Infectious diseases. A communicable disease network in Italy

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Abstract
Communicable disease surveillance systems do not always provide accurate or timely data. Furthermore, in Italy, data entry and management are only performed centrally, making the completion of missing data and an improvement in the quality of data difficult to realize. To improve this system, the Istituto Superiore di Sanita conducted a pilot trial in the region of Tuscany. The trial consisted of creating a network of persons responsible for surveillance in the region, conducting training courses in surveillance and implementing an ad hoc computerized system for the management, transmission and rapid analysis of notifications. Standardized notification forms were computerized with Epilnfo 5.0 software with quality control programmes. The system also provided printouts with individual and aggregated case report forms. The data were transmitted using an existing national network. A set of standard tables was included in the monthly regional epidemiologic bulletin for information feedback to the local health staff. Following its implementation, the percentage of notified cases with errors in the diagnostic criteria reported for case definitions decreased from 2.8 (95% Cl: 0.8–4.8) to 0.15% and individual data were centrally available on magnetic support two months after the notification date (compared to 3–4 years delay previously). We also witnessed an overall improvement in the timeliness and quality of routine notification. To create an effective national disease surveillance network, it would be beneficial to extend the system described in this pilot trial to all regions of Italy.