Karch Debra L, Chen Mi, Tang Tian
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (Dr Karch and Ms Chen), and ICF International, Inc (Ms Tang), Atlanta, Georgia.
J Public Health Manag Pract. 2014 Nov-Dec;20(6):598-607. doi: 10.1097/PHH.0000000000000033.
In 2009, the Centers for Disease Control and Prevention completed migration of all 59 surveillance project areas (PAs) from the case-based HIV/AIDS Reporting System to the document-based Enhanced HIV/AIDS Reporting System.
We conducted a PA-level assessment of Enhanced HIV/AIDS Reporting System process and outcome standards for HIV infection cases.
Process standards were reported by PAs and outcome standards were calculated using standardized Centers for Disease Control and Prevention SAS code.
A total of 59 PAs including 50 US states, the District of Columbia, 6 separately funded cities (Chicago, Houston, Los Angeles County, New York City, Philadelphia, and San Francisco), and 2 territories (Puerto Rico and the Virgin Islands).
Cases diagnosed or reported to the PA surveillance system between January 1, 2011, and December 31, 2011, using data collected through December 2012.
Process standards for death ascertainment and intra- and interstate case de-duplication; outcome standards for completeness and timeliness of case reporting, data quality, intrastate duplication rate, risk factor ascertainment, and completeness of initial CD4 and viral load reporting.
Fifty-five of 59 PAs (93%) reported linking cases to state vital records death certificates during 2012, 76% to the Social Security Death Master File, and 59% to the National Death Index. Seventy percent completed monthly intrastate, and 63% completed semiannual interstate de-duplication. Eighty-three percent met the 85% or more case ascertainment standard, and 92% met the 66% or more timeliness standard; 75% met the 97% or more data quality standard; all PAs met the 5% or less intrastate duplication rate; 41% met the 85% or more risk factor ascertainment standard; 90% met the 50% or more standard for initial CD4; and 93% met the same standard for viral load reporting. Overall, 7% of PAs met all 11 process and outcome standards.
Findings support the need for continued improvement in HIV surveillance activities and monitoring of system outcomes.
2009年，疾病控制与预防中心完成了将所有59个监测项目地区（PAs）从基于病例的艾滋病毒/艾滋病报告系统迁移至基于文档的强化艾滋病毒/艾滋病报告系统的工作。
我们对艾滋病毒感染病例的强化艾滋病毒/艾滋病报告系统的过程和结果标准进行了项目地区层面的评估。
项目地区报告过程标准，结果标准使用疾病控制与预防中心的标准化SAS代码进行计算。
共有59个项目地区，包括美国50个州、哥伦比亚特区、6个单独资助的城市（芝加哥、休斯顿、洛杉矶县、纽约市、费城和旧金山）以及2个属地（波多黎各和美属维尔京群岛）。
使用截至2012年12月收集的数据，2011年1月1日至2011年12月31日期间诊断或报告给项目地区监测系统的病例。
死亡判定以及州内和州际病例重复数据删除的过程标准；病例报告的完整性和及时性、数据质量、州内重复率、危险因素确定以及初始CD4和病毒载量报告完整性的结果标准。
59个项目地区中的55个（93%）报告称在2012年将病例与州生命记录死亡证明进行了关联，76%与社会保障死亡主文件进行了关联，59%与国家死亡索引进行了关联。70%完成了每月州内的数据重复删除，63%完成了每半年州际的数据重复删除。83%达到了85%或更高的病例确诊标准，92%达到了66%或更高的及时性标准；75%达到了97%或更高的数据质量标准；所有项目地区的州内重复率均达到5%或更低；41%达到了85%或更高的危险因素确定标准；90%达到了初始CD4的50%或更高标准；93%达到了病毒载量报告的相同标准。总体而言，7%的项目地区达到了所有11项过程和结果标准。
研究结果支持继续改进艾滋病毒监测活动和系统结果监测的必要性。
