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Underreporting of AIDS in South Carolina

Eve D. Mokotoff, MPH, CIC; Miriam Allis Galbraith, MPH
JAMA. 1990;263(18):2449-2450. doi:10.1001/jama.1990.03440180047026.
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To the Editor.—  In their article on underreporting of cases of acquired immunodeficiency syndrome (AIDS) in South Carolina, Conway and coworkers1 quote high reporting levels (83% to 100%) from other studies done in moderate-incidence (Washington State) and high-incidence (New York City) areas under active surveillance programs. In their accompanying editorial, Buehler et al2 point out that when health departments take an active approach to surveillance, AIDS reporting increases from the lower levels measured in South Carolina under passive reporting. Active surveillance activities include ongoing, regular contact with key hospitals, physicians, and other health care providers to solicit AIDS case reports actively. Michigan is, like South Carolina, a moderate-incidence state for AIDS, but, unlike in South Carolina, the Michigan Department of Public Health carried out its validation studies after the January 1986 initiation of our active surveillance program. We did our initial validation study at two of Michigan's largest


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