Is Zimbabwe ready to transition from anonymous unlinked sero-surveillance to using prevention of mother to child transmission of HIV (PMTCT) program data for HIV surveillance? : results of PMTCT utility study, 2012
Date
2016-02-29
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: Prevention of mother-to-child transmission of HIV (PMTCT) programs collect socio-demographic and
HIV testing information similar to that collected by unlinked anonymous testing sero-surveillance (UAT) in antenatal
settings. Zimbabwe evaluated the utility of PMTCT data in replacing UAT.
Methods: A UAT dataset was created by capturing socio-demographic, testing practices from the woman’s
booking-card and testing remnant blood at a laboratory from 1 June to 30 September 2012. PMTCT data were
collected retrospectively from ANC registers. UAT and PMTCT data were linked by bar-code labels that were
temporarily affixed to the ANC register. A questionnaire was used to obtain facility-level data at 53 sites.
Results: Pooled HIV prevalence was 15.8 % (95 % CI 15.3–16.4) among 17,349 women sampled by UAT, and 16.3 %
(95 % CI 15.8 %–16.9 %) among 17,150 women in PMTCT datasets for 53 sites. Pooled national percent-positive
agreement (PPA) was 91.2 %, and percent-negative agreement (PNA) was 98.7 % for 16,782 women with matched
UAT and PMTCT data. Based on UAT methods, overall median prevalence was 12.9 % (Range 4.0 %–19.4 %) among
acceptors and refusers of HIV test in PMTCT compared to 12.5 % ((Range 3.4 %–19.5 %) among acceptors in ANC
registers. There were variations in prevalence by site.
Conclusion: Although, there is no statistical difference between pooled HIV prevalence in UAT compared to PMTCT
program, the overall PPA of 91.2 % and PNA of 98.7 % fall below World Health Organisation (WHO) benchmarks of
97.6 % and 99.6 % respectively. Zimbabwe will need to strengthen quality assurance (QA) of rapid HIV testing and
data collection practices. Sites with good performance should be prioritised for transitioning.
Description
CITATION: Gonese, E., et al. 2016. Is Zimbabwe ready to transition from anonymous unlinked sero-surveillance to using prevention of mother to child transmission of HIV (PMTCT) program data for HIV surveillance? : results of PMTCT utility study, 2012. BMC Infectious Diseases, 16:97, doi:10.1186/s12879-016-1425-2.
The original publication is available at https://bmcinfectdis.biomedcentral.com
The original publication is available at https://bmcinfectdis.biomedcentral.com
Keywords
HIV-positive persons -- Zimbabwe, HIV infections -- Transmission -- Zimbabwe
Citation
Gonese, E., et al. 2016. Is Zimbabwe ready to transition from anonymous unlinked sero-surveillance to using prevention of mother to child transmission of HIV (PMTCT) program data for HIV surveillance? : results of PMTCT utility study, 2012. BMC Infectious Diseases, 16:97, doi:10.1186/s12879-016-1425-2