Comparison of adult HIV prevalence from national population-based surveys and antenatal clinic surveillance in countries with generalised epidemics: implications for calibrating surveillance data
Comparison of adult HIV prevalence from national population-based surveys and antenatal clinic surveillance in countries with generalised epidemics: implications for calibrating surveillance data
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DOI：
10.1136/sti.2008.030452
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发表时间：
2008-08-01
影响因子：
3.6
通讯作者：
Fowler, T. B.
中科院分区：
文献类型：
--
作者：
Gouws, E.;Mishra, V.;Fowler, T. B.
背景资料：对艾滋病毒在普遍流行的国家的影响的估计一般是基于长期收集的产前诊所监测数据。为了获得更具地域代表性的艾滋病毒流行率估计数，许多国家现在还在进行包括艾滋病毒检测在内的全国人口调查。我们比较了来自产前诊所监测的成人艾滋病毒流行率估计值与来自全国人口调查的估计值，以评估校准监测数据的意义。将根据产前诊所监测数据拟合流行率曲线得出的艾滋病毒流行率估计数与使用26个流行病普遍国家当年调查数据进行的全国人口调查的流行率进行统计比较。适当的转换应用于通知校正因子需要调整的流行率在国家的人口为基础的调查还没有进行。结果：艾滋病毒流行率来自产前诊所监测数据一般高估了约20%的人口为基础的调查流行率（95%置信区间：10%~ 30%）。结论：在进行了全国人口艾滋病毒调查的国家，艾滋病毒流行率调查估计数（酌情调整潜在的调查偏差）可直接用于校准产前诊所监测数据。在尚未进行全国艾滋病毒调查的国家，从产前诊所监测数据得出的艾滋病毒流行率应乘以约0.8，以调整过高估计。
Background: Estimates of the impact of HIV in countries with generalised epidemics are generally based on antenatal clinic surveillance data collected over time. In an attempt to obtain geographically more representative estimates of HIV prevalence, many countries are now also conducting national population-based surveys in which HIV testing is included. We compare adult HIV prevalence estimates from antenatal clinic surveillance to those from national population-based surveys to assess the implications for calibrating surveillance data.Methods: HIV prevalence estimates derived from fitting prevalence curves to antenatal clinic surveillance data are statistically compared to prevalence from national population-based surveys using data from 26 countries with generalised epidemics for the year in which the survey was conducted. Appropriate transformations are applied to inform the correction factors needed to adjust prevalence in countries where population-based surveys have not been conducted.Results: HIV prevalence derived from antenatal clinic surveillance data generally overestimate population-based survey prevalence by about 20% (95% confidence interval: 10% to 30%) in both urban and rural areas.Conclusions: In countries where national population-based HIV surveys have been conducted, survey estimates of HIV prevalence (adjusted for potential survey biases as appropriate) can be used directly to calibrate antenatal clinic surveillance data. In countries where national HIV surveys have not been conducted, HIV prevalence derived from antenatal clinic surveillance data should be multiplied by about 0.8 to adjust for overestimation.