ABSTRACT
This report compares rates of selected nationally notifiable diseases in the 100 most populated counties to overall U.S. rates. We analyzed data from the 2004 National Notifiable Diseases Surveillance System (NNDSS) maintained by CDC. Notifiable diseases reports, collected by the states and U.S. territories, are transmitted to CDC in an agreement with the Council of State and Territorial Epidemiologists. By using the Bureau of Census population estimates, we calculated and compared rates. Rates were higher in the most populated counties for six of the nine conditions examined in comparison with national rates: chlamydia (rate ratio:1.2), gonorrhea (rate ratio: 1.2), syphilis (rate ratio: 1.7), hepatitis A (rate ratio: 1.2), hepatitis B (rate ratio: 1.1), and shigellosis (rate ratio: 1.2). The incidence rate for Lyme disease was 40% lower among populated counties (rate ratio: 0.6). Incidence of infectious diseases is different in the most populated counties, and prevention programs should consider local occurrence.
ABSTRACT
communicable diseases. The purposes of the study is to estimate reporting proportion of National Notifiable Infectious Diseases(NNIDs) and investigate characteristics related to reporting using KAP(knowledge, attitude, practice) model. METHOD: We surveyed randomly selected 2,185 physicians (speciality: internal medicine, family medicine, pediatrics, dermatology, general physicians) of their knowledge, attitude, and practice of NNIDs reporting through self-administered mail questionnaires. Of them, 231 physicians responded (response proportion: 10.6%). RESULT: The reporting proportion was estimated to 27.0%. Recognition level (knowledge) of NNIDs was relatively high with proportion of 69.4%, and attitude (public health importance) of reporting was 65.8%. Multiple logistic regression analysis showed that knowledge, attitude significantly affected physicians' reporting in a positive direction (O.R. 6.2, 6.2 respectively). Whereas, senior age group, specialty (family medicine, pediatrics, dermatology) showed significantly lower reporting. General (tertiary care) hospital level of care showed significantly higher reporting practice (alpha=0.05). CONCLUSION: The NNIDs reporting proportion, 27.0% is similar with those studied recently. Continuous efforts to increase the performance level of communicable diseases surveillance system. Of those, restructuring surveillance systems considering characteristics of notifiable diseases classes must be stressed. Educational approach of physicians needs to be tailored specially to newly-designated diseases such as Group II, Designated Group NNIDs.