Reporting notifiable diseases: methods for improvement, attitudes and community outcome.

Notification is an important source of health information. However, it suffers from the serious limitation of under-reporting, especially in 'third world' countries. The aims of this study were to assess the impact of a special notification nurse and ward notification register on the rate of notification from a general medical unit, the knowledge and attitudes of intern medical officers regarding notification, and the community outcome of notification in a Sri Lankan setting. Overall, appointment of a special nurse improved notification rates from 9.7% to 62.1%, and the addition of a special ward notification register further improved the rate to 95.1% The results also indicated that, although a majority of intern medical officers were aware of notifiable diseases and the importance of notification, only a few of them always notified notifiable diseases. One of the main reasons given for this was that the majority of them felt that no useful action was taken on notifications by the preventive health authorities, a view that was held because there was no feedback information regarding the notifications. However, during the period of this study nearly 80% of all notifications were successfully investigated by the relevant medical officer of health office. The appointment of a nurse dedicated to notification and introduction of a ward notification register could greatly improve notification rates. Better communication between curative and preventive health sectors would improve attitudes of doctors regarding notification.