SUPPLEMENT

The quality of sero-surveillance in low- and middle-income countries: status and trends through 2007

R Lyerla¹, E Gouws² and J M Garcia-Calleja³

¹ Epidemiology and Analysis Division, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland
² UNAIDS, Geneva, Switzerland
³ WHO, Geneva, Switzerland

Correspondence to:
Dr Rob Lyerla, Epidemiology and Analysis Division, Joint United Nations Programme on HIV/AIDS, 20 Ave Appia, CH 1211 Geneva 27, Switzerland; lyerlar{at}unaids.org

Objective: To examine the quality of HIV sero-surveillance systems in 127 low-income and middle-income countries by 2007, as well as gaps in data needed for reliable estimates of HIV prevalence and size of populations at risk for infection.

Methods: The quality of countries’ surveillance systems was scored using information from 2001 through 2007. Sero-surveillance data were compiled from the US Census Bureau’s HIV/AIDS Surveillance Database, from countries’ national HIV surveillance reports available to UNAIDS, from demographic and health survey (DHS) data, from the scientific literature and from countries’ Estimation and Projection Programme (EPP) data files. The quality of systems was scored according to the classification of the epidemic in each country (generalised, concentrated or low-level).

Result: The number of countries categorised as fully functioning in 2007 was 40. 43 countries were identified as partially functioning while 44 were categorised as poorly functioning. Low scores were most often attributed to a lack of recent data or data from appropriate risk groups.

Conclusion: Many countries still have poorly functioning surveillance systems. The inclusion of HIV testing in national population-based surveys in recent years has resulted in some countries with generalised epidemics receiving higher coverage scores, but many countries with concentrated or low-level epidemics continue to lack data on high-risk populations.

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• Ghys, P D, Walker, N, McFarland, W, Miller, R, Garnett, G P (2008). Improved data, methods and tools for the 2007 HIV and AIDS estimates and projections. Sex. Transm. Infect. 84: i1-i4 [Full Text]  
• Gouws, E, Mishra, V, Fowler, T B (2008). Comparison of adult HIV prevalence from national population-based surveys and antenatal clinic surveillance in countries with generalised epidemics: implications for calibrating surveillance data. Sex. Transm. Infect. 84: i17-i23 [Abstract] [Full Text]  

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The quality of sero-surveillance in low and middle income countries

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STI Online, 10 Mar 2009 [Full text]