Reporting of notifiable medical conditions among emergency department doctors in Gauteng

Abstract

Background: Surveillance of notifiable medical conditions (NMCs) is vital for a prompt, appropriate response. In South Africa, studies have demonstrated under-reporting of NMCs despite it being mandatory. Emergency departments (EDs) are often the first point of contact for patients with NMCs.
Objectives: This study aimed to assess ED clinicians’ knowledge, attitudes, and practices regarding the reporting of conditions that are relevant to the ED, and the use of the new mobile application for reporting.
Method: A cross-sectional survey was conducted between November 2024 and April 2025, including 99 doctors at three public hospital EDs in Gauteng. The study assessed knowledge, attitudes and practices regarding NMCs and the use of the recently launched National Institute for Communicable Diseases (NICD) mobile application.
Results: The overall mean knowledge score was 61% (standard deviation [s.d.] 11.2). Knowledge accuracy of category 1 NMCs (mean 72%) exceeded that of category 2 NMCs (mean 56%; p < 0.001). Although 95% of respondents were aware that reporting NMCs is mandatory, 49% acknowledged under-reporting. Barriers to reporting included high workload, forgetfulness, and difficulty in locating the paper notification booklet. While 81% of respondents knew about the NICD mobile application, 68% had used it, and 17% had received formal training. Preference for the application versus the paper-based system was expressed by 78% of respondents.
Conclusion: Under-reporting persists primarily because of high workload. A significant knowledge gap exists, particularly concerning category 2 NMCs. While the mobile application was preferred, a lack of formal training hinders its adoption. Staff training, feedback and reminders would improve the timely notification of these conditions.
Contribution: This study identifies under-reporting of NMCs and offers recommendations to strengthen the disease surveillance system and encourages the use of digital technology for reporting.