Pilot study of the completeness of notification of adult tuberculosis in Athens, Greece.
Sotiria Chest Diseases Hospital (SCDH), a referral hospital in Athens, Greece, 2012.



To assess the completeness of the mandatory notification system for tuberculosis (TB) at the SCDH, and compare the observed and estimated annual incidence rates.



Record linkage and the capture-recapture method were applied. Data sources were the registers from the national mandatory notification register (Hellenic Centre for Disease Control and Prevention [HCDCP]), the National Reference Laboratory for Mycobacteria (NRLM) and SCDH records. The log-linear model with the lowest Akaike information criterion was selected as the most valid statistical model.



The observed and estimated TB under-reporting rates at the national level were respectively 55% (95%CI 49-60) and 75% (95%CI 71-78). The observed completeness of the HCDCP, NRLM and SCDH registers were respectively 45% (95%CI 40-51), 66% (95%CI 61-71) and 36.5% (95%CI 31-42). The estimated TB incidence rate was 15 cases per 100 000 (range 13-19/100 000), compared to the 4.9/100 000 rate officially notified.



Adult TB incidence has been largely underestimated, and the TB burden is likely to be much higher than officially notified in our setting. A thorough review of the notification system should be carried out. The implementation of a network-based notification system and retraining of all relevant personnel is advised.
European Programme for Public Health Microbiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden; National School of Public Health, Athens, Greece; Hellenic Centre for Disease Control and Prevention, Athens, Greece.
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AB
Ibarz-Pavón
Microbiology Laboratory & National Reference Laboratory for Mycobacteria, Athens, Greece.
D
D
Papaventsis
Hellenic Centre for Disease Control and Prevention, Athens, Greece.
R
R
Kalkouni
Infection Control Committee, Sotiria Chest Diseases Hospital, Athens, Greece.
G
G
Metaxas
Hellenic Centre for Disease Control and Prevention, Athens, Greece.
G
G
Spala
Hellenic Centre for Disease Control and Prevention, Athens, Greece.
T
T
Georgakopoulou
Infection Control Committee, Sotiria Chest Diseases Hospital, Athens, Greece.
T
T
Gerakis
Infection Control Committee, Sotiria Chest Diseases Hospital, Athens, Greece.
A
A
Pefanis
Microbiology Laboratory & National Reference Laboratory for Mycobacteria, Athens, Greece.
E
E
Vogiatzakis
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000068598:Data Accuracy; D018563:Disease Notification; D057286:Electronic Health Records; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D037141:Mandatory Programs; D008498:Medical Record Linkage; D008875:Middle Aged; D010865:Pilot Projects; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult