Evaluation of the HIV Case-Based Surveillance System: A Pilot of the Electronic Health Record System in Mutare District, Zimbabwe, 2021

Background: Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the Impilo Electronic Health Record System. For the period January-June 2020, only 1 out of 13 health facilities in Mutare district reported seven newly diagnosed HIV patients through the electronic health record system compared to 483 in the District Health Information System (DHIS-2) recorded from paper-based registers. We evaluated the case-based surveillance system attributes, usefulness and reasons for under-reporting from January-December 2020. Methods: We conducted a descriptive cross-sectional study using updated Centres for Disease Control guidelines for evaluating public health surveillance systems. Questionnaires were administered to 36 health workers involved in HIV testing services. Facility checklists were used to collect data on knowledge, system attributes and usefulness of the system. Completed HIV case-based surveillance forms were assessed for completeness. Epi Info Version 7 was used to generate frequencies, means and proportions. Results: The reasons for under-reporting of patients in the electronic health record system were lack of reporting guidelines 26/36 (72%), limited coordination between technical staff and health facilities 24/36 (67%) and limited competency on the Electronic health record system 22/36 (61%). Timeliness, completeness, and validity were 88%, 82% and 100% respectively. The stability of the system was affected by the lack of standard operating procedures during system interruptions. Overall representativeness was 45% despite increasing from 3/226 (1%) to 224/303 (73%) between Quarter-1 and Quarter-4 of 2020. Acceptability was 100% due to reduced paperwork and the ability to generate simple reports. The information generated was used to identify new infection hotspots 28/36 (78%). Conclusion: The HIV cases based surveillance system was timely, acceptable with good data quality. Representativeness was poor due to limited competency on the electronic health record system. As a result, health workers received further training.

Performance and Trends in Measles Case-Based Surveillance in the North West Region of Cameroon, 2009 to 2015

Background: Measles is a highly contagious viral disease associated with high morbidity and mortality in developing countries. As an infection with no specific treatment, its control is most importantly through vaccination and adequate disease surveillance. National immunization coverage for the first dose of measles/rubella vaccine in 2019 was 71%. As a result, measles continues to rage with outbreaks not sparing the North West Region (NWR) of Cameroon, hence the need for proper surveillance. Objective: Assess performance of measles case-based surveillance in the NWR of Cameroon. Methods: This was a cross-sectional, descriptive study with retrospective collection of measles surveillance records carried out at the Regional Delegation of Public Health from 2009 to 2015. The data collected using a structured form were: number of persons suspected of measles;number of persons reported to district service;number of persons whose samples were collected and forwarded to the laboratory;number whose results reached the Expanded Programme on Immunization (EPI) Central unit and the time lapse between successive phases. Results: Although not all planned activities were carried out, a constant increase in planned and carried out monitoring activities was found. The average time taken from onset of signs and symptoms in a measles case to consultation at a health facility, from consultation to notification of case to district service, from notification to investigation, from investigation to receipt of biological sample at laboratory, from receipt of sample to provision of results to the EPI Central unit, and from collection of sample to reception of results at the Central EPI unit was 2.59 days, 1.5 days, 1.5 days, 2.6 days, 4 days and 6.6 days respectively. Conclusion: There was an overall rising trend in the performance of measles case-based surveillance, although the high priority site visits witnessed a stagnation during the period, a large scale measles epidemic occurred (2015). The duration between phases of the surveillance system was within acceptable limits of WHO standards for an effective system. However, the proportion of samples reaching the laboratory and whose results are received at EPI Central Unit was 77.6%, which is lower than ≥80% prescribed by WHO.

Incomplete Reporting of HIV/AIDS by Uganda’s Surveillance System and the Associated Factors

Introduction: The United States government supported Ugandan government by introducing the District Health Information Software 2 (DHIS2) in 2012 to improve HIV/AIDS surveillance. Districts have yet to fully adopt this relatively new system given a 70.2% reporting completeness achieved nationally between April-June 2013. Methods: The study examined one dependent variable of districts’ reporting completeness against four independent variables: 1) Number of client visits;2) Number of district health units;3) Number of NGOs delivering HIV/AIDS services;and 4) Regional location. The study employed cross-sectional study design which allowed researchers to compare many different variables at the same time. HIV/AIDS program data that were reported by districts into DHIS2 during the period of April to June 2013 were used to assess for reporting completeness. Findings: Districts with the lowest number of client visits (under 2500) achieved the highest mean reporting completeness (81.6%), whereas a range of 2501 - 5000, or over 5001client visits recorded 72.4% and 51.7% respectively. The higher the number of client visits is, the lower the reporting completeness is (p < 0.05). Those districts that were receiving support from only one and two NGO recorded 56.7% and 67.2% respectively. Districts supported by over three NGOs had the highest (80.6%) mean reporting completeness. NGOs-district support was statistically associated with reporting completeness (p < 0.05). The number of health units operated by a district was also significantly associated with reporting completeness (p < 0.05). The regional location of a district was not associated with reporting completeness (p = 0.674). Conclusion: The study results led us to recommend targeted future NGO support to districts with higher patient volume for HIV/AIDS services. Particularly, newly funded NGOs are to be established in districts operating over 40 health units. Incomplete reporting undermines identification of HIV-affected individuals and limits the ability to make evidence-based decisions regarding HIV/AIDS program planning and service delivery.

