GermanRR, LeeLM, HoranJM, MilsteinRL, PertowskiCA, WallerMN, Guidelines Working Group Centers for Disease Control and Prevention (CDC), 2001. Updated guidelines for evaluating public health surveillance systems: recommendations from the Guidelines Working Group. MMWR Recomm Rep50: 1–35.
GermanRRLeeLMHoranJMMilsteinRLPertowskiCAWallerMN, Guidelines Working Group Centers for Disease Control and Prevention (CDC), 2001. Updated guidelines for evaluating public health surveillance systems: recommendations from the Guidelines Working Group. MMWR Recomm Rep50: 1–35.)| false
ReimannCA, HayesEB, DiGuiseppiC, HoffmanR, LehmanJA, LindseyNP, CampbellGL, FischerM, 2008. Epidemiology of neuroinvasive arboviral disease in the United States, 1999–2007. Am J Trop Med Hyg79: 974–979.
ReimannCAHayesEBDiGuiseppiCHoffmanRLehmanJALindseyNPCampbellGLFischerM, 2008. Epidemiology of neuroinvasive arboviral disease in the United States, 1999–2007. Am J Trop Med Hyg79: 974–979.)| false
Surveillance of arboviruses depends on health-care providers' ability to diagnose and report human cases of disease. The purposes of this study were to assess Tennessee providers' 1) self-efficacy toward diagnosis and management, 2) clinical practices, and 3) variation in these measures by provider characteristics. A survey was e-mailed to 13,851 providers, of which 916 (7%) responded. Respondents diagnosed more arboviruses in the previous year than were recorded in surveillance records, an indication of underreporting. Respondents had low to moderate self-efficacy toward diagnosis and management of arboviruses. Although more than 70% (N = 589) used paired serology, only 46% (N = 396) asked patients to return for a convalescent specimen draw within the correct time frame. One of the most commonly reported barriers to testing was uncertainty about which tests to order. Providers working in family medicine and urgent care, nurse practitioners, and those at outpatient facilities had lower rates of high self-efficacy than their counterparts working in other settings and from other specialties. Clinical practices were influenced by specialty, designation, setting, and geography but not by years of experience. Education to improve arboviral surveillance in Tennessee is warranted. Topics could include proper diagnosis and management, appropriate testing and overcoming barriers to testing, and public health reporting.
* Address correspondence to Abelardo C. Moncayo, Vector-Borne Diseases Section, Tennessee Department of Health, 630 Hart Lane, Nashville, TN 37216. E-mail: email@example.com
Authors' addresses: Julie Shaffner, Timothy F. Jones, and Abelardo C. Moncayo, Vector-Borne Diseases Section, Division of Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Health, Nashville, TN, E-mails: firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org.