Underreporting and underestimation of gonorrhea cases in the Taiwan National Gonorrhea Notifiable Disease System in the Tainan region: evaluation by a pilot physician-based sentinel surveillance on Neisseria gonorrhoeae infection

We established a pilot sentinel surveillance system for Neisseria gonorrhoeae infection in Tainan to evaluate underreporting in the National Gonorrhea Notifiable Disease System (NGNDS), and also conducted a survey to understand physicians’ specific reasons for underreporting in the Tainan region. A...

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Published inInternational journal of infectious diseases Vol. 13; no. 6; pp. e413 - e419
Main Authors Hsieh, Yu-Hsiang, Kuo, Mu-Jong, Hsieh, Tsun-Che, Lee, Hsin-Chun
Format Journal Article
LanguageEnglish
Published Canada Elsevier Ltd 01.11.2009
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Online AccessGet full text
ISSN1201-9712
1878-3511
1878-3511
DOI10.1016/j.ijid.2009.02.006

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Abstract We established a pilot sentinel surveillance system for Neisseria gonorrhoeae infection in Tainan to evaluate underreporting in the National Gonorrhea Notifiable Disease System (NGNDS), and also conducted a survey to understand physicians’ specific reasons for underreporting in the Tainan region. A sentinel surveillance network consisting of six specialty clinics was created in Tainan City. Three hundred seventeen patients who were clinically diagnosed with urethritis, cervicitis, or gonorrhea were enrolled. N. gonorrhoeae infection was detected by urine-based PCR. A questionnaire was mailed to healthcare providers who potentially see patients with gonorrhea in the Tainan region. Forty-eight N. gonorrhoeae-positive subjects were identified from the sentinel surveillance, and none of these gonorrhea cases were notified to the NGNDS by their healthcare providers. During the study period, there were 67 notified cases in the NGNDS, depicting an underestimation of at least 42% for this epidemic. Of the 16 healthcare providers who had seen cases in the past 3 months, only seven (43.8%) reported that they notified the authorities and only 23 (32%) of 71 cases were reported. ‘Not collecting a specimen’ and ‘afraid of the invasion of patient privacy by the authorities’ were the main reasons for the lack of notification. The underreporting of gonorrhea identified in this pilot is substantial. An overhaul of Taiwan's NGNDS that streamlines the reporting procedures and the requirement for laboratory confirmation, along with a continuing medical education program is warranted.
AbstractList We established a pilot sentinel surveillance system for Neisseria gonorrhoeae infection in Tainan to evaluate underreporting in the National Gonorrhea Notifiable Disease System (NGNDS), and also conducted a survey to understand physicians' specific reasons for underreporting in the Tainan region. A sentinel surveillance network consisting of six specialty clinics was created in Tainan City. Three hundred seventeen patients who were clinically diagnosed with urethritis, cervicitis, or gonorrhea were enrolled. N. gonorrhoeae infection was detected by urine-based PCR. A questionnaire was mailed to healthcare providers who potentially see patients with gonorrhea in the Tainan region. Forty-eight N. gonorrhoeae-positive subjects were identified from the sentinel surveillance, and none of these gonorrhea cases were notified to the NGNDS by their healthcare providers. During the study period, there were 67 notified cases in the NGNDS, depicting an underestimation of at least 42% for this epidemic. Of the 16 healthcare providers who had seen cases in the past 3 months, only seven (43.8%) reported that they notified the authorities and only 23 (32%) of 71 cases were reported. 'Not collecting a specimen' and 'afraid of the invasion of patient privacy by the authorities' were the main reasons for the lack of notification. The underreporting of gonorrhea identified in this pilot is substantial. An overhaul of Taiwan's NGNDS that streamlines the reporting procedures and the requirement for laboratory confirmation, along with a continuing medical education program is warranted.
We established a pilot sentinel surveillance system for Neisseria gonorrhoeae infection in Tainan to evaluate underreporting in the National Gonorrhea Notifiable Disease System (NGNDS), and also conducted a survey to understand physicians' specific reasons for underreporting in the Tainan region.OBJECTIVESWe established a pilot sentinel surveillance system for Neisseria gonorrhoeae infection in Tainan to evaluate underreporting in the National Gonorrhea Notifiable Disease System (NGNDS), and also conducted a survey to understand physicians' specific reasons for underreporting in the Tainan region.A sentinel surveillance network consisting of six specialty clinics was created in Tainan City. Three hundred seventeen patients who were clinically diagnosed with urethritis, cervicitis, or gonorrhea were enrolled. N. gonorrhoeae infection was detected by urine-based PCR. A questionnaire was mailed to healthcare providers who potentially see patients with gonorrhea in the Tainan region.METHODSA sentinel surveillance network consisting of six specialty clinics was created in Tainan City. Three hundred seventeen patients who were clinically diagnosed with urethritis, cervicitis, or gonorrhea were enrolled. N. gonorrhoeae infection was detected by urine-based PCR. A questionnaire was mailed to healthcare providers who potentially see patients with gonorrhea in the Tainan region.Forty-eight N. gonorrhoeae-positive subjects were identified from the sentinel surveillance, and none of these gonorrhea cases were notified to the NGNDS by their healthcare providers. During the study period, there were 67 notified cases in the NGNDS, depicting an underestimation of at least 42% for this epidemic. Of the 16 healthcare providers who had seen cases in the past 3 months, only seven (43.8%) reported that they notified the authorities and only 23 (32%) of 71 cases were reported. 