Page 28 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

26 Chapter 1
As shown in our framework, notification and response are the result of several steps. Timeliness in these steps requires multidisciplinary cooperation between different sectors as curative sector (first, second, third line), public health sector (local, regional, national level), and other sectors involved in surveillance and response (f.e. food safety authority, schools, daycare centers, veterinary sector). Besides cooperation, these sectors might need to invest considerable resources to achieve timely notification or response, like electronic laboratory reporting systems (59). Better defined timeliness and analyses of effective cooperation, (notification) systems and involved costs will lead to more effective and efficient preparedness.
1.4 Aim, research questions and outline
The aim of this thesis is to develop a timeframe for evaluation of timeliness in notification and response systems for infectious disease control, and to inves- tigate which elements facilitate effective preparedness in terms of notification systems, legal aspects, cooperation between stakeholders and costs involved. The following research questions will be addressed in this thesis:
1. What is the delay of infectious disease notification and reporting in the Netherlands?
2. What is the most appropriate timeframe for timeliness of infectious disease notification for outbreak control? Are infectious diseases notified within this timeframe in the Netherlands?
3. Which elements of notification systems facilitate timely notification?
4. What defines timely response and which elements in emergency prepared-
ness facilitate timeliness of response?
Section 1 of this thesis studies timeliness of surveillance, focusing on notifica- tion systems for indicator based surveillance. Chapter 2 describes the timeliness of notifications in the Netherlands under the former Law on Infectious Diseases until 2008. Incubation periods are used as timeframes for timeliness of delays between disease onset until notification at the MHS (D1) and legal timeframes to evaluate notification delay (D3). Associations between notification delay and reporting procedures (postal mail, fax, phone, e-mail) or covenants between physicians and laboratories were investigated.
Chapter 3 describes a systematic literature review on timeliness of notifi- cation systems published between 2000 -2017. Delays according to the notifi-