Page 71 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

Timeliness of notification systems: a systematic literature review 69
Timeliness
Out of 48 studies, 39 provided a predefined timeframe. Nine studies without predefined timeframe provided a comparison between outcomes of different notification systems. In total 35 out of 39 studies with a predefined timeframe referred to a quantitative, and 4 studies to a qualitative timeframe (‘immediate’, ‘as soon as possible’), see Table 1. Quantitative timeframes involved numbers of days/weeks/months, incubation periods per infectious disease (3 studies), or period for effective post exposure prophylaxes for contacts (1 study). The most common predefined timeframe for D3 P/X was reporting ≤ 1 day (12 studies), or ≤ 32-48 hour (3 studies). Predefined timeframes for notification on local level varied considerably between ≤ 1 day and ≤ 3 weeks, on regional/national level between ≤ 1 day and ≤ 2 months.
In 11 of the 39 studies (28%), notification delays met the predefined time- frame, in 12 (31%) not, and in the other 16 studies the outcomes were partly sufficient (8, 21%) or a mixed score (8, 21%). In Figure 4 these outcomes are visualized according to the delay described in a study, including information on the notification system. Notification systems involving the laboratory (D3X or D3X/P) showed the best results: 3 out of 4 (D3X) and 5 out of 7 (D3P/X) stud- ies had sufficient or mixed sufficient/partly sufficient timeliness according their predefined timeframe. Notification systems only involving physicians (D3P) showed least favourable results: in 5 out of 10 studies the timeliness was insuf- ficient according their predefined timeframes.
In 34 of these 39 studies, information on the notification system(s) was pro- vided and involved in 13 studies conventional methods, in 10 studies electronic methods, in 9 studies a combination, and in 2 studies mobile phone reporting. As shown in Figure 4, there appeared to be no relation between notification system and score. Of the eleven studies were the notification system scored sufficient, four studies used a longer predefined timeframe for delays for D3 and D4-5 [29, 34, 37, 45], and four studies with a strict predefined timeframe (D3 or D4 <1 day) used an electronic notification system. Three of the latter studies were conducted in East Asian countries. Both Chinese and the Taiwan- ese studies revealed sufficient notification [34, 35, 53, 56]. In the 12 studies with an insufficient notification system, three out of four studies with a strict timeframe (D3 < 1 day) used either conventional or electronic reporting [9, 23, 41]. Notification systems in three out of these 12 studies with insufficient scores described D1, i.e. 25%, [3, 39, 47], while in total only 5/38 studies included D1, i.e. 13%. Eight out of twelve studies were from Europe (Italy, UK, Sweden and Switzerland) [9, 20, 23, 24, 41, 47, 48, 54].
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