Evaluation of Indigenous status completeness in vaccine preventable disease notification data in the NNDSS
DOI:
https://doi.org/10.33321/cdi.2025.49.029Keywords:
vaccine preventable diseases, notifiable diseases, Indigenous status, Aboriginal and Torres Strait Islander statusAbstract
Background
High quality Indigenous status data for vaccine preventable diseases (VPDs) in the National Notifiable Diseases Surveillance System (NNDSS) is important for evaluation of immunisation programs and ultimately for improving health outcomes for Aboriginal and Torres Strait Islander peoples. We evaluated Indigenous status completeness, and factors influencing it, for VPDs in the NNDSS.
Methods
Literature review (published and grey); descriptive analysis of NNDSS data for selected VPDs over the 2010–2019 period; standardised online survey (containing closed- and open-ended questions) of key informants; semi-structured follow-up interviews.
Results
National level Indigenous status completeness for those VPDs with a Communicable Diseases Network Australia (CDNA) target of 95% was above that target for Haemophilus influenzae type b, measles, invasive meningococcal disease and invasive pneumococcal disease (IPD: < 5 and ≥ 50 years); and was within four percentage points for hepatitis A, newly acquired hepatitis B and pertussis (< 5 years).
For VPDs with an 80% target, completeness was ≥ 90% for diphtheria, mumps, rubella and tetanus; ≥ 80% for IPD (≥ 5 to < 50 years); and below target for unspecified hepatitis B (54%), laboratory confirmed influenza (47%), pertussis (≥ 5 years; 60%) and rotavirus (71%). However, completeness was above 90% for all VPDs in the Northern Territory, and all except laboratory confirmed influenza (89%) in Western Australia. Key barriers to Indigenous status completeness include the absence of an Indigenous status field on most pathology request forms and limited public health authority resource capacity to follow up missing data, particularly for high incidence diseases.
Conclusion
National level Indigenous status completeness is high for most VPDs but low for others, particularly for high incidence diseases predominantly notified by laboratories. Completeness is uniformly high for all VPDs in the Northern Territory and Western Australia; however, this is due to the resource-intensive public health follow-up of all notifications and manual cross-checking of other databases when Indigenous status is missing. To more efficiently optimise Indigenous status completeness in the NNDSS across all jurisdictions, a mix of additional strategies is needed to ensure accurate identification and recording in primary care, hospital, laboratory and public health settings, and effective transfer between them.
Downloads
References
Australian Government Department of Health and Aged Care. National Immunisation Program Schedule. Canberra: Australian Government Department of Health and Aged Care; 2023. [Accessed on 11 May 2023.] Available from: https://www.health.gov.au/topics/immunisation/when-to-get-vaccinated/national-immunisation-program-schedule.
Jackson J, Sonneveld N, Rashid H, Karpish L, Wallace S, Whop L et al. Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people, Australia, 2016–2019. Commun Dis Intell (2018). 2023;47. doi: https://doi.org/10.33321/cdi.2023.47.32.
Marmot M. Social determinants and the health of Indigenous Australians. Med J Aust. 2011;194(10):512–3. doi: https://doi.org/10.5694/j.1326-5377.2011.tb03086.x.
Australian Institute of Health and Welfare (AIHW). National best practice guidelines for collecting Indigenous status in health data sets. Canberra: AIHW; 8 April 2010. [Accessed on 11 May 2023.] Available from: https://www.aihw.gov.au/reports/indigenous-australians/national-guidelines-collecting-health-data-sets.
Australian Government Federal Register of Legislation. National Health Security (National Notifiable Disease List) Instrument 2018. [Legislation.] Canberra: Australian Government Federal Register of Legislation; 2 December 2022. [Accessed on 13 April 2023.] Available from: https://www.legislation.gov.au/Details/F2022C01206.
Miller M, Roche P, Spencer J, Deeble M. Evaluation of Australia’s National Notifiable Disease Surveillance System. Commun Dis Intell Q Rep. 2004;28:311–23.
NNDSS Annual Report Working Group. Australia’s notifiable disease status, 2016: annual report of the National Notifiable Diseases Surveillance System. Commun Dis Intell (2018). 2021;45. doi: https://doi.org/10.33321/cdi.2021.45.28.
Gibney KB, Cheng AC, Hall R, Leder K. Australia’s National Notifiable Diseases Surveillance System 1991–2011: expanding, adapting and improving. Epidemiol Infect. 2017;145(5):1006–17. doi: https://doi.org/10.1017/s0950268816002752.
