Assessing the Quality of Reporting to China's National TB Surveillance Systems

Abstract Background: The reliability of disease surveillance may be restricted by sensitivity or the ability of the system to capture all disease. Our objective was to quantify under-reporting and concordance of recording persons with tuberculosis (TB) in the national TB surveillance systems: Infectious Disease Reporting System (IDRS) and TB Information Management System (TBIMS). Methods: This retrospective review includes patients identified in 2016 from six counties in Guangdong, Jiangsu, Henan, Heilongjiang, Sichuan, and Yunnan provinces. County staff linked TB patients identified from facility-specific health and laboratory information systems with TB patients recorded in IDRS and TBIMS. Under-reporting was calculated as the percentage of TB patients not recorded in IDRS or TBIMS. Timeliness, patients recorded within 24 hours after diagnosis, and concordance, accuracy and completeness of key variables when compared to medical records, were analyzed through comparing sampled patient-records with corresponding patient-records in health facilities. Multivariable logistic regression was used to examine factors associated with under-reporting. Results: We found 505 (10.7%) patients diagnosed with TB were missing within IDRS and 1451 (30.9%) patients were missing within TBIMS. Of 171 patient-records reviewed in IDRS and 170 patient-records in TBIMS, 12.3% and 6.5% were found to be untimely, 10.7% and 7.1% were found having inconsistent home address. The risk of under-reporting to both IDRS and TBIMS was greatest in TB diagnosis at a tertiary health facilities and non-residents; the risk of under-reporting to TBIMS was greatest with patients aged 65 or older and extrapulmonary TB (EPTB).Conclusions: We found that more than one in four TB patients were not recorded in TBIMS. It is important to improve the reporting and recording of TB patients. Local TB programs that focus on training, and mentoring high-burden hospitals, facilities that cater to EPTB, and migrant patients may improve reporting and recording. Additional human resources for data collection and management, and monitoring and evaluation systems are needed to improve national surveillance systems and TB prevention, diagnosis and treatment services.

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Assessing the Quality of Reporting to China’s National TB Surveillance Systems

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052264 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2264

Author(s):

Tao Li ◽

Lijia Yang ◽

Sarah E. Smith-Jeffcoat ◽

Alice Wang ◽

Hui Guo ◽

...

Keyword(s):

Disease Surveillance ◽

Information Management System ◽

Surveillance Systems ◽

Patient Records ◽

Quality Of Reporting ◽

Home Address ◽

Infectious Disease Reporting ◽

Laboratory Information Systems ◽

Specific Health

(1) Background: The reliability of disease surveillance may be restricted by sensitivity or ability to capture all disease. Objective: To quantify under-reporting and concordance of recording persons with tuberculosis (TB) in national TB surveillance systems: the Infectious Disease Reporting System (IDRS) and Tuberculosis Information Management System (TBIMS). (2) Methods: This retrospective review includes 4698 patients identified in 2016 in China. County staff linked TB patients identified from facility-specific health and laboratory information systems with records in IDRS and TBIMS. Under-reporting was calculated, and timeliness, concordance, accuracy, and completeness were analyzed. Multivariable logistic regression was used to examine factors associated with under-reporting. (3) Results: We found that 505 (10.7%) patients were missing within IDRS and 1451 (30.9%) patients were missing within TBIMS. Of 171 patient records reviewed in IDRS and 170 patient records in TBIMS, 12.3% and 6.5% were found to be untimely, and 10.7% and 7.1% were found to have an inconsistent home address. The risk of under-reporting to both IDRS and TBIMS was greatest at tertiary health facilities and among non-residents; the risk of under-reporting to TBIMS was greatest with patients aged 65 or older and with extrapulmonary TB (EPTB). (4) Conclusions: It is important to improve the reporting and recording of TB patients. Local TB programs that focus on training, and mentoring high-burden hospitals, facilities that cater to EPTB, and migrant patients may improve reporting and recording.

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Evaluation of community-based disease surveillance systems for priority disease detection in Nairobi County Kenya

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20213763 ◽

2021 ◽

Vol 8 (10) ◽

pp. 4692

Author(s):

Annastacia Katuvee Muange ◽

John Kariuki ◽

James Mwitari

Keyword(s):

Community Involvement ◽

Surveillance System ◽

Disease Surveillance ◽

Cross Sectional Study ◽

Health Facilities ◽

Surveillance Systems ◽

Case Definitions ◽

Community Based ◽

Study Program ◽

Cross Sectional

Background: Community based disease surveillance (CBDS) may be defined as an active process of community involvement in identification, reporting, responding to and monitoring diseases and public health events of concern in the community. The scope of CBS is limited to systematic continuous collection of health data on events and diseases guided by simplified lay case definitions and reporting to health facilities for verification, investigation, collation, analysis and response as necessary.Methods: A cross sectional study design, interventions study program was adopted to determine the effectiveness of CBDS in detecting of priority diseases. Purposive and random sampling methods was employed to select the respondents.Results: The results of the study assisted the Ministry of health to understand the effectiveness of Community based surveillance in detection of priority diseases and hence strengthen the community-based surveillance initiative. From the findings, the integrated disease surveillance data for five years from 2014-2018 shows, more cases of priority diseases reported in health facilities linked to a community unit trained on CBDS. Cholera (9/5), Malaria (4757/2789), Neonatal tetanus (27/3) respectively.Conclusions: The study concluded that, use of community-based surveillance system, improves detection of the notifiable diseases in the community. The study revealed that there is a gap on training of community-based disease surveillance system and therefore there is need for continuous refresher trainings on CBDS to the CHVs and CHAs to accommodate also the newly recruited.

