Document Type : Original Articles


1 Student Research Center for Health Sciences, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran;

2 HIV/AIDs Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;

3 Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran;

4 Health Affairs, Shiraz University of Medical Sciences, Shiraz, Iran;

5 Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran


Background: Complete and fast diagnosis, registry and treatment programs are the main effective strategies for controlling infectious diseases. In addition, an organized and extended infectious disease surveillance system is crucial in designing and monitoring communicable diseases control programs. The quality of the surveillance system can be evaluated by several indices such as timeliness, completeness and sensitivity. This is an evaluation study to measure the mentioned indices for 3 zoonotic diseases (leishmaniasis, brucellosis and rabies) surveillance system. Methods: The indexes such as completeness, timeliness and sensitivity of surveillance system were measured using the data obtained from population based (door to door) interviews and recorded data obtained at each level of health and medical sectors or administrative centers within the diseases reporting system. Interviews were conducted for 5969 participants and the required information was obtained. Results: The total completeness, timeliness and sensitivity of case reporting for leishmaniasis were 26.9%, 103.2 days and 11.1%, respectively. These indexes forbrucellosiswere14.3 %, 58 days, 12.1% and those for suspected rabieswere100%, 83.4 days and 48.2%, respectively. Conclusion: It seems that so called immediate communicable diseases reporting system is not providing reliable, complete and timely information to the health authorities. Program monitoring and personnel training, especially physicians, are recommended to improve the quality of the surveillance system and the related indexes.


  1. Chin J. Control Of Communicable Diseases Manual. 17th ed. Tehran: Pour Sina; 2000.
  2. Communicable disease surveillance and response systems. Guide to monitoring and evaluating. Geneva: World Health Organization.2006. (Available from: surveillance/WHO_CDS_EPR_LYO_2006_2.pdf. Accessed July 27, 2015.)
  3. German RR, Lee LM, Horan JM, Milstein RL, Pertowski CA, Waller MN. Updated Guidelines for Evaluating Public Health Surveillance Systems. MMWR 2001; 50(RR-13): 1-35.
  4. Sickbert-Bennett EE, Weber DJ, Poole C, MacDonald PD, Maillard J-M. Completeness of communicable disease reporting, North Carolina, USA, 1995–1997 and 2000–2006. Emerg Infect Dis 2011; 17(1): 23.
  5. Thiede H, Close NS, Koepsell J, Baer A, Duchin JS. Completeness of reporting of rabies postexposure prophylaxis in King County, Washington. J Public Health Manag Pract 2008; 14(5): 448-53.
  6. Jelastopulu E, Merekoulias G, Alexopoulos E. Underreporting of communicable diseases in the prefecture of Achaia, western Greece, 1999–2004- missed opportunities for early intervention. Euro Surveill 2010; 15(21): 19579.
  7. Durusoy R, Karababa AO. Completeness of hepatitis,
  8. brucellosis, syphilis, measles and HIV/AIDS
  9. surveillance in Izmir, Turkey. BMC Public Health
  10. ; 10(1): 71.
  11. Protocol for the Assessment of National Communicable Disease Surveillance and Response Systems. Geneva: World Health Organization. 2001. (Available from: surveillance/whocdscsrisr20012.pdf?ua=1. Accessed July 27, 2015.)
  12. Fararouei M, Parisai Z, Farahmand M, Haghighi RE, Toori MA. Cancer incidence appears to be rising in a small province in Islamic Republic of Iran: a population-based cohort study. EMHJ 2015; 21(5).
  13. Tabatabaee M, Zahraee M, Ahmadnia H, Ghotbi M, Rahimi F. Principles Of Disease Prevention and surveillance. 2th ed. Tehran: rouheghalam; 2006.
  14. Fararouei M, Rezaee S, Shirazi AR, Naghmachi M, Shirazi KK, Jamshidi A, et al. National guidelines for outbreak investigation: an evaluation study. EMHJ 2013; 19(9).