Australian Bureau of Statistics. Remoteness Areas. [Webpage.] Canberra: Australian Bureau of Statistics; 21 March 2023. [Accessed on 2 May 2023.] Available from: https://www.abs.gov.au/statistics/standards/australian-statistical-geography-standard-asgs-edition-3/jul2021-jun2026/remoteness-structure/remoteness-areas.
Australian Government Department of Health and Aged Care. CDNA surveillance case definitions. Canberra: Australian Government Department of Health and Aged Care; 11 January 2023. [Accessed on 13 April 2023.] Available from: https://www.health.gov.au/resources/collections/cdna-surveillance-case-definitions.
Improving Indigenous Identification in Communicable Disease Reporting Project Steering Committee. Improving Indigenous identification in communicable disease reporting systems. [Discussion paper.] Adelaide: University of Adelaide Public Health Information Development Unit; November 2004. [Accessed on 11 May 2023.] Available from: https://phidu.torrens.edu.au/pdf/1999-2004/improving_indigenous_reporting_2004.pdf.
AIHW. The inclusion of Indigenous status on pathology request forms. Canberra: AIHW; 1 November 2013. [Accessed on 11 May 2023.] Available from: https://www.aihw.gov.au/reports/indigenous-australians/indigenous-status-on-pathology-request-forms/formats.
AIHW. Indigenous identification in hospital separations data: quality report. Canberra: AIHW; 1 May 2013. [Accessed on 2 May 2023.] Available from: https://www.aihw.gov.au/reports/indigenous-australians/indigenous-identification-in-hospital-separations/summary.
Ford BK, Kong M, Ward JS, Hocking JS, Fairley CK, Donovan B et al. Incomplete recording of Indigenous identification status under-estimates the prevalence of Indigenous population attending Australian general practices: a cross sectional study. BMC Health Serv Res. 2019;19(1):567. doi: https://doi.org/10.1186/s12913-019-4393-6.
Thomson A, Morgan S, O’Mara P, Tapley A, Henderson K, van Driel M et al. The recording of Aboriginal and Torres Strait Islander status in general practice clinical records: a cross-sectional study. Aust N Z J Public Health. 2016;40(Suppl 1):S70–4. doi: https://doi.org/10.1111/1753-6405.12400.
Australian Government Department of Health and Aged Care. NNDSS Core Dataset, Dataset Field Specifications - version 10.1.2016. [Documentation.] Not available online.
Australian Capital Territory Government Department of Health (ACT Health). Report of notifiable condition or related death form. Canberra: ACT Health. [Accessed on 5 March 2025.] Available from: https://www.act.gov.au/__data/assets/pdf_file/0015/2215230/Notifiable-Conditions-form_2022.pdf.
New South Wales Government Department of Health (NSW Health). Doctor/hospital notification form. Sydney: NSW Health; 2023. [Accessed on 9 May 2023.] Available from: https://www.health.nsw.gov.au/Infectious/Documents/doctor-hospital-notification-form.pdf.
Northern Territory Government Department of Health (NT Health). Reporting of notifiable diseases by doctors. Darwin: NT Health. [Accessed on 23 September 2022.] Available from: https://health.nt.gov.au/__data/assets/pdf_file/0008/1128329/reporting-of-notifiable-conditions-by-doctors.pdf.
Queensland Government Department of Health (Queensland Health). Notifiable conditions report form. Brisbane: Queensland Health. [Accessed on 9 May 2023.] Available from: https://www.health.qld.gov.au/__data/assets/pdf_file/0023/444245/notif-conditions-rpt.pdf.
South Australian Government Department of Health (SA Health). Report of Notifiable Conditions or Related Death. Adelaide: SA Health; 2021. [Accessed on 5 March 2025.] Available from: https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/resources/report+of+notifiable+disease+or+related+death+form.
Victoria State Government Department of Health. Confidential and Routine Conditions Notifiable by Medical Practitioners in Victoria. Melbourne: Victoria State Government Department of Health; December 2019. [Accessed on 9 May 2023.] Available from: https://content.health.vic.gov.au/sites/default/files/2021-11/notifiable-conditions-form-routine-conditions.pdf.
Government of Western Australia Department of Health (WA Health). Infectious and Related Diseases Notification Form. Perth: WA Health; 2022. [Accessed on 9 May 2023.] Available from: https://www.health.wa.gov.au/~/media/Files/Corporate/general-documents/Medical-notifications/PDF/metro_communicable_disease_statutory_notification_form.pdf.
