OBJECTIVES: To establish unlinked, anonymous sentinel surveillance for HIV-1 among pregnant women attending an antenatal clinic, to determine age-specific seroprevalences, to monitor trends and to compare seroprevalence with that detected by a population serosurvey. To establish the sustainability and costs of surveillance. DESIGN: Sentinel surveillance for HIV through serial collection of unlinked, anonymous seroprevalence data from antenatal care; comparison of sentinel data with those from a population serosurvey; financial and general audit of the sentinel surveillance. SETTING: A community antenatal clinic in a large urban centre, Mwanza Municipality, Tanzania, eastern Africa, between October 1988 and September 1991. PATIENTS: Pregnant women attending for antenatal care. MAIN OUTCOME MEASURE: Age-specific HIV-1 seroprevalences, trends over time, difference from age-specific population seroprevalences, sustainability and costs. RESULTS: Overall HIV-1 seroprevalence was 11.5% (95% confidence interval, 10.5-12.4); differences in age-specific prevalences were not significant. There was no clear evidence of change in seroprevalence over the study period in any age group, although there was some indication of a rise in some age groups in 1988-1989. Sentinel surveillance among pregnant women may have significantly underestimated population HIV-1 seroprevalence for women under the age of 35 years. HIV-1 surveillance proved feasible and sustainable. Additional recurrent costs were US$1.7 per specimen for unlinked anonymous testing and US$0.57 per woman for syphilis screening. CONCLUSIONS: HIV-1 seroprevalence did not change significantly over 3 years, probably implying a substantial incidence of HIV-1 infection. In this setting seroprevalence in pregnant women may have underestimated population seroprevalence in women aged under 35 years. With modest inputs and good organization unlinked anonymous HIV-1 sentinel surveillance of pregnant women can be introduced and sustained in an African setting. This may usefully be carried out in conjunction with syphilis screening.
OBJECTIVES: To establish unlinked, anonymous sentinel surveillance for HIV-1 among pregnant women attending an antenatal clinic, to determine age-specific seroprevalences, to monitor trends and to compare seroprevalence with that detected by a population serosurvey. To establish the sustainability and costs of surveillance. DESIGN: Sentinel surveillance for HIV through serial collection of unlinked, anonymous seroprevalence data from antenatal care; comparison of sentinel data with those from a population serosurvey; financial and general audit of the sentinel surveillance. SETTING: A community antenatal clinic in a large urban centre, Mwanza Municipality, Tanzania, eastern Africa, between October 1988 and September 1991. PATIENTS: Pregnant women attending for antenatal care. MAIN OUTCOME MEASURE: Age-specific HIV-1 seroprevalences, trends over time, difference from age-specific population seroprevalences, sustainability and costs. RESULTS: Overall HIV-1 seroprevalence was 11.5% (95% confidence interval, 10.5-12.4); differences in age-specific prevalences were not significant. There was no clear evidence of change in seroprevalence over the study period in any age group, although there was some indication of a rise in some age groups in 1988-1989. Sentinel surveillance among pregnant women may have significantly underestimated population HIV-1 seroprevalence for women under the age of 35 years. HIV-1 surveillance proved feasible and sustainable. Additional recurrent costs were US$1.7 per specimen for unlinked anonymous testing and US$0.57 per woman for syphilis screening. CONCLUSIONS:HIV-1 seroprevalence did not change significantly over 3 years, probably implying a substantial incidence of HIV-1 infection. In this setting seroprevalence in pregnant women may have underestimated population seroprevalence in women aged under 35 years. With modest inputs and good organization unlinked anonymous HIV-1 sentinel surveillance of pregnant women can be introduced and sustained in an African setting. This may usefully be carried out in conjunction with syphilis screening.
Entities:
Keywords:
Africa; Africa South Of The Sahara; Biology; Demographic Factors; Developing Countries; Diseases; Eastern Africa; English Speaking Africa; Epidemiologic Methods; Examinations And Diagnoses; Hematologic Tests; Hemic System; Hemoglobin Level; Hiv Infections; Hiv Serodiagnosis--cost; Infections; Laboratory Examinations And Diagnoses; Laboratory Procedures; Measurement; Physiology; Population; Population Characteristics; Pregnant Women; Prevalence; Reproductive Tract Infections; Research Methodology; Research Report; Sampling Studies; Screening--cost; Sexually Transmitted Diseases; Studies; Surveys--cost; Syphilis; Tanzania; Viral Diseases
Authors: M Urassa; Y Kumogola; R Isingo; G Mwaluko; B Makelemo; K Mugeye; T Boerma; T Calleja; E Slaymaker; B Zaba Journal: Sex Transm Infect Date: 2006-08 Impact factor: 3.519
Authors: K K Orroth; E L Korenromp; R G White; J Changalucha; S J de Vlas; R H Gray; P Hughes; A Kamali; A Ojwiya; D Serwadda; M J Wawer; R J Hayes; H Grosskurth Journal: Sex Transm Infect Date: 2003-04 Impact factor: 3.519
Authors: Geofrey R Somi; Mecky I N Matee; Roland O Swai; Eligius F Lyamuya; Japhet Killewo; Gideon Kwesigabo; Tuhuma Tulli; Titus K Kabalimu; Lucy Ng'ang'a; Raphael Isingo; Joel Ndayongeje Journal: BMC Public Health Date: 2006-05-03 Impact factor: 3.295
Authors: Brian D Rice; Jörg Bätzing-Feigenbaum; Victoria Hosegood; Frank Tanser; Caterina Hill; Till Barnighausen; Kobus Herbst; Tanya Welz; Marie-Louise Newell Journal: BMC Public Health Date: 2007-07-18 Impact factor: 3.295
Authors: Chitra Ramaswamy; Tanya M Ellman; Julie Myers; Ann Madsen; Kent Sepkowitz; Colin Shepard Journal: Open Forum Infect Dis Date: 2015-09-30 Impact factor: 3.835