Impacts of Recent Infection Testing Integration into HIV Surveillance in Ekiti State, South West Nigeria: A Retrospective Cross Sectional Study

Background: Timely detection of recent HIV infections is critical in achieving the HIV epidemic. The aim of this study was to evaluate the effects of integrating the Recent Infection Testing Algorithm in HIV surveillance in Ekiti State, South West Nigeria. Method: Data from the Nigeria Medical Records System (NMRS)/National Data Repository (NDR) and Index Testing (IT) Services data capturing tools were abstracted for a retrospective cross-sectional study of 719 newly diagnosed HIV-positive cases who were screened for HIV incident infection using Asante rapid recency test kits between August 2020 and June 2022 at 5 selected recency testing health facilities. The venous blood (10 ml) of all the rapid Asante tested recent patients were collected into an EDTA tube and processed for viral load testing. The plasma level of HIV-1 RNA was quantified using the CAP/CTM and cobas 4800 platform at Obafemi Awolowo University Teaching Hospital PCR Laboratory Ife. Chi-square was used to characterize the recency status of the patients. A measure of the association was done using Chi-square, while the p-value of 0.05 was considered statistically significant. Results: The median age of the participants was 39 years. The result from the study showed that of the total number of 719 new cases of diagnosed HIV-positive, 626 of them were screened for rapid Test for Recency infection (RTRI) (87%). Overall, we found that 1.8% (11/626) of clients were classified as recent. The investigation also showed that from the index cases of the 11 confirmed recent infections, a total number of 125 additional positive cases were found. Conclusion: This result indicated a rise in the number of cases discovered in the State. Therefore, incorporating recency testing within regular HIV testing programs becomes essential in order to prioritize clients for index testing and provide useful information on transmission clusters.

四川省2003年HIV/AIDS监测检测结果分析

目的 :了解本省各类人群 HIV/ AIDS流行现状 ,为今后预防和控制艾滋病流行提供可靠的依据。方法 :对全省艾滋病哨点监测资料、各市、州监测报表、省疾病预防控制中心常规监测的血清流行病学及课题研究等资料进行分析。结果 :全省全年共检测各类人群 345 4 5 3人次 ,检出艾滋病病毒 (HIV)感染者 86 7例 ,检出率 2 5 .0 9/万 ,新发现 HIV感染者比去年同期增长了 6 4 .9% ,高于全国平均水平。感染人群仍以静脉吸毒为主 ,但 HIV的传播正逐渐向商业性工作者扩散 ,并已波及到孕产妇等人群。结论 :该省 HIV流行速率明显加快 ,控制吸毒、卖淫 ,提高各类人群的自我防范意识是减低艾滋病在该省流行的重要手段。

四川省HIV/AIDS流行现状及趋势分析

目的 了解四川省艾滋病流行情况。方法 对艾滋病病毒 (HIV)哨点监测资料、全省各地监测报表、省艾滋病监测中心的常规监测和血清流行病学调查资料进行分析。结果 总的HIV检出率为 0 .5 1%,局部地区吸毒人群HIV感染率高达 35 %,四川省存在A、B、C、D和B、C重组 5个亚型。感染者以青壮年、男性、农民为主 ,75 6 %的人通过静脉吸毒感染 ,经性途径感染呈逐年上升趋势。四川省HIV感染已进入快速增长阶段。结论 四川省正面临防制艾滋病 (AIDS)的关键时期 ,应立即采取有效的防制措施。

