Masters Thesis Abstract: Erin Holmes
Geographic Trends in Infectious Disease or Geographic Variation in Notifications?
Question: Does notifications data enable an accurate analysis of the distribution and prevalence of notifiable infectious diseases in New Zealand?”
Reports of notifiable disease in the community form the backbone of notifiable disease surveillance in New Zealand and overseas. Under the New Zealand Health Act 1956 and the Tuberculosis Act 1948, Medical Practitioners are required to inform the Medical Officer of Health (MOH) of any notifiable disease they suspect or diagnose. Public Health officials rely on this surveillance data to identify cases requiring public health control, to monitor disease incidence and distribution, and to detect outbreaks, which assist in priority setting and the evolution of more effective prevention and control measures. However, it is widely recognised, both within New Zealand and elsewhere that notification rates do not always accurately reflect the true extent of notifiable diseases within the community. Such inaccuracies are detrimental to the credibility of spatial epidemiological research because it is possible that any spatial or temporal trends observed and subsequent health action taken is reflecting ‘notification trends’ rather than actual trends in disease incidence or prevalence.
Studies into the possible factors associated with disease notifications are numerous; ranging from the willingness of patients to get medical advice and to participate in labs tests, to the perceptions towards notification held by Medical Practitioners. Thus, this research will determine to what extent there is spatial variation in the notification rates for a selection of infectious diseases in New Zealand. Regression analysis will determine whether there is a relationship between notification rates and various environmental and socio-demographic factors apparent in various areas, and these initial quantitative findings will then be investigated further through semi-structured interviews with both members of the public and the health sector. The findings from this research will be critically discussed within the context of emerging Public Health legislation and in terms of their significance to the academic disciplines of health geography and spatial epidemiology.