Title |
Feasibility Study of HIV Sentinel Surveillance using PMTCT data in Cameroon: from Scientific Success to Programmatic Failure
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Published in |
BMC Infectious Diseases, January 2017
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DOI | 10.1186/s12879-016-2119-5 |
Pubmed ID | |
Authors |
Serge C. Billong, Jacob Dee, Joseph Fokam, Georges Nguefack-Tsague, Gabriel L. Ekali, Raoul Fodjo, Edith S. Temgoua, Edson-Joan Billong, Samuel M. Sosso, Jembia J. Mosoko, Francisca Monebenimp, Alexis Ndjolo, Anne-Cecile Z-K. Bissek, Omotayo Bolu, Jean-Bosco N. Elat |
Abstract |
In low-income countries (LICs), HIV sentinel surveillance surveys (HIV-SSS) are recommended in between two demographic and health surveys, due to low-cost than the latter. Using the classical unlinked anonymous testing (UAT), HIV-SSS among pregnant women raised certain ethical and financial challenges. We therefore aimed at evaluating how to use prevention of mother-to-child transmission of HIV (PMTCT) routine data as an alternative approach for HIV-SSS in LICs. A survey conducted through 2012 among first antenatal-care attendees (ANC1) in the ten regions of Cameroon. HIV testing was performed at PMTCT clinics as-per the national serial algorithm (rapid test), and PMTCT site laboratory (PMTCT-SL) performances were evaluated by comparison with results of the national reference laboratory (NRL), determined as the reference standard. Acceptance rate for HIV testing was 99%, for a total of 6521 ANC1 (49 · 3% aged 15-24) enrolled nationwide. Among 6103 eligible ANC1, sensitivity (using NRL testing as the reference standard) was 81 · 2%, ranging from 58 · 8% (South region) to 100% (West region); thus implying that 18 · 8% HIV-infected ANC1 declared HIV-negative at the PMTCT-SL were positive from NRL-results. Specificity was 99 · 3%, without significant disparity across sites. At population-level, this implies that every year in Cameroon, ~2,500 HIV-infected women are wrongly declared seronegative, while ~1,000 are wrongly declared seropositive. Only 44 · 4% (16/36) of evaluated laboratories reached the quality target of 80%. The study identified weaknesses in routine PMTCT HIV testing. As Cameroon transitions to using routine PMTCT data for HIV-SSS among pregnant women, there is need in optimizing quality system to ensure robust routine HIV testing for programmatic and surveillance purposes. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 161 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 30 | 19% |
Lecturer | 24 | 15% |
Student > Bachelor | 14 | 9% |
Researcher | 12 | 7% |
Student > Ph. D. Student | 10 | 6% |
Other | 27 | 17% |
Unknown | 44 | 27% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 43 | 27% |
Medicine and Dentistry | 30 | 19% |
Agricultural and Biological Sciences | 6 | 4% |
Psychology | 4 | 2% |
Immunology and Microbiology | 4 | 2% |
Other | 24 | 15% |
Unknown | 50 | 31% |