'Not collecting a specimen' and 'afraid of the invasion of patient privacy by the authorities' were the main reasons for the lack of notification.RESULTSForty-eight N. gonorrhoeae-positive subjects were identified from the sentinel surveillance, and none of these gonorrhea cases were notified to the NGNDS by their healthcare providers. During the study period, there were 67 notified cases in the NGNDS, depicting an underestimation of at least 42% for this epidemic. Of the 16 healthcare providers who had seen cases in the past 3 months, only seven (43.8%) reported that they notified the authorities and only 23 (32%) of 71 cases were reported. 'Not collecting a specimen' and 'afraid of the invasion of patient privacy by the authorities' were the main reasons for the lack of notification.The underreporting of gonorrhea identified in this pilot is substantial. An overhaul of Taiwan's NGNDS that streamlines the reporting procedures and the requirement for laboratory confirmation, along with a continuing medical education program is warranted.CONCLUSIONSThe underreporting of gonorrhea identified in this pilot is substantial. An overhaul of Taiwan's NGNDS that streamlines the reporting procedures and the requirement for laboratory confirmation, along with a continuing medical education program is warranted.
We established a pilot sentinel surveillance system for Neisseria gonorrhoeae infection in Tainan to evaluate underreporting in the National Gonorrhea Notifiable Disease System (NGNDS), and also conducted a survey to understand physicians’ specific reasons for underreporting in the Tainan region. A sentinel surveillance network consisting of six specialty clinics was created in Tainan City. Three hundred seventeen patients who were clinically diagnosed with urethritis, cervicitis, or gonorrhea were enrolled. N. gonorrhoeae infection was detected by urine-based PCR. A questionnaire was mailed to healthcare providers who potentially see patients with gonorrhea in the Tainan region. Forty-eight N. gonorrhoeae-positive subjects were identified from the sentinel surveillance, and none of these gonorrhea cases were notified to the NGNDS by their healthcare providers. During the study period, there were 67 notified cases in the NGNDS, depicting an underestimation of at least 42% for this epidemic. Of the 16 healthcare providers who had seen cases in the past 3 months, only seven (43.8%) reported that they notified the authorities and only 23 (32%) of 71 cases were reported. ‘Not collecting a specimen’ and ‘afraid of the invasion of patient privacy by the authorities’ were the main reasons for the lack of notification. The underreporting of gonorrhea identified in this pilot is substantial. An overhaul of Taiwan's NGNDS that streamlines the reporting procedures and the requirement for laboratory confirmation, along with a continuing medical education program is warranted.
Summary Objectives We established a pilot sentinel surveillance system for Neisseria gonorrhoeae infection in Tainan to evaluate underreporting in the National Gonorrhea Notifiable Disease System (NGNDS), and also conducted a survey to understand physicians’ specific reasons for underreporting in the Tainan region. Methods A sentinel surveillance network consisting of six specialty clinics was created in Tainan City. Three hundred seventeen patients who were clinically diagnosed with urethritis, cervicitis, or gonorrhea were enrolled. N. gonorrhoeae infection was detected by urine-based PCR. A questionnaire was mailed to healthcare providers who potentially see patients with gonorrhea in the Tainan region. Results Forty-eight N. gonorrhoeae -positive subjects were identified from the sentinel surveillance, and none of these gonorrhea cases were notified to the NGNDS by their healthcare providers. During the study period, there were 67 notified cases in the NGNDS, depicting an underestimation of at least 42% for this epidemic. Of the 16 healthcare providers who had seen cases in the past 3 months, only seven (43.8%) reported that they notified the authorities and only 23 (32%) of 71 cases were reported. ‘Not collecting a specimen’ and ‘afraid of the invasion of patient privacy by the authorities’ were the main reasons for the lack of notification. Conclusions The underreporting of gonorrhea identified in this pilot is substantial. An overhaul of Taiwan's NGNDS that streamlines the reporting procedures and the requirement for laboratory confirmation, along with a continuing medical education program is warranted.
Author Hsieh, Tsun-Che
Lee, Hsin-Chun
Kuo, Mu-Jong
Hsieh, Yu-Hsiang
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CitedBy_id crossref_primary_10_3390_pathogens11020217
crossref_primary_10_3390_jof7110990
crossref_primary_10_1186_1471_2458_14_147
crossref_primary_10_1016_S0929_6646_09_60390_9
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Taiwan
Notifiable diseases
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Snippet We established a pilot sentinel surveillance system for Neisseria gonorrhoeae infection in Tainan to evaluate underreporting in the National Gonorrhea...
Summary Objectives We established a pilot sentinel surveillance system for Neisseria gonorrhoeae infection in Tainan to evaluate underreporting in the National...
We established a pilot sentinel surveillance system for Neisseria gonorrhoeae infection in Tainan to evaluate underreporting in the National Gonorrhea...
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SubjectTerms Disease Notification - statistics & numerical data
Female
Gonorrhea
Gonorrhea - diagnosis
Gonorrhea - drug therapy
Gonorrhea - epidemiology
Humans
Infectious Disease
Male
National Health Programs
Neisseria gonorrhoeae
Notifiable diseases
Physicians - statistics & numerical data
Pilot Projects
Pulmonary/Respiratory
Sentinel Surveillance
Surveillance
Surveys and Questionnaires
Taiwan
Taiwan - epidemiology
Underreporting
Title Underreporting and underestimation of gonorrhea cases in the Taiwan National Gonorrhea Notifiable Disease System in the Tainan region: evaluation by a pilot physician-based sentinel surveillance on Neisseria gonorrhoeae infection
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https://dx.doi.org/10.1016/j.ijid.2009.02.006
https://www.ncbi.nlm.nih.gov/pubmed/19394259
https://www.proquest.com/docview/734118614
Volume 13
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