Page 115 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan
P. 115

Timeliness of infectious disease reporting, the Netherlands, 2003-2017 113
Methods
Data selection
Since 2003, the MHS have been reporting all notified infectious diseases to the RIVM through a web-based application [7]. We performed a retrospective anal- ysis of routine surveillance data and extracted data on all cases notified be- tween July 2003 and November 2017. From those, we excluded notifications of Creutzfeldt–Jacob disease and tuberculosis, as the notification procedures were not comparable with the rest. Group A diseases (polio, smallpox, Middle East respiratory syndrome coronavirus (MERS CoV), Severe acute respiratory syndrome (SARS) and viral haemorrhagic fever) were excluded as they were no- tifiable upon suspicion, before laboratory confirmation. Hepatitis C and chron- ic hepatitis B were excluded as date of disease onset in most cases was not known. We also excluded rare diseases with less than 10 notifications in the full study period. As a result, we included 19 notifiable diseases for the time period of validity of the former Act, until the end of 2008, and 28 diseases for the time period of validity of the new Act from 2009 onwards. For each case, date of symptom onset (TO), date of laboratory confirmation (TX), date of notification at the MHS (TRL) and date of reporting to the RIVM (TRN) were extracted.
Calculation of delays
The following delays were calculated for each case, as visualised in Figure 1:
- D1: total local delay, delay between onset of disease and notification to the
MHS (TRL − TO)
- D1X: disease identification delay, delay between onset of disease and lab-
oratory confirmation (TX − TO)
- D2: total testing delay, delay between ordering laboratory test by physician
and notification to the MHS (TL – TRL)
- D3: notification delay, delay between laboratory confirmation and notifica-
tion to the MHS (TRL – TX)
- D4: local reporting delay, delay between notification to the MHS and re-
porting to the RHD (TRR – TRL)
- D5: regional reporting delay, delay between reporting to the RHD and re-
porting to the NHD (TRN – TRR)
- D6: reporting delay, delay between notification at the MHS and reporting
to the RIVM (TRN – TRL)
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