温州市外来流动人口HIV感染的流行特征

为了解温州市外来流动人口HIV感染情况及其分布特征。对1988-2001年由确诊实验室确诊的流动人口HIV感染者进行统计分析。结果表明,至2001年底温州市共检出102例HIV感染者,其中流动人口82例,占82.39％,死亡10例。82例HIV感染者中外省54例(65.85％),外籍华人华侨28例(34.15％)。外省流动人口HIV感染者以新疆籍为主。男性多于女性。年龄以20-40岁之间为多。感染途径以经血传播为主,占总流动人口感染者的64.63％。1998年前感染者以华侨华人为主,而1999年后则以新疆籍的流动人口为主。调查表明,目前温州市HIV感染者仍以流动人口为主,采取切实可行的措施对控制和预防流动人口艾滋病的流行非常必要和迫切。

绵阳市海洛因成瘾者HCV和HIV抗体监测分析

[目的]了解绵阳市海洛因成瘾者HCV、HIV感染现状,深入开展社区药物维持治疗工作。[方法]对首次参加社区药物维持治疗的海洛因成瘾者进行问卷调查,采血样检测HCV和HIV血清抗体。[结果]监测574名海洛因成瘾者,HCV抗体阳性率为74.91%,HIV抗体阳性率为2.96%。不同年龄组人群HCV抗体阳性率均高,HIV抗体阳性者集中在25～40岁人群。不同吸毒方式中,单纯口吸者HCV抗体阳性率为26.79%,未检出HIV抗体阳性;单纯注射吸毒者HCV抗体阳性率为80.12%,HIV抗体阳性率为3.28%。HCV和HIV合并感染率为2.79%。[结论]海洛因成瘾者HCV和HIV感染率高,应加大健康教育和综合干预力度,积极开展社区药物维持治疗工作,以减少共用针具的高危行为。

云南省2001年HIV/AIDS监测结果分析

目的:了解云南省HIV/AIDS流行现状和趋势。方法:采用哨点监测、现患调查、高危人群常规筛检和自愿匿名检测4种血清流行病学调查方法收集了HIV流行资料,收集全省AIDS病例报告资料。结果:2001年全省共监测各类高危和重点人群95755人,发现HIV新感染者1503人,诊断艾滋病病人151人,死亡91人。哨点监测静脉吸毒人群HIV感染率为27.1％（1.1-75.0％）,思茅和昭通上升明显,7个地区静脉吸毒HIV感染率达高水平流行;性病门诊男性就诊者HIV感染率为2.7％（0-13.4％）,其中德宏州瑞丽市性病门诊男性就诊者HIV感染率为13.4％;女性就诊者为2.3％（0-7.4％）;孕产妇HIV感染率为0.2％（0-2.2％）,陇川、楚雄和丽江上升明显;其中德宏州陇川县医院孕产妇HIV感染率为:2.2％;暗娼、嫖客HIV感染率分别为2.0％、1.8％,高流行地区医院无关联人群HIV感染率为1.6％,献血员0.02％,自愿匿名检测检出率为8.0％。感染者主要为20-30岁汉族男性静脉吸毒者,以农民和无业人员居多,主要分布于我省德宏、红河、昆明、临沧和大理。结论:云南省HIV流行经静脉吸毒人群蔓延到全省,部分地区感染率快速上升,并且已进一步造成性乱人群中的传播和流行,高流行区医院无关联人群、孕产妇人群HIV流行率超过1％,预示AIDS病例将快速增加,预防和阻断母婴传播?

云南省2003年HIV/AIDS监测结果分析

目的 了解云南省HIV/AIDS流行现状和趋势。方法 采用哨点综合监测、现患调查、高危人群常规筛检和自愿匿名检测 4种血清流行病学调查方法收集HIV流行资料和全省AIDS病例报告资料。结果 2 0 0 3年全省共监测各类高危和重点人群 10 6 5 87人 ,发现HIV新检出者 2 4 5 3人 ,诊断艾滋病病人 172人 ,死亡81人。哨点监测静脉吸毒人群HIV感染率为 2 1 2 % (0 6 % - 6 3 0 % ) ,8个地区静脉吸毒HIV感染率达高水平流行 ;性病门诊男性就诊者HIV感染率为 2 6 % (0 - 10 8% ) ,其中思茅地区孟连县性病门诊男性就诊者HIV感染率为 10 8% ;孕产妇HIV感染率为 0 4 % (0 - 1 3% ) ,其中德宏州陇川县、盈江县医院孕产妇HIV感染率达到 1 3%、1 0 % ;昆明暗娼、嫖客HIV感染率分别为 2 5 %、0 8% ,全国HIV流调暗娼感染率 3 74 % (46 / 12 30 ) ;高流行地区医院无关联人群HIV感染率为 1 3% ,献血员 0 0 7% ,自愿匿名咨询检测检出率为 13 1%。感染者主要为 2 0 - 30岁汉族男性静脉吸毒者 ,以农民和无业人员居多 ,主要分布于我省德宏、红河、大理、昆明、临沧和保山。结论 云南省HIV流行经静脉吸毒人群蔓延到全省 ,HIV感染率继续上升 ,并且造成性乱人群中的传播和流行 ,孕产妇人群HIV感染率进一步上升 ,高流行地区医?

