Epidemiological surveillance

a team challenge

Abstract

The National Epidemiological Surveillance System monitors the incidence of communicable diseases, adding to their prevention and control and evaluating the effectiveness of prevention efforts. In view of recent legislative reviews, Public Health Units should play an important role in the operation of such a system. In this context, it was considered opportune in collaboration with a hospital, to develop a consultancy in order to understand reporting embarrassment factors and develop a systematic multidisciplinary review. In 2015, we retrospectively audited 26 diseases listed for mandatory notification between 2010 and 2014. We determined the notification rates of the cases identified, matching residents in Municipality B. The information sources consulted were homogeneous diagnosis groups, laboratory records, medical notifications, and 717 clinical records referring to cases of disease with positive or dubious laboratory results. We applied a questionnaire to 26 doctors to quantify and understand the under-reporting. We identified 289 cases relating to 14 of the 26 diseases audited. In Municipality B there was an overall notification rate of 34,6% (45/130). The identified cases of brucellosis, Lyme disease, Q fever, and malaria were not reported. The main reason for under notification is “bureaucracy” (53,8%). Some doctors (15,8%) only reported at the time of the patient’s discharge from hospital. Some limitations stand out for their impact, such as those relating to complementary diagnostic tests and epidemiological veterinary monitoring. A multidisciplinary and complementary interactive approach of public health services is essential. This must be integrated with other health institutions and with veterinary services, in order to ensure better monitoring, thereby helping to improve people’s health and wellbeing.