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Feasibility Study of HIV Sentinel Surveillance using PMTCT data in Cameroon: from Scientific Success to Programmatic Failure.
Billong, Serge C; Dee, Jacob; Fokam, Joseph; Nguefack-Tsague, Georges; Ekali, Gabriel L; Fodjo, Raoul; Temgoua, Edith S; Billong, Edson-Joan; Sosso, Samuel M; Mosoko, Jembia J; Monebenimp, Francisca; Ndjolo, Alexis; Bissek, Anne-Cecile Z-K; Bolu, Omotayo; Elat, Jean-Bosco N.
Afiliación
  • Billong SC; National HIV drug resistance surveillance and prevention Working Group (HIVDR-WG), National AIDS Control Committee, Yaoundé, Cameroon. sergebillong@yahoo.fr.
  • Dee J; Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaoundé1, Yaoundé, Cameroon. sergebillong@yahoo.fr.
  • Fokam J; Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon. sergebillong@yahoo.fr.
  • Nguefack-Tsague G; Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Atlanta, USA.
  • Ekali GL; National HIV drug resistance surveillance and prevention Working Group (HIVDR-WG), National AIDS Control Committee, Yaoundé, Cameroon. josephfokam@gmail.com.
  • Fodjo R; Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaoundé1, Yaoundé, Cameroon. josephfokam@gmail.com.
  • Temgoua ES; Chantal BIYA International Reference Centre (CIRCB) for research on HIV/AIDS prevention andmanagement, Yaoundé, Cameroon. josephfokam@gmail.com.
  • Billong EJ; Chair of Virology, Department of Experimental Medicine and Surgery, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy. josephfokam@gmail.com.
  • Sosso SM; National HIV drug resistance surveillance and prevention Working Group (HIVDR-WG), National AIDS Control Committee, Yaoundé, Cameroon.
  • Mosoko JJ; Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaoundé1, Yaoundé, Cameroon.
  • Monebenimp F; Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon.
  • Ndjolo A; Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon.
  • Bissek AZ; Chantal BIYA International Reference Centre (CIRCB) for research on HIV/AIDS prevention andmanagement, Yaoundé, Cameroon.
  • Bolu O; Faculty of Medicine, University of Antanarivo, Antananarivo, Madagascar.
  • Elat JN; Chantal BIYA International Reference Centre (CIRCB) for research on HIV/AIDS prevention andmanagement, Yaoundé, Cameroon.
BMC Infect Dis ; 17(1): 3, 2017 01 03.
Article en En | MEDLINE | ID: mdl-28049451
BACKGROUND: 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. METHODS: 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. RESULTS: 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%. CONCLUSIONS: 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Infecciosas del Embarazo / Infecciones por VIH / Vigilancia de Guardia / Transmisión Vertical de Enfermedad Infecciosa Tipo de estudio: Evaluation_studies / Prognostic_studies / Screening_studies Aspecto: Determinantes_sociais_saude / Ethics Límite: Adolescent / Adult / Female / Humans / Middle aged / Pregnancy País/Región como asunto: Africa Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2017 Tipo del documento: Article País de afiliación: Camerún Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Infecciosas del Embarazo / Infecciones por VIH / Vigilancia de Guardia / Transmisión Vertical de Enfermedad Infecciosa Tipo de estudio: Evaluation_studies / Prognostic_studies / Screening_studies Aspecto: Determinantes_sociais_saude / Ethics Límite: Adolescent / Adult / Female / Humans / Middle aged / Pregnancy País/Región como asunto: Africa Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2017 Tipo del documento: Article País de afiliación: Camerún Pais de publicación: Reino Unido