Underreporting of communicable diseases in the prefecture of Achaia, western Greece, 1999-2004 – missed opportunities for early intervention

Abstract

This study investigates the completeness of the reporting of infectious diseases in the prefecture of Achaia, western Greece in the period of 1999-2004. We collected hospital records relating to infectious diseases retrospectively from three major hospitals in the region and compared the records to corresponding records at the prefectural public health department (PHD). After record-linkage and cross-validation a total of 1,143 notifiable cases were identified in the three hospitals, of which 707 were reported to the PHD of Achaia, resulting in an observed underreporting of infectious diseases of 38% during the study period. At prefecture level, a further 259 cases were notified by other sources, mainly by the fourth hospital of the region not included in our study, resulting in a total of 966 cases reported to the PHD; 73% of these were reported from the three hospitals included in our study, 27% were notified by the fourth hospital not included in our study and less then 0,3% by physicians working in a private practice or health centre. Meningitis (51%), tuberculosis (12%) and salmonellosis (8%) were the most frequently reported diseases followed by hospitalised cases of varicella (7%), brucellosis (6%) and hepatitis (6%). During the study period, clustering of specific diseases like brucellosis, meningitis, mumps, and salmonellosis was observed, indicating possible outbreaks. Our results show that notification system needs to be improved, in order to ensure proper health resources allocation and implementation of focused prevention and control strategies.

Evaluation of underreporting of salmonellosis and shigellosis hospitalised cases in Greece, 2011: results of a capture-recapture study and a hospital registry review

“…The estimated reporting rates of salmonellosis and shigellosis in this study were similar to previous estimations in the country at a local level [4] and to the estimations of reporting rates in Spain [24]. Other European countries have much higher completeness that has been reported to reach almost 100% when an electronic reporting system is in place; 95.8% in Sweden [25], 99.0% in Germany [21] and 82.0% in Italy [21].…”

“…Apart from few, restricted to small geographical areas of the country, studies [4], no nation-wide study has been conducted in Greece to estimate completeness of reporting or external completeness of MNS for salmonellosis and shigellosis in an objective and measurable way.…”

Fatores associados à subnotificação de tuberculose com base no Sinan Aids e Sinan Tuberculose

“…Studies in other countries have also found TB underreporting, demonstrating that this is not a problem unique to Brazil. In Greece, reporting TB is mandatory, but studies point to underreporting of 48% based on records from three major hospitals in the country 19 . Another study carried out in Italy found an average underreporting of 69.4% among TB cases 20 .…”

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

“…There are several examples of CRS studies in the literature spanning a wide range of both communicable and non-communicable diseases (e.g. CRS of tuberculosis in several countries; Greece [79,91], Italy [92,93], the Netherlands [94,95], Romania [96], UK [97-99] and USA [17,100,101]). Despite the usefulness of this method, some cases attending healthcare are not captured in any single data source or are not correctly recorded and hence the new incidence of cases will still be affected by UR [89].…”