Effects on the quality of reporting of infectious diseases by making EU definition of cases the primary care physician in Tuzla, Bosnia and Herzegovina

Abstract

Introduction: The Public Health Reform II project was implemented in Bosnia and Herzegovina from December 2011 till December 2013 and funded by European Union. Principal aim of the project was to strengthen public health services in the country through improved control of public health threats. During several rounds of interviews with general practitioners inadequate use of case definitions was revealed. Trainings for family primary care physicians were organized to improve the situation and increase notification rates in eight selected primary care centres. The main aim was to increase notifications by trainings provided for primary care physicians. Methods: We compared quality of notifications from physicians in Tuzla before and after training, which took place on 15th of March 2013. The timeliness was used as indicator of quality. Timeliness reflects the speed between steps in a public health surveillance system. it means time interval between the first symptoms of diseases and reporting. We compared medians of timeliness before and after training by Wilcox test and averages by t.testusing R project with level of significance p<0.05. Results: There were 980 reported cases, 80% were before training and 20% were reported after the training. We found out significantly lower median of timeliness of all reported cases after the training (median=1 day) compared to the median of timeliness before the training (median=6 days) (p<0.05). Conclusion: Significant reduction in time response between the first symptoms and disease diagnosis represent results of the training in Tuzla. Primary care physicians provided better quality of reported data after the training.