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PubMed2006

Donor funding priorities for communicable disease control in the developing world.

Prior research has considered donor funding for developing world health by recipient and donor country but not by disease. Examining funding by disease is critical since diseases may be in competition with one another for priority and donors may be making allocation decisions in ways that do not correspond to developing world need. In this study I calculate donor funding for 20 historically high-burden communicable diseases for the years 1996 to 2003 and examine factors that may explain variance in priority levels among diseases. I consider funding for developing world health from 42 major donors, classifying grants according to the communicable disease targeted. Data show that funding does not correspond closely with burden. Acute respiratory infections comprise more than a quarter of the burden among these diseases but receive less than 3% of direct aid. Malaria also stands out as a high-burden neglected disease. The evidence indicates that neither developing world need nor industrialized world interests explain all funding patterns, and that donors may be imitating one another in ways that do not take into account problems in the developing world. There is an urgent need for a major increase in funding for communicable disease control in the developing world, and for more balanced allocation of the resources already provided.

Communicable Disease Control↗
PubMed1995

The reporting of communicable diseases: a controlled study of Neisseria meningitidis and Haemophilus influenzae infections.

Surveillance systems for communicable diseases in the United States are primarily passive. We compared the passive reporting system for invasive disease caused by Neisseria meningitidis and Haemophilus influenzae with a concurrent, active laboratory-based system in the four metropolitan counties of Tennessee. The passive reporting system identified approximately 50% of all cases that were identified by the active system and accurately reflected trends in disease occurrence during the study period. Of all reported cases, physicians contributed fewer than 4%. Nearly 40% of all hospitals in the study area did not participate in the passive system. This lack of participation resulted in disproportionately increased reporting of disease among blacks. Inconsistencies in case definition within the state also contributed substantially to underreporting and lack of demographic representativeness of reported cases. The median reporting interval (the time from the onset of disease to transmission of the case report to the Centers for Disease Control and Prevention) was 24 days (range, 5-157 days). Efforts to improve surveillance of those infections for which isolation of a pathogen is tantamount to a diagnosis should concentrate on laboratory-based reporting and the use of currently available computer telecommunication systems.

Centers for Disease Control and Prevention, U.S.↗
PubMed2004

Timeliness of case reporting in the Swedish statutory surveillance of communicable diseases 1998--2002.

To prepare for a new communicable disease act in Sweden, we performed an in-depth analysis of the performance of the present notification system (1998--2002). Four diseases were selected for analysis (meningococcal infection, salmonellosis, infection with penicillin-resistant pneumococci and tularaemia). Each step in the double notification flow (clinical and laboratory notifications) was studied and paper-based and electronic notifications compared. More than 15 possible single dates in the notification flows were analysed for 27,000 cases. The shortest notification flows (from date of sample collection to when the first notification was received at SMI--clinical or laboratory notification) were seen for meningococcal infections and salmonellosis (median 7 d) and the longest for tularaemia (11 d). Laboratory notifications were faster than clinical notifications, and electronic reporting 1.5-1.7 times faster than paper notifications. Further gains should be expected from the new electronic reporting system (SmiNet2), which will allow also clinical reporting electronically over the internet.

Communicable Diseases↗
PubMedDate not supplied

Morbidity pattern of communicable diseases in an urban area of Uttar Pradesh.

The period prevalence rate of communicable diseases in Uttar Pradesh, India, in the present study was found to be 119.7 per thousand population. There were 1.08 communicable diseases per morbid person. The leading cause of morbidity was ascariasis (24.1 per 1000). The morbidity was significantly higher in young persons (below 14 years of age) and in those without spouse. The social class and educational status were found to have negative association with the morbidity. However, the sex did not show any influence on the morbidity.

Age Factors↗
PubMed1997

Results of a search for missed cases of reportable communicable diseases using hospital discharge data.

To assess how reliably hospitals report serious, uncommon communicable diseases to the Department for Public Health, we searched the 1995 hospital discharge data set (HDDS) collected by the Kentucky Health Policy Board for cases of 11 diseases. Of 17 case records found, 4 represented disease occurrences that had been reported to the Department; 6 represented coding errors in the HDDS; 4 were instances where a reportable disease had been suspected but not confirmed by subsequent workup; 1 case was a resident of another state; and 2 were cases of invasive Hemophilus influenzae infection in adults that should have been reported to the Department. The study found no evidence that hospitals failed to report vaccine-preventable diseases. There was evidence that the HDDS needs improved accuracy to maximize its usefulness for public health purposes.

Communicable Disease Control↗
PubMed1993

Tempting fate: control of communicable disease in England.

Recent changes in the NHS have left many defects in the systems for the control of communicable diseases and infection and their surveillance and the management of outbreaks. Clear, explicit legislation is needed, placing the responsibilities on health authorities. New teams led by consultants need to be set up to investigate and manage outbreaks of communicable diseases of all types.

Communicable Disease Control↗
PubMedDate not supplied

[Mandatory notification of communicable diseases: what physicians think].