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Evaluation of Public Health Surveillance Systems in Refugee Settlements in Uganda, 2016 - 2019: Lessons Learnt

10.21203/rs.3.rs-602735/v1 ◽

2021 ◽

Author(s):

Alex Riolexus Ario ◽

Emily Atuheire Barigye ◽

Innocent Harbert Nkonwa ◽

Jimmy Ogwal ◽

Denis Nixon Opio ◽

...

Keyword(s):

Public Health ◽

Data Analysis ◽

Surveillance System ◽

Disease Surveillance ◽

Public Health Surveillance ◽

Health Surveillance ◽

Health Facilities ◽

Surveillance Systems ◽

Village Health ◽

Village Health Teams

Abstract BackgroundCivil wars in the Great Lakes region resulted in massive displacement of people to neighboring countries including Uganda, with associated humanitarian emergencies. Appropriate disease surveillance enables timely detection and response to outbreaks. We describe evaluation of the public health surveillance system in refugee settlements in Uganda and document lessons learnt.MethodsWe conducted a cross-sectional survey using the US CDC Updated Guidelines for Evaluating Public Health Surveillance Systems in four refugee settlements in Uganda i.e., Bidibidi, Adjumani, Kiryandongo and Rhino Camp. Using semi-structured questionnaires, key informant and focus group discussion guides, we interviewed health facility in-charges, key personnel and village health teams from 4 districts, 53 health facilities and 112 villages.ResultsAll health facilities assessed had key surveillance staff; 60% were trained on IDSR and most village health teams were trained on disease surveillance. Case detection was at 55%; facilities lacked standard case definitions (SCDs) and were using parallel Implementing Partner (IP) driven reporting system. Recording was at 79% and reporting was at 81%. Data analysis and interpretation was at 49%. Confirmation of outbreaks and events was at 76%. Preparedness was at 72% and response was at 34%. Feedback was at 82%. Recording, reporting, preparedness, feedback and confirmation of outbreaks and events were highly achieved, and capacity to evaluate and improve the system was moderately achieved. There were low scores in capacity to detect, respond and analyse data.ConclusionPublic health surveillance system had high sensitivity, timeliness and predictive value positive. It was simple, acceptable with fair data quality attributes. It was less flexible, less stable with low representativeness. The system had good recording, reporting, preparedness, feedback and confirmation of outbreaks and events. The capacity for detection, response and data analysis and interpretation was low. Lessons learnt were: IPs offer tremendous support to surveillance; training of surveillance staff on IDSR maintains effective surveillance functions; supplies of tools, personnel etc. should be planned and executed; functionalization of district teams ensures achievement of surveillance functions and attributes; regular support supervision of health facilities necessary; harmonization of reporting improves surveillance functions and attributes; appropriation of funds to districts to support refugee settlements is complementary.

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Survey of Communicable Diseases Surveillance System in Hospitals of Iran: A Qualitative Approach

Global Journal of Health Science ◽

10.5539/gjhs.v8n9p44 ◽

2015 ◽

Vol 8 (9) ◽

pp. 44 ◽

Cited By ~ 1

Author(s):

Nayeb Fadaei Dehcheshmeh ◽

Mohammad Arab ◽

Abbas Rahimi Fouroshani ◽

Fereshteh Farzianpour

Keyword(s):

Work Experience ◽

Surveillance System ◽

Disease Surveillance ◽

Qualitative Content Analysis ◽

Communicable Disease ◽

Health Sector ◽

Monitoring And Evaluation ◽

Communicable Diseases ◽

Qualitative Approach ◽

Surveillance Systems

BACKGROUND: Communicable Disease Surveillance and reporting is one of the key elements to combat against diseases and their control. Fast and timely recognition of communicable diseases can be helpful in controlling of epidemics. One of the main sources of management of communicable diseases reporting is hospitals that collect communicable diseases’ reports and send them to health authorities. One of the focal problems and challenges in this regard is incomplete and imprecise reports from hospitals. In this study, while examining the implementation processes of the communicable diseases surveillance in hospitals, non-medical people who were related to the program have been studied by a qualitative approach.METHODS: This study was conducted using qualitative content analysis method. Participants in the study included 36 informants, managers, experts associated with health and surveillance of communicable diseases that were selected using targeted sampling and with diverse backgrounds and work experience (different experiences in primary health surveillance and treatment, Ministry levels, university staff and operations (hospitals and health centers) and sampling was continued until arrive to data saturation.RESULTS: Interviews were analyzed after the elimination of duplicate codes and integration of them. Finally, 73 codes were acquired and categorized in 6 major themes and 21 levels. The main themes included: policy making and planning, development of resources, organizing, collaboration and participation, surveillance process, and monitoring and evaluation of the surveillance system. In point of interviewees, attention to these themes is necessary to develop effective and efficient surveillance system for communicable diseases.CONCLUSION: Surveillance system in hospitals is important in developing proper macro - policies in health sector, adoption of health related decisions and preventive plans appropriate to the existing situation. Compilation, changing, improving, monitoring and continuous updating of surveillance systems can play a significant role in its efficiency and effectiveness. In the meantime, policy makers’ and senior managers’ support in development and implementation of communicable disease surveillance’ plans and their reporting plays a key and core role.

