Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov 20;18(1):588.
doi: 10.1186/s12879-018-3504-z.

Evaluation of Senegal's Prevention of Mother to Child Transmission of HIV (PMTCT) Program Data for HIV Surveillance

Affiliations
Free PMC article

Evaluation of Senegal's Prevention of Mother to Child Transmission of HIV (PMTCT) Program Data for HIV Surveillance

Ousmane Diouf et al. BMC Infect Dis. .
Free PMC article

Abstract

Background: With the expansion of Prevention of Mother to Child Transmission (PMTCT) services in Senegal, there is growing interest in using PMTCT program data in lieu of conducting unlinked anonymous testing (UAT)-based ANC Sentinel Surveillance. For this reason, an evaluation was conducted in 2011-2012 to identify the gaps that need to be addressed while transitioning to using PMTCT program data for surveillance.

Methods: We conducted analyses to assess HIV prevalence rates and agreements between Sentinel Surveillance and PMTCT HIV test results. Also, a data quality assessment of the PMTCT program registers and data was conducted during the Sentinel Surveillance period (December 2011 to March 2012) and 3 months prior. Finally, we also assessed selection bias, which was the percentage difference from the HIV prevalence among all women enrolled in the antenatal clinic and the HIV prevalence among women who accepted PMTCT HIV testing.

Results: The median site HIV prevalence using routine PMTCT HIV testing data was 1.1% (IQR: 1.0) while the median site prevalence from the UAT HIV Sentinel Surveillance data was at 1.0% (IQR: 1.6). The Positive per cent agreement (PPA) of the PMTCT HIV test results compared to those of the Sentinel Surveillance was 85.1% (95% CI 77.2-90.7%), and the percent-negative agreement (PNA) was 99.9% (95% CI 99.8-99.9%). The overall HIV prevalence according to UAT was the same as that found for women accepting a PMTCT HIV test and those who refused, with percent bias at 0.00%. For several key PMTCT variables, including "HIV test offered" (85.2%), "HIV test acceptance" (78.0%), or "HIV test done" (58.8%), the proportion of records in registers with combined complete and valid data was below the WHO benchmark of 90%.

Conclusions: The PPA of 85.1 was below the WHO benchmarks of 96.6%, while the combined data validity and completeness rates was below the WHO benchmark of 90% for many key PMTCT variables. These results suggested that Senegal will need to reinforce the quality of onsite HIV testing and improve program data collection practices in preparation for using PMTCT data for surveillance purposes.

Keywords: Antenatal clinic; HIV; HIV surveillance; Prevention of mother-to-child transmission; Senegal; Sentinel surveillance.

Conflict of interest statement

Ethics approval and consent to participate

Approval to conduct the study was received from the Senegal Ministry of Health’s National Ethics Committee and from the Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC) Atlanta.

ANC surveillance procedures in Senegal are based on UNAIDS/WHO guidelines. During their first ANC visit, women were asked for verbal informed consent prior to Syphilis testing as part of the national public health program. The left-over blood from routine syphilis testing were then stripped of all personal identifiers and utilized for unlinked anonymous HIV testing (UAT). The privacy of consenting pregnant women and their data confidentiality were ensured through a permanent delinking process that does not allow HIV test results to be traced back to any personal identifying information. Data integrity was assured by a double entry and access was restricted for security measures.

Verbal consent was required prior to HIV testing under the PMTCT national public health program. HIV testing was offered to pregnant women free of charge, and positive cases were enrolled for PMTCT services according to national guidelines.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
PMTCT program data and UAT surveillance data used

Similar articles

See all similar articles

References

    1. Agence Nationale de la Statistique and ICF International (2012) 2010-11 Senegal Demographic and Health and Multiple Indicators Survey: Key Findings. Calverton: ANSD and ICF International; 2012.
    1. Conseil National de Lutte contre le SIDA (CNLS). Plan Stratégique de lutte contre Les Infections Sexuellement Transmissibles, le VIH, et le SIDA 2014 – 2017. République du Sénégal, Primature, Conseil National de Lutte Contre le Sida, 2014. https://www.cnls-senegal.org/wp-content/uploads/2018/06/PSN-2014-2017.pdf.
    1. Ngom Faye NF. Rapport sur La Prévention de la Transmission Mère-enfant du VIH au Sénégal. République du Sénégal, Ministère de la Santé et Action sociale, Division de la lutte contre le Sida et les Infections Sexuellement Transmissibles; 2014.
    1. Division de la lutte contre le Sida et les Infections Sexuellement Transmissibles. Synthèse Prévention de la Transmission Mère-Enfant. République du Sénégal, Ministère de la Santé et Action sociale, Division de la lutte contre le Sida et les Infections Sexuellement Transmissibles; 2014
    1. World Health Organization/UNAIDS 7.10 . UNAIDS/WHO Working Group on Global HIV/AIDS & STI Surveillance. Guidelines for conducting HIV sentinel serosurveys among pregnant women and other groups. Geneva: WHO/UNAIDS; 2003.

MeSH terms

Feedback