Table 1.

Classes of determinants of discrepancies of reported morbidity to actual morbidity

stages of patient care	Classes of determinants or potential distorting factors	References
Perception of the illness and Health care access	Form and perceived severity of illness	[35–40]
	Etiological concept and type of disease	[38, 40–47]
	Individual characteristics of patients	[38, 43, 48–55]
	Socio-economic characteristics of patients	[38, 43, 54–65]
	Attractiveness factors of places	[66–71]
	Geographical accessibility	[38, 42–44, 61, 72–75]
	Characteristics of the environment	[66, 76–78]
	Urbanization	[79–83]
	Movements of population	[84]
Diagnosis	Presence of an intervention program	[22, 85, 86]
	Functioning of health services: quality of service and framework	[38, 44, 48, 58, 62, 87–90]
	Staff competence	[44, 62, 87, 91]
	Lack of supplementary diagnosis	[44, 92]
	Lack of clinical standardized decision tree for diagnosing	[91, 93, 94]
	Difficulty of differential diagnosis with other diseases	[20, 31–34]
	Spatial distribution of disease	[95–97]
Data reporting	Staff competence	[84]
	Standardization of data collection tools	[84, 98]
	Large volume of work	[31]
	Falsification of data	[31]
	Typing errors	[31, 99]
	Integration of the disease into a national or global strategy	[10, 100]
	Characteristic of the response	[10, 100]