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Assessing the completeness of tuberculosis notification in a health district
1Wigan and Bolton Health Authority.
Insights
Tuberculosis notification completeness in Bolton was assessed using multiple data sources. Combining general practitioner prescriptions and hospital data with official notifications improved case detection but confirmed notification
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Surveillance
Background:
- Accurate tuberculosis (TB) surveillance is crucial for effective control programs.
- Under-ascertainment of TB cases can hinder public health interventions.
- Assessing the completeness of official notification systems is essential.
Purpose of the Study:
- To estimate the completeness of tuberculosis notification in Bolton health district.
- To evaluate the utility of general practitioner prescriptions and hospital admission data in identifying under-notified TB cases.
Main Methods:
- A retrospective study combining three data sources: official TB notifications, general practitioner (GP) prescriptions, and hospital admission data.
- Data were collected for Bolton health district over specific periods (1991-1993 and Oct 1992-Sep 1993).
- Case-finding was enhanced by cross-referencing records from these disparate sources.
Main Results:
- Over 1991-1993, 307 tuberculosis cases were notified. GP prescriptions identified 34 additional cases, 7 of which were previously un-notified.
- Between Oct 1992 and Sep 1993, a combined data approach identified 148 TB cases.
- Official notifications captured 93.2% of cases, while GP prescriptions identified 23.0% and hospital data identified 36.5%.
Conclusions:
- While general practitioner prescriptions and hospital data can supplement official tuberculosis notification, they are not adequate substitutes.
- Combining multiple data sources offers a more comprehensive picture of tuberculosis burden.
- Further efforts are needed to ensure complete tuberculosis case reporting in public health surveillance systems.
Abstract:
We have estimated the completeness of tuberculosis notification in Bolton health district by combining notification data with information from prescriptions issued by general practitioners and hospital admission data. From 1 January 1991 to 31 December 1993, 307 cases of tuberculosis were notified in Bolton. Thirty-four cases were identified using general practitioners' prescriptions: 27 of these had been notified between January 1991 and December 1993, and seven had not been notified during this period. Although prescriptions may be used as a marker for tuberculosis, they would not be an adequate alternative to notification of cases. One hundred and forty-eight cases of tuberculosis were identified between 1 October 1992 and 30 September 1993 by combining data from the three sources: 138 cases had been notified (93.2%), 28 identified from prescriptions (23.0%), and 54 identified from hospital data (36.5%).