BACKGROUND Human immunodeficiency virus(HIV)recency testing provides data that can be used to monitor the trend of new HIV infections.The effectiveness of using people identified with recent infection to identify part...BACKGROUND Human immunodeficiency virus(HIV)recency testing provides data that can be used to monitor the trend of new HIV infections.The effectiveness of using people identified with recent infection to identify partners with new HIV infection through partner notification services(PNS)is not well documented.AIM To determine the pooled prevalence of recency testing coverage,recent infection,reclassification(recent to longterm infection)and PNS cascade among newly diagnosed people living with HIV.METHODS PubMed,Cochrane Library and Embase were searched for articles published between January 2018 and November 2024.Studies were included if they reported recency coverage and/or PNS among people newly diagnosed with HIV and used recent infection testing algorithm(RITA).Recency coverage was defined as proportion of people tested using rapid testing for recent infection(RTRI)among those newly diagnosed with HIV.RITA further classifies RTRI results using viral load results(≥1000 copies/mL vs<1000 copies/mL)to confirm recency status.For studies with PNS,we evaluated the cascade:Number of partners elicited,successfully contacted,eligible for HIV testing,tested and HIV diagnosis.PNS effectiveness was measured by proportion of new HIV diagnoses from tested partners.Using random effects models,we computed the pooled estimate of recency outcomes and 95%confidence intervals(CIs).RESULTS Twenty-five studies from 17-low-and middle-income countries were included.Of 276315 newly diagnosed people living with HIV,79864 underwent RTRI with an overall pooled recency coverage of 87%(95%CI:67-96).The pooled prevalence of RTRI and RITA recency were 12%(95%CI:9-16)and 7%(95%CI:4-10),respectively.Pooled prevalence of RTRI reclassification was 34%(95%CI:22-49).Of the recent cases who agreed to PNS,253 partners were elicited with an estimated elicitation ratio of 1:1.6.Among partners elicited,99%were successfully contacted,75%were eligible for testing,68%tested for HIV,and 15%were diagnosed with HIV.CONCLUSION High recency testing coverage among newly diagnosed individuals demonstrates the feasibility of monitoring new HIV infections in LMIC.While PNS yielded moderate HIV diagnoses,its targeted approach remains a critical strategy for identifying undiagnosed cases.展开更多
<strong>Background:</strong> Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the I...<strong>Background:</strong> Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the Impilo Electronic Health Record System. For the period January-June 2020, only 1 out of 13 health facilities in Mutare district reported seven newly diagnosed HIV patients through the electronic health record system compared to 483 in the District Health Information System (DHIS-2) recorded from paper-based registers. We evaluated the case-based surveillance system attributes, usefulness and reasons for under-reporting from January-December 2020. <strong>Methods:</strong> We conducted a descriptive cross-sectional study using updated Centres for Disease Control guidelines for evaluating public health surveillance systems. Questionnaires were administered to 36 health workers involved in HIV testing services. Facility checklists were used to collect data on knowledge, system attributes and usefulness of the system. Completed HIV case-based surveillance forms were assessed for completeness. Epi Info Version 7 was used to generate frequencies, means and proportions. <strong>Results:</strong> The reasons for under-reporting of patients in the electronic health record system were lack of reporting guidelines 26/36 (72%), limited coordination between technical staff and health facilities 24/36 (67%) and limited competency on the Electronic health record system 22/36 (61%). Timeliness, completeness, and validity were 88%, 82% and 100% respectively. The stability of the system was affected by the lack of standard operating procedures during system interruptions. Overall representativeness was 45% despite increasing from 3/226 (1%) to 224/303 (73%) between Quarter-1 and Quarter-4 of 2020. Acceptability was 100% due to reduced paperwork and the ability to generate simple reports. The information generated was used to identify new infection hotspots 28/36 (78%). <strong>Conclusion:</strong> The HIV cases based surveillance system was timely, acceptable with good data quality. Representativeness was poor due to limited competency on the electronic health record system. As a result, health workers received further training.展开更多
