Notifiable disease reporting among public sector physicians in Nigeria: a cross-sectional survey to evaluate possible barriers and identify best sources of information.
BACKGROUND
Since 2001, Nigeria has collected information on epidemic-prone and other diseases of public health importance through the Integrated Disease Surveillance and Response system (IDSR). Currently 23 diseases are designated as "notifiable" through IDSR, including human infection with avian influenza (AI). Following an outbreak of highly pathogenic avian influenza A(H5N1) in Nigerian poultry populations in 2006 and one laboratory confirmed human infection in 2007, a study was carried out to describe knowledge, perceptions, and practices related to infectious disease reporting through the IDSR system, physicians' preferred sources of heath information, and knowledge of AI infection in humans among public sector physicians in Nigeria.


METHODS
During November to December 2008, 245 physicians in six Nigerian cities were surveyed through in-person interviews. Survey components included reporting practices for avian influenza and other notifiable diseases, perceived obstacles to disease reporting, methods for obtaining health-related information, and knowledge of avian influenza among participating physicians.


RESULTS
All 245 respondents reported that they had heard of AI and that humans could become infected with AI. Two-thirds (163/245) had reported a notifiable disease. The most common perceived obstacles to reporting were lack of infrastructure/logistics or reporting system (76/245, 31%), lack of knowledge among doctors about how to report or to whom to report (64/245, 26%), and that doctors should report certain infectious diseases (60/245, 24%). Almost all participating physicians (>99%) reported having a cell phone that they currently use, and 86% reported using the internet at least weekly.


CONCLUSIONS
Although the majority of physicians surveyed were knowledgeable of and had reported notifiable diseases, they identified many perceived obstacles to reporting. In order to effectively identify human AI cases and other infectious diseases through IDSR, reporting system requirements need to be clearly communicated to participating physicians, and perceived obstacles, such as lack of infrastructure, need to be addressed. Future improvements to the reporting system should account for increased utilization of the internet, as well as cell phone and email-based communication.
Kathryn E
KE
Lafond
Ibrahim
I
Dalhatu
Vivek
V
Shinde
Ekanem E
EE
Ekanem
Saidu
S
Ahmed
Patrick
P
Peebles
Mwenda
M
Kudumu
Milele
M
Bynum
Kabiru
K
Salami
Joseph
J
Okeibunor
Pamela
P
Schwingl
Anthony
A
Mounts
Abdulsalami
A
Nasidi
Diane
D
Gross
D000328:Adult; D000818:Animals; D001291:Attitude of Health Personnel; D001717:Birds; D003430:Cross-Sectional Studies; D018563:Disease Notification / Q000706:statistics & numerical data*; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype; D005585:Influenza in Birds / Q000453:epidemiology*; D007251:Influenza, Human / Q000453:epidemiology*; D020407:Internet; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D017150:Public Sector / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires