Cherutich Peter, Golden Matthew, Betz Bourke, Wamuti Beatrice, Ng'ang'a Anne, Maingi Peter, Macharia Paul, Sambai Betsy, Abuna Felix, Bukusi David, Dunbar Mathew, Farquhar Carey
Ministry of Health, Nairobi, Kenya.
National AIDS/STI Control Programme (NASCOP), Kenyatta Hospital Grounds, off Hospital Road, Nairobi, Kenya.
BMC Med Inform Decis Mak. 2016 Jul 20;16:97. doi: 10.1186/s12911-016-0337-9.
The utilization of routine health information systems (HIS) for surveillance of assisted partner services (aPS) for HIV in sub-Saharan is sub-optimal, in part due to poor data quality and limited use of information technology. Consequently, little is known about coverage, scope and quality of HIV aPS. Yet, affordable electronic data tools, software and data transmission infrastructure are now widely accessible in sub-Saharan Africa.
We designed and implemented a cased-based surveillance system using the HIV testing platform in 18 health facilities in Kenya. The components of this system included an electronic HIV Testing and Counseling (HTC) intake form, data transmission on the Global Systems for Mobile Communication (GSM), and data collection using the Open Data Kit (ODK) platform. We defined rates of new HIV diagnoses, and characterized HIV-infected cases. We also determined the proportion of clients who reported testing for HIV because a) they were notified by a sexual partner b) they were notified by a health provider, or c) they were informed of exposure by another other source. Data collection times were evaluated.
Among 4351 clients, HIV prevalence was 14.2 %, ranging from 4.4-25.4 % across facilities. Regardless of other reasons for testing, only 107 (2.5 %) of all participants reported testing after being notified by a health provider or sexual partner. A similar proportion, 1.8 % (79 of 4351), reported partner notification as the only reason for seeking an HIV test. Among 79 clients who reported HIV partner services as the reason for testing, the majority (78.5 %), were notified by their sexual partners. The majority (52.8 %) of HIV-infected patients initiated their HIV testing, and 57.2 % tested in a Voluntary Counseling and Testing (VCT) site co-located in a health facility. Median time for data capture was 4 min (IQR: 3-15), with a longer duration for HIV-infected participants, and there was no reported data loss.
aPS surveillance using new technologies is feasible, and could be readily expanded into HIV registries in Kenya and other sub-Saharan countries. Partner services are under-utilized in Kenya but further documentation of coverage and implementation gaps for HIV and aPS services is required.
在撒哈拉以南地区，利用常规卫生信息系统（HIS）对艾滋病毒的性伴辅助服务（aPS）进行监测的效果并不理想，部分原因是数据质量差以及信息技术使用有限。因此，对于艾滋病毒aPS的覆盖范围、规模和质量了解甚少。然而，价格实惠的电子数据工具、软件和数据传输基础设施如今在撒哈拉以南非洲已广泛可用。
我们在肯尼亚的18家医疗机构中，利用艾滋病毒检测平台设计并实施了一个基于病例的监测系统。该系统的组成部分包括电子艾滋病毒检测与咨询（HTC）录入表格、通过全球移动通信系统（GSM）进行数据传输，以及使用开放数据工具包（ODK）平台进行数据收集。我们定义了新的艾滋病毒诊断率，并对艾滋病毒感染病例进行了特征描述。我们还确定了因以下原因报告进行艾滋病毒检测的客户比例：a）他们被性伴告知；b）他们被医疗服务提供者告知；或c）他们从其他来源得知自己接触过艾滋病毒。对数据收集时间进行了评估。
在4351名客户中，艾滋病毒感染率为14.2%，各医疗机构的感染率在4.4%至25.4%之间。无论其他检测原因如何，在所有参与者中，只有107人（2.5%）报告在被医疗服务提供者或性伴告知后进行了检测。类似比例的1.8%（4351人中的79人）报告称性伴告知是他们寻求艾滋病毒检测的唯一原因。在79名报告将艾滋病毒性伴服务作为检测原因的客户中，大多数（78.5%）是被其性伴告知的。大多数（52.8%）艾滋病毒感染患者开始了艾滋病毒检测，57.2%在医疗机构内的自愿咨询检测（VCT）点进行了检测。数据采集的中位时间为4分钟（四分位间距：3 - 15分钟），艾滋病毒感染参与者的数据采集时间更长，且未报告数据丢失情况。
利用新技术进行aPS监测是可行的，并且可以很容易地扩展到肯尼亚和其他撒哈拉以南国家的艾滋病毒登记系统。在肯尼亚，性伴服务的利用不足，但需要进一步记录艾滋病毒和aPS服务的覆盖范围及实施差距。
