Search results for: under-reporting

Authors: Xavier Ruiz Del Portal

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This paper incorporates mobility between the legal and black economies into a model of tax evasion with endogenous labor supply in which underreporting is possible in one sector but impossible in the other. We have found that the results of the effects along the extensive margin (number of evaders) become more robust and conclusive than those along the intensive margin (hours of illegal work) usually considered by the literature. In particular, it is shown that the following policies reduce the number of evaders: (a) larger and more progressive evasion penalties; (b) higher detection probabilities; (c) an increase in the legal sector wage rate; (d) a decrease in the moonlighting wage rate; (e) higher costs for creating opportunities to evade; (f) lower opportunities to evade, and (g) greater psychological costs of tax evasion. When tax concealment and illegal work also are taken into account, the effects do not vary significantly under the assumptions in Cowell (1985), except for the fact that policies (a) and (b) only hold as regards low- and middle-income groups and policies (e) and (f) as regards high-income groups.

Keywords: income taxation, tax evasion, extensive margin responses, the penalty system

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Authors: Andreas Ateke Njoh, Shalom Tchokfe Ndoula, Amani Adidja, Germain Nguessan Menan, Annie Mengue, Eric Mboke, Hassan Ben Bachir, Sangwe Clovis Nchinjoh, Yauba Saidu, Laurent Cleenewerck De Kiev

Abstract:

Vaccines serve a great deal in protecting the population globally. Vaccine products are subject to rigorous quality control and approval before use to ensure safety. Even if all actors take the required precautions, some people could still have adverse events following immunization (AEFI) caused by the vaccine composition or an error in its administration. AEFI underreporting is pronounced in low-income settings like Cameroon. The Country introduced electronic platforms to strengthen surveillance. With the introduction of many novel vaccines, like COVID-19 and the novel Oral Polio Vaccine (nOPV) 2, there was a need to monitor AEFI in the Country. A cross-sectional study was conducted from July to December 2022. Data on AEFI per region of Cameroon were reviewed for the past five years. Data were analyzed with MS Excel, and the results were presented in proportions. AEFI reporting was uncommon in Cameroon. With the introduction of novel vaccines in 2021, the health authorities engaged in new tools and training to capture cases. AEFI detected almost doubled using the open data kit (ODK) compared to previous platforms, especially following the introduction of the nOPV2 and COVID-19 vaccines. The AEFI rate was 1.9 and 160 per administered 100 000 doses of nOPV2 and COVID-19 vaccines, respectively. This mobile tool captured individual information for people with AEFI from all regions. The platform helped to identify common AEFI following the use of these new vaccines. The ODK mobile technology was vital in improving AEFI reporting and providing data to monitor using new vaccines in Cameroon.

Keywords: adverse events following immunization, cameroon, COVID-19 vaccines, nOPV, ODK

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Authors: Zaka Nisa, Farooq Sher

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Adverse drug reactions (ADRs) underreporting is a great challenge to Pharmacovigilance. Health care professionals have to consider ADR reporting as their professional obligation, an effective system of ADR reporting is important to improve patient health care and safety. The present study is designed to assess the knowledge, attitude, practice and factors associated with ADR reporting by health care professionals (physicians and pharmacists) in public and private hospitals of Pakistan. A pretested questionnaire was administered to 384 physicians and pharmacists in public and private hospitals. Respondents were evaluated for their knowledge, attitude, and practice related to ADR reporting. The data was analyzed using the SPSS statistical software, the factors which encourage and discourage respondents in reporting ADRs were determined. Most of the respondents have shown a positive attitude towards ADR reporting. The response rate was 95.32%. Of the 367 questionnaires, including 333 (86.5%) physicians and 34 (8.8%) pharmacists with the mean age 28.34 (SD= 6.69), most of the respondents showed poor ADR reporting knowledge (83.1%). The majority of respondents (78.2%) showed positive attitude towards ADR reporting and only (12.3%) hospitals have good ADR reporting practice. Knowledge of respondents in public hospitals (8.6%) was less as compare to those in the private hospitals (29.7%) (P < 0.001). Attitude of respondents in private hospitals was more positive (92.4%) than those in public hospitals (68.8%) (P < 0.001). No significant difference was observed in practicing of ADR reporting in public (11.8%) and private hospitals (13.1%) (P value 0.89). Seriousness of ADR, unusualness of reaction, new drug involvement and confidence in diagnosis of ADR were the factors which encourage respondents to report ADR, however, lack of knowledge regarding where and how to report ADR, lack of access to ADR reporting form, managing patients was more important than reporting ADR, legal liability issues were the factors which discourage respondents to report ADR. The study reveals poor knowledge and practice regarding ADR reporting. However positive attitude was seen regarding ADR reporting. There is a need of educational training for health care professionals as well as genuine and continuous efforts are required by Government and health authorities to ensure the proper implementation of ADR reporting system in all of the hospitals.

