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[An evaluation of the surveillance system of mandatory disease reporting]
J A Peñuelas Ruiz1, R R Manrique Blázquez, A Diestro Contreras
1Unidad de Epidemiología, Centro de Salud Pública de Gandía, Valencia. jaruiz@san.gva.es
Objective:
Study of the exhaustibility and reliability of the recording of obligatory notifiable diseases (EDO) and the accumulated incidence of the EDO in a health area.
Design:
Descriptive study.
Setting:
Community setting. Epidemiological surveillance.
Patients:
People who have suffered in 1996 some EDO (excluded measles, rubella, mumps, chickenpox and influenza).
Measurements And Main Results:
They have been selected a total of 205 EDO-disease cases starting from the two recording systems: laboratory and obligatory surveillance diseases system. The exhaustibility of the laboratory has been 82%, 95% confidence interval (76-87%) and that of the EDO system 45%, 95% confidence interval (38-52%). The rate kappa for the diseases global is 0.42 95%, confidence interval (0.4-0.43) and the specific accordance proportion 0.27, 95% confidence interval (0.21-0.34). The cases search in the recording of the laboratory increases the incidence declared to the EDO system in all the diseases. The diseases with greater incidence are the hepatitis (73.59 x 10(5)), the pulmonary tuberculosis (27.07 x 10(5)) and the syphilis (18.05 x 10(5)).
Conclusions:
The EDO system presents a clear understatement, variable according to the different diseases and being maximum for the hepatitis B and C. The laboratory quantifies a high exhaustibility, and it can increase between 55 and 30% the EDO recording cases, increasing the knowledge of the morbidity caused by EDO in the Area 11. The valuation of the EDO in addition to improving the information for the assumptions of decisions in sanitary planning, optimizes the necessary elements when it is compared the EDO incidence among different geographical areas or within a same area at a different time.