安顺市1997-2006年HIV流行状况分析

目的通过对安顺市1997-2006年艾滋病疫情分析,了解安顺市艾滋病病毒(HIV)流行的特点和趋势,为制定防治对策提供科学依据。方法采用哨点监测、血清横断面调查和常规资料收集等方法进行血清流行病学调查。结果自1998年发现首例HIV感染者以来,几乎每年均有HIV阳性报告,至2002年大幅度上升,2002年报告的HIV阳性数是前5年的2.8倍;2005-2006年监测发现的HIV阳性者276例,是2004年以前8年累计发现数(121例)的2.28倍。1997-2006年,共检测26 832人份,检出HIV抗体阳性397例,阳性检出率为1.48%。感染者以青壮年为主,男性明显高于女性,男性和女性分别占80.35%、19.65%,主要以静脉吸毒传播为主。结论安顺市艾滋病的流行形势非常严峻,必须尽快采取有效的预防控制措施,减缓艾滋病在安顺的流行速度。

凉山州2003～2004年HIV/AIDS的综合监测

目的:了解凉山州各类人群艾滋病病毒感染者/艾滋病(HIV/AIDS)的感染情况及高危行为,和其流行现状和趋势。方法:按照艾滋病行为和血清学监测方案的操作程序及调查方法对全州吸毒者、女性商业性性工作者、孕产妇进行行为及血清学监测。结果:2 2 2 7例吸毒者艾滋病感染率为15 5 % (346人) ,吸毒者共用针具率为13 1% ;女性商业性性工作者感染率为0 8% (3人) ,只有5 1 1%的CSW (女性性商业工作者)在每次与客人发生性关系时都使用安全套;孕产妇监测中2 0 0 4年发现首例HIV感染者。结论:我州HIV感染途径主要还是静脉吸毒共用针具及性乱,女性商业性性行为者性行为将在艾滋病向普通人群传播中起重要作用,应当加强综合干预措施等。

1996-2005年深圳口岸HIV流行状况分析

目的了解深圳口岸艾滋病流行状况和趋势,为制定相关的预防与控制措施提供依据。方法对1996-2005年深圳口岸地区艾滋病监测资料进行统计分析,对59例艾滋病病毒(HIV)感染者进行流行病学调查。结果深圳口岸地区HIV流行近年来呈上升趋势;HIV感染者人群分布以商人和技术人员为主;入境人群高于出境人群和境内人群;以异性性接触为主要传播途径。结论深圳口岸地区艾滋病流行状况日趋严重,必须加强对口岸出入境人员的艾滋病监测、健康教育和行为干预,防止艾滋病从高危人群向普通人群传播。

四川省达州市2003年吸毒者HIV哨点监测结果分析

目的 观察达州市吸毒者HIV感染动态 ,分析HIV感染发展趋势并观察综合防制措施效果。方法 按《全国哨点监测方案》进行。结果 采血 4 2 4份 ,HIV和梅毒感染率分别为 6 5 0 9%和 9 2 0 %。女吸毒者梅毒感染率高于男性 (P <0 0 1)。静注和非静注吸毒者HIV感染率分别为 78 85 %和 16 13% ,二者有显著差异 (P <0 0 1)。分别有 5 7 72 %和 6 7 2 7%的男、女吸毒者承认通过钱或毒品交易与异性发生过性行为 ,发生性行为时每次使用安全套的比例分别为 0 94 %和 13 5 1% ,仅 4 0 85 %“有时使用”安全套的吸毒者“最近一次使用”了安全套。结论 HIV感染继续在达州市吸毒人群中流行。吸毒者存在性乱且安全套使用率低。艾滋病综合防制措施应进一步加强。

成都市HIV/AIDS疫情监测分析

目的了解流行现状,明确防制工作重点,为防控提供依据。方法收集成都市1992-2006年HIV/AIDS病例报告、流行病学个案调查表,以及哨点监测、专题调查等资料进行统计分析。结果成都市1992-2006年累计报告HIV/AIDS1319例,年平均报告增长速度为46.92%。近2年共监测各类人群399318人次,检出率为0.23%。以静脉注射吸毒传播为主(43.97%),性接触感染逐年上升。流动人口是潜在的危险因素。结论成都市艾滋病流行快速增长,存在多种潜在危险因素。应采取强有力的防制措施,不断完善监测系统,加大开展高危行为干预,加强流动人口防治,控制进一步流行。

