Page 73 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

Timeliness of notification systems: a systematic literature review 71
mixed sufficient/partly sufficient, green/red: mixed sufficient/not sufficient, orange: partly sufficient, orange/red: mixed partly/not sufficient, and red: not sufficient. Per cell the notification system is reflected: E: electronic, C: conservative, C/E: combination of electronic and conservative, MR: Mobile phone reporting, ?: unknown.
For analyzing notification systems according to standardized timeframes, 45 studies were included (Figure 4). In 13 studies (29%), the system was scored suf- ficient, in 15 studies (33%) not, and in the other 17 studies the outcomes were partly sufficient (13, 29%) or a mixed score (4, 9%). Eight studies scored better related to the standardized timeframe, eight studies scored worse. Sufficient notification systems frequently involved D1, D2 and D3X (8/13). Insufficient no- tification systems involved frequently physicians (D3P) (7/15) and public health authorities D4-5 (5/15). In parallel with the outcomes of the predefined time- frames, no clear relation between scoring result and notification system could be observed. Although the distribution of outcomes in both timeframes was comparable (24/38), some studies did score differently according to predefined or standardized timeframes: 3/12 studies scoring an insufficient notification sys- tem for the predefined timeframe improved in scoring for the standardized, while 3/11 studies changed from sufficient to partly or not sufficient.
With regard to the disease specific timeframe, eight studies provided infor- mation regarding delay D1 for one or more specific diseases. In none of them the notification system was timely enough for optimal outbreak control. Subop- timal outbreak control was shown for notification systems for hepatitis A [10, 33, 46], hepatitis B [25] and measles [11]. However the system was insufficient for outbreak control in most studies: hepatitis A [25], measles [21, 25, 46, 47], pertussis [10] and shigelloses [15, 46, 52].
Comparison and intervention studies
In 13 studies timeliness of electronic systems was compared with conventional systems. In the majority (10/13) electronic reporting was faster than conven- tional reporting, improving timeliness with days (range 0-11) [9-11, 13, 33, 40, 44, 49], up to months [20, 30]. However, none of these studies fulfilled the pre- defined timeframe, and only 2 the standardized timeframe [10, 44]. In 3 studies, conventional reporting method was as fast as, or faster than electronic systems [26, 32, 50].
Six studies analyzed a variety of interventions in the notification systems: increased frequency (daily reporting [18]), sentinel lab surveillance [21], legal adjustments [24], training [25] and better facilities (fax), SMS text messages
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