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Assessment of the core and support functions of the integrated disease surveillance and response system in Zanzibar, Tanzania

BMC Public Health ◽

10.1186/s12889-021-10758-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fatma Saleh ◽

Jovin Kitau ◽

Flemming Konradsen ◽

Leonard E. G. Mboera ◽

Karin L. Schiøler

Keyword(s):

Infectious Disease ◽

Early Detection ◽

Disease Surveillance ◽

Health Facilities ◽

Outbreak Detection ◽

World Health ◽

Support Functions ◽

The Core ◽

Surveillance And Response ◽

Facility Level

Abstract Background Disease surveillance is a cornerstone of outbreak detection and control. Evaluation of a disease surveillance system is important to ensure its performance over time. The aim of this study was to assess the performance of the core and support functions of the Zanzibar integrated disease surveillance and response (IDSR) system to determine its capacity for early detection of and response to infectious disease outbreaks. Methods This cross-sectional descriptive study involved 10 districts of Zanzibar and 45 public and private health facilities. A mixed-methods approach was used to collect data. This included document review, observations and interviews with surveillance personnel using a modified World Health Organization generic questionnaire for assessing national disease surveillance systems. Results The performance of the IDSR system in Zanzibar was suboptimal particularly with respect to early detection of epidemics. Weak laboratory capacity at all levels greatly hampered detection and confirmation of cases and outbreaks. None of the health facilities or laboratories could confirm all priority infectious diseases outlined in the Zanzibar IDSR guidelines. Data reporting was weakest at facility level, while data analysis was inadequate at all levels (facility, district and national). The performance of epidemic preparedness and response was generally unsatisfactory despite availability of rapid response teams and budget lines for epidemics in each district. The support functions (supervision, training, laboratory, communication and coordination, human resources, logistic support) were inadequate particularly at the facility level. Conclusions The IDSR system in Zanzibar is weak and inadequate for early detection and response to infectious disease epidemics. The performance of both core and support functions are hampered by several factors including inadequate human and material resources as well as lack of motivation for IDSR implementation within the healthcare delivery system. In the face of emerging epidemics, strengthening of the IDSR system, including allocation of adequate resources, should be a priority in order to safeguard human health and economic stability across the archipelago of Zanzibar.

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Situational analysis of diabetic retinopathy treatment Services in Ghana

BMC Health Services Research ◽

10.1186/s12913-021-06608-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Agatha Mensah-Debrah ◽

Kwesi Nyan Amissah Arthur ◽

David Ben Kumah ◽

Kwadwo Owusu Akuffo ◽

Isaiah Osei Duah ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Vitreoretinal Surgery ◽

Health Facilities ◽

Service Utilisation ◽

Eye Care ◽

Treatment Service ◽

Treatment Services ◽

Disadvantaged Population ◽

Anti Vegf ◽

Geographical Regions

Abstract Background Although the equitable distribution of diabetic retinopathy (DR) services across Ghana remains paramount, there is currently a poor understanding of nationwide DR treatment services. This study aims to conduct a situation analysis of DR treatment services in Ghana and provide evidence on the breadth, coverage, workload, and gaps in service delivery for DR treatment. Methods A cross-sectional study was designed to identify health facilities which treat DR in Ghana from June 2018 to August 2018. Data were obtained from the facilities using a semi-structured questionnaire which included questions identifying human resources involved in DR treatment, location of health facilities with laser, vitreoretinal surgery and Anti–vascular endothelial growth factor therapy (Anti-VEGF) for DR treatment, service utilisation and workload at these facilities, and the average price of DR treatment in these facilities. Results Fourteen facilities offer DR treatment in Ghana; four in the public sector, seven in the private sector and three in the Christian Health Association of Ghana (CHAG) centres. There was a huge disparity in the distribution of facilities offering DR services, the eye care cadre, workload, and DR treatment service (retinal laser, Anti-VEGF, and vitreoretinal surgery). The retinal laser treatment price was independent of all variables (facility type, settings, regions, and National Health Insurance Scheme coverage). However, settings (p = 0.028) and geographical regions (p = 0.010) were significantly associated with anti-VEGF treatment price per eye. Conclusion Our results suggest a disproportionate distribution of DR services in Ghana. Hence, there should be a strategic development and implementation of an eye care plan to ensure the widespread provision of DR services to the disadvantaged population as we aim towards a disadvantaged population as we aim towards a universal health coverage.

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