The importance of accounting for testing and positivity in surveillance by time and place: an illustration from HIV surveillance in Japan
The importance of accounting for testing and positivity in surveillance by time and place: an illustration from HIV surveillance in Japan
复制标题
按时间和地点衡量监测中检测和阳性率的重要性：以日本艾滋病毒监测为例
DOI：
10.1017/s0950268818002558
复制
发表时间：
2018
影响因子：
4.2
通讯作者：
Oishi K.
中科院分区：
文献类型：
--
作者：
Kato H.;Kanou K.;Arima Y.;Ando F.;Matsuoka S.;Yoshimura K.;Matano T.;Matsui T.;Sunagawa T.;Oishi K.
检测次数是一个重要的监测指标。我们使用艾滋病毒监测数据来说明这一点，重点是东京和冲绳，这两个县在日本艾滋病毒的高通知率。仅限于当地公共卫生中心和附属中心报告的检测数据，我们评估了2007-2014年期间的艾滋病毒监测数据，基于年度艾滋病毒报告率（每10万人口），艾滋病毒检测率（每10万人口）和艾滋病毒检测阳性（阳性）的比例。在全国范围内，检测活动和阳性率呈反比关系; 2008年，检测率达到峰值，但阳性率最低。虽然东京的报告率（中位数= 0.98，范围= 0.89-1.33）高于冲绳（中位数= 0.61，范围= 0.42-1.09），但冲绳的检测率（中位数= 187，范围= 158-274）略高于东京（中位数= 172，范围= 163-210）。与东京（中位数= 0.57%，范围= 0.46-0.67%）相比，冲绳（中位数= 0.34%，范围= 0.24-0.45%）的阳性率明显较低。相对于全国检测率（中位数= 85，范围= 80-115）和阳性率（中位数= 0.34%，范围= 0.28-0.36%），东京的阳性率更高，尽管有更多的检测。2014年，在冲绳，所有三个指标都有所上升，尽管进行了更多的测试，但积极性仍在上升，这为人们提供了一个值得关注的强有力的理由。与其他信息一起，对检测结果和阳性结果的说明改进了对监测数据的解释，以指导公共卫生评估。
The number of tests performed is an important surveillance indicator. We illustrate this point using HIV surveillance data, focusing on Tokyo and Okinawa, two prefectures with high HIV notification rates in Japan. Restricting to data reported from local public health centres and affiliate centres where testing data are accessible, we assessed HIV surveillance data during 2007–2014, based on the annual HIV notification rate (per 100 000 population), HIV testing rate (per 100 000 population) and proportion testing HIV-positive (positivity). Nationally, testing activity and positivity showed an inverse relationship; in 2008, the testing rate peaked, but positivity was lowest. While notification rates were higher for Tokyo (median = 0.98, range = 0.89–1.33) than Okinawa (median = 0.61, range = 0.42–1.09), Okinawa had slightly higher testing rates (median = 187, range = 158–274) relative to Tokyo (median = 172, range = 163–210). Positivity was substantially lower in Okinawa (median = 0.34%, range = 0.24–0.45%) compared with Tokyo (median = 0.57%, range = 0.46–0.67%). Relative to the national testing rate (median = 85, range = 80–115) and positivity (median = 0.34%, range = 0.28–0.36%), Tokyo had higher positivity, despite more testing. In 2014 in Okinawa, all three indicators increased, providing a strong reason to be concerned as positivity increased despite more testing. Together with other information, accounting for testing and positivity improve interpretation of surveillance data to guide public health assessments.