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Rob van Hest Capture-recapture Methods in Surveillance - RePub ...

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Underreport<strong>in</strong>g of tuberculosis <strong>in</strong> the Netherlands<br />

Figure 6.2 Schematic view of the distribution of observed number of tuberculosis<br />

patients <strong>in</strong> the Netherlands <strong>in</strong> 1998, after record-l<strong>in</strong>kage of three tuberculosis registers<br />

(light grey = culture-positive), and the number of validated tuberculosis patients among<br />

the culture-negative cases (dark grey = Netherlands Tuberculosis Register; white =<br />

Pathological Anatomy Laboratory Computerised Archive).<br />

Discussion<br />

Ma<strong>in</strong> f<strong>in</strong>d<strong>in</strong>gs<br />

This study shows that, even <strong>in</strong> a country with a well-organised system of tuberculosis<br />

control, record-l<strong>in</strong>kage and cross-validation improve the data quality of tuberculosis<br />

registration and case-ascerta<strong>in</strong>ment. These f<strong>in</strong>d<strong>in</strong>gs underscore the need for scrut<strong>in</strong>y of all<br />

tuberculosis registers, especially with regard to hospital-based data. Total and verified<br />

observed under-notification of tuberculosis <strong>in</strong> the Netherlands <strong>in</strong> 1998 was 13.4% and<br />

10.1% respectively. The latter was slightly higher than a previously reported under-<br />

87

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