Laura De Almeida, Publications Officer, chats with Dr Susan Nzenze, Head of Notifiable Medical Conditions and Acting Head of the Division of Public Health Surveillance and Response (DPHSR), about the importance of Notifiable Medical Conditions (NMCs) and how they inform outbreak responses.
Briefly explain what NMCs are and why they are important in public health surveillance?
NMCs are diseases of public health importance that pose significant risk to the population based on several reasons, for example, potential to cause outbreaks and high fatality, high burden, diseases targeted for elimination or antimicrobial resistance. Through surveillance, we can collect, analyse, and use epidemiological data systematically to inform public health measures for prevention and response.
What criteria determine whether a disease becomes notifiable in South Africa?
This is based on the International Health Regulation 2005 (IHR) and the National Health Act 61 of 2003.
How do NMCs contribute to the early detection of outbreaks or emerging health issues?
NMCs are grouped into four categories, with Category 1 diseases (such as epidemic-prone or a new virus or disease) legally required to be reported immediately, followed by written or electronic notification within 24 hours of clinical suspicion or laboratory confirmation. This rapid reporting system enables early detection, verification, and response to potential outbreaks or rising health emergencies.
Briefly describe the process of what happens when a healthcare provider reports an NMC?
Once a healthcare provider reports an NMC, alerts are automatically sent to officials at the sub-district, district, provincial, and national levels. Teams verify the alert, and once confirmed, outbreak investigation and response activities commence.
How does the data collected from NMC reporting influence public health decision-making or policy during an outbreak?
The NMC reporting contains epidemiological data on the index case, which assists with outbreak investigation activities. On its own, the NMC data cannot influence policy but provides critical evidence for decision-making on person, place, and severity of illness (hospitalisations and death). These data are used by decision makers for policy.
What are some common challenges faced in the reporting and tracking of NMCs?
A major challenge in the NMC system is the clinical under-reporting of cases. When a healthcare worker sends a sample for testing, it typically indicates sufficient clinical suspicion to report the case, but this step is often missed. Laboratory notifications alone do not include the clinical and personal details needed to verify and investigate a case, resulting in delays in response.
Can you share an example where timely NMC reporting directly led to a successful outbreak intervention or containment?
Each notified case helps achieve timely outbreak intervention and containment, which highlights the importance of prompt reporting.
What role do healthcare providers and laboratories play in ensuring accurate and timely reporting of NMCs?
Healthcare providers and laboratories play a crucial role in ensuring accurate and timely NMC reporting. By complying with the reporting requirements, cases can be detected and responded to more efficiently.
How can public health authorities improve awareness and compliance among health workers regarding the importance of reporting NMCs?
We offer training to healthcare workers in both public and private facilities to improve awareness and compliance. Laboratory data from the National Health Laboratory Service is automatically reported, and similar systems are being developed for private laboratories. In the meantime, private laboratories report detected NMCs directly to the National Institute for Communicable Diseases.
For more on the NMC system, including resources, tutorial videos, contact details, and more, click here.
