemic: Multicenter Time-Series Analyses

Kim

Jeon

et al. 2021

JoF

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“…Under-diagnosis may arise when biological samples are not requested from or provided by patients, where there are budget restrictions forcing healthcare professionals to limit their requests for testing samples, lack of knowledge of which tests to perform, inadequate diagnostic tools, or due to restrictions of laboratory testing regimes (regulations on which tests to apply routinely, and lack of availability of more specialised tests). Under-notification may result from an inadequate reporting system or lack of knowledge of when, for which diseases and how to report correctly including knowledge of ICD codes [25-29]. The proportion of cases reported is often higher where there is a legal requirement to report (some diseases or pathogens have mandatory reporting statuses) [30] or where there are incentives for healthcare workers to request or test biological samples from patients or to report results [26].…”

Section: Introductionmentioning

confidence: 99%

Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods

et al. 2014

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BackgroundEfficient and reliable surveillance and notification systems are vital for monitoring public health and disease outbreaks. However, most surveillance and notification systems are affected by a degree of underestimation (UE) and therefore uncertainty surrounds the 'true’ incidence of disease affecting morbidity and mortality rates. Surveillance systems fail to capture cases at two distinct levels of the surveillance pyramid: from the community since not all cases seek healthcare (under-ascertainment), and at the healthcare-level, representing a failure to adequately report symptomatic cases that have sought medical advice (underreporting). There are several methods to estimate the extent of under-ascertainment and underreporting.MethodsWithin the context of the ECDC-funded Burden of Communicable Diseases in Europe (BCoDE)-project, an extensive literature review was conducted to identify studies that estimate ascertainment or reporting rates for salmonellosis and campylobacteriosis in European Union Member States (MS) plus European Free Trade Area (EFTA) countries Iceland, Norway and Switzerland and four other OECD countries (USA, Canada, Australia and Japan). Multiplication factors (MFs), a measure of the magnitude of underestimation, were taken directly from the literature or derived (where the proportion of underestimated, under-ascertained, or underreported cases was known) and compared for the two pathogens.ResultsMFs varied between and within diseases and countries, representing a need to carefully select the most appropriate MFs and methods for calculating them. The most appropriate MFs are often disease-, country-, age-, and sex-specific.ConclusionsWhen routine data are used to make decisions on resource allocation or to estimate epidemiological parameters in populations, it becomes important to understand when, where and to what extent these data represent the true picture of disease, and in some instances (such as priority setting) it is necessary to adjust for underestimation. MFs can be used to adjust notification and surveillance data to provide more realistic estimates of incidence.

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“…In Taiwan, the overall prevalence based on National Gonorrhea Notifiable Disease System was 55 per 100,000 people, 36,37 although the number was likely to be underestimated. 38 The prevalence of genital chlamydial infection was not available because it is not a notifiable disease and has not been studied in the general population. Studies on high school students in the USA, however, showed that the prevalence of gonococcal infection tended to be lower than that of chlamydial infection.…”

Section: Discussionmentioning

confidence: 99%

High-risk sexual behaviours and genital chlamydial infections in high school students in Southern Taiwan

Hsieh

Shih²,

Lin

et al. 2010

Int J STD AIDS

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The objective of this study was to determine the prevalence of high-risk sexual behaviours and sexually transmitted infections (STIs) and associated risk factors in Taiwanese high school students. Students in grades 10 and 11 (mean age: 15.9 +/- 0.9; range: 13-20 years) at two schools were recruited. An anonymous online real-time computer-assisted self-interviewing questionnaire was designed to assess demographic factors and sexual behaviours. Urine specimens were tested for genital chlamydial and gonococcal infections. The same survey and screening was conducted one year later on the same group of students. Overall, 670 individual students (993 visits) were enrolled with 323 students in both surveys. Twenty-seven percent had had sexual intercourse, and more than three quarters (79%) of them had engaged in high-risk sexual behaviours. Having friends using drugs increased the odds of practicing high-risk sexual behaviours (odds ratio [OR] 1.99, 95% CI: 1.13 to 3.50). Among 182 sexually active students, 8.8% had chlamydial (female: 12.5%; male: 5.3%) and 1.1% had gonococcal infections. Having sex with someone met on the Internet was the most significant risk factor for acquiring chlamydia (OR 8.14, 95% CI: 2.82 to 23.51). In conclusion, this adolescent population reported high prevalence of high-risk sexual behaviours and had a high prevalence of chlamydia supportive of a potential epidemic of STIs and HIV.

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Underreporting and underestimation of gonorrhea cases in the Taiwan National Gonorrhea Notifiable Disease System in the Tainan region: evaluation by a pilot physician-based sentinel surveillance on Neisseria gonorrhoeae infection

Abstract: The underreporting of gonorrhea identified in this pilot is substantial. An overhaul of Taiwan's NGNDS that streamlines the reporting procedures and the requirement for laboratory confirmation, along with a continuing medical education program is warranted.

Cited by 8 publications

References 15 publications

No Change of Pneumocystis jirovecii Pneumonia after the COVID-19 Pandemic: Multicenter Time-Series Analyses

No Change of Pneumocystis jirovecii Pneumonia after the COVID-19 Pandemic: Multicenter Time-Series Analyses

Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods

High-risk sexual behaviours and genital chlamydial infections in high school students in Southern Taiwan

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