山东省羁押及收教人员HIV-1抗体血清学监测

目的:了解山东省监狱、劳教所羁押、收教人员艾滋病病毒(HIV)感染状况及特点,为制定防制措施提供依据。方法:采用EXCEL数据库和SPSS10.0软件对全省72 801名羁押、收教人员经筛查复检为HIV抗体阳性并经免疫印迹试验确认(WB)的结果及相关资料进行统计分析。结果:共发现HIV-1抗体阳性感染者21例,均为男性,感染率为0.0289%,其中外来人员13例,占总数的61.90%;HIV-1抗体不确定者9例,占确认数的28.13%。结论:我省羁押、收教人员HIV感染尚属低流行状态,但其为艾滋病传播的高危行为人群,应加强对该人群(尤其是外来男性)的监测与干预。

四川省高危人群HIV/AIDS监测结果分析

对成都市妇教所1895 例高危人群进行HIV 哨点监测, 结果显示: 90.2% 的高危人群具有多个性伴, 这些高危人群从不使用避孕套的比例高达86.3% , 并在他们当中首次发现HIV 感染者, 感染率为0.53‰。提示HIV已向性乱人群播散, 应加强其监测力度,

广东顺德2001～2003年HIV监测结果分析

目的 对 2 0 0 1～ 2 0 0 3年佛山市顺德区开展的HIV监测结果进行分析评价 ,从而了解人群HIV感染和流行状况 ,为实施控制措施提供理论依据。 方法 对吸毒者、性病患者等高危人群、供血 (浆 )者、桑拿室服务人员等重点人群和志愿献血人员、住院病人等一般人群开展了HIV抗体监测以及对吸毒者进行高危因素和对HIV感染者进行个案调查。 结果 2 0 0 1～ 2 0 0 3年共监测 10 60 0 4人次 ,发现HIV感染者 3 9例 (含 5例艾滋病病人 ) ,其中哨点监测检出率为 1 0 6% ,常规监测点检出率为 0 0 2 %。 结论 吸毒者仍是顺德区HIV感染的最主要人群 ,但一般人群感染也显上升的趋势。应加大对一般人群的监测力度 。

昆明市HIV/AIDS监测结果分析

目的 及时掌握昆明市艾滋病病毒 (HIV)的流行动态 ,特别是对一般人群的传播范围。方法 对监测人群的血清流行病学资料进行分析。结果 2 0 0 1年共检测血清标本 3 52 8份 ,检出 55例HIV感染者 ,检出率为1 56 %。其中哨点监测 1 738人 ,检出 36名HIV感染者 ;面上扩大监测 1 590人 ,检出 6名HIV感染者 ;匿名检测2 0 0人 ,检出 1 3名HIV感染者 ;检出率分别为 2 0 7%、0 38%、6 50 %。HIV感染者本市占 74 55 % ,外地占2 5 45 %。男性多于女性 ,其比例为 2 0 5∶1。年龄在 1 6～ 39岁的占 96 36 % ;职业以无业、农民为主。 56 36 %是通过静脉吸毒感染 ,43 64 %通过性途径感染。结论 HIV进入一般人群的危险性增大 ;性传播有明显上升趋势 ,构成比为 43 64 % ,与 2 0 0 0年 (2 8 1 7% )相比差异有非常显著的统计学意义 (P <0 0 1 )。控制吸毒特别是性途径造成的HIV传播 ,提高重点人群和一般人群的自我防范意识 。

某监测哨点住院结核患者人类免疫缺陷病毒(HIV)感染状况

目的通过哨点监测住院结核患者中HIV感染和发病状况。方法对住院结核病连续病例常规采用HIV血清抗体ELISA法初筛,阳性者抽血复验,并送省疾病控制中心HIV检测中心进行免疫印迹试验(WB)确认。结果本哨点3年间共对3345例住院结核患者进行了HIV筛查,其中男性2 257例(67.5%),女性1 088例(32.5%);平均年龄(41.1±13.0)岁;职业以农民为主,占64.5%,其次是行政管理、技术人员,占24.6%,商业服务者占10.1%,学生占0.8%。入院时肺结核患者3274例,其中涂阳肺结核患者598例(18.3%),涂阴肺结核患者2676例(81.7%)。初治结核患者1 057例(32.3%),复治2 217例(67.7%)。共检出HIV血清阳性者2例,均为男性;年龄分别为49和40岁;2人均为性传播感染,HIV感染率为0.06%。结论住院结核病患者中HIV感染率接近全国平均0.05%的感染水平。