文摘BACKGROUND Human immunodeficiency virus(HIV)recency testing provides data that can be used to monitor the trend of new HIV infections.The effectiveness of using people identified with recent infection to identify partners with new HIV infection through partner notification services(PNS)is not well documented.AIM To determine the pooled prevalence of recency testing coverage,recent infection,reclassification(recent to longterm infection)and PNS cascade among newly diagnosed people living with HIV.METHODS PubMed,Cochrane Library and Embase were searched for articles published between January 2018 and November 2024.Studies were included if they reported recency coverage and/or PNS among people newly diagnosed with HIV and used recent infection testing algorithm(RITA).Recency coverage was defined as proportion of people tested using rapid testing for recent infection(RTRI)among those newly diagnosed with HIV.RITA further classifies RTRI results using viral load results(≥1000 copies/mL vs<1000 copies/mL)to confirm recency status.For studies with PNS,we evaluated the cascade:Number of partners elicited,successfully contacted,eligible for HIV testing,tested and HIV diagnosis.PNS effectiveness was measured by proportion of new HIV diagnoses from tested partners.Using random effects models,we computed the pooled estimate of recency outcomes and 95%confidence intervals(CIs).RESULTS Twenty-five studies from 17-low-and middle-income countries were included.Of 276315 newly diagnosed people living with HIV,79864 underwent RTRI with an overall pooled recency coverage of 87%(95%CI:67-96).The pooled prevalence of RTRI and RITA recency were 12%(95%CI:9-16)and 7%(95%CI:4-10),respectively.Pooled prevalence of RTRI reclassification was 34%(95%CI:22-49).Of the recent cases who agreed to PNS,253 partners were elicited with an estimated elicitation ratio of 1:1.6.Among partners elicited,99%were successfully contacted,75%were eligible for testing,68%tested for HIV,and 15%were diagnosed with HIV.CONCLUSION High recency testing coverage among newly diagnosed individuals demonstrates the feasibility of monitoring new HIV infections in LMIC.While PNS yielded moderate HIV diagnoses,its targeted approach remains a critical strategy for identifying undiagnosed cases.
文摘<strong>Background:</strong> Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the Impilo Electronic Health Record System. For the period January-June 2020, only 1 out of 13 health facilities in Mutare district reported seven newly diagnosed HIV patients through the electronic health record system compared to 483 in the District Health Information System (DHIS-2) recorded from paper-based registers. We evaluated the case-based surveillance system attributes, usefulness and reasons for under-reporting from January-December 2020. <strong>Methods:</strong> We conducted a descriptive cross-sectional study using updated Centres for Disease Control guidelines for evaluating public health surveillance systems. Questionnaires were administered to 36 health workers involved in HIV testing services. Facility checklists were used to collect data on knowledge, system attributes and usefulness of the system. Completed HIV case-based surveillance forms were assessed for completeness. Epi Info Version 7 was used to generate frequencies, means and proportions. <strong>Results:</strong> The reasons for under-reporting of patients in the electronic health record system were lack of reporting guidelines 26/36 (72%), limited coordination between technical staff and health facilities 24/36 (67%) and limited competency on the Electronic health record system 22/36 (61%). Timeliness, completeness, and validity were 88%, 82% and 100% respectively. The stability of the system was affected by the lack of standard operating procedures during system interruptions. Overall representativeness was 45% despite increasing from 3/226 (1%) to 224/303 (73%) between Quarter-1 and Quarter-4 of 2020. Acceptability was 100% due to reduced paperwork and the ability to generate simple reports. The information generated was used to identify new infection hotspots 28/36 (78%). <strong>Conclusion:</strong> The HIV cases based surveillance system was timely, acceptable with good data quality. Representativeness was poor due to limited competency on the electronic health record system. As a result, health workers received further training.
