Completeness of infectious disease notification in the United Kingdom: A systematic review

Abstract

Objectives: Infectious disease legislation in the United Kingdom has recently changed. Our aim was to provide a baseline against which to assess the impact of these changes by synthesising current knowledge on completeness of notification and on factors associated with better reporting rates.

Methods: We systematically reviewed the literature for studies reporting completeness of reporting of notifiable infectious diseases in the United Kingdom over the past 35 years.

Results: Altogether, 46 studies met our search criteria. Reporting completeness varied from 3% to 95% and was most strongly correlated with the disease being reported. Median reporting completeness was 73% (range 6%-93%) for tuberculosis, 65% (range 40%-95%) for meningococcal disease, and 40% (range 3%-87%) for other diseases (Kruskal-Wallis test, p < 0.05). Reporting completeness did not change for either tuberculosis or meningococcal disease over the period studied. In multivariate analysis, none of the factors examined (study size, study time period, number of data sources used to assess completeness, uncorrected or corrected study design) were significantly associated with reporting completeness.

Conclusion: Reporting completeness has not improved over the past three decades. It remains sub-optimal even for diseases which are under enhanced surveillance or are of significant public health importance.