South African Medical Journal

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The development of passive health surveillance by a sentinel network of family practitioners in South Africa

Pierre J T de Villiers, Leon N Geffen


Objective. For the South African Sentinel Practitioner Research Network (SASPREN), a volunteer network of family practitioners in South Africa, to develop a health surveillance system through the surveillance of important health events.

Motivation. The incidence of important preventable diseases and the burden of disease are not reliably known in South Africa, both in the public and private sector. Incidence rates determined at primary care level could help with planning and delivery of appropriate health services and monitoring of the impact of intervention programmes.

Methods. Altogether 183 sentinel practitioners were recruited in nine provinces, from 2 478 doctors invited to participate. Of these 120 were active in reporting all their new cases of 13 selected health events to the study centre on mailed postcards. After data-capturing, incidence rates were calculated for defined periods. Feedback was given to the sentinels through a newsletter and personalised reports.

Results. A network of sentinel family practitioners has been established in South Africa, and can provide incidence rates for both diseases and interventions through a simple and cheap surveillance system. The calculated rates demonstrated periodic trends for certain events, as well as inter-provincial, -gender and -population group differences.

Conclusions. As the validity of the dataset and its generalisation to the whole population is uncertain, its usefulness as point estimates of incidence rates is
unknown. This information serves as an important pointer for further research. The trends of these rates may provide a valuable tool for monitoring the impact of public health policies.

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