Variations in national infectious diseases surveillance in Europe

Area of Science:

• Public Health
• Epidemiology
• European Health Policy

Background:

• The Maastricht Treaty mandates public health development at the European Community (EC) level.
• Existing national public health surveillance systems require assessment for EC-level integration.
• Sexually transmitted diseases (STD), hepatitis, and tuberculosis (TB) are key areas for surveillance.

Purpose of the Study:

• To assess the feasibility of establishing EC-level public health surveillance.
• To survey and standardize data on national surveillance systems in Europe.
• To identify variations and challenges in current surveillance practices.

Main Methods:

• A survey was conducted in 1991-92 across seventeen European countries (twelve EC members plus Austria, Finland, Norway, Sweden, and Switzerland).
• Public health institutions responsible for surveillance were visited.
• Standardized data were collected on surveillance systems for STD, hepatitis, and TB.

Main Results:

• National surveillance systems exhibited wide variations in type, design, and quality.
• A trend towards voluntary reporting systems was observed, contrasting with mandatory notification.
• Reporting completeness for STD varied significantly (under 10% to over 90%), with inconsistent use of case definitions. Data dissemination methods also varied.
• Surveillance data were disseminated through national epidemiological bulletins in most countries.

Conclusions:

• The heterogeneity of national public health surveillance systems hinders EC-level development.
• A coordinated strategy is essential for effective public health surveillance at the EC level.
• Standardization of systems and definitions is crucial for cross-national comparability.