Reasons for under-reporting of notifiable conditions.

OBJECTIVE: To determine the reasons for under-reporting of notifiable conditions by doctors in a tertiary hospital.
DESIGN: Questionnaire survey.
SETTING: King Edward VIII Hospital, Durban. PARTICIPANTS: A stratified sample of 77 doctors was interviewed. MAIN OUTCOME MEASURES: Doctors' knowledge about notifiable conditions was assessed. Their knowledge was quantified by assigning a score of 1 for each notifiable condition listed. Doctors' opinions of the problems or shortcomings in the reporting system and their suggestions to improve it were also obtained.
RESULTS: The overall mean score of correctly listed notifiable conditions was 5.7 (SD 2.6). Only 23.4% of doctors read Epidemiological Comments and 28.6% the table of notifications in the South African Medical Journal. The notification form was considered too complicated by 13% of the doctors and too laborious by 55.8%. Some doctors (19.5%) either did not know the location of a book for notifications, or did not know if one existed.
CONCLUSIONS: The overall knowledge of doctors with regard to notifiable conditions was poor. Factors influencing knowledge of notifiable conditions and under-reporting are the accessibility and complexity of the notification form, lack of motivation because of poor feedback on reported cases, and a perception that it is useless to report notifiable conditions. A short, simple and readily accessible form is recommended to improve the reporting rate. Information on the notification process, in particular the importance of notification for disease control and health planning, should be included in undergraduate training and continuing medical education for doctors.