The health surveillance program in Saudi Arabia began in 1933 (1353 Hijjra). The program has improved over the years and now 19 regions report 47 communicable diseases (13 reported within 24 hours & 34 reported weekly). Since a surveillance system cannot succeed without a continuing and reliable source of information from the reporter, this study aimed to evaluate the knowledge, attitudes and practices of those responsible for reporting communicable diseases in Makkah.
Methodology
A cross-sectional survey was conducted. Random health units were selected from a list of all medical facilities in the Makkah Regional Health Affairs (RHA). All public health physicians and non-physicians working in reporting were selected, and a maximum of 20 physicians working at each hospital were selected through stratified random sampling. All physicians working in other health units were selected. Self-administered questionnaires were constructed in English and Arabic to evaluate the knowledge, attitude, and practices (KAP) of the reporters. Another questionnaire was made to evaluate administration practices. Heads of the selected health units were interviewed face-to-face. Likert scale was used to evaluate the attitude of the reporters.
Results
The response rate was 90% (310). Egyptians accounted for the majority (57%) of the participants, followed by Saudis (11%) and Indians (9%). Only 51 (17%) had attended one or more courses in public health during 1995. The highest scores for knowledge were found among those working in RHA (100%) and lowest in private clinics (70%). Similar results were found for practices but were lower (35%) for private clinic physicians. Of physicians, 57% took information from the diagnosed cases themselves, which took them a median of 5 minutes (1-25 minutes). Only 19 (36%) of the non-physicians were able to list 4 diseases that required reporting within 24 hours, and 32 (60%) could list 4 diseases reported weekly. Of non-physicians, 50 (94%) stated they had enough time for reporting. They spent a median of 6 hours weekly (1-96 hours). The attitude of all participants was good. They agreed with the surveillance system, confidentiality, and training. They all thought information requested in the reporting forms was important. The main objectives of reporting were listed as to allow RHA to conduct epidemiological investigations (61%) and to follow MOH regulation (16%).
Conclusion
The knowledge and practices varied in different health units. Attitude of reporters of surveillance and the reporting form was very encouraging. Knowledge can be improved by giving a clear description of the diseases required for reporting, regular feedback, and holding courses in surveillance especially for the private sectors.