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Under-reporting in hepatitis B notifications.

S S Abdool Karim1, Q Abdool Karim

  • 1Department of Community Health, University of Natal, Durban.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|March 2, 1991
PubMed
Summary
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Hepatitis B under-reporting is significant, with at least 7 laboratory-confirmed cases for every notified case nationally. Reporting consistency varies regionally, impacting trend analysis between different areas.

Area of Science:

  • Epidemiology
  • Public Health

Background:

  • Hepatitis B surveillance relies on notification data, which may not fully reflect disease incidence.
  • Accurate hepatitis B reporting is crucial for effective public health interventions and trend analysis.

Purpose of the Study:

  • To estimate the under-reporting level of hepatitis B nationally and regionally.
  • To assess the consistency of hepatitis B reporting over time and across different geographical areas.

Main Methods:

  • Comparison of hepatitis B notification data with laboratory-confirmed positive test results from January 1985 to December 1988.
  • Calculation of reporting ratios (notifications to positive laboratory tests) to quantify under-reporting.

Main Results:

  • A national reporting ratio of at least 7:1 (laboratory-confirmed cases to notified cases) was observed throughout the study period.

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  • National hepatitis B reporting levels demonstrated consistency across the study years.
  • The Cape region exhibited the highest and most stable reporting levels compared to other regions.

    • Conclusions:

    • The true national incidence of hepatitis B is at least seven times greater than indicated by notification data alone.
    • National and Cape region hepatitis B trend analyses using notification data are considered valid.
    • Inter-regional comparisons of hepatitis B incidence rates require caution due to regional reporting inconsistencies.