Page 122 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan
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120 Chapter 5
served for pertussis, malaria, leptospirosis and psittacosis. The shortening of the delay in group ‘C’ exceeded that in ‘group B’ diseases (averages 2.1 vs 0.9). In period 3, this delay decreased further (12/18 diseases, with 6/12 statistically significant). In 2016–2017, the percentage of cases notified more than 3 days after laboratory confirmation had substantially decreased compared with peri- od 1, as calculated by Reijn [1]. This percentage decreased for shigellosis from 42.0% to 11.9%, for Shiga toxin-producing Escherichia coli (STEC) from 33.3% to 16.9%, for measles from 15.7% to 12.5%, for typhoid fever from 22.3% to 14.3% and for hepatitis A from 20.9% to 4.6%.
Figure 3. Median and boxplota notification delay and reporting delay, per year of diag- nosis per disease, the Netherlands, July 2003–November 2017(n = 144,066)
D3: notification delay; D6: reporting delay.
a IQR: 25th–75th percentile in boxes, values between 1.5 IQR (lines) and outliers ( ͦ) Extremes and outliers > 20 were removed to allow the medians and interquartile ranges to be visible in the graph.
The median reporting delays also showed a clear decrease in period 2 (medians of 7/19 diseases decreased, 6/7 statistically significantly). Malaria, psittacosis and pertussis, for which the legal timeframe for reporting to the RIVM was ad- justed, were reported significantly faster (p < 0,05), see Table 1. In period 3, no further decrease in median delays was observed.
When displayed per year, a gradual shortening was observed for the notification delay from the beginning of the study period (July 2003) until 2012. For the
 



























































































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