Haeri Mazanderani Ahmad F, Murray Tanya Y, Johnson Leigh F, Ntloana Mathilda, Silere-Maqetseba Tabisa, Guo Sufang, Sherman Gayle G
Department of Paediatrics & Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2196, South Africa.
Centre for HIV & STIs, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg 2131, South Africa.
Diagnostics (Basel). 2023 Aug 1;13(15):2563. doi: 10.3390/diagnostics13152563.
To gain a detailed overview of vertical transmission in South Africa, we describe insights from the triangulation of data sources used to monitor the national HIV program. HIV PCR results from the National Health Laboratory Service (NHLS) were analysed from the National Institute of Communicable Diseases (NICD) data warehouse to describe HIV testing coverage and positivity among children <2 years old from 2017-2021. NICD data were compared and triangulated with the District Health Information System (DHIS) and the Thembisa 4.6 model. For 2021, Thembisa estimates a third of children living with HIV go undiagnosed, with NICD and DHIS data indicating low HIV testing coverage at 6 months (49%) and 18 months (33%) of age, respectively. As immunisation coverage is reported at 84% and 66% at these time points, better integration of HIV testing services within the Expanded Programme for Immunization is likely to yield improved case findings. Thembisa projects a gradual decrease in vertical transmission to 450 cases per 100,000 live births by 2030. Unless major advances and strengthening of maternal and child health services, including HIV prevention, diagnosis, and care, can be achieved, the goal to end AIDS in children by 2030 in South Africa is unlikely to be realised.
为全面详细了解南非的垂直传播情况，我们描述了用于监测国家艾滋病项目的多数据源三角测量所得出的见解。从国家传染病研究所（NICD）数据仓库分析了国家卫生实验室服务（NHLS）的艾滋病毒聚合酶链反应结果，以描述2017年至2021年2岁以下儿童的艾滋病毒检测覆盖率和阳性率。将NICD数据与地区卫生信息系统（DHIS）和Thembisa 4.6模型进行了比较和三角测量。2021年，Thembisa估计三分之一的感染艾滋病毒儿童未被诊断出来，NICD和DHIS数据显示，在6个月（49%）和18个月（33%）龄时艾滋病毒检测覆盖率较低。由于在这些时间点报告的免疫接种覆盖率分别为84%和66%，在扩大免疫规划中更好地整合艾滋病毒检测服务可能会提高病例发现率。Thembisa预测到2030年垂直传播将逐渐减少至每10万活产450例。除非在孕产妇和儿童保健服务方面取得重大进展并加强这些服务，包括艾滋病毒预防、诊断和治疗，否则南非到2030年在儿童中终结艾滋病的目标不太可能实现。
