Masking through averages--intraprovincial heterogeneity in HIV prevalence within the Western Cape.
Masking through averages--intraprovincial heterogeneity in HIV prevalence within the Western Cape.
复制标题
通过平均值掩盖西开普省艾滋病毒流行的省内异质性。
DOI：
10.7196/samj.1136
复制
发表时间：
2006
期刊：
影响因子：
--
通讯作者：
L. Makubalo
中科院分区：
文献类型：
--
作者：
N. Shaikh;F. Abdullah;C. Lombard;L. Smit;D. Bradshaw;L. Makubalo
OBJECTIVE
To measure HIV prevalence at health-district level in the Western Cape (WC) and to compare these findings with those of the National HIV Antenatal Surveys (NHASs). This investigation aimed to estimate the degree of heterogeneity of HIV prevalence within the province in order to inform the design of appropriate and targeted HIV interventions.
METHOD
Annual cross-sectional, unlinked district HIV antenatal surveys were implemented in all 25 health districts of the WC for the years 2001 - 2004, concurrently with the NHAS. A stratified proportional sample was drawn for each district, involving all 344 antenatal clinics in the province, and the anonymous screening method as described by the World Health Organization (WHO) was applied.
RESULTS
The NHAS revealed a significant increase in HIV prevalence in the WC from 8.6% (95% confidence interval (CI): 5.6 - 11.6) in 2001 to 15.4% (95% CI: 12.5 - 18.2) in 2004. The district-level HIV surveys showed wide variation in HIV prevalence across the health districts, which increased progressively during this period (a range of 0.6 - 22% for the year 2001 increased to 1 - 33% in 2004). Spatial analysis of HIV prevalence by health district for this period also revealed progressive spatial growth of the sub-epidemics, with the highest prevalence observed in districts located in the Cape metropole region.
CONCLUSIONS
These concurrent surveys highlight the fact that examining a provincial estimate of HIV prevalence alone has the potential to mask epicentres within the province. This underscores the importance of expanding the surveillance systems to detect heterogeneity sub-provincially, in order to link with local-level planning and resource allocation.
