| The struggle between the mankind and infectious diseases is an eternal subject. The disease spectrum made a transformation from infectious diseases to cerebral vascular diseases and malignant tumors, so people thoughtly began to neglect the importance of infectious diseases control. In recent years, globalization intensifies, transport and tourism developed, the increasing number of population, the abuse of antibiotics as well as the impact of environmental factors, and the accelerating spread of the virus mutation led the infectious diseases which have been already controlled to reoccur and the emergence of new infectious diseases. All these infectious diseases increase the burden of disease, and in 85 percent of developing countries, the infectious disease is a serious public health problem.The report of infectious disease is an important content of the infectious disease management. The overall, prompt, accurate report is the source of information of preventing and controling the infectious diseases from spreading, and the information to the prevention and control of infectious disease plays a very important role. On abroad, developed countries adopt the national electronic monitoring system to raise the report quality. In my country, the epidemic of SARS disclosed the serious defects of information reporting system: non-completion, non-accuration and non-promption. In 2003, our governments invested three billion Yuan to strengthen the building of information reporting system. The direct network reporting system has been built on Apr 2004. The opening of this system maked the work of reporting to be changed qualitativly, the quality of reporting to be improved and promptness of reporting to be increased clearly.At present, China Information System for Diseases Control and Prevention has been in motion, which increase the speed of information transmission, but it can not solve the problem of the low quality of initial information source. The system has extended to small towns level, but traditional information transmission, for example, telephone, post and sending by bicycle, still are main methods. China is a large agricultural country. The rural population accounts for 70 percent of the nation's total population, and 66 percent of their outpatients are in the village health clinic room, and 16 percent in township hospitals. Rural poor sanitary conditions easily breed and spread infectious diseases. From November 16, 2005 to July 2006, China's total number reported of human infection with the highly pathogenic avian influenza is 19 cases, with the exception of two cases for urban residents, and the other cases are fanners or children living in the rural areas. Therefor it is high time to improve the quality of rural statutory infectious diseases reporting and use scientific and accurate methods to evaluate its quality.ObjectiveThe reseach is one of sub-subjects of program: Infectious SARS and Other Infectious Diseases from World Bank loan for the Henan / China granted by foreign countries. This study aimed to clear social interventions, as well as test results of statutory reporting of infectious diseases at the grass-roots level in rural areas of Henan Province. At the same time, other objectives are to further promote the project and provide government policy-makers with a scientific basis to formulate relatively sound policies, and improve and perfect the mechanism of the statutory information transmission of infectious diseases in the rural areas of Henan Province.Methods1. Object: Song and Yiyang counties of Henan Province are two samples of this study. The reseaech objects included all infectious diseases responsibile reporters of four experimental townships and 4 control ones, and the total number is 305. The research object still included the report situation of statutory infectious diseases: the integrity and accuracy of report cards filled by rural doctors, the situation of repeat cards of infectious diseases in the direct network system and the report rate and promptness of infectious diseases.2. Methods: Adopt multi-stage stratified cluster sampling and simple random sampling method to confirm samples. Confirm the sample size according to related documents; Using qualitative research and quantitative research to evaluate the effect of intervention trial.3. Content: Staff survey includes: general states of objects, basic knowledge of infectious diseases on the statutory infectious disease diagnosis and the report of the statutory, infectious diseases statutory reporting procedures, the statutory infectious diseases training, supervision and inspection report of communicable diseases, infectious disease reporting system and implementation and the management of infectious diseases etc. Agencies investigating include: data and information of statutory report infectious diseases in eight samples of the township from November 2005 to March 2006.4. Analysis of the data: Input, audit data by Epidata and analyze the data by SPSS 12.0.Results1. After intervention, in the report of infectious diseases five areas, namely, the statutory classification of infectious diseases, infectious disease diagnosis, the report card filled out, the report time, the way to report, the the report awareness rate of the experimental group were higher than the control group by 37.41%, 54.18 %, 30.31%, 27.86%, 13.40%.2. The logistic regression analysis revealed that the intervention that the project used was the main influence factors to increase knowledge about infectious diseases related to the report.3. In the intervention phase, in the pilot township, report incidence rate was 1.89 ‰, and in the control township, reported incidence rate was 1.46‰; in the same period of previous year's, report incidence rate was 1.18‰in the pilot township.4. Compared with the control, the report cards quality of the pilot township were improved by 11.25%; repeat report rate and omissions rate were reduced by 30.86% and 56.33%, and the report pormptness rate was increased by 36.12 %. These differences between two groups all had statistical significance.5. As to quality Composite Index of infectious diseases statutory reporting of information, the pilot townships were higher than the control townships.ConclusionThe intervention measures taken by the project is scientific, rational and effective. At first, the training on the knowledge of the diagnosis of lawful infectious diseases, equipment of basic report tools and clearness of the ways, time and program on reporting increased the ability of responsible people to report lawful infectious diseases. Secondly, the training of the report knowledge on health workers and the net direct report knowledge on prevention staff increased the quality of writing of report card, shortened the time from diagnosis to record, from filling record to report and from report to auditting, lowered omissions rate in various links.To further increase the information quality of the report of lawful infecious diseases in rural areas, the following policy recommendations were made: strengthening monitoring of report of the infectious diseases on law enforcement; establishing a sound incentive mechanism of infectious diseases reporting; using various training ways to strengthen the job-training of primary medical staff, especially, the massive rural doctors. |
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