Keywords: adverse drugs reactions (ADR), pharmacovigilance, spontaneous ADR reporting, knowledge of ADR, attitude of health care profesionals, practice of ADR reporting

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Authors: Temosho Promise Chuene, T. Chitura

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Background: Foot and mouth disease is a real challenge in South Africa. The disease is a serious threat to the viability of livestock farming initiatives and affects local and international livestock trade. In Limpopo Province, the Kruger National Park and other game reserves are home to the African buffalo (Syncerus caffer), a notorious reservoir of the picornavirus, which causes foot and mouth disease. Out of the virus’s seven (7) distinct serotypes, Southern African Territories (SAT) 1, 2, and 3 are commonly endemic in South Africa. The broad objective of the study was to establish the trend of foot and mouth disease in Limpopo Province over a seven-year period (2014-2020), as well as the adoption and comprehensive reporting of the measures that are taken to contain disease outbreaks in the study area. Methods: The study used secondary data from the World Organization for Animal Health (WOAH) on reported cases of foot and mouth disease in South Africa. Descriptive analysis (frequencies and percentages) and Analysis of variance (ANOVA) were used to present and analyse the data. Result: The year 2020 had the highest prevalence of foot and mouth disease (3.72%), while 2016 had the lowest prevalence (0.05%). Serotype SAT 2 was the most endemic, followed by SAT 1. Findings from the study demonstrated the seasonal nature of foot and mouth disease in the study area, as most disease cases were reported in the summer seasons. Slaughter of diseased and at-risk animals was the only documented disease control strategy, and information was missing for some of the years. Conclusion: The study identified serious underreporting of the adopted control strategies following disease outbreaks. Adoption of comprehensive disease control strategies coupled with thorough reporting can help to reduce outbreaks of foot and mouth disease and prevent losses to the livestock farming sector of South Africa and Limpopo Province in particular.

Keywords: livestock farming, African buffalo, prevalence, serotype, slaughter

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Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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Authors: Nadjet Mekaouche, Hanane Zitouni, Fatma Boudia, Habiba Fetati, A. Saleh, A. Lardjam, H. Geniaux, A. Coubret, H. Toumi

