SETTING: Sotiria Chest Diseases Hospital (SCDH), a referral hospital in
Athens, Greece, 2012.
OBJECTIVE: To assess the completeness of the mandatory notification
system for tuberculosis (TB) at the SCDH, and compare the observed and
estimated annual incidence rates.
DESIGN: Record linkage and the capture-recapture method were applied.
Data sources were the registers from the national mandatory notification
register (Hellenic Centre for Disease Control and Prevention [HCDCP]),
the National Reference Laboratory for Mycobacteria (NRLM) and SCDH
records. The log linear model with the lowest Akaike information
criterion was selected as the most valid statistical model.
RESULTS: The observed and estimated TB underreporting rates at the
national level were respectively 55% (95% CI 49-60) and 75% (95% CI
71-78). The observed completeness of the HCDCP, NRLM and SCDH registers
were respectively 45% (95 %CI 40-51), 66% (95%CI 61-71) and 36.5%
(95%CI 31-42). The estimated TB incidence rate was 15 cases per 100 000
(range 13-19/100 000), compared to the 4.9/100 000 rate officially
notified.
CONCLUSION: Adult TB incidence has been largely underestimated, and the
TB burden is likely to be much higher than officially notified in our
setting. A thorough review of the notification system should be carried
out. The implementation of a network-based notification system and
retraining of all relevant personnel is advised