AIHW. Taking the next steps: Identification of Aboriginal and Torres Strait Islander status in general practice. Canberra: AIHW; 15 July 2013. [Accessed on 11 May 2023.] Available from: https://www.aihw.gov.au/reports/indigenous-australians/taking-the-next-steps-in-general-practice/related-material.
Thompson SC, Woods JA, Katzenellenbogen JM. The quality of Indigenous identification in administrative health data in Australia: insights from studies using data linkage. BMC Med Inform Decis Mak. 2012;12:133. doi: https://doi.org/10.1186/1472-6947-12-133.
AIHW. National best practice guidelines for data linkage activities relating to Aboriginal and Torres Strait Islander people: 2012. Canberra: AIHW; 9 July 2012. [Accessed on 11 May 2023.] Available from: https://www.aihw.gov.au/reports/indigenous-australians/national-best-practice-guidelines-for-data-linkage/summary.
Federal Financial Relations. Vaccine Preventable Diseases Surveillance Program. [Webpage.] Canberra: Australian Government Treasury, Federal Financial Relations; 2021. [Accessed on 5 March 2025.] Available from: https://federalfinancialrelations.gov.au/agreements/vaccine-preventable-disease-surveillance-program.
Walker J, Adegbija O, Smoll N, Khan A, Whicker J, Carroll H et al. Epidemiology of mumps outbreaks and the impact of an additional dose of MMR vaccine for outbreak control in regional Queensland, Australia, 2017–2018. Commun Dis Intell (2018). 2021;45. doi: https://doi.org/10.33321/cdi.2021.45.67.
Westphal DW, Eastwood A, Levy A, Davies J, Huppatz C, Gilles M et al. A protracted mumps outbreak in Western Australia despite high vaccine coverage: a population-based surveillance study. Lancet Infect Dis. 2019;19(2):177–84. doi: https://doi.org/10.1016/S1473-3099(18)30498-5.
Rowe SL, Stephens N, Cowie BC, Nolan T, Leder K, Cheng AC. Use of data linkage to improve communicable disease surveillance and control in Australia: existing practices, barriers and enablers. Aust N Z J Public Health. 2019;43(1):33–40. doi: https://doi.org/10.1111/1753-6405.12846.
AIHW. Health information in Australia: an evolving landscape with an integrated future. Canberra: AIHW; 7 July 2022. [Accessed on 11 May 2023.] Available from: https://www.aihw.gov.au/getmedia/6d6f08b4-15e6-4b58-bb62-76b9e9e4cc4f/aihw-aus-240_Chapter_10.pdf.aspx.
AIHW. COVID-19 register and linked data set. Canberra: AIHW; 2023. [Accessed on 11 May 2023.] Available from: https://www.aihw.gov.au/reports-data/covid-linked-data-set/about.
Population Health Research Network (PHRN). Impact story: Linked data in the fight against COVID-19. Perth: University of Western Australia, PHRN; 2021. [Accessed on 11 May 2023.] Available from: https://www.phrn.org.au/media/82108/impact-story-linked-data-in-the-fight-against-covid-19.pdf.
Hull B, Hendry A, Dey A, Brotherton J, Macartney K, Beard F. Annual immunisation coverage report 2021. Commun Dis Intell (2018). 2023;47. doi: https://doi.org/10.33321/cdi.2023.47.47.
McNamara BJ, Jones J, Shepherd C, Gubhaju L, Joshy G, McAullay D et al. Identifying young Aboriginal and Torres Strait Islander children in linked administrative data: a comparison of methods. Int J Popul Data Sci. 2020;5(1):1100. doi: https://doi.org/10.23889/ijpds.v5i1.1100.
Australian Government Department of Health and Aged Care. Third National Hepatitis B Strategy. Canberra: Australian Government Department of Health and Aged Care; 2018. [Accessed on 11 May 2023.] Available from: https://www.health.gov.au/sites/default/files/documents/2022/06/third-national-hepatitis-b-strategy-2018-2022.pdf.
Australian Government Department of Health and Aged Care. Role and Functions of an Australian Centre for Disease Control. Canberra: Australian Government Department of Health and Aged Care; November2022. [Accessed on 2 May 2023.] Available from: https://www.cdc.gov.au/sites/default/files/2023-12/role-and-functions-of-an-australian-centre-for-disease-control.pdf.
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2025 Communicable Diseases Intelligence
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