OBJECTIVE: To find out the opinion of family doctors concerning the statutory notification of communicable diseases (SNCD) and to analyse factors associated to a good attitude towards SNCD. SETTING: Guimarães Health Centre, Guimarães. METHODS: Analytical cross-sectional study. Questionnaire survey. The 52 family doctors of the Health Centre were asked to express their opinion on some issues, including the utility of SNCD, reasons for the under-reporting of communicable diseases, up-to-dateness of the list of notifiable conditions, facility of filling in the notification form, and their own attitude towards notification. The variables utility of SNCD and attitude towards notification were then considered together with other variables (including postgraduate time, length of the family doctor's lists of patients, working in exclusivity, and how the degree of general practitioner is obtained). RESULTS: The SNCD was considered at least somewhat useful by 96% of the doctors. Thirty percent of the doctors considered excess work and/or lack of time as the main reason for under-reporting, and 29% it attributed to lack of sufficient motivation. The list of notifiable conditions was considered out dated by 46% of the doctors. Thirty eight percent of them considered the multiple notification of a case of disease not inconvenient and 54% stated that they had used it to notify all or almost all of cases they knew. The doctors who worked exclusively as civil servants and who had smaller lists of patients seemed to have a greater compliance regarding notification (p < 0.05). CONCLUSIONS: The majority of doctors considered the notification useful. They attributed the under-reporting to some conditions that are difficult to change. In this population, the doctors who worked exclusively as civil servants and who had smaller lists of patients showed a more favourable attitude towards reporting notifiable conditions.

Adult↗
PubMed1991

Survey of Louisiana physicians on communicable disease reporting.

We evaluated the participation of Louisiana physicians in the reporting of communicable diseases. In the spring of 1990 we surveyed a stratified random sample of Louisiana physicians from specialties likely to see patients with reportable diseases. Between 30% and 67% of physicians indicated that they reported all the cases of the queried diseases they had seen during the past year. The proportion reporting all cases differed by disease. AIDS and pertussis were always reported by more than half of the respondents. Mumps was least reported. Perceived barriers and suggestions to improve reporting are discussed.

Communicable Diseases↗
PubMed1991

A discrete-time communicable disease model with a stochastic contact rate for nonhomogeneous populations.

A discrete-time communicable disease model with a stochastic contact rate for nonhomogeneous populations is described which is capable of simulating the irregular incidence patterns seen in many communicable diseases. The epidemic curve for these contagious diseases is typically characterized by epidemics of varying intensity separated by variable time intervals. The compartmental model is an extension to the Reed-Frost theory with age-specific stochastic contact rates. The population is partitioned into age constant groups and is closed; the births flowing into the first age group equals the deaths from all age groups. The population in each age group is subdivided into four states that characterize the course of an infection: susceptible, incubation, infectious, and immune. The incubation and infectious states are divided further depending on the length of the time period and the statistics of the condition. The age specific contact rates are random variables with a seasonal variation and a population specified density function. An example is presented in which all parameters and distributions of the model are estimated for measles in the city of Baltimore, Maryland for the years 1900 through 1917. The computer calculated epidemic curves adequately describe the incidence pattern of the data with no significant differences noted.

Adolescent↗
PubMed1999

[Evaluation of the law of communicable disease control: compulsory isolation can reduce the high-risk behavior of HIV-positive individuals].

The Swedish approach to HIV is based on HIV-positive individuals' fulfilling their societal obligation to prevent further spread of the disease. Under section 38 of the Communicable Disease Act of 1989, compulsory admission to hospital may be resorted to in cases where voluntary efforts have failed to bring about modification of high-risk behaviour. The article consists in a report of a retrospective study of the effects of such enforced isolation in the HIV-positive subgroup committed under the Act within an eight-year period. Relevant information was obtained from the records of medical and psychiatric hospitals, the social services and correctional care authorities. Modification of high-risk behaviour was assessed by enquiries involving attending physicians, the social services, and prison and police authorities, and by interviews with the patients. During the 8-year period, 1.5 per cent (44/2982) of registered HIV-positive patients in Stockholm County were committed by the county administrative court to compulsory admission. Of the 44 patients, 25 (57%) were born in Sweden, and 19 (43%) elsewhere (mostly sub-Saharan African countries where HIV is highly endemic). Intravenous drug abuse was very common in the subgroup, and 34 per cent of them were diagnosed as having a psychiatric disorder or intellectual handicap. Thirty-four (77%) of the subgroup were released after varying periods of isolation. Follow-up at 6, 18 and 36 months showed the overwhelming majority to be capable of maintaining a low-risk profile, and only 20 per cent to be characterised by continued high-risk behaviour (suspected or verified). The results thus suggest that individuals with the intellectual and psychiatric capacity to comprehend the serious nature of HIV infection and its modes of transmission can successfully modify risk behaviour by undergoing intensified individualised programmes, provided the duration of isolation is sufficiently long.

Adult↗
PubMed1991

Health status in Finland and other Nordic countries with special reference to chronic non-communicable diseases.

It is a general belief that the health status of the populations of the Nordic Countries, Denmark, Finland, Iceland, Norway and Sweden is very good. Infant mortality is the lowest in these countries. However, other indicators of the health status such as overall life expectancy and incidence of mortality from chronic non-communicable diseases demonstrate a large variation between the Nordic countries. Compared with other countries frequency of several non-communicable diseases is among the highest worldwide. Moreover, the incidence and mortality trends in non-communicable diseases suggest a heterogeneous development among the Nordic countries.

Chronic Disease↗