15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. C10383)

Garcia Calleja JM, Ghys P, Zaniewski E, Stanecki K, Walker N
WHO, Geneva, Switzerland

METHODS: 141 low- and middle-income countries were included in the analysis over the 1991-2001 period. Data on HIV/AIDS surveillance were collected from US Census Bureau, EURO-HIV, National AIDS Programme reports and other sources. Countries' surveillance systems were scored on four dimensions of quality, depending on the level of the epidemic (generalized versus low-level/concentrated epidemics). Scores were given for five overlapping 5 year periods starting in 1991-1995 through 1998-2002. The dimensions are Frequency and Timeliness, Appropriateness, Consistency, and Coverage. Countries' surveillance systems were grouped in 3 broad categories of quality, based on their overall scores: fully implemented, partially implemented and poorly implemented or non-functioning systems.

RESULTS: A summary of the results is presented in the Tables. Overall there is a large variation over the years in the quality of HIV surveillance systems. During the 1991-2002 period there is a declining trend in the quality but more than half of the countries have maintained a fully or partially functioning system. Following a decline in the mid nineties, the most affected countries with generalised epidemics have recently improved their HIV surveillance systems with 56% of countries having a fully implemented system. Between 97-01 and 98-02, the number of countries with fully implemented systems increased from 21 to 32, and those with poorly implemented systems decreased from 12 to 7. [table: see text] [table: see text] [table: see text]

CONCLUSIONS: The quality of HIV sero-surveillance varies considerably among regions and epidemic states and over time. Overall HIV surveillance in countries has been declining in the 1991-2002 period, but there is some improvement in countries with generalised epidemics in recent years. Many countries still have poor functioning systems and require urgent strengthening. Analysis of the quality of surveillance is an important tool both for evaluating the quality of estimates and for prioritizing country support.

040711
C10383

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