Underreporting of Human Alveolar Echinococcosis, Germany
2008

Underreporting of Human Alveolar Echinococcosis in Germany

Sample size: 114 publication 10 minutes Evidence: moderate

Author Information

Author(s): Jorgensen Pernille, an der Heiden Matthias, Kern Petra, Schöneberg Irene, Krause Gérard, Alpers Katharina

Primary Institution: Robert Koch Institute, Berlin, Germany

Hypothesis

How many cases of human alveolar echinococcosis are actually occurring in Germany compared to what is reported?

Conclusion

The national surveillance system failed to detect 67% of alveolar echinococcosis cases in Germany over three years.

Supporting Evidence

  • The study estimated that 70 cases were missed, leading to a total of 184 cases over three years.
  • Pathologists reported only 49 cases in a survey, indicating underreporting.
  • The sensitivity of the national surveillance system was found to be only 33%.

Takeaway

The study found that many cases of a rare disease called alveolar echinococcosis are not being reported in Germany, which means doctors might not know how many people are really sick.

Methodology

The study used a capture-recapture method to estimate the number of unreported cases by comparing data from three different sources.

Potential Biases

There is a risk of bias due to the reliance on voluntary reporting from pathologists and microbiologic laboratories.

Limitations

The study may have overestimated the number of cases due to lenient matching criteria and the potential for bias in reporting.

Participant Demographics

Median age of participants was 52 years, with a range from 15 to 92 years; 53% were female.

Statistical Information

P-Value

0.03

Confidence Interval

95% CI 150–242

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3201/eid1406.071173

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