University of Canterbury Home
    • Admin
    UC Research Repository
    UC Library
    JavaScript is disabled for your browser. Some features of this site may not work without it.
    View Item 
    1. UC Home
    2. Library
    3. UC Research Repository
    4. Faculty of Science | Te Kaupeka Pūtaiao
    5. Science: Theses and Dissertations
    6. View Item
    1. UC Home
    2.  > 
    3. Library
    4.  > 
    5. UC Research Repository
    6.  > 
    7. Faculty of Science | Te Kaupeka Pūtaiao
    8.  > 
    9. Science: Theses and Dissertations
    10.  > 
    11. View Item

    Mandatory Disease Notification and Underascertainment: A Geographical Perspective (2007)

    Thumbnail
    View/Open
    thesis_fulltext.pdf (12.56Mb)
    Type of Content
    Theses / Dissertations
    UC Permalink
    http://hdl.handle.net/10092/1378
    http://dx.doi.org/10.26021/5793
    
    Thesis Discipline
    Geography
    Degree Name
    Master of Science
    Publisher
    University of Canterbury. Geography
    Collections
    • Geospatial Research Institute: Theses and Dissertations [23]
    • Science: Theses and Dissertations [4397]
    Authors
    Holmes, Erin Alison
    show all
    Abstract

    Mandatory notification of disease forms the backbone of disease surveillance in New Zealand and overseas. Notification data is used by public health professionals and academics to identify cases requiring public health control, monitor disease incidence and distribution, and in epidemiological research. However, there is emerging evidence that notification rates do not accurately reflect the true extent of notifiable diseases within the community, resulting in the underascertainment of many notifiable cases. While adequate surveillance does not necessarily require that all cases of notifiable disease be captured, the systematic underascertainment of disease can have significant implications for perceived spatial and demographic trends in disease prevalence; potentially threatening the credibility of spatial epidemiological research by under or overestimating the burden of disease in different populations. There is evidence that systematic underascertainment occurs as a result of the differential actions of laboratories and general practitioners. It has also been recognised that that underascertainment can be influenced by a patient's willingness to seek medical attention and participate in laboratory tests. However, few studies have investigated whether these factors systematically influence notification either in New Zealand or overseas. Furthermore, the discipline of health geography has been slow to engage with this topic of public health importance, despite the inherently spatial nature of the processes involved, and the close ties to the geographic literature on health service utilization and healthcare provision. This thesis explores the spatial and temporal variation in notification rates in New Zealand for the period 1997-2005 and the potential relationships between notification rates and different variables. Unlike many underascertainment studies, which have used individual data and capture-recapture methods, data constraints inspired a unique ecological approach to investigating the factors which may be associated with notification in New Zealand. Variables were divided into categories based on Anderson's behavioural model for healthcare utilization and the influence of these variables on notification was determined through multiple regression analyses. The main findings of this research indicate that in New Zealand notification rates have increased during the period 1997-2005 and that there is a north-south gradient in notifications, with substantially lower rates in the North Island than in the South Island. Furthermore, it is also evident that the variables associated with notification vary according to disease, spatial aggregation and spatial scale. Notification rates are significantly associated with a range of predisposing and enabling factors which might influence patient choice to consult for many frequently underascertained diseases. More variation in enteric diseases is explained by the independent variables analysed than the variation in non-enteric diseases. However, further research into these relationships, and underascertainment in general, is required before firm conclusions can be drawn.

    Keywords
    underascertainment; ascertainment; under-reporting; infectious disease; enteric disease; notification; notification-bias; notifiable disease; New Zealand; Canterbury; public health; geography; epidemiology; spatial epidemiology; GIS; mapping
    Rights
    Copyright Erin Alison Holmes
    https://canterbury.libguides.com/rights/theses

    Related items

    Showing items related by title, author, creator and subject.

    • Spatial patterns and determinants of Campylobacteriosis in the Czech Republic 

      Marek L (2017)
    • Investigating spatial variation and change (2006–2017) in childhood immunisation coverage in New Zealand 

      Marek L; Hobbs M; McCarthy J; Wiki J; Tomintz M; Campbell M; Kingham, Simon (Elsevier BV, 2020)
      Background Immunisation is a safe and effective way of protecting children and adults against harmful diseases. However, immunisation coverage of children is declining in some parts of New Zealand. Aim Use a ...
    • Slipping under the radar: worsened health outcomes in semi-urban areas of New Zealand 

      Marek L; Wiki J; Campbell M; Kingham, Simon; Sabel C; Tomintz M; Hobbs M (2020)
    Advanced Search

    Browse

    All of the RepositoryCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThesis DisciplineThis CollectionBy Issue DateAuthorsTitlesSubjectsThesis Discipline

    Statistics

    View Usage Statistics
    • SUBMISSIONS
    • Research Outputs
    • UC Theses
    • CONTACTS
    • Send Feedback
    • +64 3 369 3853
    • ucresearchrepository@canterbury.ac.nz
    • ABOUT
    • UC Research Repository Guide
    • Copyright and Disclaimer
    • SUBMISSIONS
    • Research Outputs
    • UC Theses
    • CONTACTS
    • Send Feedback
    • +64 3 369 3853
    • ucresearchrepository@canterbury.ac.nz
    • ABOUT
    • UC Research Repository Guide
    • Copyright and Disclaimer