Using routine programmatic data to measure HIV incidence among pregnant women in Botswana.

IF 3.2 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Population Health Metrics Pub Date : 2022-03-04 DOI:10.1186/s12963-022-00287-2

Katrina F Ortblad, Shreshth Mawandia, Odirile Bakae, Lenna Tau, Matias Grande, Goabaone Pankie Mogomotsi, Esther Mmatli, Modise Ngombo, Laura Seckel, Renee Heffron, Jillian Pintye, Jenny Ledikwe

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Abstract

Introduction: Pregnant women in sub-Saharan Africa have high risk of HIV acquisition, yet approaches for measuring maternal HIV incidence using routine surveillance systems are undefined. We used programmatic data from routine antenatal care (ANC) HIV testing in Botswana to measure real-world HIV incidence during pregnancy.

Methods: From January 2018 to September 2019, the Botswana Ministry of Health and Wellness implemented an HIV testing program at 139 ANC clinics. The program captured information on testers' age, testing date and result, and antiretroviral treatment (ART) initiation. In our analysis, we excluded individuals who previously tested HIV-positive prior to their first ANC visit. We defined incident HIV infection as testing HIV-positive at an ANC visit after a prior HIV-negative result within ANC.

Results: Overall, 29,570 pregnant women (median age 26 years, IQR 22-31) tested for HIV at ANC clinics: 3% (836) tested HIV-positive at their first recorded ANC visit and 97% tested HIV-negative (28,734). Of those who tested HIV-negative, 28% (7940/28,734) had a repeat HIV test recorded at ANC. The median time to HIV re-testing was 92 days (IQR 70-112). In total, 17 previously undiagnosed HIV infections were detected (HIV incidence 8 per 1000 person-years, 95% CI 0.5-1.3). ART initiation among women newly diagnosed with HIV at ANC (853) was 88% (671/762).

Conclusions: In Botswana, real-world HIV incidence among pregnant women at ANC remains above levels of HIV epidemic control (≤ 1 per 1000 person-years). This study shows how HIV programmatic data can answer timely population-level epidemiological questions and inform ongoing implementation of HIV prevention and treatment programs.

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使用常规规划数据测量博茨瓦纳孕妇的艾滋病毒发病率

导言：撒哈拉以南非洲地区的孕妇感染 HIV 的风险很高，但利用常规监测系统测量孕产妇 HIV 感染率的方法尚未确定。我们利用博茨瓦纳常规产前护理（ANC）HIV检测的项目数据来测量孕期HIV的实际发病率：从 2018 年 1 月到 2019 年 9 月，博茨瓦纳卫生与健康部在 139 个产前检查诊所实施了一项 HIV 检测计划。该项目采集了检测者的年龄、检测日期和结果以及开始抗逆转录病毒治疗（ART）的信息。在我们的分析中，我们排除了在首次产前检查之前检测出 HIV 阳性的人。我们将事件 HIV 感染定义为在 ANC 就诊时检测出 HIV 阳性，而之前在 ANC 中检测结果为阴性：总共有 29570 名孕妇（中位年龄 26 岁，IQR 22-31）在产前检查诊所接受了 HIV 检测：3%的孕妇（836 人）在首次产前检查时检测出 HIV 阳性，97% 的孕妇（28734 人）检测出 HIV 阴性。在检测结果为阴性的人群中，28%（7940/28734 人）在产前检查时再次进行了艾滋病毒检测。再次检测 HIV 的中位时间为 92 天（IQR 70-112）。总共发现了 17 例之前未确诊的 HIV 感染病例（HIV 感染率为每千人年 8 例，95% CI 为 0.5-1.3）。在产前检查中新诊断出感染艾滋病毒的妇女（853 人）中，开始接受抗逆转录病毒疗法的比例为 88% (671/762)：结论：在博茨瓦纳，产前检查中孕妇的实际 HIV 感染率仍高于 HIV 流行控制水平（≤ 1 人/1000 年）。这项研究表明，艾滋病项目数据可以及时回答人口层面的流行病学问题，并为正在实施的艾滋病预防和治疗项目提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Population Health Metrics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

0.00%

发文量

审稿时长

29 weeks

期刊介绍： Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.