Abstract
Background: South Africa introduced electronic reporting of notifiable medical conditions (NMCs) in 2018, augmenting the traditional paper-based system, which is known to produce incomplete and delayed information, delaying disease outbreak responses. As information regarding the performance of the electronic system is sparse, this study compared the electronic versus paper-based reporting systems, focusing on data quality, disease trends and factors influencing system adoption.
Methods: A mixed-methods design integrated quantitative and qualitative data. Secondary NMC data for 23 conditions reported between June 2018 and May 2024 were extracted from the National Institute for Communicable Diseases database. In addition, doctors and infection prevention and control (IPC) nurses from five hospitals were purposively sampled to complete survey questionnaires. Quantitative analysis was performed using SPSS, applying descriptive statistics to provide frequencies. Qualitative responses were analysed using Tesch’s open coding method to identify themes related to NMC reporting practices. Triangulation was applied by integrating the national surveillance data and participant survey responses to strengthen the validity of the findings.
Results: This study showed that from 2018 to 2024, a total of 98017 NMC cases were reported, of which 93562 were submitted electronically and 4455 via the paper-based system. The electronic reporting system was used more frequently and effectively than the paper-based system, particularly in terms of reporting volumes and perceived reliability. The predominance of electronic reporting reflects a broader transition toward digital surveillance; however, paper-based reporting remains a supplementary mechanism during system disruptions or for possible outbreaks. Key challenges identified included poor data quality, completeness variation in reporting practices and potential duplication of electronic data. Respondents indicated that electronic reporting was a reliable, secure and convenient method of reporting NMCs. Support and ongoing training were identified as critical to improving system performance and sustaining the transition to electronic reporting.
Conclusion. The electronic NMC reporting system was more widely used and performed better than the paper-based system. Achieving a complete transition across all health professionals will rely on continuous training, infrastructure strengthening and support.
Keywords: notifiable medical conditions; disease surveillance system; electronic reporting, data accuracy; digital surveillance; data quality.
Background
Notifiable medical conditions (NMCs) remain a significant challenge to global public health, requiring timely detection and coordinated response to prevent widespread outbreaks and reduce morbidity and mortality effectively [1]. Surveillance systems play a critical role in analysing trends, monitoring disease patterns and informing public health action [2]. Timely and accurate notification of NMCs is therefore a vital surveillance function allowing health authorities to assess the risk and initiate...