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Medicines have undeniably played a major role in prolonging shelf life and improving quality. The absolute efficacy of the drug remains a lever for innovation, its benefit/risk balance is not always assured and it does not always have the expected effects. Prior to marketing, knowledge about adverse drug reactions is incomplete. Once on the market, phase IV drug studies begin. For years, the drug was prescribed with less care to a large number of very heterogeneous patients and often in combination with other drugs. It is at this point that previously unknown adverse effects may appear, hence the need for the implementation of a pharmacovigilance system. Pharmacovigilance represents all methods for detecting, evaluating, informing and preventing the risks of adverse drug reactions. The most severe adverse events occur frequently in hospital and that a significant proportion of adverse events result in hospitalizations. In addition, the consequences of hospital adverse events in terms of length of stay, mortality and costs are considerable. It, therefore, appears necessary to develop ‘hospital pharmacovigilance’ aimed at reducing the incidence of adverse reactions in hospitals. The most widely used monitoring method in pharmacovigilance is spontaneous notification. However, underreporting of adverse drug reactions is common in many countries and is a major obstacle to pharmacovigilance assessment. It is in this context that this study aims to describe the experience of the pharmacovigilance service at the University Hospital of Oran (EHUO). This is a retrospective study extending from 2011 to 2017, carried out on archived records of declarations collected at the level of the EHUO Pharmacovigilance Department. Reporting was collected by two methods: ‘spontaneous notification’ and ‘active pharmacovigilance’ targeting certain clinical services. We counted 217 statements. It involved 56% female patients and 46% male patients. Age ranged from 5 to 78 years with an average of 46 years. The most common adverse reaction was drug toxidermy. For the drugs in question, they were essentially according to the ATC classification of anti-infectives followed by anticancer drugs. As regards the evolution of declarations by year, a low rate of notification was noted in 2011. That is why we decided to set up an active approach at the level of some services where a resident of reference attended the staffs every week. This has resulted in an increase in the number of reports. The declarations came essentially from the services where the active approach was installed. This highlights the need for ongoing communication between all relevant health actors to stimulate reporting and secure drug treatments.

Keywords: adverse drug reactions, hospital, pharmacovigilance, spontaneous notification

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Authors: Vaiddehi Bansal, Laura Hinson, Mayumi Rezwan, Erin Leasure, Mithila Iyer, Connor Roth, Poulomi Pal, Kareem Kysia

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As digital usage becomes increasingly ubiquitous worldwide, technology-facilitated gender-based violence (GBV) has garnered increasing attention in the recent years, especially during the COVID-19 pandemic. This form of violence is defined as “action by one or more people that harms others based on their sexual or gender identity or by enforcing harmful gender norms. This action is carried out using the internet and/or mobile technology that harms others based on their sexual or gender identity or by enforcing harmful gender norms”.Common forms of technology-facilitated GBV include cyberstalking, cyberbullying, sexual harassment, image-based abuse, doxing, hacking, gendertrolling, hate speech, and impersonation. Most literature on this pervasive yet complex issue has emerged from high-income countries, and few studies comprehensively summarize its prevalence, manifestations, and implications. This rigorous scoping review examines the evidence base of this phenomenon in low and middle-income countries across Asia, summarizing trends and gaps to inform actionable recommendations. The research team developed search terms to conduct a comprehensive search of peer-reviewed and grey literature. Query results were eligible for inclusion if they were published in English between 2006-2021 and with an explicit emphasis on technology-facilitated violence, gender, and the countries of interest in the Asia region. Title, abstracts, and full-texts were independently screened by two reviewers based on inclusion criteria, and data was extracted through deductive coding. Of 2,042 articles screened, 97 met inclusion criteria. The review revealed a gap in the evidence-base in Central Asia and the Pacific Islands. Findings across South and Southeast Asia indicate that technology-facilitated GBV comprises various forms of abuse, violence, and harassment that are largely shaped by country-specific societal norms and technological landscapes. The literature confirms that women, girls, and sexual minorities, especially those with intersecting marginalized identities, are often more vulnerable to experiencing online violence. Cultural norms and patriarchal structures tend to stigmatize survivors, limiting their ability to seek social and legal support. Survivors are also less likely to report their experience due to barriers such as lack of awareness of reporting mechanisms, the perception that digital platforms will not address their complaints, and cumbersome reporting systems. The COVID-19 pandemic has further exacerbated perpetration and strained support mechanisms. Prevalence varies by the form of violence but is difficult to estimate accurately due to underreporting and disjointed, outdated, or non-existent legal definitions. Addressing technology-facilitated GBV in Asia requires collective action from multiple actors, including government authorities, technology companies, digital and feminist movements, NGOs, and researchers.

Keywords: gender-based violence, technology, online sexual harassment, image-based abuse

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