How do Iranian physicians report notifiable diseases? The first report from Iran

Epidemiologic surveillance through notifiable diseases is an essential component of a public health program. Surveillance systems relay mostly on physicians to report notifiable diseases The aim of this study was to identify physicians' knowledge about reporting of notifiable diseases as well as their self-reported practices and perceptions regarding disease reporting barriers and ways to improve compliance.

A validated, reliable self-administered questionnaire addressing knowledge of notifiable diseases, self-reported practices, reasons for noncompliance with reporting requirements, and suggestions to improve compliance with reporting was distributed to 400 general physicians (GPs) attending medical conferences in Shiraz, Iran between March and July 2006. Knowledge was quantified by evaluating the answers to 45 questions (with 1 point awarded for each correct answer). Associations between the independent variables and physician knowledge were modeled using analysis of covariance.

The response rate was 75%. The overall mean score was 17.03 +/- 7.45 (range, 4 to 31). Knowledge of the location of the posted notifiable diseases list was positively associated with score on knowledge questions (F = 4.431; P = .036). Fully 88% of the participants stated that they had never reported a notifiable disease. There was no significant association between the participants' self-reported practices and knowledge question scores. The major barriers to reporting notifiable diseases were the extra time required for reporting and poor knowledge of the list of reportable diseases and reporting requirements. The most frequent suggestions for improving physicians' compliance with disease reporting were to simplify the reporting process and to shift the responsibility for notification to another person, such as a secretary or a nurse.

Our findings suggest poor knowledge of disease notification requirements among GPs. Modifying physisicans' knowledge and motivation, eliminating barriers to disease reporting, and promoting some facilitating factors could help reduce the underreporting of notifiable diseases.